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Emergency Medicine Australasia: EMA

Thomas Woodward, Julia Hocking, Lucy James, David Johnson
OBJECTIVE: ED access block is an ongoing significant problem and has been associated with excess mortality. Multiple models of care have been studied in an effort to improve access block and other key performance indicators (KPIs) of ED. METHODS: This present study describes the impact of a new model of care using an ED led, consultant run clinical decision unit (CDU) on performance, using a retrospective analysis of data for 9 month periods before and after the introduction of the CDU model of care...
July 16, 2018: Emergency Medicine Australasia: EMA
Amanda McConnell, Robert Bonnin, Wyn Bellis
No abstract text is available yet for this article.
July 16, 2018: Emergency Medicine Australasia: EMA
Jonathon Stewart, Peter Sprivulis, Girish Dwivedi
Interest in artificial intelligence (AI) research has grown rapidly over the past few years, in part thanks to the numerous successes of modern machine learning techniques such as deep learning, the availability of large datasets and improvements in computing power. AI is proving to be increasingly applicable to healthcare and there is a growing list of tasks where algorithms have matched or surpassed physician performance. Despite the successes there remain significant concerns and challenges surrounding algorithm opacity, trust and patient data security...
July 16, 2018: Emergency Medicine Australasia: EMA
Jolene Cj Lim, Cerissa Papanastasiou, Katie Moore
OBJECTIVE: Within the complex and dynamic emergency medicine workforce setting, the Australasian College for Emergency Medicine (ACEM) New Fellows (FACEMs) Early Career Survey was established in 2014 to capture information on the work profiles, future career plans and challenges experienced among new FACEMs. METHODS: The voluntary online survey is distributed twice yearly to new FACEMs who gained their Fellowship the preceding 6-12 months. Eligible new FACEMs were contacted by email and invited to participate...
July 15, 2018: Emergency Medicine Australasia: EMA
Paul Buntine, Francis Thien, John Stewart, Yee Ping Woo, Martin Koolstra, Lindsay Bridgford, Mineesh Datta, Stella M Gwini
OBJECTIVE: To assess the association between the use of a flowchart incorporating Wells score, PERC rule and age-adjusted D-dimer and subsequent imaging and yield rates of computed tomography pulmonary angiogram and nuclear medicine ventilation perfusion scans being ordered in the ED for the assessment of pulmonary embolism. METHODS: A flowchart governing ED pulmonary embolism investigation was introduced across three EDs in Melbourne, Australia for a 12 month period...
July 15, 2018: Emergency Medicine Australasia: EMA
Rob Eley, Kirsten Vallmuur, Jesani Catchpoole
OBJECTIVE: To characterise patients presenting to EDs for a bicycle-related injury, identify contributing factors to the injuries and describe the data gaps. METHODS: A retrospective study of bicycle-related injury presentations over the 5 year period 2010-2014 to two major metropolitan EDs. Data collected from the emergency presentation database consisted of patient demographics, presenting complaint, discharge diagnosis and details about the circumstances and mechanism of the accident...
July 15, 2018: Emergency Medicine Australasia: EMA
Bui Hai Hoang, Xuan Dung Dao, Shinji Nakahara, Tetsuya Sakamoto
Out-of-hospital cardiac arrest patients require immediate interventions by bystanders and emergency medical services (EMS). However, in many low- and middle-income countries (LMIC), bystanders witnessing a cardiac arrest rarely perform chest compressions and contact EMS. This paper attempts to draw lessons from a case of a patient with a cardiac arrest who could have survived with immediate interventions. A 40 year old man collapsed following electrocution at a construction site. His colleagues immediately transferred him to hospital via taxi, without performing chest compressions...
July 15, 2018: Emergency Medicine Australasia: EMA
Hannah Green
No abstract text is available yet for this article.
July 12, 2018: Emergency Medicine Australasia: EMA
Julia Crilly, Amy Sweeny, John O'Dwyer, Brent Richards, David Green, Andrea P Marshall
OBJECTIVE: Timely and appropriate assessment and management within the ED impacts patient outcomes including in-hospital mortality and length of stay (LOS). Within the ED, several processes facilitate timely recognition of the need for intensive care unit (ICU) admission. This study describes characteristics and outcomes for patient presentations admitted to ICU from ED, categorised by Australasian Triage Score (ATS), ICU admission time and ICU admission source. METHODS: A retrospective observational cohort study with linked health data of adult ICU admissions during 2012...
