Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2013
Comparative StudyWhole-body computed tomography in the initial assessment of trauma patients: is there optimal criteria for patient selection?
To describe the use of whole-body computed tomography (WBCT) at this Major Trauma Centre; to determine independent predictors of multi-region injury; and to evaluate the accuracy of the decision to perform WBCT in detecting multi-region injury. ⋯ The decision to perform WBCT scans in trauma should be at the discretion of the treating clinician. Applying a prediction rule would increase the number of WBCT scans performed without improving overall accuracy.
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Emerg Med Australas · Apr 2013
Comparative StudyOutcomes in older patients requiring comprehensive allied health care prior to discharge from the emergency department.
There is increasing focus on use of multidisciplinary services within the ED to facilitate discharge of older patients that might otherwise require hospitalisation. The risks associated with this are not well established. We aimed to determine whether older patients requiring allied health-facilitated discharge from the ED were at increased risk of hospital readmission and death after discharge. ⋯ Facilitated discharge of selected older adults by a CCT is relatively safe in the short term. Such patients have an increased likelihood of hospitalisation in the year after discharge. The 1 year mortality rate even in a 'low-risk' discharged population is 10%.
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Emerg Med Australas · Apr 2013
Clinical Trial Observational StudySub-dissociative dose intranasal ketamine for limb injury pain in children in the emergency department: a pilot study.
The present study aims to conduct a pilot study examining the effectiveness of intranasal (IN) ketamine as an analgesic for children in the ED. ⋯ In this population, an average dose of 1.0 mg/kg IN ketamine provided adequate analgesia by 30 min for most patients.
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Emerg Med Australas · Apr 2013
Observational StudyCommon laboratory tests predict imminent medical emergency team calls, intensive care unit admission or death in emergency department patients.
To estimate the ability of commonly measured laboratory variables to predict imminent (within the same or next calendar day) medical emergency team (MET) calls, ICU admission or death. ⋯ Commonly performed laboratory tests can help predict imminent MET calls, ICU admission or death in ED patients. Prospective investigations of the clinical utility of such predictions appear desirable.
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Emerg Med Australas · Apr 2013
Caught in the middle: tensions around the emergency department care of people with advanced cancer.
People with advanced cancer frequently present to hospital EDs. International studies report conflicting attitudes towards providing such care and difficulties with communication. The experience of Australian clinicians, however, is not described. ⋯ Despite limitations in the ED environment and resources, clinicians in oncology, PC and emergency medicine support the important role the ED plays in providing the necessary access and expertise for people with advanced cancer.