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EMA Vol 20, Number 4, August 2008

Review article: Hypertonic saline use in the ED

  • hypertonic saline is recommended as an alternative to mannitol in Rx of raised intracranial pressure in traumatic brain injury.
  • it is also recommended for Rx of severe and symptomatic hyponatraemia & is worth considering for both recalcitrant tricyclic antidepressant toxicity and for cerebral odema complicating paediatric DKA.
  • it is NOT recommended for hypovolaemic resuscitation.

Review article: Leaving the ED without being seen (LWBS or DNW = did not wait)

  • review of literature but unable to draw firm conclusions but there are suggestive patterns of behaviour.
  • ideally requires cross-sectoral data mapping (comparing attendance data at regional EDs) to truly detect re-attendance and admission rates.

Research: Re-presentation and suicide rates in ED patients who present as self-harm

  • NZ-based study
  • 1.1% (ie. 8 patients) of the 754 patients who attended ED with deliberate self-harm went on to commit suicide within 12 months of discharge
  • 18% re-attended with 12 months of index presentation.
j/ema2008_20_4.txt · Last modified: 2008/08/29 13:50 (external edit)