Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
SAFE: Safety of procedural sedation and analgesia administration in the fast-track area of the emergency department.
To determine whether undertaking procedural sedation in the low-acuity fast-track area is safe and effective in improving patient flow. ⋯ The sedation of patients outside a high-acuity area is safe and significantly improves patient flow.
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Emerg Med Australas · Feb 2025
Skeletal radiograph interpretation discrepancies in the emergency department setting: A retrospective chart review.
To determine the frequency and clinical consequences of discrepancies in skeletal radiograph interpretation between emergency and radiology doctors in an Australian ED. ⋯ The rate of clinically significant discrepancies in the interpretation of skeletal radiographs by emergency medicine doctors is low. This data support using the ED interpretation of radiographs to guide initial management as safe practice.
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Emerg Med Australas · Feb 2025
Low-acuity emergency department presentation characteristics and their association with Medicare-subsidised general practitioner services across New South Wales: A data linkage study.
Identify clinical and demographic characteristics of low-acuity presentations (LAPs) to the ED and analyse correlations between population rates of LAPs to ED and rates of Medicare-subsidised general practitioner (GP) services across statistical areas. ⋯ A relationship between LAPs to ED and Medicare-subsidised GP episodes of care exists for non-metropolitan but not metropolitan areas.
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Emerg Med Australas · Feb 2025
Observational StudyImpact of the Astra Zeneca COVID-19 vaccine on an emergency department.
To assess the impact of the AstraZeneca (AZ) vaccine roll-out on an ED. Primary outcomes are ED length of stay (LOS), investigation ordering and costs. Secondary measures are compliance with the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ) Vaccine-Induced Thrombotic Thrombocytopaenia Syndrome (VITT) guidelines. ⋯ A high number of young, low acuity patients presented to the ED with AZ vaccine concerns and were associated with financial and workload implications. The quantity of ED presentations appears to be associated with vaccine administration rates. There was poor compliance with the THANZ guidelines, and they appear to have contributed to the high volume of investigations.
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Emerg Med Australas · Feb 2025
Pre-hospital 'dirty adrenaline': A descriptive case series of patients receiving peripheral dilute adrenaline infusions in Central Australian remote nurse-led clinics prior to aeromedical retrieval.
'Dirty adrenaline' is the informal term used for a rapidly made peripheral dilute adrenaline infusion in the emergency treatment of shock, most commonly 1 mg adrenaline in 1 L 0.9% NaCl. It has long been part of the remote clinician's arsenal despite no supporting scientific literature. Remote clinics in Central Australia can be hours away from critical care support. The region's high prevalence of renal and cardiac disease means that access to early vasopressors and inotropes is a necessity for treating shock. To tackle this, remote clinicians often use 'dirty adrenaline'. We present a review of 'dirty adrenaline' use in this region. ⋯ 'Dirty adrenaline' is safe to administer and appears to considerably improve survival when used to treat fluid-resistant shock in remote nurse-led clinics guided by an off-site critical care physician.