Background Gaps in the treatment of patients with acute asthma have been repeatedly described in Australia. We conducted a retrospective audit of acute asthma care at a Victorian tertiary institution. Aims To describe acute asthma care at a large health network in metropolitan Melbourne, and evaluate the extent to which Emergency Department (ED) care was consistent with National Asthma Council guidelines. Methods A retrospective audit was performed of medical records between July 2017 and June 2019. We included adult patients admitted to campuses within the Western Health network in Melbourne, Victoria, where the length of stay was at least 12 h, and the primary discharge diagnosis was asthma. Results Four hundred and ninety-three admissions were included in the analysis, representing 392 individual patients. Seventy-one percent of patients were female and 27% were current smokers. Ninety-six percent of patients had a prior asthma diagnosis, 63% had a previous hospital presentation and 75% were prescribed an inhaled preventer. In the ED, systemic corticosteroids and inhaled salbutamol were prescribed in 65% and 82% admissions respectively; adjunctive treatments included ipratropium (67% of admissions), magnesium sulfate (30%), adrenaline (11%) and non-invasive ventilation (9%). Overall, ED care was guideline concordant in 59% of admissions. On the wards, treatments prescribed within 24 h of admission included corticosteroids (90% of admissions), salbutamol (84%), ipratropium (64%) and inhaled preventers (63%). The proportion of patients prescribed these treatments, as well as documented follow up (e.g. asthma action plans), varied significantly depending on the treating specialty. Conclusion The emergency treatment of patients with acute asthma frequently deviated from guidelines and there was significant variation in inpatient treatment. Quality improvement initiatives that incorporate structural changes are required to improve asthma care.
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[1]
[Anonymous], W HLTH ANN REPORT 20
[2]
Australian Institute of Health and Welfare, ASTHM
机构:
Harvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USAHarvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
Camargo, Carlos A., Jr.
Rachelefsky, Gary
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Univ Calif Los Angeles, David Geffen Sch Med, Execut Care Ctr Asthma Allergy & Resp Dis, Los Angeles, CA 90095 USAHarvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
Rachelefsky, Gary
Schatz, Michael
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h-index: 0
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Kaiser Permanente Med Ctr, Dept Allergy, San Diego, CA USAHarvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
机构:
Monash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Monash Univ, Sch Clin Sci, Monash Hlth, Melbourne, Vic, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Craig, Simon
Kuan, Win Sen
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h-index: 0
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Natl Univ Hlth Syst, Emergency Med Dept, Singapore, Singapore
Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Singapore, SingaporeMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Kuan, Win Sen
Kelly, Anne-Maree
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h-index: 0
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Western Hlth, Joseph Epstein Ctr Emergency Med Res, Melbourne, Vic, Australia
Univ Melbourne, Melbourne Med Sch Western Precinct, Dept Med, Melbourne, Vic, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Kelly, Anne-Maree
Van Meer, Oene
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h-index: 0
机构:
Leiden Univ, Med Ctr, Leiden, NetherlandsMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Van Meer, Oene
Motiejunaite, Justina
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h-index: 0
机构:
BIOmarkers CArdioNeuroVASc Dis, U942, INSERM, Paris, France
St Louis Lariboisiere Hosp, AP HP, Dept Anesthesiol & Crit Care, Paris, France
Lithuanian Univ Hlth Sci, Dept Cardiol, Kaunas Clin, Kaunas, LithuaniaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Motiejunaite, Justina
Keijzers, Gerben
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h-index: 0
机构:
Gold Coast Univ Hosp, Dept Emergency Med, Brisbane, Qld, Australia
Bond Univ, Fac Hlth Sci & Med, Brisbane, Qld, Australia
Griffith Univ, Sch Med, Brisbane, Qld, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Keijzers, Gerben
Jones, Peter
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h-index: 0
机构:
Auckland City Hosp, Emergency Dept, Auckland, New Zealand
Univ Auckland, Dept Surg, Auckland, New ZealandMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Jones, Peter
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Body, Richard
Karamercan, Mehmet A.
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h-index: 0
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Gazi Univ, Fac Med, Emergency Med Dept, Ankara, Turkey
Istanbul Bagcilar Training & Res Hosp, Dept Emergency Med, Istanbul, TurkeyMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Karamercan, Mehmet A.
