John van Bockxmeer @jvbockxmeer
Emergency doctor inspiring healthy communities. Primary health leader. Founder of Fair Game Charity. Safety, quality & innovation. Port Hedland Aus & Vancouver fairgame.org.au South Hedland, Australia Joined September 2012-
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We studied acute migraine prescribing in our rural hospital cf urban research. Opioid & imaging rates were lower (-19.4+-5.9%), similar NSAIDs/IV hydration. Contextual differences impact prescribing patterns. Training/medications/investigations/wait times pubmed.ncbi.nlm.nih.gov/40170326/
Children with non-accidental ED injuries have increased risk of future death. Our study triangulates data from 1,469 px to confirm if injury, poisoning or burns were true physical abuse. Screening lowered hospitalisations, improved safety & documentation. onlinelibrary.wiley.com/doi/10.1111/17…
Children with non-accidental ED injuries have increased risk of future death. Our study triangulates data from 1,469 px to confirm if injury, poisoning or burns were true physical abuse. Screening lowered hospitalisations, improved safety & documentation. onlinelibrary.wiley.com/doi/10.1111/17… https://t.co/SZjhXwF81I
Screening for paediatric #PhysicalAbuse #OpenAccess doi.org/10.1111/1742-6… @jvbockxmeer @Makate_HealthEc @WileyHealth @acemonline
Lots of what we learnt about mastitis management has changed. Heat, pumping & massage are out, antibiotics equivocal. Updated @aafp guidelines emphasise ice, hydration, nsaids, feeding technique, behavioural interventions to minimise breast pumps. pubmed.ncbi.nlm.nih.gov/39172675/
Low acuity paediatric ed presentations can strain resources. 2 yr study of 6881 infants shows factors associated & parental perceptions of child vulnerability. We should reduce barriers to community care Mon-Tues 10am-2pm as 82% present on weekdays & 70% during office hours.
How many opioid tablets do patients utilise upon discharge from the ED? Study of 2240 patients with acute pain condition consumed median of 5 tabs of 5 mg MEq during 2 subsequent weeks. 8 tabs for renal colic/abdo pain, 24 tabs for fractures.2/3rds unused cmaj.ca/content/196/25…
On evening shifts we should prioritise geriatric patient admissions. Study of adults> 75yrs in French EDs higher in-hospital mortality, longer admission & more adverse events in ED overnight v ward tf before midnight. jamanetwork.com/journals/jamai…
Our new paper in @CMAJ highlights five things to know about exercise as a treatment for depression. cmaj.ca/content/196/17…
Dry eye update! Drs should advise use of OTC artificial tears > 6x a day as exposure to preservatives can cause toxic conjunctivitis and make things worse! Ointment at bed is best, increases contact time. Assess for evaporative v tear deficiency subtypes jamanetwork.com/journals/jama/…
UK study demonstrates non-antibiotic preventative treatment for recurrent UTI not inferior to guideline daily low dose prophylaxis. Abx group had higher resistance. These meds work by being metabolised to bactericidal formaldehyde in distal renal tubules. bmj.com/content/376/bm…
Happy to read this NZ retrospective study of 347 subarachnoid haemorrhages suggesting possible extension of CT timing to to 24hr from headache. Rule out aneurysmal SAH, sensitivity 100%. @sineadtaylor emj.bmj.com/content/39/11/…
Heartbreaking news
What are the cancer risks of CT scans in children? Taiwanese study from @CMAJ of 7807 cases of tumour, leukaemia, lymphoma matched with controls concludes exposure to a single CT scan was not associated with increased risk. 4 or more = significant risk. cmaj.ca/content/195/16…
NEW: we need to talk about NHS staff retention. At a time when Britain’s healthcare system is acutely short of workers, *1 in 7* UK-trained doctors are practising overseas. No other developed country is like this, which immediately tells you there’s a problem. Let’s dig deeper:
Spot on.. 'significantly increasing medium density housing and existing suburbs that are well served by public infrastructure'. Need to make sure infrastructure sheet public services in these areas are maintained and developed in line with population growth.
Spot on.. 'significantly increasing medium density housing and existing suburbs that are well served by public infrastructure'. Need to make sure infrastructure sheet public services in these areas are maintained and developed in line with population growth.
Great @rrh_journal opinion piece by Dr John Floridis on the importance of staff debriefs after critical events in #rural hospitals. Simulation & technology useful, integrate into our training and university curricula. @ACRRM rrh.org.au/journal/articl…
NEW: housing shortages, affordability crises and NIMBYism are growing problems in many countries, but what’s especially striking is how much worse they all are in Anglophone countries 🇬🇧🇺🇸🇦🇺🇳🇿🇨🇦🇮🇪 What’s going on? My column -> enterprise-sharing.ft.com/redeem/1a2c0ab…
For the pharmacology lovers.. our take on ceiling doses to avoid harm prescribing #ketorolac, ibuprofen & naproxen for acute pain. Published today as part of the @UBCmedicine 'This Changed My Practice' series. #FOAMed thischangedmypractice.com/ceiling-doses-…
Alumni Brag! Congrats to alum @jvbockxmeer on his co-authored publication "Advance care planning for pregnant patients" in @theMJA! onlinelibrary.wiley.com/doi/full/10.56…
Dr Marian Dover @DoverMarian
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