Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2013
Randomized Controlled Trial Multicenter StudyRationale and methodology for a multicentre randomised trial of fibrinolysis for pulmonary embolism that includes quality of life outcomes.
Submassive pulmonary embolism (PE) has a low mortality rate but can degrade functional capacity. ⋯ An investigator-initiated, FDA-regulated, multicentre trial of fibrinolysis for submassive PE was conducted, but was limited by screening costs and a low mortality rate. Quality of life measurements might represent a more important patient-centred end-point.
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Emerg Med Australas · Dec 2013
Characteristics of Aboriginal and Torres Strait Islander presentations to three Victorian emergency departments.
Aboriginal and Torres Strait Islander (ATSI) people have significant health disparity compared with other Australians. The present study examines the characteristics of ATSI patients presenting to three EDs of a single healthcare network to determine whether any healthcare disadvantages exist. ⋯ ATSI people living in Melbourne's south-east have social and health utilisation inequities, which might have an impact on their health status.
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Emerg Med Australas · Dec 2013
Randomized Controlled TrialIntravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: A randomised controlled trial.
I.v. 0.9% sodium chloride (normal saline) is frequently used to treat ED patients with acute alcohol intoxication despite the lack of evidence for its efficacy. ⋯ I.v. normal saline therapy added to observation alone does not decrease ED length of stay compared with observation alone. Intoxication symptom scores and general state of intoxication were similar in both groups. The present study suggests that either approach is reasonable, but observation alone might be preferred as it is less resource intensive.
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Training and the practice of emergency medicine are stressful endeavours, placing emergency medicine physicians at risk of burnout. Burnout syndrome is associated with negative outcomes for patients, institutions and the physician. The aim of this review is to summarise the available literature on burnout among emergency medicine physicians and provide recommendations for future work in this field. ⋯ Both work-related (hours of work, years of practice, professional development activities, non-clinical duties etc.) and non-work-related factors (age, sex, lifestyle factors etc.) are associated with burnout. Despite the heavy burnout rates among emergency medicine physicians, little work has been performed in this field. Factors responsible for burnout among various emergency medicine populations should be determined, and appropriate interventions designed to reduce burnout.
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Emerg Med Australas · Dec 2013
ReviewReview article: Evacuating hospitals in Australia: What lessons can we learn from the world literature?
The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. ⋯ Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response.