Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2016
Observational StudyThe VHOT (Vindaloo Hastens Outpouring of Troponins) Study.
Multiple cardiac and non-cardiac processes may cause an elevated highly sensitive troponin (hsTn). We postulated that the consumption of a seriously hot vindaloo could cause an increase in hsTn levels in seemingly healthy volunteers. ⋯ Eating a seriously hot vindaloo does not appear to be a risk factor for troponitis, and people may consume vindaloo safely with the knowledge that this is unlikely to result in significant damage to their myocardium. However, clinicians should be aware of the biological variability of hsTn and exercise caution when interpreting apparent changes within the normal range.
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Emerg Med Australas · Dec 2016
N-acetylcysteine regimens for paracetamol overdose: Time for a change?
Paracetamol overdose is one of the commonest pharmaceutical poisonings in the world. For nearly four decades, intravenous acetylcysteine regimens have been used to treat most patients successfully and prevent or mitigate hepatotoxicity. ⋯ Recent studies show that distributing the loading-dose of acetylcysteine over the first few hours of treatment may decrease the incidence of adverse reactions. In addition, varying the duration of acetylcysteine administration may potentially benefit certain cohorts of poisoned patients, depending on their risk of developing hepatotoxicity.
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Emerg Med Australas · Dec 2016
ReviewReview article: Effectiveness of ultra-brief interventions in the emergency department to reduce alcohol consumption: A systematic review.
To assess the effectiveness of ultra-brief interventions (ultra-BI) or technology-involved preventive measures in the ED to reduce alcohol harm and risky drinking. Medline, Embase, PsycINFO, CINAHL and EBM reviews were searched for articles published between 1996 and 2015. Randomised controlled trials and quasi-randomised trials, which compared an ultra-BI with screening, standard care or minimal intervention for adults and adolescents at risk for alcohol-related harm presenting to an ED, were included. ⋯ No studies showed an effect on frequency of alcohol consumption or ED representation. Heterogeneity in study design, definition of risky, harmful or hazardous alcohol use, intervention types, outcomes, outcome timeframes and outcome measures prevented the performance of quantitative meta-analysis. Despite its limited effectiveness in reducing alcohol use in the short-term, with the large number of people attending EDs with risky drinking, the use of an effective ultra-BI would have the potential to have a measurable population effect.
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Emerg Med Australas · Dec 2016
Paediatric acute care: Highlights from the PAC-APLS conference, Sydney, 2015.
The Paediatric Acute Care Conference (PACC) is an annual conference organised by Advanced Paediatric Life Support (APLS) Australia to advance paediatric acute care topics for clinicians in pre-hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. All PACC content is made available free online (https://vimeo.com/aplsaustralia). The PAC conference 2015 was held at Coogee, Sydney. We provide a summary of some of the presentations.