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Emergency Medicine Australasia: EMA

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https://www.readbyqxmd.com/read/28419793/impact-of-emergency-department-discharge-stream-short-stay-unit-performance-and-hospital-bed-occupancy-rates-on-access-and-patient-flowmeasures-a-single-site-study
#1
Amith L Shetty, Caleb Teh, Matthew Vukasovic, Shannon Joyce, Milan R Vaghasiya, Roberto Forero
OBJECTIVE: The ED discharge stream short stay units (EDSSUs) aim to facilitate patient flows through EDs. We investigate the relationship between EDSSU census and hospital bed occupancy rates (BORs) on National Emergency Access Target (NEAT) performance and did-not-wait (DNW) rates at a tertiary metropolitan adult ED in Sydney, Australia. METHODS: We collated data for all ED presentations between 1 January 2012 and 31 December 2014. Daily ED, EDSSU census and ED-accessible hospital BORs were tabulated with daily ED NEAT performance and DNW rates...
April 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28419735/hospital-use-in-aboriginal-and-non-aboriginal-patients-with-chronic-disease
#2
David Whyatt, Matthew Yap, Raji Tenneti, Glenn Pearson, Alistair Vickery
OBJECTIVE: The objective of this study was to compare rates of hospital utilisation in Aboriginal and non-Aboriginal peoples before and after hospital admission for chronic obstructive pulmonary disease, heart failure and/or type 2 diabetes mellitus. METHODS: This was a longitudinal cohort study from 2002 to 2014, which was conducted in all hospitals in Western Australia. The participants of this study were Aboriginal and non-Aboriginal patients with a principal diagnosis of heart failure, type 2 diabetes or chronic obstructive pulmonary disease, on admission to hospital, where such an event had not occurred in the previous 3 years...
April 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28406572/review-article-workplace-violence-in-the-emergency-department-a-systematic-review-and-meta-analysis
#3
REVIEW
Shradha Nikathil, Alexander Olaussen, Robert A Gocentas, Evan Symons, Biswadev Mitra
Patient or visitor perpetrated workplace violence (WPV) has been reported to be a common occurrence within the ED. No universal definition of violence or recording of such events exists. In addition ED staff are often reluctant to report violent incidents. The true incidence of WPV is therefore unclear. This systematic review aimed to quantify WPV in EDs. The association of WPV to drug and alcohol exposure was explored. The databases MEDLINE, Embase, PsycInfo and the Cochrane Library were searched from their commencement to 10 March 2016...
April 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28406552/auckland-regional-emergency-medicine-trainee-mentoring-uptake-survey
#4
Gordon Michael Mike Nicholls, Emma Lawrey, Peter Jones
OBJECTIVE: The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring...
April 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28393486/paediatric-lumbar-punctures-how-do-paediatric-and-emergency-doctors-differ
#5
Chee Cheen Yeong, Simon S Craig, John A Cheek
OBJECTIVE: The objective of the study was to identify any differences between emergency physicians and emergency trainees and paediatricians and paediatric trainees in performing paediatric lumbar punctures (LPs). METHODS: Anonymous cross-sectional electronic survey was distributed to emergency physicians, emergency trainees, paediatricians and paediatric trainees within three hospitals of a single public health network. There were four standardised clinical scenarios (neonate, infant, young child and adolescent), with accompanying questions relating to neurological evaluation and imaging prior to LP, the use of written consent forms and parental presence during the procedure...
April 9, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28378954/pre-hospital-and-retrieval-medicine-clinical-governance-and-workforce-models
#6
Marcus Kennedy, Mark Elcock, Daniel Ellis, Gary Tall
Pre-hospital and retrieval medicine (PHARM) has developed significantly in the past decade. This perspective article proposes that PHARM should develop with a clear focus on contemporary health governance principles, and that its workforce and models of care adopt modern interdisciplinary approaches. Many of the older systems of managing clinical standards, and outdated cultural approaches to professional 'turf', workforce and scope of practice have little place in high-performance organisations. This paper calls us to attention with a recommendation that best and safest systems of care, structured to optimise patient outcomes and system performance should be our goal...
