Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2008
ReviewReview article: Non-invasive assessment of cardiac output with portable continuous-wave Doppler ultrasound.
Cardiac output is considered an important parameter when assessing the cardiovascular status of a critically ill patient. Both non-invasive (e.g. bioimpedance, echocardiography) and invasive methods (Swan Ganz catheter) have been used to measure cardiac output. ⋯ In this short review article, we will introduce this new technique, discuss the required skills and compare it with methods already in use. In particular, a critical comparison with the 'gold standard', the invasive measurement of cardiac output with the pulmonary artery catheter, will be given.
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Emerg Med Australas · Jun 2008
Teaching paediatric resuscitation skills in a developing country: introduction of the Advanced Paediatric Life Support course into Vietnam.
In 2001, a nationwide study revealed deficiencies in the emergency care of seriously ill and injured children in Vietnam. In response, a project was initiated to conduct the Advanced Paediatric Life Support course in Vietnam and ascertain whether this course would provide a practical and sustainable method of improving the knowledge and skills of medical and nursing staff in this area. After approval to use the course was secured and funding obtained, the project commenced in 2003. ⋯ As the skill and confidence of the Vietnamese instructors grew, the number and responsibilities of the international faculty reduced. The infrastructure now exists for the course to operate in a sustainable fashion within Vietnam. We believe that this project demonstrates that the course can be successfully modified to provide teaching in paediatric emergency care in a developing country.
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Emerg Med Australas · Jun 2008
Assessing the impact of streaming in a regional emergency department.
To evaluate the impact of a streaming model, previously validated in metropolitan EDs, on selected performance indicators in a regional ED. ⋯ The implementation of the streaming model had an impact on the two performance indicators associated with length of stay in this regional ED, but did not have a significant impact (positive or negative) on the percentage of patients who did not wait to be seen. These results might interest other EDs in regional hospitals.
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To perform a review of the efficacy of adenosine, including its potential role as first-line treatment in unstable supraventricular tachycardia (SVT) and its use in wide complex tachycardias and diagnosing difficult arrhythmias. The dose and administration, nature and frequency of side-effects and relevant interactions and dosage adjustments are also discussed. ⋯ There is extensive evidence showing adenosine to be efficacious at treating SVT, but no more efficacious than cheaper alternatives. More studies are required to investigate other areas of adenosine use.
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Emerg Med Australas · Jun 2008
Comparative StudyVariables that predict admission to hospital from an emergency department observation unit.
To determine factors predictive for patients requiring ongoing hospital admission from the emergency department observation unit (EDOU). ⋯ Variables exist that predict a 'failed' short stay admission. These might be used to identify patients less suitable for admission to the EDOU and better suited to admission directly under a hospital team.