EMA Journal August 2013
From Andrew Gosbell & Tony Brown Issue 4 (Vol. 25) of Emergency Medicine Australasia published online on 2 August 2013 First Do No Harm. In Fact, First Do Nothing, at Least not a Cannula (#FOAMed) This thought provoking editorial considers the potential cascade of over-investigation, diagnosis and treatment that may be initiated in the ED. Using the example of peripheral intravenous catheters (PIVC), where a recent study (Pain With No Gain?) demonstrated that 50% of PIVCs inserted in adult patients went unused, Egerton-Warburton (@First_do_noharm) one of that article’s authors, and Ieraci (@SueIeraci) contend that investigations and procedures should only be performed in the ED when absolutely necessary. ‘Not doing stuff’ is a difficult paradigm shift as this can challenge current practice and ED attitudes to be ‘hand’s on’, but must to be considered in minimising risk and improving overall care to patients. Point of care testing in snakebite: an envenomed case with false negative coagulation studies (#FOAMed) Early detection of venom-induced consumptive coagulopathy (VICC) in Australian snake bite is a key step for initiating anti-venom. Point-of-care (POC) testing for international normalised ratio (INR) and D-dimer are available, and may be used in smaller or rural hospitals where on-site laboratory coagulations studies are not readily available. However, Cubitt and colleagues report a case of severe tiger snake envenoming with VICC where POC te...
Source: Life in the Fast Lane - Category: Emergency Medicine Doctors Authors: Mike Cadogan Tags: Education EMA Emergency Medicine Featured Journal ADAPT ADP Egerton-Warburton EMA Journal First Do No Harm NEAT Pain With No Gain? Sue Ieraci Source Type: blogs
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