|
1
|
Gursanscky J, Kelly AM, Hamad A, Tagg A, Klim S, Ritchie P, Law I, Krieser D. Outcome of reduction of paediatric forearm fracture by emergency department clinicians. Emerg Med Australas 2023; 35:347-349. [PMID: 36596645 DOI: 10.1111/1742-6723.14162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Paediatric forearm fractures are common. Anecdotally, there is a trend towards ED reduction of selected fractures under procedural sedation. We aimed to determine the rate of subsequent operative intervention for fracture re-displacement. METHODS Retrospective observational study of children with a forearm/wrist fracture undergoing fracture reduction in ED. Outcome of interest was operative intervention for fracture re-displacement within 6 weeks. RESULTS Among 176 patients studied, operative intervention occurred in nine patients (5.1%, 95% confidence interval 2.7-9.4%). CONCLUSION Reduction of paediatric forearm fractures under procedural sedation by ED clinicians is increasingly common and results in a low rate of subsequent operative intervention.
Collapse
Affiliation(s)
| | - Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia
- Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ahmad Hamad
- School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Tagg
- Western Health, Melbourne, Victoria, Australia
| | - Sharon Klim
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia
| | | | - Ian Law
- Western Health, Melbourne, Victoria, Australia
| | | |
Collapse
|
|
2
|
Gursanscky J, Klim S, Krieser D, Tagg A, Kaufman J. Chlorhexidine skin cleaning to reduce clean-catch urine contamination in infants: A pilot study. Emerg Med Australas 2022; 34:282-284. [PMID: 35021267 DOI: 10.1111/1742-6723.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Clean-catch urine (CCU) samples are frequently contaminated. Our aim was to determine if cleaning with 0.1% chlorhexidine before CCU is a safe and feasible method to reduce contamination. METHODS Prospective interventional pilot study. Children 1-24 months underwent perigenital skin cleaning with 0.1% chlorhexidine. Primary outcome was contamination rate, and secondary outcomes were parent and clinician satisfaction with the procedure. RESULTS Twelve of 54 urine samples were contaminated (22%, 95% CI 13-35). Over 90% of parents and clinicians were either 'satisfied' or 'very satisfied'. No adverse events were recorded. CONCLUSION Cleaning with chlorhexidine solution before CCU is safe and feasible.
Collapse
Affiliation(s)
- Jared Gursanscky
- Department of Paediatric Emergency Medicine, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.,Department of Paediatrics, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia
| | - Sharon Klim
- Department of Paediatric Emergency Medicine, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia
| | - David Krieser
- Department of Paediatric Emergency Medicine, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Andrew Tagg
- Department of Emergency Medicine, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan Kaufman
- Department of Paediatrics, Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| |
Collapse
|
|
3
|
Gursanscky J, Young J, Griffett K, Liew D, Smallwood D. Benefit of targeted, pharmacist-led education for junior doctors in reducing prescription writing errors - a controlled trial. J Pharm Pract Res 2018. [DOI: 10.1002/jppr.1330] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Joanne Young
- Quality Use of Medicines Pharmacist; Royal Melbourne Hospital; Melbourne Australia
| | | | - Danny Liew
- Melbourne Epicentre; Royal Melbourne Hospital; Melbourne Australia
| | - David Smallwood
- Department General Medicine; Royal Melbourne Hospital; Melbourne Australia
| |
Collapse
|