Emergency medicine Australasia : EMA
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The COVID-19 pandemic has led to the development of alternative means of accessing unplanned care in order to avoid unnecessary ED presentations and hospital admissions. We explore the definition of emergency medicine, which patients are better served by accessing unplanned hospital care via alternative pathways, and the concept of emergency care completion.
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To determine the rate of unplanned return visits (uRVs) within 48 h to a paediatric ED over a 12-month period and describe the factors associated with these uRV. ⋯ The present study has demonstrated associations between uRV and initial-visit triage category 3, age between 3 months and 5 years, and presentations because of infectious illness. Middle-grade doctor changeover was also associated with an increase in uRVs.
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Emerg Med Australas · Aug 2022
Effect of a simplified billing form and the SARS-CoV-2 pandemic on compensable billings in an Australian metropolitan emergency department - an interrupted time series analysis.
To evaluate the effect of a simplified billing form on billings recovery. ⋯ Total billings did not change. Less patients were identified, but each generated 59% more billings.
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Emerg Med Australas · Aug 2022
Use of clonidine in the treatment of Irukandji syndrome: A 4-year retrospective cohort study on safety, efficacy and clinical utility.
Irukandji syndrome (IS) is an extremely painful condition that causes a significant catecholamine surge and sympathetic autonomic response related to the envenomation from certain types of jellyfish. Current management involves intravenous fluids, magnesium sulphate and large doses of opioids for symptom control. Clonidine, a centrally acting alpha-2 agonist, is often used as an analgesic adjunct to reduce opioid requirements in acute pain. The present study explores the safety and efficacy of clonidine in reducing opioid requirements in IS. ⋯ Patients with IS who received clonidine required significantly lower opioid requirements than those who did not receive clonidine. Clonidine was safe to administer and should be considered early when treating IS. The optimal clonidine dose remains unclear and requires prospective studies to validate our findings.