An audit of propofol administration in the intensive care unit: Infusion pump-recorded versus electronically documented amounts.

Background: Although propofol is widely used for sedation in intensive care units around Australia, evaluation of bedside nursing practices of the administration of propofol have been limited. We investigated whether there was a discrepancy between the amount of propofol delivered by the infusion pump and that recorded electronically and consequently patient exposure to avoidable harms.

Aims: The aim of this research was to compare the total amount of propofol administered to intensive care patients via a programmable infusion pump with that documented in the electronic medical record (EMR).

The Twist X-Ray: A Novel Test for Dynamic Scapholunate Instability.

 Scapholunate instability (SLI) is the most common form of carpal instability. Early detection of SLI is imperative as early reconstructive procedures can potentially prevent the natural history of progressive degenerative arthritis. After wrist arthroscopy, magnetic resonance imaging (MRI) remains the next best noninvasive diagnostic option; however, access still remains costly and is often limited in many health care systems worldwide.

Radiofrequency electromagnetic field exposure and risk perception: A pilot experimental study.

Background: Exposure to far-field radiofrequency electromagnetic fields (RF-EMF) has raised public concerns in recent decades. However, it is not known if individuals' perception towards the health risks of RF-EMF is dependent on their knowledge of the objectively measured personal RF-EMF exposure levels.

Objectives: This pilot study aimed to demonstrate the feasibility of objectively measuring personal RF-EMF exposure from mobile phone base stations (MPBS) and to determine if the risk perception of people to the potential health risk of exposure to RF-EMF from MPBS is dependent on their knowledge of personal RF-EMF exposure levels.

The pharmacokinetics of intranasal droperidol in volunteers characterised via population modelling.

Background: Droperidol is used parenterally to treat nausea and vomiting, migraine and acute behavioural disturbance. Intranasal use is not reported for droperidol. Intranasal drug administration reduces need for intravenous line placement and risk of needle-stick.

Extended-release quetiapine overdose is associated with delayed onset of toxicity compared to immediate-release quetiapine overdose.

Objectives: There are currently no studies comparing toxicity after extended-release (XR) and immediate-release (IR) quetiapine overdose. To compare the time course of toxicity of XR and IR quetiapine overdose.

Methods: Retrospective analysis of toxicology unit consultations from July 2013 to April 2016.

Intensive care implications of epidemic thunderstorm asthma.

Objective: To investigate the environmental precipitants, treatment and outcome of critically ill patients affected by the largest and most lethal reported epidemic of thunderstorm asthma.

Design, Setting And Participants: Retrospective multicentre observational study. Meteorological, airborne particulate and pollen data, and a case series of 35 patients admitted to 15 intensive care units (ICUs) due to the thunderstorm asthma event of 21-22 November 2016, in Victoria, Australia, were analysed and compared with 1062 total ICU-admitted Australian patients with asthma in 2016.

Personal Exposure to Radio Frequency Electromagnetic Fields among Australian Adults.

The measurement of personal exposure to radiofrequency electromagnetic fields (RF-EMFs) is important for epidemiological studies. RF-EMF exposure can be measured using personal exposimeters that register RF-EMFs over a wide range of frequency bands. This study aimed to measure and describe personal RF-EMF exposure levels from a wide range of frequency bands.

The NACSTOP Trial: A Multicenter, Cluster-Controlled Trial of Early Cessation of Acetylcysteine in Acetaminophen Overdose.

Historically, intravenous acetylcysteine has been delivered at a fixed dose and duration of 300 mg/kg over 20 to 21 hours to nearly every patient deemed to be at any risk for hepatotoxicity following acetaminophen overdose. We investigated a 12-hour treatment regimen for selected low-risk patients. This was a multicenter, open-label, cluster-controlled trial at six metropolitan emergency departments.

Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations: a clinical study and the modified pins rubber band traction system revisited.

Background: The purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes.

Methods: Data was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study.

Deliberate Self-poisoning with a Lethal Dose of Pentobarbital with Confirmatory Serum Drug Concentrations: Survival After Cardiac Arrest with Supportive Care.

Introduction: Pentobarbital (PB) is a euthanasia drug in doses of 2 to 10 grams, causing death within 15-30 minutes. We report a case of recovery from lethal pentobarbital deliberate self-poisoning with confirmatory serum drug concentrations.

Case Report: A 45-year-old male purchased 20 grams of PB powder over the Internet.

Quantitative analysis of in-vivo thumb carpometacarpal joint kinematics using four-dimensional computed tomography.

The purpose of this study was to define the normal thumb carpometacarpal joint kinematics in-vivo during opposition and abduction using four-dimensional computed-tomography in four volunteers. Movement of the metacarpal relative to the trapezium was quantified using both Euler and helical axis representations. Articular surface contact patterns were also analysed.

