Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2019
Letter Case ReportsTwo cases of lead poisoning from inhaled opium in Victoria.
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Emerg Med Australas · Feb 2019
ReviewReview article: A primer for clinical researchers in the emergency department: Part VII. Considering a research higher degree in emergency medicine: How does it work, where to start, what to consider.
In this series we address important topics for clinicians who participate in research or are considering research as part of their career path in emergency medicine. While much emergency research is successfully done by clinicians without a research higher degree (RHD), undertaking a master's degree or doctorate allows a research topic to be pursued in greater depth. ⋯ However, the expertise provided through a RHD often ultimately complements clinical training and establishes an excellent foundation for future research and career. This article provides an overview of RHDs and what to consider before embarking on one.
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Emerg Med Australas · Feb 2019
Review Meta AnalysisReview article: Utility of troponin after syncope: A systematic review and meta-analysis.
The role of serum troponin testing in patients presenting to the ED after syncope is unclear. The aim of this systematic review was to examine the practice and utility of troponin testing among patients presenting to the ED after syncope. We conducted a search of MEDLINE, Embase, Cochrane Library, Web of Science and Scopus databases from 1990 to February 2017 using keyword and subject headings for syncope and troponin testing. ⋯ Troponin testing was commonly performed for the assessment of patients with syncope with a substantial proportion returning positive results. The correlation between raised troponin and patient outcomes was not adequately reported. It is possible that an elevated troponin may indicate serious illness, rather than myocardial damage alone.
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Emerg Med Australas · Feb 2019
ReviewReview article: Managing medical emergencies in rural Australia: A systematic review of the training needs.
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. ⋯ However, many of the studies were performed by training providers that may benefit from deficient results. Given that the data was over 10 years old and that advances have been made in knowledge, training opportunities and technology, the implications for current training needs of rural doctors in Australia could not be accurately assessed. Thus there is a need for further research to identify current training needs.
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Emerg Med Australas · Feb 2019
Impact of the four-hour National Emergency Access Target on 30 day mortality, access block and chronic emergency department overcrowding in Australian emergency departments.
Previous research reported strong associations between ED overcrowding and mortality. We assessed the effect of the Four-Hour Rule (4HR) intervention (Western Australia (WA) 2009), then nationally rolled out as the National Emergency Access Target (Australia 2012) policy on mortality and patient flow. ⋯ The 4HR was introduced as a means of driving hospital performance by applying a time target. Patient flow improved, but the evidence for mortality benefit is controversial with improvement only in WA. Further research with more representative data from a larger number of hospitals over a longer time across Australia is needed to increase statistical power to detect long-term effects of the policy.