Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2012
Randomized Controlled TrialHow fast does oral dexamethasone work in mild to moderately severe croup? A randomized double-blinded clinical trial.
For children with croup controversy remains over dosage and time to onset of action of oral steroids. The Cochrane Collaboration and other reviews have suggested 0.6 mg/kg dexamethasone be used (despite some evidence that 0.15 mg/kg is effective) with no expectation of benefit before 4-6 h. This randomized double-blinded clinical trial examines whether 0.15 mg/kg dexamethasone works by 30 min. ⋯ For children with croup an oral dose of 0.15 mg/kg dexamethasone offers benefit by 30 min, much earlier than the 4 h suggested by the Cochrane Collaboration. This result might encourage doctors to treat more children with all severities of croup being less worried about potential side-effects and delayed benefit.
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Emerg Med Australas · Feb 2012
Multicenter StudyImpact of pain location, organ system and treating speciality on timely delivery of analgesia in emergency departments.
This retrospective, observational cohort study investigated whether the clinical features of a patient's pain, including anatomical location, organ system and likely treating speciality, impact on the delivery of analgesia within 30 min in EDs. ⋯ Patients presenting with burns, orthopaedic conditions or with a limb location of pain are more likely to receive analgesia within 30 min in Australian EDs. Clinicians should be aware of possible trends in the delivery of timely analgesia to patients with pain.
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Emerg Med Australas · Feb 2012
Demand for public hospital emergency department services in Australia: 2000-2001 to 2009-2010.
Hospital EDs are a significant and high-profile component of Australia's health-care system, which in recent years have experienced considerable crowding. This crowding is caused by the combination of increasing demand, throughput and output factors. The aim of the present article is to clarify trends in the use of public ED services across Australia with a view to providing an evidence basis for future policy analysis and discussion. ⋯ This growth in demand exceeds general population growth, and the variability between states both in utilization rates and overall trends defies immediate explanation. The growth in demand for ED services is a partial contributor to the crowding being experienced in EDs across Australia. There is a need for more detailed study, including qualitative analysis of patient motivations in order to identify the factors driving this growth in demand.
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Emerg Med Australas · Feb 2012
Impact of polymerase chain reaction results on patient management during a viral meningitis outbreak in Tropical North Queensland.
Enterovirus is the most commonly isolated pathogen in viral meningitis. We report on the first outbreak of viral meningitis in Tropical Queensland and the effect of polymerase chain reaction (PCR) results on antibiotic use and hospital length of stay. ⋯ In our study a positive result on PCR was not associated with a shorter hospital length of stay or a shorter duration of antibiotic therapy. This contrasts with previous reports on this topic and requires further evaluation.