Emergency medicine Australasia : EMA
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This article reviews the evidence regarding the use of phenytoin in adult and paediatric patients experiencing seizures in the ED in Australasia, including relevant pharmacokinetics, dosage, therapeutic drug monitoring and methods of administration. It summarizes current evidence regarding the use of phenytoin in a number of seizure types commonly seen in ED. A search of Medline, Embase and Cochrane was performed using appropriate keyword and MeSH headings. ⋯ It should not be given to treat or prevent eclamptic or alcohol-related seizures. There is insufficient evidence regarding its use in preventing febrile convulsions, treating or preventing seizures due to space occupying lesions or intracerebral haemorrhage and thrombosis. In conclusion, phenytoin is appropriate for treatment of some seizures seen in the ED; it is associated with significant adverse effects; trials are ongoing regarding the use of other anticonvulsants in the treatment of status epilepticus.
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Emerg Med Australas · Apr 2010
Comparative StudyAccuracy of interpretation of arterial blood gases by emergency medicine doctors.
It is not currently known how accurately emergency medicine (EM) doctors interpret arterial blood gases (ABG). The present study explores this question. ⋯ Neither group performed to the predefined 'expert level'. There was a trend to improved interpretation with progression through ACEM training. There is scope to improve the training given to EM trainees in ABG interpretation and to incorporate ABG interpretation into consultant continuing education.
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To assess the implementation and utility of US for assisting peripheral venous access in a paediatric ED. ⋯ The US guidance may improve the success rate of peripheral vascular access in children rated to have difficult or very difficult vascular access.
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Flood is the most common natural disaster in Australia and causes more loss of life than any other disaster. This article describes the incidence and causes of deaths directly associated with floods in contemporary Australia. ⋯ In modern developed countries with adequate emergency response systems and extensive resources, deaths that occur in floods are almost all eminently preventable. Over 90% of the deaths are caused by attempts to ford flooded waterways or inappropriate situational conduct. Knowledge of the leading causes of flood fatalities should inform public awareness programmes and public safety police enforcement activities.
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Emerg Med Australas · Apr 2010
Investigating moderate to severe paediatric trauma in the Auckland region.
To investigate differences between paediatric patients with moderate to severe trauma admitted from two paediatric ED, with respect to: demographics, patterns of presentation, mechanism of injury, injury severity scores (ISS), interventions and outcome. ⋯ This study suggests that there are no differences in the numbers or severity of paediatric trauma patients admitted from the Starship and KidzFirst ED. This indicates triage is to the closest ED despite having a tertiary referral centre for paediatric trauma available in Auckland City.