Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2023
Accuracy and clinical use of biliary point-of-care ultrasound: A retrospective cohort study.
To assess the utilisation and diagnostic accuracy of biliary point-of-care ultrasounds (POCUS) performed and archived in a single New Zealand ED. ⋯ Biliary POCUS was primarily utilised for and was accurate for the detection of gallstones. Further quality assurance and training could be directed at earlier credentialing to address technical errors and improved documentation of POCUS findings.
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Emerg Med Australas · Apr 2023
Snapshot of suspected acute coronary syndrome assessment processes in the emergency department: A national cross-sectional survey.
The Snapshot of Suspected ACS Assessment (SSAASY) study aims to describe the assessment processes for patients with suspected acute coronary syndrome (ACS) in Australian EDs, and to compare these processes with the National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand (NHFA/CSANZ) guidelines. ⋯ The SSAASY study reported the strategies used to assess suspected ACS. In line with current NHFA/CSANZ guidelines, highly sensitive troponin assays are widely utilised. However, serial sampling intervals were longer than guideline recommendations, suggesting a translational gap between guidelines and clinical practice.
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The objectives of the present study were to report the proportion of older teenagers, including the subgroup operating a motor vehicle, presenting to an adult major trauma centre after injury with a positive blood alcohol concentration (BAC) over a 12-year period. ⋯ A substantial proportion of older teenagers included in the registry had alcohol exposure prior to trauma. Despite a modest down-trending incidence, the need for continuing preventive measures is emphasised. In particular, preventive efforts should be targeted at male, older teenagers undertaking drinking activities on weekend days and driving motor vehicles.
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Emerg Med Australas · Apr 2023
Observational StudyRaising the D-dimer threshold for ruling out pulmonary embolism: A single-site, observational study with a historical comparison.
The objective of this study was to assess the impact of introduction of a new pulmonary embolism (PE) diagnostic guideline with a raised D-dimer threshold. ⋯ The introduction of the new guideline was associated with a reduction in overall imaging rates without evidence of missed PE. Further evaluation in other settings is recommended.
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Emerg Med Australas · Apr 2023
High-dose vasoactive agents in aeromedical retrievals for septic shock: A role for vasopressin?
To determine the number of patients retrieved by aeromedical teams for septic shock requiring vasopressor support who meet criteria for vasopressin therapy under the Surviving Sepsis Campaign 2021 guidelines. ⋯ A sufficient percentage of patients on vasopressors for septic shock require vasopressin therapy to meet current best treatment guidelines, and the inclusion of vasopressin in retrieval drug kits should be considered by Australian aeromedical services.