Klim, Sharon
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h-index: 0
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Klim, Sharon
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Harjola, Veli-Pekka
Verschuren, Franck
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Catholic Univ Louvain, Dept Acute Med, Clin Univ St Luc, Brussels, BelgiumMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Verschuren, Franck
Holdgate, Anna
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h-index: 0
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Liverpool Hosp, Dept Emergency Med, Sydney, NSW, Australia
Univ New South Wales, Southwest Clin Sch, Sydney, NSW, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Holdgate, Anna
Christ, Michael
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h-index: 0
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Luzerner Kantonsspital, Emergency Dept, Luzern, SwitzerlandMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Christ, Michael
Golea, Adela
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h-index: 0
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Univ Med & Pharm, Cty Emergency Hosp Cluj Napoca, Emergency Med, Cluj Napoca, RomaniaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Golea, Adela
Graham, Colin A.
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Chinese Univ Hong Kong, Emergency Med, Hong Kong, Peoples R ChinaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
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Capsec, Jean
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Tours Univ Hosp, Publ Hlth Dept, Tours, FranceMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
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Barletta, Cinzia
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h-index: 0
机构:
Santa Eugenio Hosp, Dept Emergency Med, Rome, ItalyMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Barletta, Cinzia
Garcia-Castrillo, Luis
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h-index: 0
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Serv Urgencias Hosp Marques Valdecilla, Santander, SpainMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Garcia-Castrillo, Luis
Laribi, Said
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h-index: 0
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Tours Univ, Sch Med, INSERM, U1100, Tours, France
Tours Univ Hosp, Emergency Med Dept, Tours, FranceMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
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Univ Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, WalesUniv Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
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Symonds, Pearl
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Univ Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, WalesUniv Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
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Mankragod, R. H.
Morris, Keith
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h-index: 0
机构:
Univ Wales Coll Cardiff, Inst Llandaff, Cardiff, WalesUniv Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
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Obama Municipal Hosp, Dept Emergency Med, Obama, Fukui, JapanHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Chiba, Takuyo
Hagiwara, Yusuke
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Tokyo Metropolitan Childrens Med Ctr, Dept Pediat Emergency & Crit Care Med, Fuchu, Tokyo, JapanHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Hagiwara, Yusuke
Watase, Hiroko
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Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USAHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Watase, Hiroko
Tsugawa, Yusuke
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h-index: 0
机构:
Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA
St Lukes Life Sci Inst, Ctr Clin Epidemiol, Tokyo, JapanHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Tsugawa, Yusuke
Brown, David F. M.
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h-index: 0
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Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USAHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Brown, David F. M.
Camargo, Carlos A., Jr.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USAHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
机构:
Harvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USAHarvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
Camargo, Carlos A., Jr.
Rachelefsky, Gary
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Execut Care Ctr Asthma Allergy & Resp Dis, Los Angeles, CA 90095 USAHarvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
Rachelefsky, Gary
Schatz, Michael
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Med Ctr, Dept Allergy, San Diego, CA USAHarvard Univ, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
机构:
Monash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Monash Univ, Sch Clin Sci, Monash Hlth, Melbourne, Vic, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Craig, Simon
Kuan, Win Sen
论文数: 0引用数: 0
h-index: 0
机构:
Natl Univ Hlth Syst, Emergency Med Dept, Singapore, Singapore
Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Singapore, SingaporeMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Kuan, Win Sen
Kelly, Anne-Maree
论文数: 0引用数: 0
h-index: 0
机构:
Western Hlth, Joseph Epstein Ctr Emergency Med Res, Melbourne, Vic, Australia
Univ Melbourne, Melbourne Med Sch Western Precinct, Dept Med, Melbourne, Vic, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Kelly, Anne-Maree
Van Meer, Oene
论文数: 0引用数: 0
h-index: 0
机构:
Leiden Univ, Med Ctr, Leiden, NetherlandsMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Van Meer, Oene
Motiejunaite, Justina
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h-index: 0
机构:
BIOmarkers CArdioNeuroVASc Dis, U942, INSERM, Paris, France
St Louis Lariboisiere Hosp, AP HP, Dept Anesthesiol & Crit Care, Paris, France
Lithuanian Univ Hlth Sci, Dept Cardiol, Kaunas Clin, Kaunas, LithuaniaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Motiejunaite, Justina
Keijzers, Gerben
论文数: 0引用数: 0
h-index: 0
机构:
Gold Coast Univ Hosp, Dept Emergency Med, Brisbane, Qld, Australia
Bond Univ, Fac Hlth Sci & Med, Brisbane, Qld, Australia
Griffith Univ, Sch Med, Brisbane, Qld, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Keijzers, Gerben
Jones, Peter
论文数: 0引用数: 0
h-index: 0
机构:
Auckland City Hosp, Emergency Dept, Auckland, New Zealand
Univ Auckland, Dept Surg, Auckland, New ZealandMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Jones, Peter
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Body, Richard
Karamercan, Mehmet A.
