bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients with adverse drug reactions attending an emergency department
Authors: Collits Brian L , Kennedy Michael , Wu Michael , McIntosh(Deceased) James 
Published: August 2010

AbstractAimTo study the incidence and identify the economic impact of patients with adverse drug reactions attending the emergency department.SettingA metropolitan district hospital.MethodsOver a one year period, all attendances were screened for adverse reactions in accordance with specific criteria. An economic assessment was conducted to ascertain the direct cost to the health care system of identified patient presentations.ResultsOne hundred and one attendances (0.59%) were due to adverse drug reactions and adverse reactions accounted for 44 hospital admissions via the emergency department (0.88%). Using a clinical costing model, adverse drug reactions cost $162,000 per annum.ConclusionPatients with adverse drug reactions form a small percentage of attendances but are a significant cost to manage.
Electronic injury surveillance in an emergency department
Authors: Pitt W Robert , Jones Denise , Graham Cheryl , Nixon James W , Balanda Kevin P 
Published: August 2010

AbstractInjury control is one of the four priorities of the current National Health Strategy. Injury control targets are an integral part of this strategy and these require the measurement of the incidence of selected injuries. The strategy encourages local community based injury prevention programs. These programs need local data describing the determinants and distribution of injury in the particular community. Emergency department injury surveillance data is one source for this data. However manual data collection has been difficult to implement in Australian hospitals. This study reports an evaluation of the first electronic injury surveillance system integrated into an emergency department patient management system in Australia. This system was well accepted by emergency department staff and achieved good criteria validity in the range 88% to 100% on the injury data items. Emergency department nurses described the departmental requirement to collect injury data as being acceptable. Most nurses rated the injury coding system as satisfactory.
Drowning is rarely associated with spinal injury
Authors: Angley Christopher J , Allen Mervyn R 
Published: August 2010

AbstractA nine year retrospective review was conducted of the case notes of 60 patients with spinal injury related to water accidents presenting to the Spinal Injuries Unit of the Royal Adelaide Hospital. A retrospective review was also performed of the South Australian Coroner's records of 113 drowning deaths occurring between January 1990 and May 1995.Ninety percent of patients admitted to the spinal injuries unit were males, most were young (13–62 years, mean 25 years) and 75% sustained injury diving into shallow water. Seventy three percent of injuries were to the lower cervical spine (C5, C6, C7). Thirty percent resulted in permanent tetraplegia. An additional 25% had transient neurological loss. Thirteen percent had loss of consciousness, half of which were near‐drownings. There were no deaths and only one case of aspiration pneumonia. Prehospital spinal immobilisation was poorly documented. Only 15% of cases were recorded as having adequate spinal immobilisation applied. Only 2% of drowning deaths in the Coroner's records were reported as having associated spinal injuries.
The technical requirements for warming during fluid replacement
Authors: Russell W John 
Published: August 2010

AbstractEquipment available for warming during fluid replacement frequently fails in basic ways to meet its requirements. The fluids which need warming most are blood or blood products which have been stored close to 0°C. These require sufficient heat to raise the temperature to at least 32°C but some warmers are underpowered. Heat transfer is also a problem but if water is used, the difficulty can be reduced by agitation.All passive devices may benefit from use of a container with material which has a good heat transfer characteristic. However, the common polyvinyl chloride (PVC) is a good insulator and will impede heating unless very thin. Denser material such as the polythenes gives better heating. Units made of aluminium which has excellent heat conductivity will give a good warming performance.Units which have passive transfer systems cannot have heating above 42°C or blood may haemolyse. However, setting the heater at 37°C lessens the performance at high flow as there is a smaller gradient for the heat transfer.Unless the basis for fluid heating is understood, medical practitioners who use rapid fluid replacement will continue to accept poorly performing equipment and may jeopardise the recovery of their patients.
Brachial plexus and major vascular injury during parachuting
Authors: Lui Jeffrey , Holdgate Anna 
Published: August 2010

