The New Zealand medical journal
-
A case of cutaneous larva migrans is presented. The patient acquired the parasite in a suburban Christchurch property. ⋯ It is rare in New Zealand, however. Presumably there were very specific, favourable local factors to allow maturation and transmission of the larva in this case.
-
CT pulmonary angiography (CTPA), D-dimer testing, and pre-test probability scoring have greatly improved the ability to manage patients with suspected pulmonary embolism. International guidelines suggest combining these investigations for the best yield. We have been investigating the use of CTPA in patients with suspected pulmonary embolism (PE) admitted to the Department of General Medicine at Christchurch Hospital, New Zealand. ⋯ There was a very low uptake of the formal use of pre-test probability scores by medical registrars. This audit confirms that, in patients with low or moderate risk of PE and a negative D-dimer, an alternative diagnosis should be considered. The management of suspected venous thromboembolism (VTE) could be improved; it is likely that after hours CTPA could be reduced.
-
To identify the appropriateness of calls to on-call house officers in a major tertiary teaching hospital. ⋯ The most important function an on-call house officer performs is responding to urgent medical situations. Frequent interruptions mean that house officers may become less efficient and more prone to making mistakes. The majority of calls received by on-call house officers did not need immediate responses and would have been better communicated via a less intrusive system such as text-messaging or the keeping of a non-urgent jobs list. If house officers were paged more appropriately then they would be interrupted less frequently and would be able to provide safer, more efficient, and timelier patient care.
-
To review the management and outcome of patients presenting with acute biliary pain/cholecystitis, mild acute pancreatitis, or cholangitis to a major New Zealand (NZ) metropolitan hospital. ⋯ The management of acute gallstone-related disease at a major NZ metropolitan hospital fails to meet with current international standards. Few patients undergo index cholecystectomy, and a large proportion of those treated conservatively return to the health sector with ongoing problems.
-
To examine a representative series of adverse events in New Zealand public hospitals where death was the final outcome recorded, with a view to determining the relationship between adverse event and death. ⋯ Because of the nature of the record review procedure used in the New Zealand Quality of Healthcare Study, a finding of death did not necessarily mean that an adverse event and death were causally related. Indeed, it is possible that extrapolations of mortality rates in this and other similar studies over-estimate by about a half the number of deaths caused by healthcare management.