Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2007
Management of haemodynamically stable patients with abdominal stab wounds.
Australasian trauma centres receive relatively low numbers of penetrating injuries from stabbings. There is limited agreement regarding protocols to guide the management of haemodynamically stable patients with penetrating injuries. This has resulted in a wide variation in practice with anecdotally high negative laparotomy rates. The aim of the present study was to review the ED procedures, investigations and disposition of this group of patients. ⋯ The number of penetrating abdominal injuries remains low. Imaging alone cannot reliably exclude intraperitoneal injury. A greater utilization of ED wound exploration and laparoscopy based on agreed guidelines could improve management. An algorithm for the management of these patients is suggested.
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Emerg Med Australas · Jun 2007
Early computerized tomography accurately determines the presence or absence of scaphoid and other fractures.
To validate the use of early CT in predicting scaphoid fracture and other fractures in patients with suspected scaphoid fracture. ⋯ Early CT scans show promise in the diagnosis of scaphoid and other fractures of the wrist and carpals. Further study is warranted to validate early CT in clinical scaphoid fracture as an alternative to other early advanced imaging, or plaster immobilization and 2 week review.
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Emerg Med Australas · Jun 2007
Frova intubating catheter position can be determined with aspirating oesophageal detection device.
Intubating catheters (e.g. gum-elastic bougie) are an invaluable adjunct in the management of a difficult airway. Traditional tactile 'click' (from tracheal rings) and 'hold up' (from carina or bronchus) techniques for confirming tracheal placement are, however, fallible, and definitive placement can only be confirmed following passage of the endotracheal tube. Ensuing delays might contribute to the development of arterial hypoxaemia. Our aim was to determine whether an aspirating oesophageal detector device might be useful for confirming placement of the Frova intubating catheter (a hollow-bore intubating catheter). ⋯ In the operating theatre setting the aspirating oesophageal detector device reliably predicts tracheal and oesophageal placement of the Frova intubating catheter.
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Emerg Med Australas · Jun 2007
Multicenter StudyPractice makes perfect? Evaluation of cricoid pressure task training for use within the algorithm for rapid sequence induction in critical care.
To assess task training in cricoid pressure application suitable for incorporation into the algorithm for rapid sequence induction in acute care. ⋯ The application of cricoid force by critical care staff can be significantly improved by up to 3 min of practice on a simple task trainer.
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Emerg Med Australas · Jun 2007
Is cardiac monitoring during transport of low-risk chest pain patients from the emergency department necessary?
Incidence of life threatening arrhythmia for patients who present to the ED with low-risk chest pain (CP) (non-ischaemic electrocardiograms and normal cardiac marker profiles) is rare. These patients are often transported with cardiac monitoring by nurse escort from the ED. We aimed to show that this group of patients are at low risk of experiencing life-threatening arrhythmia disturbances. ⋯ CP patients who present to the ED with normal electrocardiograms and cardiac marker profiles are at low risk (<1%) of experiencing an adverse event during transport from the ED. This subset of patients might not require cardiac monitoring or nurse escort during transportation from the ED.