Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2013
Timing of appropriate antibiotics in patients with septic shock: a retrospective cohort study.
The objective of the present study was to describe the factors associated with delays in the delivery of appropriate antibiotics to patients admitted to the intensive care unit (ICU) from the ED or wards with septic shock. ⋯ This retrospective cohort study found that there were significant delays associated with the administration of appropriate antibiotics in patients admitted to the ICU from the ED or the wards with septic shock. Delays were greater in patients who were not seen by an emergency physician, those in whom the diagnosis of sepsis was not considered initially and in those whose therapy was delayed while awaiting the performance of investigations.
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Emerg Med Australas · Aug 2013
Introduction of an accelerated diagnostic protocol in the assessment of emergency department patients with possible acute coronary syndrome: the Nambour Short Low-Intermediate Chest pain project.
Emergency physicians can feel pressured by opposing forces of clinical reality and the need to publish successful key performance indicators in an environment of increasing demands and cost containment. This is particularly relevant to management of patients with undifferentiated chest pain and possible acute coronary syndrome. ⋯ We report findings from the Nambour Short Low-Intermediate Chest pain risk trial, which safely introduced an accelerated diagnostic protocol with reduced ED length of stay and high patient acceptability. Over a 7-month period, there were no major adverse cardiac events by 30 days in 19% of undifferentiated chest pain presentations with possible acute coronary syndrome discharged after normal sensitive cardiac troponin taken 2 h after presentation and scheduled to return for outpatient exercise stress test.