The New Zealand medical journal
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The aims of this study were to describe the variation in volumes and types of injuries admitted to a level one trauma centre in New Zealand over two 14-day periods before and during the national level 4 lockdown for COVID-19; and highlight communities at risk of preventable injury that may impact negatively on hospital resources. ⋯ Despite the significant reduction in admissions during level 4 lockdown, hospitals should continue to provide full services until resource limitations are unavoidable. Immediate messaging is recommended to reduce rates of injury on the farm and at home, specifically falls prevention. Ongoing attention of road users to road safety is essential to reduce the incidence of preventable major injury. These immediate measures can potentially reduce unnecessary pressure on hospital beds and resources during the pandemic.
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The coronavirus 2019 (COVID-19) pandemic requires significant changes to standard operating procedures for non-COVID-19 related illnesses. Balancing the benefit from standard evidence-based treatments with the risks posed by COVID-19 to patients, healthcare workers and to the population at large is difficult due to incomplete and rapidly changing information. ⋯ While the risks due to COVID-19 in patients with acute coronary syndromes is unclear, the benefits of standard management are well established in this condition. As an aid to decision making, we recommend systematic estimation of the risks and benefits for management of any condition where there is likely to be an increase in non-COVID-19 related mortality and morbidity due to changes in routine care.
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There has been a lot of speculation that patients with coronavirus disease 2019 (COVID-19) who are receiving angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may be at increased risk for adverse outcomes. We reviewed the available evidence, and have not found this to be the case. We recommend that patients on such medications should continue on them unless there is a clinical indication to stop their use.
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Admission of patients with likely fatal illness to ICU "solely for possible organ donation" has been a long-standing practice in New Zealand. This is advocated as a means of increasing the availability of organs for transplant. We sought to determine the extent and characteristics of current clinical practice. ⋯ There are already a small number of patients being admitted to ICUs in New Zealand "solely for possible organ donation", the majority following prior family discussion of donation. These patients occupy a small number of ICU bed-days and contribute ~15% of the deceased donation activity. Organ Donation New Zealand has developed and recently promulgated recommended best practice guidelines for clinicians in the ICU and emergency departments and is supporting expansion of the practice within the scope of these guidelines.