AbstractA case of bilateral shoulder injuries during parachuting with a unilateral brachial plexus and major vascular injury is reported. A literature review over the past 50 years describes the distribution of parachuting injuries and predictive risk factors. The combination of injuries in the reported case has never been described in the literature.
Steam inhalation
Authors: Martin Hugh , Brodie Lynne , Fitzgerald Dominic , Van Asperen Peter 
Published: August 2010

AbstractA description is given of burn injuries caused by hot water during inhalational therapy for croup and upper respiratory tract infections. Thirty children were admitted to the Royal Alexandra Hospital for Children Burns Unit. Most children were under six years (range from seven months to 14 years). The injuries were more severe than average scalds. The majority (23 of 30) had burns of less than 15%, but more than half required skin grafting. The average length of stay was 18.5 days (1 to 77 days). Steam inhalation has no beneficial effects and can cause serious injury.
The diagnosis of traumatic intra‐abdominal haemorrhage in patients with normal vital signs
Authors: Wilkes Garry J , McSweeney Peter A 
Published: August 2010

AbstractTwo cases of haemorrhagic shock from intra‐abdominal blood loss are presented. In both cases the pulse rate and blood pressure remained in the normal range following minimal volume resuscitation, despite significant blood loss. The presentation and evaluation of patients with suspected intra‐abdominal haemorrhage following blunt abdominal trauma is discussed. The value of a high speed helical CT scanner located in the emergency department is demonstrated.
Emergency medicine registrars and perceptions of rural practice
Authors: MBBS Steven Doherty , Hungerford Philip , Beeney Linda 
Published: August 2010

AbstractAimTo determine those factors which influence trainees' attitudes to the practice of emergency medicine in rural areas.MethodA questionnaire containing a rating scale was sent to all trainees of the Australasian College for Emergency Medicine who had passed their primary examination up to and including examination 1995.1, asking them to rate the influence of a number of variables on their likelihood to practice emergency medicine in rural areas.ResultsRegistrars who spend greater than six months of basic or advanced training in rural areas or who intend spending greater than six months training in rural areas believe they are more likely to work as emergency medicine specialists in rural areas.The broader clinical role, smaller and friendlier hospital environment, different casemix of rural medicine and rural lifestyle are significant positive attractions of rural emergency medicine.Potentially greater on‐call arrangements, perceived lack of resident medical officers and perceived lack of specialist services are significant deterrents to rural emergency medicine practice.ConclusionThe study demonstrates those factors which influence trainees' attitudes to rural emergency medicine.
The predictive significance of presenting symptoms, signs and radiography in paediatric head injuries
Authors: Wyllie Peter 
Published: August 2010

AbstractObjectiveTo analyse the significance of commonly used symptoms, signs and radiography in predicting skull fractures, intracranial injuries and the need for neurosurgical intervention in paediatric head injuries.SettingA paediatric tertiary referral hospital in central Sydney.MethodA 10 year retrospective chart review of all patients admitted with head injuries.ResultsSkull fractures were associated with decreasing age, findings of a scalp haematoma, clinical signs of a basal skull fracture and suspected skull depression/penetration. Intracranial injury (ICI) was associated with decreasing GCS scores, eye signs, suspected skull depression/penetration and skull fractures. Neurosurgical operative treatment was associated with decreasing GCS scores, eye signs, and skull fractures.Skull fractures were associated with neurosurgical operative treatment in all age groups. However the association of skull fractures and ICI was not significant in three of the five age groups examined.ConclusionsIn stratifying the risk of a complicated paediatric head injury, a greater focus should be made on specific physical findings. Less emphasis should be placed on historical features. Abnormal skull radiography may assist in stratifying the risk of intracranial injuries or the need for neurosurgical treatment. However the limitations of this imaging modality need to be acknowledged.
Which rewarming therapy in hypothermia? A review of the randomised trials
Authors: Rogers Ian 
Published: August 2010

