Emergency medicine Australasia : EMA
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Tramadol is a synthetic analgesic new to the Australasian market where its use is rapidly increasing. It is used extensively overseas, particularly in Europe where it has been popular since its introduction in Germany in the late 1970s. Tramadol has a dual mechanism of action: weak mu opioid receptor agonist and a reuptake inhibitor of serotonin and noradrenaline. ⋯ Its use is advocated in a variety of acute and chronic pain states as well as some non-analgesic applications. The use of tramadol in an emergency setting is not well studied, with most published trials assessing its efficacy and tolerability in postoperative or dental models. This literature review concludes that tramadol does not offer any particular benefits over existing analgesics for the majority of emergency pain relief situations.
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Emerg Med Australas · Feb 2005
ReviewChronic pain syndromes in the emergency department: identifying guidelines for management.
To explore current literature on chronic pain syndromes and develop ED recommendations for the management and minimalization of chronic non-cancer pain. ⋯ Emergency Medicine lacks a cohesive, informed strategy for management of chronic pain. The proposed guidelines represent the first step toward establishing consistency in the management of patients with chronic pain syndromes. Further work needs to be undertaken at a national level in developing evidence based guidelines.
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Emerg Med Australas · Feb 2005
Prospective analysis of the effect of physician experience with the FAST examination in reducing the use of CT scans.
The objective of this study was to examine the effect of ultrasound experience level on emergency physicians' Focused Assessment with Sonography for Trauma (FAST) exam accuracy and emergency physicians' confidence in using FAST findings to assist in managing patients with blunt trauma. ⋯ FAST accuracy was greatest among more experienced emergency physicians. A normal FAST exam assisted more experienced emergency physicians with the perceived need to order significantly fewer CT scans than less experienced emergency physicians.
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Emerg Med Australas · Feb 2005
Clinical TrialRelative utility of serum troponin and the OESIL score in syncope.
To investigate the utility of both a random troponin T level taken greater than 4 h after a syncopal event and the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score in predicting outcome post syncope. ⋯ A normal serum troponin T has a poor negative predictive value for adverse cardiac outcomes following syncope. A simple risk stratification system, such as the OESIL score, can predict those patients most at risk after a syncopal episode.