1,721,099 research outputs found
Pre-hospital triage: The national perspective
No full textTriage in emergency medicine describes the process of categorising patients on the basis of urgency.\ud
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Triage of patients is of importance in three main areas; firstly as a component of primary assessment to guide the treatment of individual patients, secondly as a basis for individual allocation of resources and finally as a case mix description of patient groups.\ud
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In the pre-hospital environment the first and second of these are of most concern. Ambulance officers are faced with deciding how much treatment is offered to the patient in the pre-hospital area, and the effects of treatment in the field on outcome, both good and bad. Vital decisions are often required, in the knowledge that the time required to apply that treatment must be balanced against the delay in accessing advanced care.\ud
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The ambulance officer is also confronted with choices to be made regarding the source of medical care most appropriate to the patient in the circumstances.\ud
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This paper reviews the concepts of triage as it applies to pre-hospital care, the current status of triage models used in the pre-hospital environment both internationally and in Australia and finally presents a plea for consistency based on scientific grounds both within the pre-hospital environment and the hospital system
[Editorial] Paramedics and scope of practice
No full textFree to read on journal website (may need to create free account first)\ud
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<i>Highly-trained paramedics can initiate the pathway of care that will achieve optimal outcomes for patients</i>\ud
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The question, posed to me by the Journal’s editorial staff, “Are paramedics exceeding the evidence?”, is a very global one that implies a dichotomous response. However, nothing in our complex health system can be so simply evaluated, so the question gets an equally global (if vague and unhelpful) answer: “Yes, probably, but no more or less than the rest of health care”..
Analysis of 24 cases of bullrout envenomation
No full textNotesthes robusta (bullrout) is a spined freshwater fish found in the rivers, creeks and estuaries of the east coast of Australia.\ud
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Its sting causes intense pain at the site of envenomation. The symptoms may be successfully treated by immersion of the affected part in hot water and infiltration with local anaesthetic.\ud
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This is a review of 24 cases of presumed bullrout envenomation presenting to the Emergency Department of Ipswich General Hospital. The characteristic and pathognomonic presentation is described and the response to treatment demonstrated
Prehospital fluid resuscitation: Conventional wisdom or inadequate science?
No full textAfter 25 years, the medical community remains unconvinced that prehospital fluid resuscitation in traumatised patients improves survival. Despite this lack of conviction, fluid resuscitation has been introduced in almost every Emergency Medical System (EMS) throughout the world and few would be prepared to suggest its removal.</p></div><div class="para"><p>Is there a logic behind this dichotomy or is it a case of conventional wisdom having no basis in science?</p></div><div class="para"><p>The aim of this paper is to identify and explore the essential questions which underlie the logic of current practice in an attempt to guide future conventions.</p></div><div class="para"><p>There are three questions which need to be addressed:</p></div><div class="para"><ul id="l1" class="custom"><li><span class="bullet">1</span><div class="text">What is the right focus for scientific evaluation?</div></li><li><span class="bullet">2</span><div class="text">Is current clinical practice appropriate?</div></li><li><span class="bullet">3</span><div class="text">Do the risks and complications outweigh any potential benefit?</div></li></ul></div><div class="para"><p>Fluid resuscitation is potentially life-saving when performed in the right manner, on the right patient, at the right time. The focus must be changed from technical issues to the knowledge and judgement required to deliver therapy appropriate to the needs of the particular patient
The new epidemics
No full textIn developed countries we once thought that the scourge of infectious diseases was tamed. Antibiotics were controlling infection in individual patients, vaccines were preventing illness and great faith was placed in the capacity of science to confound the most cunning organism. However, things have changed and in the new millennium we are confronting a host of challenges to public health from infectious diseases.\ud
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Epidemics mean an excess of cases in the community from that normally expected or the appearance of a new infection (Webber ####, 22)\ud
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Chapter 11 outlined the background to infectious diseases and the individual strategies directed towards the control and management of infectious diseases. The aim of this chapter is to outline the impact that infectious diseases have on population health, to identify the risks of major outbreaks and to identify the strategies required to reduce the risk and to manage any possible outbreak.\u
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