Although the present study has limitations, it appears to show that CRP has limited diagnostic utility for the detection of bacteraemia in ED patients.

A higher rate of EDOU management failure in SSTIs than the generally accepted rate of 15% was observed in most studies identified by this review. Risk factors identified were varied, but presence of a fever and elevated inflammatory markers were commonly associated with failure of EDOU admission by multiple studies. Recognition of risk factors and the increased application of clinical decision tools may help to improve disposition of patients at high risk for clinical deterioration or management failure.

Patients with supraventricular tachycardia (SVT) commonly present to the emergency department (ED). Current guidelines [1,2] do not recommend routine pathology testing and a report on the topic has questioned their role. A systematic review concluded that troponin testing is commonly performed with a high proportion of positive fi ndings, but these results were not associated with major adverse cardiac events. [3] The conclusions of this review were limited by paucity of data and heterogeneity among studies. Unnecessary and/or inappropriate investigations in the ED have been associated with adverse effects. False-positive results or incidental findings may lead to unnecessary investigation, at the risk of the true pathology being ignored. It is also important with respect to utilisation of resources, particularly in Australia where costs to the health care system are substantially borne by the taxpayer. [4] Evidence-based implementation of protocols for investigations, education program for medical staff and audit/feedback processes have been previously associated with safe and efficient diagnostic practices. [5] Among patients presenting to the ED with SVT, we aimed to describe adjunct investigations and assess whether the results of such investigations influenced management in the ED.

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