AbstractIntroductionHypothermia may be encountered at some time in most parts of Australasia. There is a need to evaluate the merits of the various practical rewarming therapies available.MethodAn electronic and manual search of databases to identify randomised trials published between 1966 and 1996 inclusive which evaluated rewarming therapies in hypothermia.ResultsThere is a paucity of randomised trials on this subject and many of the rewarming therapies recommended in authoritative texts and reviews have never been evaluated in randomised clinical trials. In published trials core afterdrop is typically <0.5 C and is least with active core rewarming. Passive rewarming alone may be expected to raise core temperature by 0.75 C/hr and the addition of inhalation and/or forced air rewarming can be expected to at least double this.ConclusionsThe choice of rewarming therapy may be largely one of practicality and availability. Future rewarming research should focus on clinical outcomes in patients with moderate to severe hypothermia.
Management of periorbital infections
Authors: Bryant Michael 
Published: August 2010

AbstractA case of orbital infection complicated by a subperiosteal abscess is presented. Orbital infections may be distinguished clinically from preseptal (periorbital) cellulitis by the presence of proptosis, pain and limitation of eye movement and reduced visual acuity.Complications of orbital infections include blindness, central nervous system infection, cavernous sinus thrombosis and death. Suspected orbital infections require CT scanning to stage the lesion and determine the need for surgery. Orbital infections require aggressive parenteral antibiotic therapy. Orbital abscesses require urgent surgical exploration and drainage.
Resuscitation outcomes in the elderly
Authors: Day Robert 
Published: August 2010

AbstractThe elderly are using an increasingly greater proportion of emergency department resources. Age alone is a poor prognostic indicator of outcome from life threatening illness. The outcomes of resuscitation from major injury, primary cardiac arrest, myocardial infarction and sepsis in the elderly are well documented in the medical literature. A summary of the current literature concerning outcomes of resuscitation in the elderly is presented.The predictors of in hospital mortality for the elderly after major trauma are a high injury severity score, a low trauma score, increasing age, severe head injury, burns, shock, sepsis, prolonged ventilation and pre‐existing disease. Those who survive and are discharged from hospital do not usually require long term nursing care. Elderly major trauma victims should be treated aggressively in the emergency department.The outcome of resuscitation from primary cardiac arrest in the elderly differs little from that of the younger population, where the initial rhythm is the main determinant of survival rather than age.Myocardial infarction and its complications are more prevalent in the elderly. There is a greater net reduction in mortality in those aged over 75 years treated with thrombolytic agents than in any other age group.No reliable early predictors of outcome from sepsis in the elderly have been found. Factors such as severity of illness, pre‐existing disease and functional status are more important than the age per se.
Urethral self‐insertion case report and review of the literature
Authors: Lamberth Paul 
Published: August 2010

AbstractSelf insertion of foreign bodies into the urethra is an unusual cause of presentation to the emergency department. In this case, a 36 year old man inserted a safety pin into his urethra. Medical advice was sought 10 hours after the pin became lodged in an open position with the point facing distally. After local anaesthetic gel was instilled into the urethra, the pin was closed with external pressure and removed.An open safety pin in the urethra has previously been reported only once in the medical literature. This appears to be the only definite description of a safety pin with such an unfavourable orientation being easily removed.Though removal of foreign bodies in the emergency department is likely to be an exceptional occurrence, there are important implications for emergency department staff. These include the diagnosis of foreign bodies presenting with complications, where the history of foreign body may not be given, and the issue of psychiatric review.
Recognition of deficits of physical and cognitive function in the elderly by medical staff in the emergency department
Authors: Caplan Gideon A , Croker William D , RN Ann Brown 
Published: August 2010