April 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28378949/de-labelling-self-reported-penicillin-allergy-within-the-emergency-department-through-the-use-of-skin-tests-and-oral-drug-provocation-testing
#7
Joseph Marwood, Gonzalo Aguirrebarrena, Stephen Kerr, Susan A Welch, Janet Rimmer
OBJECTIVE: Self-reported penicillin allergy is common among patients attending the ED, but is a poor predictor of true immunoglobulin E-mediated hypersensitivity to penicillin. We hypothesise that with a combination of skin testing and drug provocation testing, selected patients can be safely de-labelled of their allergy. METHODS: This prospective study enrolled a sample of patients presenting to an urban academic ED between 2011 and 2016 with a self-reported allergy to penicillin...
April 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28378942/effects-of-a-hospital-wide-intervention-on-emergency-department-crowding-and-quality-a-prospective-study
#8
Drew B Richardson, Kate Brockman, Angela Abigail, Gregory J Hollis
OBJECTIVE: The objective of this study was to determine the impact of a management-supported, multimodal, hospital-wide intervention on ED crowding and quality measures. METHODS: This is a prospective descriptive study of the first 20 weeks of the intervention, with 3 years of historical controls. The study was conducted in a 600 bed adult/paediatric tertiary hospital with 80 000 ED presentations annually. ED information system data were collected on all presentations in matched 20 week periods...
April 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28371469/improving-emergency-department-medical-clinical-handover-barriers-at-the-bedside
#9
Gerrard Oren Marmor, Michael Yonghong Li
OBJECTIVE: The present paper describes our experience of developing and piloting a best practice model of medical clinical handover. Secondary aims were to improve reliability of communication, identify negative effects on patient care and assess staff adherence and acceptance of the process. METHODS: We described existing handover practice. We designed and implemented a process incorporating bedside handover, the Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) tool and handover documentation...
March 29, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28371459/patient-satisfaction-with-procedural-sedation-in-the-emergency-department
#10
Olivia G Johnson, David McD Taylor, Marina Lee, Juen-Li Ding, Aadith Ashok, Damian Johnson, Daniel Peck, Jonathan Knott, Laurence Weinberg
OBJECTIVE: The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation. METHOD: We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli)...
March 29, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320079/ketamine-reduces-the-need-for-intubation-in-patients-with-acute-severe-mental-illness-and-agitation-requiring-transport-to-definitive-care-an-observational-study
#11
Cathrin S Parsch, Adrianne Boonstra, David Teubner, Wade Emmerton, Brian McKenny, Daniel Y Ellis
OBJECTIVES: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline. METHODS: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015. RESULTS: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320071/adherence-to-national-exercise-guidelines-by-patients-attending-emergency-departments-a-multi-site-survey
#12
Paul Berlingeri, Neil Cunningham, David McD Taylor, Jonathan Knott, Daniel McLean, Rex Gavan, Luke Plant, Hayley Chen, Tracey Weiland
OBJECTIVE: The proportion of adults in Australia meeting or exceeding the national guidelines for physical activity has remained relatively static over the past 10 years. The research objective was to measure self-reported physical activity and sedentary behaviour among ED patients in accordance with Australia's current physical activity and sedentary behaviour guidelines, revised in 2014. METHODS: A convenience sample of participants was recruited from three EDs in Melbourne between February and May 2016...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320069/usefulness-of-laboratory-and-radiological-investigations-in-the-management-of-supraventricular-tachycardia
#13
Aadith Ashok, Miguel Cabalag, David McD Taylor
OBJECTIVE: Although ED patients presenting with supraventricular tachycardia (SVT) are commonly investigated, the value of these investigations has been questioned. We aimed to determine the frequency and utility of investigations in patients with SVT. METHODS: We undertook an explicit retrospective medical record audit of patients with SVT who presented to a single ED (January 2004 to June 2014). Data on demographics, presenting complaints, investigations and outcomes were extracted...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320068/thoracic-electrical-bioimpedance-versus-suprasternal-doppler-in-emergency-care
