Fractures of the facial skeleton are a common reason for patients to present to EDs and general medical practice in Australia. Trauma to the maxillofacial region can lead to airway obstruction, intracranial injuries, loss of vision or long term cosmetic and functional deficits. This article focuses on the emergency assessment, triage and non-specialist management of traumatic injuries of the orbit and facial skeleton.
A prospective, randomised, placebo controlled, double blinded trial to assess the efficacy of intravenous magnesium sulphate (20mmol over 30 minutes) versus placebo in patients presenting to the emergency department with rapid atrial fibrillation and flutter. The end points were slowing of the ventricular rate and reversion to sinus rhythm. A total of 41 patients were enrolled. The mean decrease in heart rate 30 minutes after commencing the infusion was 24.1/min for the magnesium group compared to 11.0/min for the placebo group (different at the 95% level of significance). The mean decrease in heart rate and the reversion rate four hours after commencing the infusion were the same at the 95% level of significance for the two groups. We conclude that magnesium has a significant effect in the acute slowing of ventricular rate but no effect in achieving reversion to sinus rhythm.
Oral pain and odontogenic infections are common reasons for patients to present to EDs and general medical practice in Australia. Although most odontogenic infections can be managed on an outpatient basis, because of their proximity to the airway, infections in this region can be life threatening, requiring urgent surgical intervention and ICU management. This article focuses on the emergency assessment, triage and nonspecialist management of oral pain and odontogenic infections.
The use of ocean colour classification algorithms, linked to water quality gradients, can be a useful tool for mapping river plumes in both tropical and temperate systems. This approach has been applied in operational water quality programs in the Great Barrier Reef to map river plumes and assess trends in marine water composition and ecosystem health during flood periods. In this study, we used the Forel–Ule colour classification algorithm for Sentinel-3 OLCI imagery in an automated process to map monthly, annual and long-term plume movement in the temperate coastal system of Liverpool Bay (UK). We compared monthly river plume extent to the river flow and in situ water quality data between 2017–2020. The results showed a strong positive correlation (Spearman’s rho = 0.68) between the river plume extent and the river flow and a strong link between the FUI defined waterbodies and nutrients, SPM, turbidity and salinity, hence the potential of the Forel–Ule index to act as a proxy for water quality in the temperate Liverpool Bay water. The paper discusses how the Forel–Ule index could be used in operational water quality programs to better understand river plumes and the land-based inputs to the coastal zones in UK waters, drawing parallels with methods that have been developed in the GBR and Citclops project. Overall, this paper provides the first insight into the systematic long-term river plume mapping in UK coastal waters using a fast, cost-effective, and reproducible workflow. The study created a novel water assessment typology based on the common physical, chemical and biological ocean colour properties captured in the Forel–Ule index, which could replace the more traditional eutrophication assessment regions centred around strict geographic and political boundaries. Additionally, the Forel–Ule assessment typology is particularly important since it identifies areas of the greatest impact from the land-based loads into the marine environment, and thus potential risks to vulnerable ecosystems.
Dentoalveolar trauma and dislocations of the temporomandibular joint are common reasons for patients to present to EDs in Australia. The majority of medical practitioners receive very little formal training in the management of these injuries and might not have ready access to dental services out of hours for advice. This article focuses on the emergency assessment, triage and non-specialist management of dentoalveolar trauma and injuries to the temporomandibular joint.
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