Emergency medicine Australasia : EMA
-
Emerg Med Australas · Apr 2007
Case ReportsUncommon cause of cardiac arrest in the emergency department.
A previously healthy 48-year-old woman presented to a peripheral ED with non-specific signs and symptoms, including vomiting, abdominal cramping, shortness of breath, tachycardia and hypertension. Despite supportive measures the patient rapidly deteriorated, resulting in a cardiac arrest during an interhospital transfer. This required aggressive resuscitation, but without success. The case represents a diagnostic dilemma in the ED regarding the diagnosis and initial management of the patient's presentation.
-
Emerg Med Australas · Feb 2007
Randomized Controlled Trial Comparative StudyComparison between single-dose oral prednisolone and oral dexamethasone in the treatment of croup: a randomized, double-blinded clinical trial.
To compare the effectiveness of three corticosteroid regimens in children with mild to moderate croup. ⋯ Both prednisolone 1 mg/kg and low-dose dexamethasone (0.15 mg/kg) were found not to differ in efficacy from the currently recommended 0.6 mg/kg dexamethasone. The use of these corticosteroid regimens in treating patients with mild to moderate croup is thus supported.
-
Emerg Med Australas · Feb 2007
Multicenter StudyImproving asthma discharge management in relation to emergency departments: The ADMIRE project.
The present paper describes the process, outcomes and lessons learned from a federally funded, multicentre action research project aimed at improving discharge practices for asthma patients who attend ED and are discharged home. Thirty-two ED participated and worked locally to improve discharge practices using previously published best-practice guidelines. Although they achieved some improvements, major barriers to best-practice discharge outside ED control were identified, including access to GP, hospital policies regarding supply of medications and access to appropriate asthma education. The ED developed some useful tools to assist with improving asthma management that have been compiled as a toolkit and are available online.
-
Commercial aviation in-flight emergencies are relatively common, so it is likely that a doctor travelling frequently by air will receive a call for help at some stage in their career. These events are stressful, even for experienced physicians. The present paper reviews what is known about the incidence and types of in-flight emergencies that are likely to be encountered, the international regulations governing medical kits and drugs, and the liability, fitness and indemnity issues facing 'Good Samaritan' medical volunteers. ⋯ Medical volunteers may find assisting with an in-flight emergency stressful, but should acknowledge that they play a vital role in successful outcomes. The medico-legal liability risk is extremely small, and various laws and industry indemnity practices offer additional protection to the volunteer. In addition, cabin crew receive training in a number of emergency skills, including automated defibrillation, and are one of several sources of help available to the medical volunteer, who is not expected to work alone.
-
Emerg Med Australas · Feb 2007
Comparative StudyEvidence-based implementation of adult asthma guidelines in the emergency department: a controlled trial.
To determine if an evidence-based implementation (EBI) strategy could lead to the successful implementation of guidelines for the management of adult asthma in a large rural ED. ⋯ An EBI significantly improved compliance at the study hospital with no improvement noted in the control hospital. These improvements were maintained at 12 month follow up. An EBI can lead to significant improvements in the management of asthma at a large rural referral hospital ED and might have implications for hospitals with similar roles and profiles.