论文数: 0引用数: 0
h-index: 0
机构:
Gazi Univ, Fac Med, Emergency Med Dept, Ankara, Turkey
Istanbul Bagcilar Training & Res Hosp, Dept Emergency Med, Istanbul, TurkeyMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Karamercan, Mehmet A.
Klim, Sharon
论文数: 0引用数: 0
h-index: 0
机构:
Western Hlth, Joseph Epstein Ctr Emergency Med Res, Melbourne, Vic, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Klim, Sharon
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机构:
Harjola, Veli-Pekka
Verschuren, Franck
论文数: 0引用数: 0
h-index: 0
机构:
Catholic Univ Louvain, Dept Acute Med, Clin Univ St Luc, Brussels, BelgiumMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Verschuren, Franck
Holdgate, Anna
论文数: 0引用数: 0
h-index: 0
机构:
Liverpool Hosp, Dept Emergency Med, Sydney, NSW, Australia
Univ New South Wales, Southwest Clin Sch, Sydney, NSW, AustraliaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Holdgate, Anna
Christ, Michael
论文数: 0引用数: 0
h-index: 0
机构:
Luzerner Kantonsspital, Emergency Dept, Luzern, SwitzerlandMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Christ, Michael
Golea, Adela
论文数: 0引用数: 0
h-index: 0
机构:
Univ Med & Pharm, Cty Emergency Hosp Cluj Napoca, Emergency Med, Cluj Napoca, RomaniaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Golea, Adela
Graham, Colin A.
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Univ Hong Kong, Emergency Med, Hong Kong, Peoples R ChinaMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Graham, Colin A.
Capsec, Jean
论文数: 0引用数: 0
h-index: 0
机构:
Tours Univ Hosp, Publ Hlth Dept, Tours, FranceMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Capsec, Jean
Barletta, Cinzia
论文数: 0引用数: 0
h-index: 0
机构:
Santa Eugenio Hosp, Dept Emergency Med, Rome, ItalyMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Barletta, Cinzia
Garcia-Castrillo, Luis
论文数: 0引用数: 0
h-index: 0
机构:
Serv Urgencias Hosp Marques Valdecilla, Santander, SpainMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
Garcia-Castrillo, Luis
Laribi, Said
论文数: 0引用数: 0
h-index: 0
机构:
Tours Univ, Sch Med, INSERM, U1100, Tours, France
Tours Univ Hosp, Emergency Med Dept, Tours, FranceMonash Med Ctr, Emergency Dept, Melbourne, Vic, Australia
机构:
Univ Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, WalesUniv Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
Davies, Brian H.
Symonds, Pearl
论文数: 0引用数: 0
h-index: 0
机构:
Univ Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, WalesUniv Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
Symonds, Pearl
Mankragod, R. H.
论文数: 0引用数: 0
h-index: 0
机构:Univ Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
Mankragod, R. H.
Morris, Keith
论文数: 0引用数: 0
h-index: 0
机构:
Univ Wales Coll Cardiff, Inst Llandaff, Cardiff, WalesUniv Hosp Llandough, Wales Asthma Allergy & Immunol Res Unit, Penarth CF64 2XX, Vale Glamorgan, Wales
机构:
Obama Municipal Hosp, Dept Emergency Med, Obama, Fukui, JapanHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Chiba, Takuyo
Hagiwara, Yusuke
论文数: 0引用数: 0
h-index: 0
机构:
Tokyo Metropolitan Childrens Med Ctr, Dept Pediat Emergency & Crit Care Med, Fuchu, Tokyo, JapanHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Hagiwara, Yusuke
Watase, Hiroko
论文数: 0引用数: 0
h-index: 0
机构:
Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USAHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Watase, Hiroko
Tsugawa, Yusuke
论文数: 0引用数: 0
h-index: 0
机构:
Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA
St Lukes Life Sci Inst, Ctr Clin Epidemiol, Tokyo, JapanHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Tsugawa, Yusuke
Brown, David F. M.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USAHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA
Brown, David F. M.
Camargo, Carlos A., Jr.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USAHarvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Emergency Med, 326 Cambridge St,Ste 410, Boston, MA 02114 USA