Emergency medicine Australasia : EMA
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Arterial line insertion is a common ED procedure with considerable clinician variation in preferred technique and equipment. This article aims to review some of the controversies and evidence surrounding this common ED procedure.
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Emerg Med Australas · Feb 2023
Multicenter StudyProthrombinex®-VF in chronic liver disease: Friend or foe?
Management of coagulopathy in chronic liver disease (CLD) poses a challenge for critical care physicians. Prothrombinex®-VF is a low-volume product with rapid onset of action. Evidence for its efficacy and safety in CLD is limited and cases of acute intravascular coagulation and fibrinolysis (AICF) and/or disseminated intravascular coagulation (DIC) have been reported. Our objective was to evaluate the role of Prothrombinex®-VF in reversal of coagulopathy and the incidence AICF/DIC, thromboembolic events and mortality. ⋯ Prothrombinex®-VF did not lead to meaningful reversal of coagulopathy and should be used with caution in CLD. Patients with ACLF were more likely to develop AICF/DIC following Prothrombinex®-VF, although the association is uncertain. Further studies are needed to evaluate the safety and efficacy of Prothrombinex®-VF use in CLD.
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Emerg Med Australas · Feb 2023
Bandaids are not the fix: Examining the patterns of injury-related emergency department presentations in Australian children.
To provide an epidemiological understanding of the types of injuries treated in ED in Australian children, describe the impact of these injuries in volume and severity, and assess the patterns by demographic and temporal factors. ⋯ This is the first large-scale quantification of paediatric injury-related ED presentation patterns in Australia since the conclusion of the National Injury Surveillance and Prevention Program about 30 years ago. It provides valuable information to inform paediatric ED resourcing decisions as well as important evidence for injury prevention practitioners.
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Emerg Med Australas · Feb 2023
Observational StudyImpact of COVID-19 Pandemic on Emergency Department Patient Volume and Flow: Two Countries, Two Hospitals.
COVID-19 greatly disrupted the provision of emergency care across the globe. ED service delivery was urgently redesigned as human and material resources were mobilised, and patients with respiratory symptoms were isolated. This study aimed to compare ED patient volume and flow metrics before and during the COVID-19 pandemic. ⋯ Total daily presentations varied considerably according to government mandated social restrictions and testing requirements in both EDs. The reductions in waiting and admission delay times corresponded with improvements in hospital capacity.
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Emerg Med Australas · Feb 2023
Observational StudyClinical Characteristics and Predictors for Hospitalisation During the Initial Phases of the Delta Variant Covid-19 Outbreak Sydney, Australia.
The COVID-19 Delta variant of concern continues to pose significant challenges to health systems globally, with increased transmissibility and different patient populations affected. In Sydney, a virtual model of care was implemented in response to the COVID-19 pandemic and Special Health Accommodation (SHA) was made available for community patients with COVID-19 who could not isolate at home or needed health support. ⋯ Initial symptoms and vital signs were just as predictive for short-term deterioration as age and pre-existing comorbidities and should be included in future risk prediction models for COVID-19. Based on this, we derive a proposed risk prediction score that incorporates these predictors with further validation required.