Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2012
Prospective comparison of point-of-care international normalised ratio measurement versus plasma international normalised ratio for acute traumatic coagulopathy.
Early detection of acute traumatic coagulopathy (ATC) might be useful to guide trauma resuscitation. This study aimed to compare results from a point-of-care (POC) international normalised ratio (INR) measuring device with plasma INR in acute trauma patients. ⋯ POC INR measurements using this method during the trauma reception and resuscitative phases cannot be used to identify or exclude patients with ATC. Further studies are required to determine if there is any role for POC INR measures during trauma resuscitation.
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Emerg Med Australas · Aug 2012
Initial resuscitation for Australasian Triage Scale 2 patients in a Nepalese emergency department.
Triage is recognized as important in providing timely care to emergency patients. However, systematic triage is only practised in two EDs in Nepal. The first objective of this study was to assess the performance of one of these departments in seeing triaged patients in a timely fashion. Second, an epidemiological survey of patients presenting to the ED was performed to describe the conditions seen and initial resuscitation undertaken. ⋯ Patients triaged as ATS 2 were seen in a timely fashion. Seriously ill patients requiring resuscitation present commonly to this ED. This is a big challenge for junior doctors. Improved training, treatment protocols and equipment are needed to help manage this burden.
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Emerg Med Australas · Aug 2012
Use of step stool during resuscitation improved the quality of chest compression in simulated resuscitation.
Resuscitation on a medical bed is difficult because of the need to match the height of the bed to the height of the rescuer, which is impossible on a fixed-height medical bed. This study investigated the effect of using a step stool on chest compressions performed on a manikin in a fixed-height medical bed. ⋯ In-hospital resuscitation was conducted on a fixed-height medical bed by rescuers of different heights. The use of a step stool may improve the quality and effectiveness of chest compressions, particularly for short rescuers.
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Emerg Med Australas · Aug 2012
Simple external rotation of the leg increases the size and accessibility of the femoral vein.
To determine if external rotation of the leg increases the size and accessibility of the femoral vein compared with a neutral position. ⋯ The total and accessible femoral vein diameter is increased and the surface depth of the vein is decreased by placing the leg in external rotation compared with the neutral position.
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Emerg Med Australas · Aug 2012
Once or twice-daily, algorithm-based intravenous cephazolin for home-based cellulitis treatment.
Cellulitis is a common presentation to the ED and a significant cause of hospitalization that can be managed in hospital-in-the-home programmes. Current clinical-practice guidelines recommend once or twice-daily i.v. antibiotics; however, there is an absence of data describing the impact of these guidelines in real-world practice-based settings. This study aims to describe the safety and effectiveness of home-based cellulitis treatment according to an online treatment algorithm. ⋯ An online decision support algorithm can support the effective use of a once or twice-daily treatment regimen for uncomplicated cellulitis. This approach can increase the efficiency and capacity of home-based therapy, resulting in better alignment of treatment options with clinicians and patients' preferences.