Awareness in the emergency department: A patient's story.

Theresa is a lady with brittle asthma. She presented to the Emergency Department (ED) with an asthma attack and was rapidly intubated and ventilated. From subsequent blood gas results, ventilator pressures and a chest X-ray it soon became clear that she did require ventilation to be continued. The ICU consultant requested she be ventilated until the relaxant wore off and she was subsequently extubated in the ED. Unfortunately she was fully aware for the time she was ventilated. This is her story.

Impact of the New Zealand 2011 Rugby World Cup on an urban emergency department.

AIMS: The next Rugby World Cup will take place in England commencing August 2015. This paper describes the preparation and workload relating to the previous Rugby World Cup, held in New Zealand 2011, as it affected the primary receiving hospital for the main venue. This paper describes preparation arrangements and actual workload patterns to assist planners with future similar events. METHODS: Preparations for the tournament were summarised, and data gathered from the Auckland City Hospital database were analysed for total and hourly presentation rates, short-stay observation workload, admission rate, 6-hour target compliance and type of presentation. RESULTS: Overall workload during the tournament increased by 8%, but much larger spikes in attendances per hour and short-stay workload related to the major events were experienced. Alcohol-related presentations were very much more prominent than usual. Pre-arranged additional staffing and flow arrangements allowed the department to maintain 6-hour target compliance. CONCLUSION: Major sporting events, such as the Rugby World Cup, require special arrangements to be put in place for the main local receiving Emergency Department, especially around the major events of a tournament.

Effects of backpack load and task demand on trunk forward lean: Pilot findings on two boys.

Trunk forward lean (TFL) has been identified as a postural adaptation to increases in backpack load, and spinal forces have been presumed based on TFL. This pilot project examined the combined effects of increasing backpack load and task demand on TFL. Two boys with typical development, aged 11 and 9, were participants. Peak5 Motion Analysis Videography was used to gather 2D kinematic data under three levels of backpack load (0%, 8.5% and 17% body weight) and three levels of task demand (stand, walk and run). Passive reflective markers were placed on anatomical landmarks, and TFL was calculated by the angle formed by a line joining the right acromion and right greater trochanter and a vertical reference line. Descriptive statistics were performed to compare TFL under the nine experimental conditions. Although TFL most often increased with increases in backpack load and task demand, TFL was not dose dependent. Postural patterns varied between participants, and the findings supported a ceiling effect. In conclusion, to compensate for changes in inertia and center of gravity when wearing a backpack, TFL represents a dynamic emergent strategy that varies based on task demand and characteristics of the individual. Further research on TFL is warranted, and clinicians should be cautious when recommending safe carrying loads for children based on posture.