Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2005
Case ReportsUnusual cause of sudden onset headache: spontaneous intracranial hypotension.
Spontaneous intracranial hypotension is a very distinctive but unusual cause of acute headache. The postural nature of the headache can be easily overlooked in the celerity to exclude subarachnoid haemorrhage. We describe the clinical and radiological features of a case that emphasizes some of the diagnostic difficulties. An approach to management and treatment for this condition is outlined.
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Emerg Med Australas · Oct 2005
Case ReportsDefinitive management of acute cardiac tamponade secondary to blunt trauma.
Blunt cardiac injuries are a leading cause of fatalities following motor-vehicle accidents. Injury to the heart is involved in 20% of road traffic deaths. Structural cardiac injuries (i.e. chamber rupture or perforation) carry a high mortality rate and patients rarely survive long enough to reach hospital. ⋯ The presence of normal clinical signs or normal ECG studies does not exclude tamponade. In recent years the widespread availability and use of ultrasound for the initial assessment of severely injured patients has facilitated the early diagnosis of cardiac tamponade and associated cardiac injuries. Two cases of survival from blunt traumatic cardiac trauma are described in the present paper to demonstrate survivability in the context of rapid assessment and intervention.
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Emerg Med Australas · Oct 2005
Non-urgent presentations to a paediatric emergency department: parental behaviours, expectations and outcomes.
To identify factors that influence the attendance of children with non-urgent medical problems to a tertiary paediatric ED and to define parental expectations of the hospital visit. ⋯ The expectations of parents who attend the paediatric ED with children who have non-urgent chronic complaints are high. Rapid access to outpatient clinics might provide an acceptable alternative for these patients, and free valuable ED resources.
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Emerg Med Australas · Oct 2005
Difference in trauma team activation criteria between hospitals within the same region.
The present study was conducted to establish the current criteria for trauma team activation (TTA) in hospitals in the Metropolitan Sydney area, and examine the rationale behind their use. ⋯ The criteria for TTA differ between hospitals within the same region. The criteria currently used will result in over-triage of trauma patients, but this might be of benefit in training the trauma team in centres that do not see a large volume of trauma patients. There are several advantages in standardization of criteria including optimization of patient care, training, research and audit. Further work is needed to validate existing criteria for use throughout the region.