Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2016
Patient intention and self-reported compliance in relation to emergency department attendance after using an after hours GP helpline.
To determine ED attendance and compliance with GP advice following a call to an after hours telephone triage and advice service. ⋯ An after hours GP helpline may divert some callers intending to go to the ED to other care. However, patient non-compliance may limit the capacity of telephone triage and advice service to reduce demand for ED. Further research is needed to better understand the effect of the service.
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Emerg Med Australas · Oct 2016
Lower urgency paediatric injuries: Parent preferences for emergency department or general practitioner care.
Injuries are a significant proportion of lower urgency (triage category 4 or 5) child presentations to the EDs in metropolitan Melbourne. The purpose of the present study was to assess parental preferences and experiences regarding the treatment of lower urgency child injuries and the role of general practitioners (GPs) in such care. ⋯ Treatment provided in the ED for child injuries is valued highly by most parents, with a higher proportion of children with an injury being referred to the ED by their GP. Improving GP treatment skills and training opportunities may reduce GP referrals of lower urgency child injuries to the ED.
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Emerg Med Australas · Oct 2016
Heterogeneity in cervical spine assessment in paediatric trauma: A survey of physicians' knowledge and application at a paediatric major trauma centre.
Evidence-based decision-making tools are widely used to guide cervical spine assessment in adult trauma patients. Similar tools validated for use in injured children are lacking. A paediatric-specific approach is appropriate given important differences in cervical spine anatomy, mechanism of spinal injury and concerns over ionising radiation in children. The present study aims to survey physicians' knowledge and application of cervical spine assessment in injured children. ⋯ Physicians actively engaged in paediatric trauma care demonstrate marked heterogeneity in their knowledge and application of cervical spine assessment. This is compounded by a lack of paediatric-specific evidence and definitions, involvement of multiple specialties and staff turnover within busy departments. A validated decision-making tool for cervical spine assessment will represent an important advance in paediatric trauma.
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Emerg Med Australas · Oct 2016
Walk them or no leg to stand on! Diagnostic delay of neurologic conditions in young children.
Diagnosis of low incidence neurological conditions can be a challenge in paediatric emergency medicine. Neurological examination in young children can be very difficult, and medical staff may not previously have encountered conditions like acute demyelinating encephalomyelitis. We propose that the simple process of walking a child (provided they were previously ambulant) is the crucial step in the neurological examination. We present three cases to demonstrate this important part of the examination.
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Emerg Med Australas · Oct 2016
Accuracy of working diagnosis by paramedics for patients presenting with dyspnoea.
The present study aims to determine the agreement between paramedic and ED or hospital working diagnosis in dyspnoeic patients. ⋯ There was moderate agreement between paramedic and ED or hospital diagnosis. The number of cases with no clearly documented working diagnosis suggested that a singular working diagnosis may not always serve the complexity of presentation of some dyspnoea patients: more open descriptors such as 'mixed disease' or 'atypical features' should be encouraged.