Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2019
ReviewReview article: Environmental heatstroke and long-term clinical neurological outcomes: A literature review of case reports and case series 2000-2016.
Global temperatures are rising; extreme environmental heat can result in adverse health effects including heatstroke. Acute effects of heat are well recognised, but there is less understanding of potential long-term adverse outcomes. Our aim was to review recent medical literature for clinical cases of environmental heatstroke with a focus on neurological outcome. ⋯ Cerebellar injury was common suggesting cerebellar structures are vulnerable to heat. These findings highlight that people of all ages and pre-morbid states are at risk of severe heat-related illness. In the face of climate change, effective interventions for heat-related illness, including both treatment and prevention are necessary.
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Emerg Med Australas · Apr 2019
Observational StudyPatients admitted via the emergency department to the intensive care unit: An observational cohort study.
Timely and appropriate assessment and management within the ED impacts patient outcomes including in-hospital mortality and length of stay (LOS). Within the ED, several processes facilitate timely recognition of the need for intensive care unit (ICU) admission. This study describes characteristics and outcomes for patient presentations admitted to ICU from ED, categorised by Australasian Triage Score (ATS), ICU admission time and ICU admission source. ⋯ Most patients are appropriately identified in ED as requiring ICU admission, although around one in four were triaged ATS 3/4. Patients admitted to the ward first tended to have poorer outcomes than those directly admitted to ICU. Factors predicting the need for ICU admission should be identified to support clinical decision-making.
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Emerg Med Australas · Apr 2019
New Fellows Early Career Survey 2014-2017: Shift of trends in emergency medicine workforce.
Within the complex and dynamic emergency medicine workforce setting, the Australasian College for Emergency Medicine (ACEM) New Fellows (FACEMs) Early Career Survey was established in 2014 to capture information on the work profiles, future career plans and challenges experienced among new FACEMs. ⋯ A shift in the employment profile of early career Fellows was observed between 2014 and 2017, with the potential push factor of limited specialist positions in metropolitan areas now starting to result in an increase in new FACEMs choosing to work in regional and rural areas and in the number working across multiple workplaces.
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Emerg Med Australas · Apr 2019
Observational StudyHow closely do blood gas electrolytes and haemoglobin agree with serum values in adult emergency department patients: An observational study.
The aims of this study were to establish the bias (mean difference) and 95% limits of agreement (LoA) between electrolyte values (sodium and potassium) and haemoglobin between whole blood analysed by the ED resuscitation room blood gas analyser and specimens analysed using standard techniques in the central hospital laboratory and to determine the proportion of analyses falling outside defined clinically acceptable LoA and pathology expert defined standards. ⋯ Agreement between blood gas analysis and laboratory analysis for sodium, potassium and haemoglobin concentrations shows acceptable agreement for use in time critical clinical decision-making in ED.