Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2014
Implications for public access defibrillation placement by non-traumatic out-of-hospital cardiac arrest occurrence in Singapore.
The American Heart Association recommends automated external defibrillator placement in public areas with a high probability (>1) of out-of-hospital cardiac arrest (OHCA) occurring in 5 years. We aimed to determine the incidence rate of OHCA for different location categories in Singapore. ⋯ In this study, we found the categories and individual sites that clearly fulfilled the American Heart Association criteria of at least 1 OHCA per site per 5 years. This study provides a model of how cardiac arrest registry data can be used to guide local health policy on automated external defibrillator deployment.
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Emerg Med Australas · Jun 2014
Comparative StudyFirst comparison of the Venner(TM) A.P. Advance(TM) versus the Macintosh laryngoscope for intubations by non-anaesthetists: A manikin study.
The present study aims to study whether using a videolaryngoscope (A.P. Advance™) facilitates or hinders intubation by non-anaesthetists inexperienced in its use. ⋯ The use of the A.P. Advance™ videolaryngoscope should not be considered, without adequate prior training and experience, in the management of a difficult airway. The level of adequate training has yet to be established.
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Emerg Med Australas · Jun 2014
Need to address poor numeracy skills in the emergency department environment.
Substantial evidence exists for lack of numerical skills among many health professionals. Although poor numeracy has long been recognised as a contributor to medication error, other activities for which numerical literacy are required, such as interpretation of diagnostic results, have been largely ignored. Poor self-awareness of lack of numerical literacy increases the risk, especially in the busy and hurried emergency environment. ⋯ In contrast, education for nurses frequently occurs during both pre- and post-registration programmes. Interventions have had mixed success, although additional emphasis in increasing conceptual understanding of numbers is encouraging. The consequences of poor numerical literacy should be addressed in all clinical staff, not only by practice change to remove the potential for errors to be made, but also complemented by self-awareness and education.
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Each year, the Newborn and Paediatric Emergency Transport Service (NETS) receives over 3600 calls from health professionals regarding the management and transportation of critically ill children across New South Wales, with toxicological emergencies making up 1.5% of these calls. The aim of the present study is to describe the characteristics of patients transported for toxicological emergencies and their retrieval management. ⋯ Many children with toxicological emergencies require only non-invasive monitoring, which could be provided by trained ambulance crews in select scenarios. Involvement of a toxicologist in the initial consultation to identify these patients might reduce retrieval numbers and costs. Children on regular medication and those living with family members on psychotropic or cardiac drugs were identified as high-risk groups that should be targeted for medication safety education.
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Patient outcome feedback has been defined as 'the natural process of finding out what happens to one's patients after their evaluation and treatment (in the ED)'. It seems likely that emergency medicine trainees and Fellows will improve their diagnostic accuracy if they increase the frequency with which they find out what happens to their patients. Not only does this allow testing of their own diagnosis with the final diagnosis, but also allows meaningful feedback on therapies commenced in the ED. We believe that seeking outcome feedback should be more actively encouraged by the ACEM training programme.