Emergency medicine Australasia : EMA
-
Emerg Med Australas · Aug 2018
Observational StudyDoes respiratory variation of inferior vena cava diameter predict fluid responsiveness in spontaneously ventilating children with sepsis.
The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. ⋯ IVC collapsibility has poor test characteristics for predicting fluid responsiveness in spontaneously ventilating children with sepsis.
-
Emerg Med Australas · Aug 2018
The Sydney Triage to Admission Risk Tool (START): A prospective validation study.
The present study aims to prospectively validate the Sydney Triage to Admission Risk Tool (START) to predict ED disposition. ⋯ The overall performance of the START tool with respect to model discrimination and accuracy has been prospectively validated. Further clinical trials are required to test the clinical effectiveness of the tool in improving patient flow and overall ED performance.
-
Emerg Med Australas · Aug 2018
Incidence and outcome of subarachnoid haemorrhage in the general and emergency department populations in Queensland from 2010 to 2014.
To determine: (i) incidence and outcome of subarachnoid haemorrhage (SAH) in the general population; and (ii) proportions of SAH in both the general ED population and in ED patients presenting with headache. ⋯ The incidence of SAH was similar to that previously reported for Australia. One in 50 ED patients with headache had SAH. Ten in 50 000 ED attendances had a SAH. These estimates can assist in the risk assessment for SAH.
-
Emerg Med Australas · Aug 2018
Is it time for a culture change? Blood culture collection in the emergency department.
To describe how frequently blood cultures (BCs) are obtained in the ED and to describe the incidence of true- and false-positive BC results. ⋯ BCs are a common investigation in the ED with a high false-positive rate. Strategies are required to reduce false positives, including reducing inappropriate collection and improving collection techniques.
-
Emerg Med Australas · Aug 2018
Emergency demand, repeat and frequent presentations by older patients in metropolitan Melbourne: A retrospective cohort study using routinely collected hospital data.
To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. ⋯ The rate of repeat and frequent PAGP-type presentations by older people decreased in 2012 compared with 2008, suggesting that initiatives implemented to reduce avoidable presentations may have had an effect. However, an increase in the rate of frequent non-PAGP-type presentations, predominately for acute exacerbation of cardiovascular and respiratory conditions, has important implications for planning future healthcare delivery; hence, the importance of initiatives such as the Health Care Home.