Emergency medicine Australasia : EMA
-
Emerg Med Australas · Feb 2011
The Emergency Medicine Capacity Assessment Study: perceived resource requirements to support a major increase in intern numbers in Australian emergency departments.
A 70% increase in graduating interns is projected in Australia from 2007 to 2012. Emergency medicine is a key term in the intern year. There is little information on the preparedness of EDs for this increase, and what resources will be required. ⋯ We recommend attention to ED communications infrastructure, an increase in rostered supervisory time for senior ED medical staff, and the provision of additional ED medical educators to teach interns.
-
Emerg Med Australas · Feb 2011
Using 0.45% saline solution and a modified dosing regimen for infusing N-acetylcysteine in children with paracetamol poisoning.
N-acetylcysteine (NAC) administration is recommended to all patients judged to be at risk of developing hepatotoxicity following paracetamol overdose. However, it has been shown that standard i.v. dosing can cause symptomatic hyponatraemia in children. We describe a case series using 0.45% NaCl plus 5% dextrose for infusing i.v. NAC in children with paracetamol poisoning. ⋯ These findings support the use of saline-containing solutions to administer NAC as an alternative to 5% dextrose, and suggest that a two-stage infusion regimen should be further investigated with prospective studies.
-
Toxic cardiac arrest is an uncommon manifestation of poisoning. Patients might benefit from resuscitative measures that are over and above those recommended in standard ACLS resuscitation guidelines. ⋯ Treating medical staff should seek expert advice from a toxicologist or from their Poisons Information Centre network (Australia 13 11 26; New Zealand 0800 764 766) at the earliest opportunity when managing patients with cardiac arrest or intractable shock from known or suspected poisoning. Ideally, toxicological expertise should be sought before the withdrawal of active treatment in cardiac arrest or shock from known or suspected poisoning.
-
Emerg Med Australas · Feb 2011
Comparative StudyComparison of visual analogue and Likert scales in evaluation of an emergency department bedside teaching programme.
The present study compares visual analogue scale (VAS) to Likert-type scale (LTS) instruments in evaluating perceptions of an ED bedside clinical teaching programme. A prospective study was conducted in the ED of an urban, adult tertiary hospital. Prospective pairing occurred of a teaching consultant and registrar who were relatively quarantined from normal clinical duties. ⋯ An ED bedside teaching programme is perceived to be a beneficial educational intervention. The VAS is a reliable and valid alternative to the LTS for educational evaluation and might provide advantages in educational measurement. Further research into the significance of extreme values and educationally important changes in scores is required.
-
Emerg Med Australas · Feb 2011
Case ReportsErythema multiforme major due to occupational exposure to the herbicides alachlor and butachlor.
Alachlor and butachlor are commonly used chloroacetanilide herbicides. They are cytotoxic, but there have been rare reported cases of alachlor or butachlor induced erythema multiforme major. We report the case of a 38-year-old farmer with erythema multiforme major due to the occupational exposure to alachlor/butachlor. ⋯ These results confirmed the diagnosis of erythema multiforme major. The patient was admitted and received systemic and topical steroids. After 18 days, most lesions had healed, and he was discharged.