Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2009
Randomized Controlled Trial Comparative StudyNebulized fentanyl versus intravenous morphine in children with suspected limb fractures in the emergency department: a randomized controlled trial.
To compare the efficacy of nebulized fentanyl (NF) with i.v. morphine (IVM) in paediatric patients presenting to the ED with clinically suspected limb fractures. ⋯ NF in a dose of 4 microg/kg given via a standard nebulizer provided clinically significant improvements in pain scores, comparable to IVM. NF should be considered as a treatment option for use in children presenting in acute pain.
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Emerg Med Australas · Jun 2009
Structured team approach to the agitated patient in the emergency department.
Behavioural disturbance and aggression in the ED is an increasing problem. The present study describes the characteristics of patients with acute behavioural disturbance and their emergent treatment in an ED with a structured team approach. ⋯ Acute behavioural disturbance was common in the present study, and underlying causes were predominantly organic in nature. A team approach appears to be valuable in managing these incidents.
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Emerg Med Australas · Jun 2009
Frequent attenders with mental disorders at a general hospital emergency department.
To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the documented care of those frequent attenders. ⋯ The documented management of frequent attenders with mental disorders at a general hospital ED appeared to be less than optimal. Furthermore, the majority of those frequent attenders also attended other general hospital ED in the same city, and this did not appear to be recognized.
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Emerg Med Australas · Apr 2009
ReviewReview article: indications for thoracolumbar imaging in blunt trauma patients: a review of current literature.
Thoracolumbar spine injury is a common complication of blunt multitrauma and up to one third of fractures are associated with spinal cord dysfunction. Delayed fracture diagnosis increases the risk of neurological complications. While validated screening guidelines exist for traumatic c-spine injury equivalent guidelines for thoracolumbar screening are lacking. ⋯ There is limited low level evidence guiding surveillance TL imaging in adult blunt trauma patients. Despite this, we propose and evaluate an algorithm with a high negative predictive value for TL fractures. This should be incorporated into spinal injury assessment protocols.
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Emerg Med Australas · Apr 2009
Reviewing deaths in the emergency department: deaths in the department or deaths within 48 h.
To investigate an ED death audit process that included deaths occurring within 48 h of admission in addition to deaths in the ED. ⋯ The present study demonstrates that auditing both ED deaths and 48 h deaths identifies additional issues relevant to the ED compared with auditing ED deaths alone or relying on standard hospital incident reporting.