Emergency medicine Australasia : EMA
-
Emerg Med Australas · Apr 2016
Chest pain risk assessment in Indigenous and non-Indigenous Australians using HEART Score.
The objectives of this study were to investigate factors that correlate to cardiac events within 30 days in Indigenous and non-Indigenous Australians who present to ED with chest pain and to describe the predictive ability of the HEART Score in these groups. ⋯ The HEART Score is a reliable predictor of patient outcome in both Indigenous and non-Indigenous Australians. Modification of the HEART Score may not be required for use in the Indigenous Australian population who present to the ED with chest pain.
-
Emerg Med Australas · Apr 2016
Qualitative study of patients' choice between public and private hospital emergency departments.
The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies. ⋯ Patients who choose to attend public EDs appear to value financial concern over waiting time; those who choose to attend private EDs appear to value waiting time ahead of financial concerns.
-
Emerg Med Australas · Apr 2016
Use of serum lactate levels to predict survival for patients with out-of-hospital cardiac arrest: A cohort study.
We examined the association of serum lactate levels and early lactate clearance with survival to hospital discharge for patients suffering an out-of-hospital cardiac arrest (OHCA). ⋯ In OHCA patients who had serum lactate levels measured, both lower initial serum lactate and early lactate clearance in the first 48 h following OHCA were associated with increased likelihood of survival. However, the use of lactate in isolation as a predictor of survival or neurological outcome is not recommended. Prospective studies that minimise selection bias are required to determine the clinical utility of serum lactate levels in OHCA patients.
-
Emerg Med Australas · Apr 2016
Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription.
History, clinical examination and throat culture may be inadequate to rule in or out the presence of group A streptococci (GAS) infection in patients with sore throat in a remote location. We correlated the diagnostic accuracy for guiding antibiotic prescription of clinical decision and physiological scoring systems to a rapid diagnostic point of care (POC) test result in paediatric patients presenting with sore throat. ⋯ Clinician judgement and Centor score are inadequate tools for clinical decision-making for children presenting with sore throat. Adjunctive POC testing provides sufficient accuracy to guide antibiotic prescription on first presentation.
-
Emerg Med Australas · Apr 2016
Observational StudyAccuracy of QT interval measurement on electrocardiographs displayed on electronic 'smart' devices.
The objective of the study was to compare QT intervals measured on the original bedside electrocardiographs (ECG), facsimile, iPhone, iPad and 17 inch computer monitor. ⋯ The QT interval can be reliably measured using facsimile, iPhone and computer, but not the iPad. However, it varies between doctors. Lead V2 is recommended for QT interval measurement if only a single lead is to be used for clinical purposes.