Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2019
Methamphetamine presentations to an emergency department: Management and complications.
There is little recent published data characterising methamphetamine intoxication. The present study aims to describe the clinical effects, management, complications and disposition of patients with methamphetamine exposure. ⋯ The main toxicity seen with methamphetamines is acute behavioural disturbance, which is managed well with sedation. Complications, apart from rhabdomyolysis and acute kidney injury, are rare. Most patients are managed within the ED and discharged home.
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Emerg Med Australas · Aug 2019
Improving emergency department trauma care in Fiji: Implementing and assessing the trauma call system.
The trauma team process was recently implemented at the Colonial War Memorial (CWM) Hospital, Suva. This study audits the trauma call procedure at the hospital over a period of 12 months. ⋯ This was a severely injured cohort of patients with a high mortality rate. The rate of missed calls was not assessed in this study. Time to CT scan could be improved with an onsite radiographer. Time to team assembly could be improved with trauma team training and early notification from pre-hospital providers. There is a need to continue to monitor and refine the trauma call process and to extend data capture to measure injury severity and outcomes.
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Emerg Med Australas · Aug 2019
Comparative Study Observational StudyComparison of emergency department time performance between a Canadian and an Australian academic tertiary hospital.
To compare performance and factors predicting failure to reach Ontario and Australian government time targets between a Canadian (Sunnybrook Hospital) and an Australian (Austin Health) academic tertiary-level hospitals in 2012, and to assess for change of factors and performance in 2016 between the same hospitals. ⋯ Austin outperformed Sunnybrook for Ontario and Australian government time targets. Both hospitals failed the Australian targets. Factors predicting failure to achieve targets were different between hospitals, but were mainly clinical resources. Sunnybrook focussed on increasing human resources. Austin focussed on increasing human resources, observation unit and hospital beds. Intrinsic hospital characteristics and infrastructure influenced target success.
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Emerg Med Australas · Aug 2019
Variables associated with completeness of medical record documentation in the emergency department.
The completeness of ED medical record documentation is often suboptimal. We aimed to determine the variables associated with documentation completeness in a large, tertiary referral ED. ⋯ Documentation completeness is less among senior doctors, headache patients and for examination findings. Research should determine if the supervision responsibilities of senior doctors affects documentation and if medico-legal and patient care implications exist.
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Emerg Med Australas · Aug 2019
Cardiac transvenous pacing in the retrieval setting: A retrospective case series.
To report on the safety and efficacy of transvenous cardiac pacing wire insertion outside a tertiary hospital by a medical retrieval service. ⋯ This paper demonstrates that transvenous cardiac pacing can be safely and successfully implemented for symptomatic patients by pre-hospital and retrieval physicians in the aeromedical retrieval setting.