AbstractAimsTo evaluate the recognition of deficits of physical and cognitive function in the elderly by emergency department medical staff.MethodsRetrospective survey of the records of 486 patients aged 75 years and over discharged from the emergency department.ResultsAssessments of cognitive and physical function were noted in 88 (18.8%) and 115 (24.6%) records respectively. Less experienced doctors recorded assessments less frequently for cognitive and physical function than senior doctors (16.3% vs 32.6%; Chi2 = 10.0; p = 0.0015 and 21.9% vs 38.2% Chi2 = 12.0; p = 0.0005 respectively). Senior doctors recorded more assessments on cognitively or physically impaired patients than non‐impaired patients. Less experienced doctors did not.ConclusionMore experienced doctors exhibited unwritten clinical judgement in recording assessments for impaired patients more frequently than non‐impaired patients. There is a need for better teaching of geriatric emergency medicine to improve the assessment of cognitive and physical function of elderly patients in the emergency department by junior doctors.
Trauma in the western region of Saudi Arabia
Authors: Ansari Mohammed ZRH 
Published: August 2010

AbstractObjectiveTo evaluate the pattern of injuries and available prehospital and hospital care in this rapidly emerging country with western type hospital and trauma care resources serving a population that in many areas is still considered to be developing.SettingAccident & Emergency Department of King Khalid National Guard Hospital, Jeddah, Saudi Arabia.MethodRecords of all patients admitted to the accident and emergency department sustaining injuries due to trauma were studied, including patients brought in dead.ResultsInjuries represented 10% of all accident and emergency referrals. Falls were the most common cause of injury, followed by sports injuries and road traffic accidents. The male to female ratio for all injuries was 3:1; 84% of injured patients were below the age of 30 years with 34% 10 years old or less.Sprains and strains were the commonest injury type (23%); followed by lacerations (20%) and fractures (19%).Total mortality among seriously injured patients was 35%. Eight out of 14 brought in dead to the accident and emergency department had an ISS of less than 30 and four had a score of less than 18.ConclusionsTrauma constitutes a major cause of mortality in Saudi Arabia. Road traffic accidents account for only 10% of injured patients, but cause greatest mortality and morbidity.Untrained ambulance staff and the lack of paramedics were identified as causal in the mortality among patients brought dead to the accident and emergency department with a very low injury severity score. Recommendations are made to improve the outcome of trauma victims.
Severe subcutaneous emphysema and pneumomediastinum
Authors: MBChB Craig Hourigan , Bergman Jack 
Published: August 2010

AbstractSpontaneous pneumomediastinum has been commonly associated with recreational drug abuse. This often follows vigorous inhalation and the performance of a ritual valsalva‐type manoeuvre. We describe a case of extensive pneumomediastinum and subcutaneous emphysema associated with intravenous drug abuse and bystander mouth‐to‐mouth resuscitation. This case presents a new dimension to the clinical presentation of illicit drug abuse, and supports the importance of appropriately learned Basic Life Support in high risk population groups.
Haematoma block: a potentially useful technique for Australasia
Authors: Gulick Tod , Pederson Leigh 
Published: August 2010

AbstractHaematoma block is a simple, safe and effective anaesthetic technique used to facilitate the reduction of closed fractures. It was described in the 1920s and is in common use worldwide. Haematoma block has been used effectively in patients as young as two years of age. It has the advantages of ease of administration, fast onset, long duration of fracture‐site analgesia, and it does not require specialised equipment. Haematoma block may be safely administered by a single doctor. It is unique in the ability to provide fracture‐site analgesia without sedation or cumbersome tourniquet, making it ideal for many medical retrieval situations. The safety of the technique makes it well suited to rural practice. The speed and minimal monitoring requirement enhances its utility in the busy urban emergency department.
Medical evacuation from the Lake Kutubu region of Papua New Guinea
Authors: Robins Anthony 
Published: August 2010

