Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2022
Observational StudyStatus Epilepticus Australasian Registry for Children: A pilot prospective, observational, cohort study of paediatric status epilepticus.
Paediatric status epilepticus (SE) has potential for long-term sequelae. Existing data demonstrate delays to aspects of care. The objective of the present study was to examine the feasibility of collecting data on children with paediatric SE and describe current management strategies in pre-hospital and in-hospital settings. ⋯ In children presenting with SE in Australia medical management differed from previous reports, with midazolam as the preferred benzodiazepine, and levetiracetam replacing phenytoin as the preferred second-line agent. This pilot study indicates the feasibility of a paediatric SE registry and its utility to understand and optimise practice.
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First rib fractures (FRFs) have historically been a marker for severe trauma and poor outcomes. The aim of the present study was to assess whether an association still exists between a fractured first rib and global trauma scores suffered by the patient, examine mortality rates and identify other commonly associated injuries. ⋯ A larger than expected proportion of FRFs were not associated with severe trauma scores or high mortality. These findings suggest that patients with an FRF may have a greater chance of surviving their traumatic FRF than previously reported. Clinicians should be aware of the potential for severity and specific associated injuries when treating a patient with FRFs.
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Emerg Med Australas · Oct 2022
Sydney 'lockout' liquor licensing law restrictions have been associated with a sustained reduction in emergency department presentations from assaults over 5 years.
The present study assessed the impact of changes to the New South Wales Liquor Act in 2014 on assault-related presentations to the ED of St Vincent's Hospital. This hospital is the primary receiving hospital for the area affected by these laws. ⋯ There has been a significant reduction in assault-related presentations to St Vincent's Hospital following the changes to the liquor licensing laws that has been sustained for 5 years with no significant decrease in the those with severe assault injuries.
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Emerg Med Australas · Oct 2022
Observational StudyHyperkalaemia in the emergency department: Epidemiology, management and monitoring of treatment outcomes.
To describe the epidemiology, treatment and monitoring of treatment outcomes of patients presenting to the ED with hyperkalaemia. ⋯ Most ED patients with hyperkalaemia have identifiable clinical and medication-related risk factors. Variations in care were widespread and monitoring for iatrogenic adverse events was suboptimal.
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Emerg Med Australas · Oct 2022
Trends in computed tomography aortography and acute aortic syndrome in an emergency department within Aotearoa New Zealand.
Acute aortic syndrome (AAS) comprises a triad of life-threatening aortic conditions that are difficult to diagnose because of their non-specific clinical presentations. Contrast-enhanced computed tomography aortography (CTA) has a high sensitivity and specificity for these conditions. However, under- and over-investigation of patients with suspected AAS using CTA carries significant risk. The aim of the present study was to evaluate the diagnostic imaging practices of CTA use for patients presenting to an ED with suspected AAS. ⋯ Thoracic CTA use for investigating suspected AAS in our ED has recently increased. However, the annual incidence of AAS did not increase over the same period, but was higher than reported in overseas institutions.