A blinded, randomized trial comparing bicolumnar arthrodesis to radioscapholunate arthrodesis in scapholunate advanced collapse II arthritis: a pilot study.

Unlabelled: The purpose of this study was to compare the outcome of scaphoid excision with capitolunate and triquetrohamate arthrodesis (bicolumnar arthrodesis) to radioscapholunate arthrodesis in patients with scapholunate advanced collapse (SLAC) II wrist arthritis. Twelve patients with symptomatic SLAC II arthritis were recruited and randomized to receive either bicolumnar arthrodesis or radioscapholunate arthrodesis. The primary outcome was wrist function as assessed by the patient rated wrist evaluation.

Comparison of the Thunderbeat and Other Energy Devices in Laparoscopic Colorectal Resection: A Single-Center Experience.

The THUNDERBEAT (TB) is a relatively novel energy device that is used in laparoscopic colorectal resection (LCR), which integrates both ultrasonic and bipolar energy. There are limited data on its use in LCR, compared with bipolar diathermy (LigaSure [LS]) or ultrasonically generated heat (Harmonic ACE [HA]). The aim of this study was to compare outcomes in patients undergoing LCR with TB versus LS or HA, for both benign and malignant colorectal diseases.

Managing diabetic foot infections: a survey of Australasian infectious diseases clinicians.

Background: Diabetic foot infections (DFI) present a major morbidity, mortality and economic challenge for the tertiary health sector. However, lack of high quality evidence for specific treatment regimens for patients with DFIs may result in inconsistent management. This study aimed to identify DFI caseload proportion and patterns of clinical practice of Infectious Diseases (ID) Physicians and Trainees within Australia and New Zealand.

Review article: A primer for clinical researchers in the emergency department: Part VI. Measuring what matters: Core outcome sets in emergency medicine research.

In this series we address important topics for clinicians who participate in research as part of their work in the ED. The overarching goal of clinical research is to improve care and determine which treatment is best. Yet, defining and measuring outcomes - what is 'best' - can be one of the most difficult steps in the design of a study, in particular when answers to research questions cannot be captured in simple binary results.

Community treatment orders: towards a new research agenda.

Objectives: The aim of this study was to report on a half-day multi-stakeholder symposium on community treatment orders (CTOs) hosted by the Melbourne Social Equity Institute (MSEI), which identified research gaps and opportunities, and produced an agreed agenda for future CTO research.

Methods: The MSEI convened a symposium for 22 experts in CTO research to discuss research priorities in this field in Australasia. An independent moderator elicited views and recommendations and produced a report detailing possible research projects.

Elderly patients with suspected chronic digoxin toxicity: A comparison of clinical characteristics of patients receiving and not receiving digoxin-Fab.

Objective: The aim of the present study was to compare clinical features of patients with elevated serum digoxin concentrations who were treated with digoxin-Fab with those where the immunotherapy was not given by a tertiary hospital toxicology service.

Methods: This was a retrospective series of patients with supratherapeutic serum digoxin concentrations referred to the toxicology service from August 2013 to October 2015. Data collected included demographics, presenting complaint, digoxin dose, other medications taken, serum digoxin, potassium and creatinine concentration on presentation and initial and post-digoxin-Fab heart rate.

Outcomes of standardised approach to metabolic bone disease of prematurity.

Aim: To assess the current protocol of metabolic bone disease (MBD) at three Monash Health neonatal units (Melbourne, Australia).

Methods: Retrospective audit of 171 infants born at <32 weeks' gestation over 18 months. Mean gestational age was 28.

Post-operative telephone review is safe and effective: prospective study - Monash outpatient review by phone trial.

Introduction: Studies have shown that post-operative telephone follow-up is satisfactory and effective. As high quality evidence is scant, we conducted a randomized controlled trial to compare it against outpatient clinic review for emergency laparoscopic appendicectomy or cholecystectomy.

Method: Patients who received emergency laparoscopic appendicectomy or cholecystectomy were eligible for this study.

Scaphoid Fracture Fixation in a Nonunion Model: A Biomechanical Study Comparing 3 Types of Fixation.

Purpose: Union of a scaphoid fracture after fixation is influenced by various factors, one of which is fracture stability. This study aims to compare the biomechanical stability of 3 different types of scaphoid fracture fixation in a scaphoid nonunion model.

Methods: Thirty cadaveric scaphoid specimens were assigned to one of 3 different fixation groups: (1) single 3.

An exploration of participants' experience of an intensive care nursing transition to specialty practice program.

Background: Transition to specialty practice programs were developed to support, educate and facilitate recruitment and retention of nurses in specialised areas of practice. The intensive care nursing transition to specialty practice program in this study was implemented in 2000. To date, in Australia there are no published studies which focus on intensive care nursing transition to specialty practice programs.