Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2008
Comparative StudyExternal injury documentation in major trauma victims is inadequate: grounds for routine photography in the emergency department?
There is no widely accepted measure of clinical documentation quality in the ED. The present study creates a measure for comparing the quality of clinical documentation of external injuries with autopsy reports. This is used to discuss the advantages and disadvantages of introducing routine photography to improve clinical documentation of injuries. ⋯ Clinical documentation of external injuries in major trauma is poor. This is presumably because of many factors, including time pressures and high-stress environments. A possible strategy to improve this documentation is routine photography, which should offer both clinical and legal benefits.
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Emerg Med Australas · Dec 2008
Comparative StudyComparative review of the clinical use of intranasal fentanyl versus morphine in a paediatric emergency department.
Comparison of intranasal fentanyl (INF) and parenteral morphine in children in an ED. Primary objective was to compare time to analgesia from presentation, with secondary objectives to assess patient profiles, specifics of opiate analgesics used plus rate of i.v. access for analgesia alone. ⋯ Use of INF in our paediatric ED setting was associated with a significantly reduced time to analgesia for patients requiring immediate analgesia compared with parenteral morphine. Since the introduction of an INF protocol to our department in mid-2005, INF use has increased, with a corresponding decrease in the use of morphine and a reduction in i.v. access for analgesia.
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Emerg Med Australas · Dec 2008
Comparative StudyPain score documentation and analgesia: a comparison of children and adults with appendicitis.
There is a growing body of evidence suggesting that administration of analgesia in paediatric ED is inadequate. The present study was designed to assess pain score documentation and provision of opioid analgesia to children and adults with confirmed appendicitis in a mixed Australian ED. ⋯ Documentation of pain scores and provision of i.v. morphine is generally poor. Children are less likely than adults to have a pain score documented, or receive i.v. morphine when presenting with appendicitis.
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Emerg Med Australas · Dec 2008
Improving documentation of endotracheal intubation in an adult emergency department.
To evaluate the effect of an educational intervention and documentary pro forma on the adequacy of documentation of intubation in an adult ED. ⋯ Documentation improved slightly following the intervention, but was still unsatisfactory. We believe that to achieve an adequate level of documentation in the medical record for an episode of intubation, there needs to be a formal and structured mechanism, either via mandatory use of a specifically designed form and/or by participation in an organized data registry.
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To profile a helicopter emergency medical service in rural Australia. To assess patient injury severities and outcomes. To compare missions involving ambulance officers with physicians. To determine any time advantage of the aircraft over ground transfer. ⋯ We could not identify a significant survival benefit attributable to the addition of a doctor, although numbers for this comparison were small. Predicting missions where flight physicians might provide benefit remain imprecise and should be a priority area for prospective evaluation. We have demonstrated that in the absence of special circumstances, a helicopter response within 100 km from base does not improve time to definitive care.