Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2013
Implementation and performance evaluation of an emergency department primary practitioner physiotherapy service for patients with musculoskeletal conditions.
The study aims to describe the implementation of a primary practitioner physiotherapy service within a large regional ED and to evaluate its impact on waiting time and length of stay. ⋯ The current study found that patients with musculoskeletal problems seen by a primary practitioner physiotherapy service had improved waiting times and length of stay relative to ACEM and Victorian Department of Health targets, and though constrained by a retrospective non-randomised design, to a similar group of patients seen by medical staff. Further evaluation of the physiotherapy practitioner service is required.
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Emerg Med Australas · Dec 2013
New emergency department quality measure: From access block to National Emergency Access Target compliance.
The study aims to investigate the effect of time of day and ED occupancy on the ability of EDs to admit or discharge patients within 4 h in accordance with the National Emergency Access Target (NEAT), and to compare this with corresponding levels of access block, the measure for ED performance before NEAT. ⋯ EDs face rising levels of NEAT non-compliance at times when corresponding access block levels have traditionally not been a concern. A higher proportion of patients breach the target during periods that would intuitively not be flagged as flow bottlenecks. The findings support the need for service level analysis and new solutions to guide workflow reform and maximise NEAT compliance.
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As of September 2013, three new oral anticoagulants (NOACs) are now available for clinical use on the Pharmaceutical Benefits Scheme in Australia. All three are for stroke prevention in atrial fibrillation, and one will also be available for the treatment of deep venous thrombosis and pulmonary embolism. All have been evaluated in large, multicentre randomised clinical trials. ⋯ There are a few clinically important interactions with other medications or diet. Concerns exist about the potential for irreversible bleeding in the small number of patients in which that occurs. This short report will discuss the pharmacology of these agents, the indications for use, aspects of laboratory monitoring and the management of bleeding with these agents.
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Emerg Med Australas · Dec 2013
Letter Randomized Controlled TrialAmitriptyline versus tizanidine in the management of tension-type headache in Nepal.