#14
Mohammed H Elwan, Jeremy Hue, Samira J Green, Salah M Eltahan, Mark R Sims, Timothy J Coats
OBJECTIVE: There are a number of cardiac output (CO) monitors that could potentially be used in the ED. Two of the most promising methods, thoracic electrical bioimpedance and suprasternal Doppler, have not been directly compared. The aim of this study was to investigate the feasibility of CO monitoring using suprasternal Doppler and bioimpedance in emergency care and compare haemodynamic data obtained from both monitors. METHODS: Haemodynamic measurements were made on the same group of patients using bioimpedance (Niccomo, Medis, Germany) and suprasternal Doppler (USCOM, Sydney, Australia)...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320067/patterns-of-low-acuity-patient-presentations-to-emergency-departments-in-new-south-wales-australia
#15
Alexandre S Stephens, Richard A Broome
OBJECTIVE: To explore the patterns of low acuity patient (LAP) presentations to EDs in New South Wales (NSW), Australia. METHODS: Retrospective study of NSW public hospital ED presentations between January 2013 and December 2014 that were registered in the NSW Emergency Department Data Collection (n = 409 035). LAPs were defined according to the Australian Institute of Health and Welfare (AIHW), Sprivulis and multiple ACEM methods. Multivariable logistic regression was used to assess the adjusted odds of LAP ED presentation by a suite of sociodemographic factors...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320047/drinking-water-and-disorientation-the-perils-of-a-long-hot-australian-summer
#16
Panida Kanjanauptom, John A Cheek
No abstract text is available yet for this article.
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28273685/training-in-a-private-hospital-a-trainee-s-perspective
#17
Shalina Navaratnam
No abstract text is available yet for this article.
March 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28273678/learning-on-the-fly-how-rural-junior-doctors-learn-during-consultations-with-retrieval-physicians
#18
Timothy Baker, Koshila Kumar, Marcus Kennedy
OBJECTIVE: This study explores how rural junior doctors learn while consulting retrieval physicians about critically ill and injured patients, as well as the tensions characterising teaching and learning in this setting. METHODS: Data were collected via three focus groups, involving rural junior doctors (n = 8), rural senior doctors (n = 3) and retrievalists (n = 3). The discussions were transcribed and subject to multistage coding. RESULTS: Rural junior doctors believe they learn from interactions with retrieval physicians...
March 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28266183/capturing-the-art-of-emergency-medicine-does-film-foster-reflection-in-medical-students
#19
Gabrielle Brand, Steve Wise, Zarrin S Siddiqui, Antonio Celenza, Daniel M Fatovich
OBJECTIVE: Integrating arts and humanities-based pedagogy into curricula is of growing interest among medical educators, particularly how it promotes reflection and empathy. Our aim was to explore whether a 2.50 min film titled 'The Art of the ED' stimulated reflective learning processes in a group of first year medical students. METHODS: The film was shown prior to their first clinical placement in an ED. Student participation was voluntary and not assessable...
March 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28266169/establishing-a-dedicated-toxicology-unit-reduces-length-of-stay-of-poisoned-patients-and-saves-hospital-bed-days
#20
Katherine Z Isoardi, Melanie C Armitage, Keith Harris, Colin B Page
OBJECTIVE: This study evaluates the effect on the average length of stay (LOS), relative stay index (RSI), bed days and costs saved following the establishment of a dedicated clinical toxicology unit in an Australian tertiary referral hospital. METHODS: This retrospective descriptive study uses Health Roundtable and other state and federal data to compare the average LOS, RSI, estimated bed days and costs saved by patients admitted with a diagnosis-related group (DRG) of X62 (Poisoning/Toxic Effects of Drugs and Other Substances), over the 4 year period 2012-2015...
March 7, 2017: Emergency Medicine Australasia: EMA
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