Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2013
ReviewReview article: Clinical impact of non-cardiologist-performed transthoracic echocardiography in emergency medicine, intensive care medicine and anaesthesia.
There is increased realisation of the emerging role of point-of-care transthoracic echocardiography (TTE) as 'ultrasound-assisted examination', given the low sensitivity of clinical examination for cardiovascular pathologies and the time-critical nature of these pathologies. There is evidence that point-of-care TTE provides higher accuracy in patient assessment and management, with potential prognostic impact by assessing the severity of cardiac dysfunction and response to treatment. ⋯ Recent reports have examined more advanced ultrasound devices and patients in the critical care settings of emergency medicine, intensive care and anaesthesia. The diagnostic capability of new portable devices is improving rapidly and outdating its predecessors, thereby improving confidence in echocardiography findings.
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Emerg Med Australas · Feb 2013
Triggers for head computed tomography following paediatric head injury: Comparison of physicians' reported practice and clinical decision rules.
To compare head computed tomography (CT) triggers for paediatric head injury as reported by senior paediatric emergency physicians in Australia and New Zealand with triggers in published evidence-based clinical decision rules (CDRs). ⋯ High-quality, published CDRs exist for head CT use after paediatric head injury. Physician-reported CT triggers differ from CDR-recommended triggers. The major published head injury CDRs should be prospectively validated in the Australasian setting before incorporating them into local practice and CPGs.
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The shocked neonate often causes anxiety in the ED. This article aims to provide a systematic, practical approach to recognition and initial management of these patients. ⋯ Practical tips for intravenous access and the rationale behind choice of inotrope and anaesthetic induction agent are discussed. The major underlying causes - sepsis, cardiac disease, metabolic disease and non-accidental injury - along with their investigation and management are considered.
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To compare access and utilisation of EDs in Queensland public hospitals between people who speak only English at home and those who speak another language at home. ⋯ This study showed that there was a significant association between lower utilisation of emergency care and speaking languages other than English at home. Further researches are needed using in-depth methodology to investigate if there are language barriers in accessing emergency care in Queensland.
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Emerg Med Australas · Feb 2013
Improvement in the accuracy of references in the journal Emergency Medicine Australasia.
To study any change in reference accuracy in the Australasian emergency medicine journal (now known as Emergency Medicine Australasia), in the 10 years since a previous analysis was undertaken. ⋯ This paper demonstrates a significant improvement in the accuracy of references in the journal Emergency Medicine Australasia over the past decade. This paper did not identify the reasons for this improvement, but potential causes might include the introduction of a web-based peer review and manuscript submission process, as well as improved reference bibliography systems by authors. In addition, an increase in the overall standard of paper submitted to the journal might have contributed to this improvement.