brought to you by Oz E Medicine Journal Club

see also EMA index

see also Volume 20, Number 3, June 2008

• hypertonic saline is recommended as an alternative to mannitol in Rx of raised intracranial pressure in traumatic brain injury.
• it is also recommended for Rx of severe and symptomatic hyponatraemia & is worth considering for both recalcitrant tricyclic antidepressant toxicity and for cerebral odema complicating paediatric DKA.
• it is NOT recommended for hypovolaemic resuscitation.

• review of literature but unable to draw firm conclusions but there are suggestive patterns of behaviour.
• ideally requires cross-sectoral data mapping (comparing attendance data at regional EDs) to truly detect re-attendance and admission rates.

• NZ-based study
• 1.1% (ie. 8 patients) of the 754 patients who attended ED with deliberate self-harm went on to commit suicide within 12 months of discharge
• 18% re-attended with 12 months of index presentation.