Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2009
ReviewReview article: Convulsive and non-convulsive status epilepticus: an emergency medicine perspective.
Status epilepticus (SE) is divided into convulsive and non-convulsive types; both are associated with significant morbidity and mortality. Although convulsive SE is easily recognized, non-convulsive SE remains an elusive diagnosis as physical signs are varied and subtle. ⋯ Benzodiazepines, specifically lorazepam, continue to be the most commonly recommended first-line therapy; best treatment for refractory status cases depends on resources available and must be tailored to the individual institution. In order to facilitate care, it is recommended that each institution develop a management protocol for these patients.
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Emerg Med Australas · Oct 2009
Injuries significantly associated with thoracic spine fractures: a case-control study.
To determine injuries significantly associated with traumatic thoracic spine (T-spine) fractures ⋯ Cervical and lumbar spine injuries and rib fractures are significantly associated with T-spine fracture. The presence of these injuries should raise suspicion of concomitant T-spine injury.
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Emerg Med Australas · Oct 2009
ReviewReview article: inotrope and vasopressor use in the emergency department.
Shock is a common presentation to the ED, with the incidence of septic shock increasing in Australasia over the last decade. The choice of inotropic agent is likely dependent on previous experience and local practices of the emergency and other critical care departments. ⋯ Delays in transfer to inpatient facilities means that patients receive advanced critical care within the ED for longer, requiring initiation and titration of vasoactive agents in the ED. This article discusses the general concepts of shock and the indicators for inotrope and vasopressor use, revises the various agents available and reviews the current evidence for their use.