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Journal of Emergency Medicine, Trauma and Acute Care - Volume 2017, Issue 1
Volume 2017, Issue 1
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High-pressure injection injury: Role of early detection and aggressive intervention
Authors: Khalid Bashir and Keebat KhanEmergency department physicians can easily underestimate the severity of damage underlying the innocuous looking high-pressure injection injuries. These work-related injuries lead to significant lifelong morbidity as functionality is compromised in most cases, even after recovery due to high rates of amputation. Hence it is important to consider all high-pressure injection injuries as surgical emergencies. A detailed case history including pre Read More
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Diagnostic performance of the cardiac FAST in a high-volume Australian trauma centre
Background: Cardiac injury is uncommon, but it is important to diagnose, in order to prevent subsequent complications. Extended focused assessment with sonography in trauma (eFAST) allows rapid evaluation of the pericardium and thorax. The objective of this study was to describe cardiac injuries presenting to a major trauma centre and the diagnostic performance of eFAST in detecting haemopericardium as well as broader cardiac inj Read More
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Identifying a safe site for intercostal catheter insertion using the mid-arm point (MAP)
Background: Over 85% of chest injuries requiring surgical intervention can be managed with tube thoracostomy/intercostal catheter (ICC) insertion alone. However, complication rates of ICC insertion have been reported in the literature to be as high as 37%. Insertional complications, including the incorrect identification of the safe zone chest wall location for ICC placement, are common issues, with up to 41% of insertions occurring out Read More
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Evolution of emergency medical services in Saudi Arabia
Authors: Talal AlShammari, Paul Jennings and Brett WilliamsAim: The purpose of this study was to provide an overview of the evolution of emergency medical services (EMS) in Saudi Arabia to describe its history, organisational service providers, governance, EMS statistics and the educational development of the field with the disparity of educational approaches. Background: The EMS is an important part of the healthcare system as it is often the first point of contact for medical emergencies. The EMS Read More
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Spinal clearance practices at a regional Australian hospital: A window to major trauma management performance outside metropolitan trauma centres
Authors: Angus W. Carter, Susan P. Jacups, Helen M. Ackland, Andrew Wright, Amy Lawson, Drew Armit and Richard MooneyBackground: Prevention of secondary spinal injury via spinal protection measures is a standard component of trauma management, and a high-quality spinal clearance process is imperative in achieving this aim. To evaluate the current practice with a view to achieving best practice, we sought to examine the spinal clearance process and outcomes at a regional Australian referral hospital, which services a large geographical catchment Read More
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Disconnect between available literature and clinical practice: Exploring gaps in the management of t-BPPV in the emergency department
Authors: Khalid Bashir, Sameer Pathan, Saleem Farook, Muhammad Masood Khalid and Sameh ZayedBackground: Healthcare costs associated with the diagnosis of benign paroxysmal positional vertigo (BPPV) alone approach $2 billion per year in the United States. Post-traumatic BPPV (t-BPPV) is well recognized, and can be managed with simple bedside physical maneuvers. Despite the availability of literature and clear guidelines supporting this approach, physical maneuvers are underutilized. The aim of this study was to explore the reaso Read More
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Partial replacement of board-certified specialist-grade physicians with emergency medicine trainees in a busy emergency department: Lack of adverse effect on time to physician
Objectives: Standard emergency department (ED) operation goals include minimization of the time interval between patients' initial ED presentation and initial emergency physician (EP) evaluation. Following up on previous work defining factors influencing the “time to physician” (tMD) in a busy ED, the current study was undertaken to evaluate whether tMD was adversely impacted by the ED's partial replacement of specialist-grade EPs with Read More
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Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study
Background: Helicopter emergency medical services (HEMS) and ground EMS (GEMS) are both integral parts of out-of-hospital transport systems for patients with ST-elevation myocardial infarction (STEMI) undergoing emergency transport for primary percutaneous coronary intervention (PPCI). There are firm data linking time savings for PPCI transports with improved outcome. A previous pilot analysis generated preliminary estimates for p Read More
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