July 11, 2018: Emergency Medicine Australasia: EMA
Ajith Thampi, Jessica Forbes, Kimberly Humphrey
No abstract text is available yet for this article.
July 10, 2018: Emergency Medicine Australasia: EMA
Kimberly Humphrey, Lisa Brichko
No abstract text is available yet for this article.
July 8, 2018: Emergency Medicine Australasia: EMA
Gerben Keijzers, Daniel M Fatovich, Diana Egerton-Warburton, Louise Cullen, Ian A Scott, Paul Glasziou, Pat Croskerry
Deliberate clinical inertia is the art of doing nothing as a positive response. To be able to apply this concept, individual clinicians need to specifically focus on their clinical decision-making. The skill of solving problems and making optimal clinical decisions requires more attention in medical training and should play a more prominent part of the medical curriculum. This paper provides suggestions on how this may be achieved. Strategies to mitigate common biases are outlined, with an emphasis on reversing a 'more is better' culture towards more temperate, critical thinking...
July 2, 2018: Emergency Medicine Australasia: EMA
Kerina J Denny, Amy Sweeny, Julia Crilly, Samuel Maloney, Gerben Keijzers
OBJECTIVE: To describe how frequently blood cultures (BCs) are obtained in the ED and to describe the incidence of true- and false-positive BC results. METHODS: Retrospective descriptive study of all patients presenting to a tertiary-level, mixed Australian ED over a 15 month period. RESULTS: A total of 3617 (3.67%) patients had BCs collected. Around one (12.1%) in eight of these BCs were positive; nearly half (45.2%) of which were identified as a false positive...
July 1, 2018: Emergency Medicine Australasia: EMA
Anthony Bell
No abstract text is available yet for this article.
July 1, 2018: Emergency Medicine Australasia: EMA
Maura Kennedy, Kathleen Tp Davenport, Shan Woo Liu, Glenn Arendts
No abstract text is available yet for this article.
June 21, 2018: Emergency Medicine Australasia: EMA
John Moloney
A number of new time critical medical interventions are highly specialised. As such, they are not available in many hospitals and EDs. This necessitates transfer to another facility, which is often associated with some degree of delay. Processes to facilitate timely access to these interventions should aim to replicate or improve on that which would have been available should the patient have been in the community, and responded to, primarily, by an emergency medical service.
June 12, 2018: Emergency Medicine Australasia: EMA
Ian Ferguson, Hatem Alkhouri, Toby Fogg, Anders Aneman
OBJECTIVE: This study aimed to quantify the proportion of patients undergoing rapid sequence intubation using ketamine in Australian and New Zealand EDs between 2010 and 2015. METHODS: The Australian and New Zealand Emergency Department Airway Registry is a multicentre airway registry prospectively capturing data from 43 sites. Data on demographics and physiology, the attending staff and indication for intubation were recorded. The primary outcome was the annual percentage of patients intubated with ketamine...
June 11, 2018: Emergency Medicine Australasia: EMA
Matthew W Trinder, Samuel W Wellman, Sana Nasim, Dieter G Weber
OBJECTIVES: To assess the rate of undertriage of major trauma patients and to assess factors contributing to undertriage in a modern Australian Level 1 trauma centre. METHODS: A retrospective case series of 600 consecutive major trauma (injury severity score [ISS] >15) patients admitted to Royal Perth Hospital (RPH) during 2015 was performed. Data were compiled via the prospectively maintained hospital trauma registry for all patients admitted with a major trauma during the study period...
June 11, 2018: Emergency Medicine Australasia: EMA
Anne-Maree Kelly
No abstract text is available yet for this article.
June 9, 2018: Emergency Medicine Australasia: EMA
Catherine Brock, Yuan Yi, Timothy Papaluca, Benjamin Lucas, Peter W Angus, David Taylor, Christopher Leung
OBJECTIVE: To explore the feasibility of an ED chronic hepatitis B (CHB) screening programme. METHODS: Adult patients born in intermediate-high CHB prevalent regions completed a pre-screening questionnaire and were offered CHB testing. ED staff were surveyed to gauge potential barriers to the programme. RESULTS: Eighty patients demonstrated limited knowledge of hepatitis B virus transmission and perceived many barriers to screening. Among 65 tested for CHB, no new cases were detected but 36 (55...
June 9, 2018: Emergency Medicine Australasia: EMA
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