Emergency medicine

Alcohol is implicated in more emergency department presentations than we realise

Diana Egerton-Warburton MB BS, FACEM · Andrew Gosbell PhD · Angela Wadsworth BA(Hons) · Daniel M Fatovich MB BS, FACEM, PhD · Drew B Richardson MB BS(Hons), FACEM, MD

Outcomes are worse for trauma patients who present when senior specialist expertise is less available

Biswadev Mitra MHSM, PhD, FACEM · Peter A Cameron MB BS, MD, FACEM · Mark C B Fitzgerald MB BS, FACEM, FRACMA · Stephen Bernard MD, FACEM, FCICM · John Moloney FANZCA, GradCertArts(Writing), GradCertEmergHealth · Dinesh Varma MB BS, FRANZCR · Huyen Tran MB BS, FRCPA, FRACP · Martin Keogh GradDipCCRN, GradDipManagement

So far, so good — a strategy for improving outcomes, which could itself be improved

Kenneth M Hillman MD, FRCA, FCICM · Jack Chen MB BS, PhD, MBA · Daryl Jones MD, FRACP, FCICM,

MET calls are disruptive and inconvenient but cause no major harm to patients

The Concord Medical Emergency Team (MET) Incidents Study Investigators

This complication is rare, but potentially disastrous

Eugene Ng MB BS · Michelle Lee MB BS

Too much alcohol is not the only hazard at the pub

Chameen Samarawickrama · John Leaney · Stephanie Watson

Funding needed for venom immunotherapy to protect allergic patients against the effects of jack jumper ant stings

Raymond J Mullins PhD, FRACP, FRCPA · Simon G A Brown MB BS, PhD, FACEM

More patients are receiving treatment from a doctor or nurse within an appropriate time for the urgency category

Elizabeth Ingram

MSF reflects on the emergency medical response in the wake of a disaster

Daniel Martinez Garcia MD · Alexandra L Brown BA

Population density is independently associated with survival after out-of-hospital cardiac arrest

Ziad Nehme BEmergHlth(Hons) · Emily Andrew BBiomedSc · Peter A Cameron MB BS, MD · Janet E Bray RN, PhD · Stephen A Bernard MB BS, MD · Ian T Meredith BSc(Hons), MB BS, PhD · Karen Smith BSc(Hons), PhD

The high rate of injuries and fatalities among paramedics is a serious public health issue

Brian J Maguire DPH, MSAEMT-P · Peter F O’Meara BHA, MPP, PhD · Richard F Brightwell PhD, BSc(Hons), PGCertEd · Barbara J O’Neill BSNRN-OCN · Gerard J Fitzgerald MD, FACEM, FRACMA

How should we treat patients who may lack the capacity to decide in their own best interests?

Peter A Roberts MB BS, FACEM

How should we treat patients who may lack the capacity to decide in their own best interests?

Kerri Eagle LLB(Hons), LLM, FRANZCP · Christopher J Ryan MB BS, MHL, FRANZCP

Can safety evidence for tranexamic acid in elective surgery support its use in trauma?

James Jarman · Andrew Brier

Can safety evidence for tranexamic acid in elective surgery support its use in trauma?

Ian Roberts

Can safety evidence for tranexamic acid in elective surgery support its use in trauma?

Russell L Gruen · Ian G Jacobs · Michael C Reade

Good diagnostic accuracy could have a major impact on health service delivery

William A Parsonage DM, MRCP, FRACP · Jaimi H Greenslade BPsych(Hons), PhD · Christopher J Hammett MB ChB, FRACP · Arvin Lamanna MB BS, FRACP · Jillian R Tate BSc(Hons), MSc · Jacobus P Ungerer MB ChB, MMed, FRCPA · Kevin Chu MB BS, MSc · Martin Than MB BS · Anthony F T Brown MB ChB · Louise Cullen MB BS

To the Editor: The article by Segard and Macdonald is interesting but has significant methodological weaknesses and reports data that do not support all of their conclusions.1 Methodologically, retrospective dataset reviews with little demographic or morbidity data to avoid confounding (it is unclear why these were not available) are problematic. Additionally, death certificates were used as a surrogate for improved outcomes from additional diagnosis. Segard and Macdonald ...

David Mountain

In reply: We thank Mountain for his comments. As he points out, it is only possible to infer cause and effect from observational data. The fact that referrals for D-dimer levels and computed tomography pulmonary angiography increased during the same period does not prove that one “drove” the other, although we believe this is a reasonable inference. Importantly, D-dimer testing was introduced as a “rule-out” ...

William B G Macdonald · Tatiana Segard

Outlier patients may be at risk if their therapeutic and monitoring needs are only met on their home ward

John D Santamaria MD BS, FRACP, FCICM · Antony E Tobin MB BS, FRACP, FCICM · Matthew H Anstey MB BS, FCICM, FACEM · Roger J Smith BN, MPH · David A Reid

New recommendations will hopefully help standardise care of people bitten by snakes in Australia

Mark Little FACEM, MPH

Half of asylum seekers needed ED care in 2011, suggesting primary health care in closed detention is lacking

Adrienne K Deans MB BS, FRACGP, FACEM · Clare J Boerma MB BS · James Fordyce MB BS, MPH, FACEM · Mark De Souza MB BS, FACEM · Didier J Palmer FRCP, FRCS, FACEM · Joshua S Davis MB BS, FRACP, PhD