Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2014
Prehospital paediatric burn care: New priorities in paramedic reporting.
The present study evaluates the prehospital care of paediatric burn patients in Queensland (QLD). As first aid (FA) treatment has been shown to affect burn progression and outcome, the FA treatment and the risk of associated hypothermia in paediatric patients were specifically examined in the context of paramedic management of burn patients. ⋯ Despite FA and patient temperatures being important prognostic factors for burn patients, paramedic documentation of these was often incomplete, and there was no consistent use of burns dressings.
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Emerg Med Australas · Dec 2014
Current and future directions in clinical fatigue management: An update for emergency medicine practitioners.
Physicians worldwide are working round the clock to meet the demands of healthcare systems, especially in acute medical settings such as EDs. Demanding shift work schedules cause fatigue and thus deterioration in mood and motor performance. This article explores the effects of sleep deprivation, focusing on cognition, executive decision-making and the implications for clinical care. ⋯ Fatigue management training shows promise in enhancing safety in aviation and might have a role in medical shift work. Strategic napping improves performance during night shift in the ED, but does not fully negate fatigue. Drugs offer limited benefit for performance under sleep-deprived conditions, and whenever possible, sleep and/or strategic napping takes precedence.
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Emerg Med Australas · Dec 2014
Factors influencing ceftriaxone use in community-acquired pneumonia: Emergency doctors' perspectives.
To explore the perceptions of ED doctors regarding the use of ceftriaxone in patients with community-acquired pneumonia (CAP). ⋯ As most cases of CAP are initially diagnosed and treated empirically in the ED, any interventions that aim to decrease inappropriate use of ceftriaxone for CAP should address the factors identified here that influence ED doctors' prescribing decisions.
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Emerg Med Australas · Dec 2014
Peripheral intravenous catheter duration and failure in paediatric acute care: A prospective cohort study.
Children admitted to hospital commonly require peripheral intravenous catheters (PIVCs) for treatment. This study sought to address a gap in the literature about current practice in the securement and dressing of PIVCs in paediatric acute care, and to ascertain the duration and failure of these devices. ⋯ Observed failure rates were high for a clinically essential device; however, there is no established rate of acceptability against which the results can be benchmarked against to facilitate effectiveness of practice. Many PIVCs appeared to remain in place longer than needed. Dressing and securement practice was homogenous. PIVC placement in the antecubital fossa should be minimised to reduce the risk of paediatric PIVC failure.