Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2023
Role of the emergency department in implementing an extracorporeal membrane oxygenation cardiopulmonary resuscitation.
The Royal Brisbane and Women's Hospital has introduced an extracorporeal membrane oxygenation (ECMO) cardiopulmonary resuscitation (E-CPR) service with collaboration between ED and ICU teams for refractory cardiac arrest patients. E-CPR is potentially beneficial to patients who do not gain return of spontaneous circulation after conventional advanced cardiac life support treatments, provided specific demographic and biochemical inclusion criteria are met. ⋯ We discuss our rationale to use the ED and the emergency physician role in leading the multidisciplinary team, with ICU leading the cannulation team. The development of ED processes and the increased availability of this intervention can significantly impact the survivability of refractory cardiac arrest with good neurological outcomes.
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Emerg Med Australas · Feb 2023
Observational StudyDedicated nursing care pathway improved management of opioid-poisoned patients in the emergency department: A before-after observational study.
Opioid overdose is increasing and accounts for two-thirds of poisoning deaths. Opioid induced respiratory depression is life-threatening and can be under-recognised even in the hospital setting. We aimed to evaluate the effect of a care pathway on the management of opioid-poisoned patients. ⋯ Following the introduction of a dedicated opioid poisoning nursing care pathway, naloxone delivery and observation documentation increased. A care pathway may improve ED management of opioid poisoning.
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Emerg Med Australas · Feb 2023
Does wearing a surgical mask influence face touching by healthcare workers? A retrospective cohort study.
At the start of the COVID-19 pandemic, healthcare workers (HCW) in our ED were advised against and actively discouraged from wearing masks when not seeing respiratory patients, as mask wearing was thought to increase the risk of droplet transmission by face touching. The primary objective of the present study was to determine whether HCW using face masks were more or less likely to touch their faces than those not wearing masks. ⋯ Mask wearing did not change face touching or the duration of face touches. However, significantly fewer mucosal touches were observed when wearing a mask, which may help to reduce nosocomial droplet transmission of viruses.
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Emerg Med Australas · Feb 2023
CommentImproving the safety of anticoagulation initiation in patients discharged from the emergency department.
To improve the safety of anticoagulation initiation by increasing the proportion of patients reviewed by a pharmacist. ⋯ The real-time electronic intervention improved the number of patients reviewed by a pharmacist. ED pharmacist reviewed patients were more likely to have safe anticoagulation initiation.
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Emerg Med Australas · Feb 2023
Cervical spine immobilisation is only required in drowning patients at high risk of axial loading of the spine.
Wave forced impacts are known to result in cervical spine injuries (CSI) and approximately 20% of drownings in Australia occur at the beach. The most common mechanism of injury in studies examining the frequency of CSI in drowning patients is shallow water diving. The aim of the present study was to determine what proportion of CSIs occurring in bodies of water experienced a concomitant drowning injury in a location where wave forced impacts are likely to be an additional risk factor. ⋯ The combination of CSI and drowning is uncommon. Cervical spine precautions are only required in drowning patients with signs or a history, or at high risk of, axial loading of the spine. This paper supports the move away from routine cervical spine precautions even in a high-risk population.