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
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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Emerg Med Australas · Dec 2013
Evaluation of a multifaceted intervention on documentation of vital signs at triage: A before-and-after study.
Triage systems provide a centralised safety mechanism where all patients are assessed for clinical urgency at point of entry to the ED. ⋯ Progressive sustained improvements in vital sign documentation were observed over the study period; however, no such increases were noted in guideline adherence. To facilitate evaluation of guideline adherence, we recommend specific vital sign parameters be included in the Australasian Triage Scale Guideline for all levels of urgency.
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The aims of this research were to characterise the injury patterns associated with nail guns, highlight their potential complications and review treatment options. ⋯ The present study characterises the injury patterns caused by nail guns. Treatment of these injuries should be based on clinical findings; however, the majority of cases should undergo surgical treatment. The required operation is a short and safe treatment modality that might allow a thorough assessment of the injury, removal of embedded material, repair of structural damage and a sterile washout to be performed.