Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2007
Self-rated health in the unwell elderly presenting to the emergency department.
Self-rated health (SRH) has been shown to be a reliable predictor of functional decline and mortality. These studies, however, have largely focused on well community-dwelling elderly. We assessed whether the predictive value of SRH would still be valid for the acutely unwell older person presenting to the ED. ⋯ The ability of SRH to predict functional decline and mortality persists for the acutely unwell elderly presenting to the ED. SRH is a simple and valuable tool to assess the elderly in the ED and to identify high-risk patients who would benefit from comprehensive geriatric assessment aimed at delaying such outcomes.
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Emerg Med Australas · Jun 2007
Emerging epidemic in Australia: abdominal stab wounds. Twenty-four months at a major trauma centre.
The incidence of abdominal stab wounds treated at the Royal Melbourne Hospital, Parkville, Vic., Australia has noticeably increased over the 12 month period to March 2006, mirroring an increase in penetrating abdominal trauma throughout many Australian trauma centres. Management protocols for abdominal stab wounds are still contentious. The current study quantifies the increase in stab wounds at the Royal Melbourne Hospital over a 24 month period and analyses the management modalities used. ⋯ Abdominal stab wounds treated at Royal Melbourne Hospital have substantially increased over the past 12 months. Although management is still contentious, a management protocol for anterior abdominal stab wounds is proposed, outlining the role of CT scanning, conservative management, laparoscopy and laparotomy.
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Emerg Med Australas · Apr 2007
Comparative StudyEmergency department staff can effectively resuscitate in level C personal protective equipment.
ED staff are expected to perform resuscitation of trauma victims of chemical, biological and radiation incidents while wearing level C personal protective equipment (PPE). The present project assessed the subjective discomfort, physiological impact and performance of staff wearing PPE. ⋯ ED staff are able to perform resuscitation procedures in PPE without adverse physiological effects or impact on performance. Subjective concerns regarding task performance were not reflected in objective measurements. This might indicate that appropriate training and feedback could reduce the negative impression associated with activities undertaken while wearing PPE.
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Emerg Med Australas · Apr 2007
Could bystander first-aid prevent trauma deaths at the scene of injury?
To identify potentially preventable prehospital deaths following traumatic cardiac arrest. ⋯ Five (4.5%) potentially preventable prehospital trauma deaths were identified. Three deaths potentially involved airway obstruction and two involved excessive bleeding. There is a case for increased awareness of the need for bystander first-aid at scene following major trauma.