Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2015
Observational StudyInterrater agreement between expert and novice in measuring inferior vena cava diameter and collapsibility index.
In critical care medicine, US views of the inferior vena cava (IVC) and its change with respiration are used to estimate the intravascular volume status of unwell patients and, in particular, to answer the question: 'Is this patient likely to be fluid responsive?' Most commonly in the literature, the subxiphisternal (SX) window in the longitudinal plane is utilised. To date, no study has specifically assessed interrater agreement in estimating IVC diameter between emergency medicine specialists (experts) and trainees (learners). ⋯ The wide 95% limits of agreement demonstrate a poor interrater agreement between the IVC US measurements obtained by expert and learner users in the assessment of fluid status. These ranges are greater than clinically acceptable.
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Emerg Med Australas · Aug 2015
Triage-based resource allocation and clinical treatment protocol on outcome and length of stay in the emergency department.
The present study aimed to determine the relationship between the triage-based resource allocation and clinical treatment (TRACT) protocol and mortality and length of stay (LOS) in ED. ⋯ The TRACT protocol decreased the ED mortality in ESI 1 group and reduced the ED LOS in ESI levels 2 and 3 groups.
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Emerg Med Australas · Aug 2015
Emergency department clinical redesign, team-based care and improvements in hospital performance: A time series analysis.
The objective was to evaluate the impact of an ED clinical redesign project that involved team-based care and early senior assessment on hospital performance. ⋯ An ED-focused clinical redesign project was associated with a 17% improvement in NEAT performance with no evidence of an increase in clinical deterioration on inpatient wards and evidence for an improvement in hospital mortality.
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Emerg Med Australas · Aug 2015
Letter Case ReportsMethaemoglobinaemia in acute indoxacarb poisoning.