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Emergency Medicine Australasia: EMA

Lucy Kennedy, Scott Wrigley, Marcus Kennedy, Vincent Pellegrino
OBJECTIVE: Audit of extracorporeal membrane oxygenation (ECMO) retrieval service operating in Victoria, Australia, regarding retrieval factors and patient survival to intensive care unit (ICU) discharge. METHODS: Retrospective cohort analysis of Adult Retrieval Victoria ECMO retrievals with subsequent ICU admission (n = 88) from January 2014 to December 2017. RESULTS: Complications occurring during veno-arterial ECMO transfer have significant association with decreased survival to ICU discharge (P = 0...
September 18, 2018: Emergency Medicine Australasia: EMA
Waruna de Alwis
The concept of freestanding EDs is a popular operational model of emergency care in the USA. This model has been described as an emergency physician-created innovative solution in resolving ongoing overcrowding issues in EDs. A decentralised community-based emergency care model may be a solution to meet the increasing demand for emergency and unscheduled acute care in Australia. It may also help to reduce the number of acute hospital admissions through EDs. The aim of freestanding EDs should be to manage and discharge a cohort of patients, mainly in Australasian Triage Scale 3 and 4 categories, currently seen in hospital-based EDs...
September 14, 2018: Emergency Medicine Australasia: EMA
Diana Egerton-Warburton, Fern McAllan, Radha Ramanan, Zheng Jie Lim, Daniel Nagle, Claire Dendle, Rhonda Stuart
OBJECTIVE: Our objective was to examine the impact of a human factor-designed multimodal intervention on the proportion of unused peripheral i.v. cannula (PIVC) insertion in our ED. METHODS: A pre- and post-multimodal intervention retrospective cohort study was conducted using a structured electronic medical record review within a single adult tertiary ED in Australia. Pre-intervention data was collected 30 days prior to the multimodal intervention, with 30 day post-intervention data collected 3 months after the intervention commenced...
September 12, 2018: Emergency Medicine Australasia: EMA
Alannah L Cooper, Yusuf Nagree, Adrian Goudie, Peter R Watson, Glenn Arendts
OBJECTIVE: To determine if an ultrasound-guided femoral nerve block (FNB) is superior to an ultrasound-guided fascia iliaca compartment block (FICB) in providing pain relief to patients with a neck of femur or proximal femoral fracture. METHODS: A double-blind randomised controlled trial was conducted. All participants received two blocks, one active and one placebo. An active FICB was administered to 52 participants and 48 participants received an active FNB. RESULTS: Analysis was completed on data collected from 100 participants...
September 9, 2018: Emergency Medicine Australasia: EMA
Shizar Nahidi, Roberto Forero, Sally McCarthy, Nicola Man, Nick Gibson, Mohammed Mohsin, David Mountain, Daniel Fatovich, Gerard Fitzgerald, Ghasem Sam Toloo
OBJECTIVE: The implementation of the time target policy (Four-Hour Rule/National Emergency Access Target [4HR/NEAT]) constituted a major change for ED, and potentially on quality of care. The present study aimed to understand perceptions and experiences of ED staff during 4HR/NEAT implementation. METHODS: A semi-structured interview was used to explore views and perceptions of 119 ED staff from 16 EDs in New South Wales, Australian Capital Territory, Queensland and Western Australia...
September 4, 2018: Emergency Medicine Australasia: EMA
Ian S deSouza
No abstract text is available yet for this article.
September 3, 2018: Emergency Medicine Australasia: EMA
Catherine M Lunter, Ellen L Carroll, Charlotte Housden, Joanne Outtrim, Faye Forsyth, Annie Rivera, Chris Maimaris, Adrian Boyle, Barbara J Sahakian, David K Menon, Virginia Fj Newcombe
OBJECTIVE: Despite mild traumatic brain injury (mTBI) accounting for 80% of head injury diagnoses, recognition of individuals at risk of cognitive dysfunction remains a challenge in the acute setting. The objective of this study was to evaluate the feasibility and potential role for computerised cognitive testing as part of a complete ED head injury assessment. METHODS: mTBI patients (n = 36) who incurred a head injury within 24 h of presentation to the ED were compared to trauma controls (n = 20) and healthy controls (n = 20) on tests assessing reaction time, speed and attention, episodic memory, working memory and executive functioning...
September 3, 2018: Emergency Medicine Australasia: EMA
Lisa Brichko, Viet Tran, Joanne Cobbett, Kimberly Humphrey
No abstract text is available yet for this article.
September 3, 2018: Emergency Medicine Australasia: EMA
Jonathan Moores, Gustodio A de Jesus
OBJECTIVE: Timor Leste has one of the highest maternal death rates in the world at 215 per 100 000 live births.1 Post-partum haemorrhage (PPH) accounts for 27% of maternal deaths globally. Annually the Timor Leste National Ambulance Service (TLNAS) attends over 20 000 cases, of which 2% are diagnosed with PPH. The objective of this study was to evaluate prehospital care of PPH patients transported by the TLNAS. METHODS: A retrospective audit of PPH patients transported between May 2015 and May 2017...
September 3, 2018: Emergency Medicine Australasia: EMA
Adam Douglas
No abstract text is available yet for this article.
