Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2018
Prehospital analgesic choice in injured patients does not impact on rates of vomiting: Experience from a New South Wales primary retrieval service.
This study aimed to explore the analgesic regimes adopted in our contemporary retrieval practice and the incidence of vomiting in ED after prehospital analgesic use. ⋯ The frequency of vomiting in the retrieved patients observed in our study was less than previously reported in the literature. Opioids still prevailed over ketamine as the preferred initial analgesic, with ketamine most commonly used as an adjunct. Multi-centre trials in this field would be preferable in future in view of the relatively low incidence of vomiting in retrieved trauma patients.
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Emerg Med Australas · Jun 2018
'What the hell is water?' How to use deliberate clinical inertia in common emergency department situations.
Appropriate deliberate clinical inertia refers to the art of doing nothing as a positive clinical response. It includes shared decision-making to improve patient care with the use of clinical judgement. ⋯ The insertion of peripheral intravenous cannulae, investigating patients with suspected renal colic and the investigation of low risk chest pain are all opportunities for the thoughtful clinician to 'stand there' and use effective patient communication to avoid low value tests and procedures. Awareness is key to identifying these opportunities to practice deliberate clinical inertia, as many of the situations may be so much a part of our environment that they are hidden in plain view.