Emergency medicine Australasia : EMA
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The first extended care paramedic (ECP) model of care in New Zealand was introduced in the Kapiti region, north of Wellington in 2009. The ECP model aimed to increase the proportion of patients presenting to the ambulance service who could be treated in the community. This study evaluated the first 1000 patients seen by ECPs. ⋯ We observed that ECPs have significant potential to reduce hospital ED attendances by treating more patients in the community, and this is associated with a low rate of subsequent ED presentations. Prioritisation of dispatch of ECPs to particular types of patients might be useful in maximising this reduction.
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Body packing is the term used to describe the ingestion of illicit substances for transport across control lines. Where the diagnosis of body packing is made independently in the ED, the issue of reporting the case to law enforcement officials poses a difficult scenario given the legal obligations of patient confidentiality. We describe a case of a body packer brought into the ED and subsequently reported to the police. The conflicts between patient confidentiality versus statutory exceptions to confidentiality along with case law regarding this scenario are discussed.
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Emerg Med Australas · Dec 2012
Factors associated with failure to follow up with a general practitioner after discharge from the emergency department.
To identify factors associated with failure to follow up with a general practitioner (GP) after discharge from the ED or emergency medicine unit (EMU). ⋯ Participants who were aware of the reason for follow up with a GP, who were admitted to EMU, had health insurance or had a regular GP were more likely to comply with follow-up advice. This highlights that good patient communication is important for successful follow up, and that alternative avenues for completion of management need to be explored for patients without health insurance or a regular GP.
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Emerg Med Australas · Dec 2012
Case ReportsLemierre's syndrome: diagnosis in the emergency department.
A 15-year-old boy presented with signs of sepsis and a history of sore throat, fevers and shortness of breath. Full examination revealed an erythematous oropharynx and mild tonsillar swelling. He rapidly deteriorated requiring admission to intensive care. ⋯ Internal jugular vein thrombosis ensues with septic emboli and metastatic infections that most frequently involve the lungs. Although increasing in incidence, diagnosis is often delayed. We discuss why and describe its clinical presentation, investigations of choice and treatment strategies.