September 2, 2018: Emergency Medicine Australasia: EMA
Jessica Roberts, Sara Watts, Sharon Klim, Peter Ritchie, Anne-Maree Kelly
OBJECTIVES: Whole body computed tomography (WBCT) scanning for trauma has gained popularity but its role in low-risk patients is controversial. We aimed to determine the rate of serious axial/truncal injury and emergency intervention in conscious, stable patients undergoing WBCT for blunt trauma in two non-trauma centre EDs in the Victorian trauma system. METHODS: Retrospective cohort study by medical record and radiology report review. Patients were included if they were conscious, haemodynamically stable adults presenting by ambulance and having WBCT scan...
September 2, 2018: Emergency Medicine Australasia: EMA
Gerard V Moynihan, Heike Koelzow
Venous thromboembolic disease (VTE) increases the risk of mortality in trauma patients. To decrease the occurrence of VTE, low dose anticoagulants are commonly prescribed. This may be unacceptable in trauma patients who have a high risk of bleeding. Inferior vena cava (IVC) filters can be employed as an alternative strategy to decrease the risk of pulmonary embolism (PE). Insertion of an IVC filter is an invasive procedure that has a range of complications. The benefits of IVC filter insertion must be compared to its risk of complications in each individual patient...
August 31, 2018: Emergency Medicine Australasia: EMA
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Neck pain and whiplash injuries are a common presentation to the ED, and a frequent cause of disability globally. This rapid review investigated best practice for the assessment and management of musculoskeletal neck pain in the ED. PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2017. Primary studies, systematic reviews and guidelines were considered for inclusion. English-language articles published in the past 12 years addressing acute neck pain assessment, management or prognosis in the ED were included...
August 30, 2018: Emergency Medicine Australasia: EMA
Barry Gunn, Simon Chu
No abstract text is available yet for this article.
August 28, 2018: Emergency Medicine Australasia: EMA
Shizar Nahidi, Roberto Forero, Nicola Man, Mohammed Mohsin, Gerard Fitzgerald, Ghasem Sam Toloo, Sally McCarthy, Nick Gibson, Daniel Fatovich, David Mountain
OBJECTIVE: It has been 10 years since the ACEM Access Block Solutions Summit and 5 years since the introduction of the Four-Hour Rule/National Emergency Access Target (4HR/NEAT) policy. The impact of this policy on ED management and on ED staff has been poorly understood. The aim of the present study was to identify changes in ED management resulting from the policy based on ED staff experiences. METHODS: Semi-structured interviews were conducted and transcribed, imported to NVivo 11 and analysed using a combination of content, thematic analysis and phenomenological focus within a theoretical framework known as the 'logic model'...
August 26, 2018: Emergency Medicine Australasia: EMA
Timothy Edwards, Julia Williams, Michaela Cottee
No abstract text is available yet for this article.
August 24, 2018: Emergency Medicine Australasia: EMA
Kate Kloot, Timothy R Baker
OBJECTIVES: A small amount of data from rural emergency facilities is collated with large urban datasets, but there are no dedicated rural emergency datasets. METHODS: A network of 10 rural hospitals provided ongoing detailed emergency presentation data. RESULTS: Of 59 044 emergency presentations, 25 237 patients were managed entirely at the small local hospital, including 586 triage category 2 cardiac patients, 5663 paediatric patients and 310 mental health clients...
August 21, 2018: Emergency Medicine Australasia: EMA
Maria Yk Chow, Slaven Nikolic, Amith Shetty, Kevin Lai
OBJECTIVES: To compare patient satisfaction levels, staff perspectives and the time required using Structured Interdisciplinary Bedside Rounds (SIBR; Emory University, Atlanta, GA, USA) versus traditional medical ward rounds (TR) in the ED. METHODS: We conducted an observational cross-sectional study. Ward rounds were categorised into a modified SIBR and TR at a tertiary ED in Australia according to predefined criteria. We compared the duration of ward rounds, invited patients and staff to complete anonymous questionnaires to compare patient satisfaction and staff perspectives...
August 20, 2018: Emergency Medicine Australasia: EMA
Nigel J Raymond, Mai Nguyen, Sandra Allmark, Lisa Woods, Brad Peckler
OBJECTIVE: Use of the Sequential Organ Failure Assessment (SOFA) score has been proposed by the Third International Consensus Definitions for Sepsis and Septic Shock. The utility in the ED is not yet well established. We retrospectively studied the application of a modified SOFA (mSOFA) score, to assess its ability to predict mortality. METHODS: At our urban tertiary teaching hospital staff recorded patients with probable sepsis in the ED Information System (EDIS)...
August 20, 2018: Emergency Medicine Australasia: EMA
Nadav Harel, Jeremy T Moskovitch, Tracey J Weiland, Michael R Augello
Prisoners are a particularly vulnerable minority group whose healthcare needs and management differ substantially from the general population. The overall burden of disease of prisoners is well documented; however, little is known regarding the aetiology and frequency of prisoners' acute medical complaints requiring an ED visit. Objectives of the review were to identify, review and appraise existing literature regarding prisoners' presentations to EDs. We performed systematic electronic searches in MEDLINE, EMBASE, PsycINFO, PubMed, Cochrane, and Web of Science using MeSH terms and keywords...
August 17, 2018: Emergency Medicine Australasia: EMA
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