Increased hospital costs associated with red blood cell transfusion.

Background: Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little is known of the cost of these transfusion-associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose-dependent relationship.

Study Design And Methods: A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted.

Measuring the incidence of hospital-acquired complications and their effect on length of stay using CHADx.

Objectives: To use an automated Classification of Hospital Acquired Diagnoses (CHADx) reporting system to report the incidence of hospital-acquired complications in inpatients and investigate the association between hospital-acquired complications and hospital length of stay (LOS) in multiday-stay patients.

Design: Retrospective cross-sectional study for calendar years 2010 and 2011.

Setting: South Metropolitan Health Service in Western Australia, which consists of two teaching and three non-teaching hospitals.

Correlation of paired toxic plasma and saliva paracetamol concentrations following deliberate self-poisoning with paracetamol.

What Is Already Known About This Subject: • Paracetamol is commonly used in deliberate self poisoning (DSP) and this requires blood sampling to refine risk assessment. If saliva concentrations agreed with plasma concentrations, then this could support the development of non-invasive testing. Our pilot work supports this hypothesis, but was largely confined to nontoxic concentrations.

Patient perceptions of the potential lethality associated with deliberate self-poisoning.

Introduction: Little is known about patient perceptions of the lethality of their overdose. Our aim was to compare patient perceptions with the risk assessment of clinical toxicologists.

Methods: A prospective observational study of overdose patients presenting to a tertiary hospital.

Brain abnormalities detected on magnetic resonance imaging of amphetamine users presenting to an emergency department: a pilot study.

Objectives: To determine the prevalence of occult brain abnormalities in magnetic resonance imaging of active amphetamine users.

Design, Setting And Participants: Prospective convenience study in a tertiary hospital emergency department (ED). Patients presenting to the ED for an amphetamine-related reason were eligible for inclusion.

Morbidity associated with heroin overdose presentations to an emergency department: a 10-year record linkage study.

Introduction: To examine hospitalizations in a cohort of 224 patients who presented with non-fatal heroin overdose to an ED.

Methods: A record linkage study, using the morbidity, mental health and mortality databases in the Data Linkage Unit of the Department of Health, Western Australia. The main outcome measures were hospital separations 5 years before and after entry into the cohort.

Guidelines for the management of paracetamol poisoning in Australia and New Zealand--explanation and elaboration. A consensus statement from clinical toxicologists consulting to the Australasian poisons information centres.

Paracetamol is involved in a large proportion of accidental paediatric exposures and deliberate self-poisoning cases, although subsequent hepatic failure and death are both uncommon outcomes. The optimal management of most patients with paracetamol overdose is usually straightforward. However, several differing nomograms and varying recommendations regarding potential risk factors for hepatic injury introduce complexity.

Deliberate self-poisoning with tiagabine: an unusual toxidrome.

Tiagabine is an anticonvulsant acting by selective inhibition of neuronal and glial gamma-aminobutyric acid uptake, resulting in increased gamma-aminobutyric acid-mediated inhibition in the brain. Few reports in the literature describe the clinical course of severe tiagabine intoxication. A 44-year-old woman presented after deliberate self-poisoning with 100 tiagabine 15 mg tablets (1,500 mg; 25 mg/kg).

Amphetamine-related presentations to an inner-city tertiary emergency department: a prospective evaluation.

Objective: To describe the prevalence, characteristics and outcomes of amphetamine-related presentations to a tertiary hospital emergency department (ED).

Design, Setting And Participants: Prospective observational study of amphetamine-related presentations to the ED of the Royal Perth Hospital (RPH), an adult, inner-city, tertiary referral hospital, between 3 August and 2 November 2005. For all patients presenting to the ED, the treating doctors were automatically prompted by the computerised data entry system to consider amphetamine use.

Antivenom dosing in 35 patients with severe brown snake (Pseudonaja) envenoming in Western Australia over 10 years.

Objective: To investigate the doses of antivenom administered to adult patients with severe brown snake envenoming.

Design And Setting: Review of charts from Western Australian adult teaching hospitals, December 1991 to December 2001.

Patients: 35 patients with severe brown snake envenoming, defined prospectively as afibrinogenaemia (< 0.

Prospective evaluation of repeated supratherapeutic acetaminophen (paracetamol) ingestion.

Study Objective: Repeated supratherapeutic ingestion of acetaminophen is potentially lethal but poorly described. We provide the first prospective description of the characteristics, course, and outcome of patients with repeated supratherapeutic ingestion of acetaminophen.

Methods: This was a prospective case series of consecutive patients aged 12 years and older with acetaminophen dosage greater than 4 g per 24 hours referred to our poison center.

Successful resuscitation after cardiac arrest following massive brown snake envenomation.

We report a 44-year-old Western Australian man who suffered a cardiac arrest several hours after a bite by a brown snake. He was successfully resuscitated after bolus administration of undiluted brown snake antivenom. We suggest that an initial bolus dose of at least five ampoules (5000 units) of undiluted brown snake antivenom should be given as primary therapy for cardiac arrest following brown snake envenomation in Western Australia.