Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2004
Case ReportsCongenital diaphragmatic hernia masquerading as pneumonia.
Patients with congenital diaphragmatic hernia usually present in the immediate neonatal period with respiratory distress. However, presentation beyond the neonatal period has sporadically been reported. ⋯ Fortunately, after performing ultrasound, suspicion was raised and she was later diagnosed to have left congenital diaphragmatic hernia of Bochdalek type. Although rare, this entity should form one of the differential diagnoses of unresolving pneumonia in children.
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Emerg Med Australas · Apr 2004
Clinical TrialPracticality of performing medical procedures in chemical protective ensembles.
To determine whether certain life saving medical procedures can be successfully performed while wearing different levels of personal protective equipment (PPE), and whether these procedures can be performed in a clinically useful time frame. ⋯ A significantly greater time to complete procedures was documented in Level A PPE (fully encapsulated suits) compared with Levels C and D. There was however, no significant difference in times between Level B and Level C. The common practice of equipping hospital and medical staff with only Level C protection should be re-evaluated.
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Emerg Med Australas · Apr 2004
Clinical TrialProlonged pre-procedure fasting time is unnecessary when using titrated intravenous ketamine for paediatric procedural sedation.
Paediatric procedural sedation (PPS) is a common procedure in most general EDs. Many departmental guidelines suggest mandatory fasting times for children undergoing PPS, in an attempt to decrease the incidence of postoperative vomiting and (theoretically) aspiration pneumonitis, despite there being little or no evidence in the literature to support these mandatory fasting times. ⋯ Prolonged preprocedure fasting time did not reduce the incidence of postprocedure vomiting in this case series; to the contrary there was a increased incidence of vomiting with longer fasting times (P = 0.08). There was an increase in postprocedure vomiting with increasing age of the patients.
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Emerg Med Australas · Feb 2004
Comparative StudyMultidisciplinary assessment at triage: a new way forward.
To evaluate a dual doctor and nurse triage system at a tertiary referral hospital. ⋯ We feel that multidisciplinary triage performs a useful function in our department enabling us to reduce waiting times. The process is widely accepted amongst the staff and it ensures a senior doctor assesses most patients. It reduces the number of patients leaving prior to being seen by a doctor and it provides one way of getting around access block and a physically small department.
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Emerg Med Australas · Feb 2004
Workplace factors leading to planned reduction of clinical work among emergency physicians.
There is anecdotal evidence that ACEM Fellows are reducing or planning to reduce their clinical workload. We investigated the extent of, and reasons for, these reductions. ⋯ Fellows are significantly reducing their clinical workload largely in response to excessive workload and lack of resources. These findings have important implications for professional longevity and work force planning. Re-evaluation of workplace practice, especially identified stressors, is indicated.