AbstractAims To review and analyse med ical evacuation data collected at the Chevron Niugini Ridge Hospital in the Lake Kutubu area of the Southern Highlands Province of Papua New Guinea.Setting The Kutubu oil field area in Southern Highlands Province including two camps and 51 local villages.Methods Medical evacuation records spanning the four year period 1993–1997 were reviewed for the Lake Kutubu area. Patient origin, age, sex, diagnostic category, referral destination and transfer modality were analysed.Results Seventy five percent of medical evacuations involved villagers. Trauma was the most common medical evacuation diagnostic category followed by complicated obstetric, respiratory and malaria diagnoses. Most medical evacuations (86%) were referred to the Ridge Hospital and Southern Highlands medical facilities. Methods of transport were evenly distributed between road, helicopter and fixed wing transfers. An above average number of medical evacuations occurred during November each year.Conclusion Further trauma research in Papua New Guinea will allow health planners to address this important cause of medical evacuation. Papua New Guinea Governments should consider developing a formal medical evacuation network.
Food of the zebra finch (Poephila guttata), and an examination of granivory in birds of the Australian arid zone
Authors: MORTON S. R. , DAVIES P. H. 
Published: August 2010

AbstractBirds are important granivores in the Australian arid zone, and this paper reviews their role by assembling available data on diet and habitat selection of the granivorous species occurring in the region. Paucity of dietary information is alleviated by a study of the food of the zebra finch (Poephila guttata) at two sites in the eastern arid zone. Zebra finches subsisted entirely on grass seeds of a relatively narrow specific range; 17 classes of seeds (at least 19 species) were eaten, but one class dominated the diet at each study site and only five classes (probably six species) were significant overall. Comparative information concerning granivorous species‐ suggested that the seeds of grasses and shrubs are of most importance in diets, that larger species tended to eat larger seeds from a wider variety of plants because of the addition of shrub species to the diet, and that Acacia shrublands contained most species. Characteristics of the arid zone that are of particular importance to granivorous birds appear to be the abundance of grasses and the patchy and erratic nature of the rainfall.
Patterns of air temperature and accumulation of snow in subalpine heathlands and grasslands on the Bogong High Plains, Victoria
Authors: WILLIAMS R. J. 
Published: August 2010

Abstract On well drained sites in the subalpine tract of the Bogong High Plains, Victoria, the distribution of grassland, dominated by Poa spp., and closed heathland, dominated by Prostanthera cuneata, can be correlated with patterns of maximum and minimum air temperature, and the accumulation and persistence of snow. Both maximum and minimum temperatures are lower, and the accumulation and persistence of snow is less in grassland, the dominant community of gentle slopes and hollows, than in closed heathland, the dominant community on steeper, leeward slopes. On gentle slopes and in hollows, the development of closed heath may be limited by the accumulation of cold air, relatively low temperatures and exposure to strong winds. However, on leeward slopes where snow persists the longest (until mid‐late December), the development of heath may be limited by a shortening of the growing season. The distribution of grassland and heathland, especially the limits to the distribution of the heath, may also be affected by infrequent climatic events, such as the co‐incidence of unusually low temperatures during winters when snow cover is meagre.
Pre‐dispersal seed losses to insects in species of Leptospermum (Myrtaceae)
Authors: ANDERSEN ALAN N. 
Published: August 2010

AbstractPre‐dispersal seed losses to insects in species of Leptospermum at Wilson's Promontory in south‐eastern Australia varied markedly between species, seasons, sites and individuals. The proportion of fruits attacked by insects averaged 11% (range 3–37%) in populations of Leptospermum juniperinum, 23% (6–95%) in Leptospermum myrsinoides, 23% (0–47%) in Leptospermum laevigatum, and 28% (8–45%) in Leptospermum lanigerum. The proportion of seeds lost in attacked fruits also varied widely. Differences between species varied markedly from year to year, but differences between sites were relatively constant. Fruit production by L. myrsinoides was unusually low at most sites during 1984; in each case this coincided with unusually high rates of insect attack, suggesting that predator satiation operates during normal seasons.