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Emergency Medicine Australasia: EMA

Julia M Lappin, Muhammad H Ayub, David Rogers, Madeleine Morgan, Jean-Yves Kanyamibwa, Anthony Shakeshaft
OBJECTIVE: To evaluate the effectiveness of a routine screening and triage tool for alcohol withdrawal syndrome (AWS) in improving clinical care delivery in an ED setting. METHODS: In a regional ED in Australia, a screening and triage tool for AWS was introduced to routine ED assessment for a 13 week period. Subjects were all presentations to ED aged 16 and above with relevant presenting problems during the pre-intervention phase (1 January 2015-31 December 2016) and the post-intervention phase (8 August 2016-4 November 2016)...
March 12, 2018: Emergency Medicine Australasia: EMA
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
Shahina Braganza, Alex Markwell, Suneth Jayasekara
No abstract text is available yet for this article.
March 2, 2018: Emergency Medicine Australasia: EMA
Jessica Forbes
No abstract text is available yet for this article.
March 2, 2018: Emergency Medicine Australasia: EMA
Avijit Barai, Bruce Lambie, Conor Cosgrave, Joanne Baxter
OBJECTIVE: Distal radius fracture (DRF) is a common presentation to the ED. However, little is known about the long-term functional outcome of these patients following their initial management in the ED. METHODS: In order to evaluate the long-term functional outcome of DRF, we collected the Disabilities of Arm, Shoulder and Hand (DASH) scores from the patients who attended our ED with DRF between January 2014 and June 2015. We divided the patients into two groups based on their overall management: (i) conservative group who did not have any surgical interventions; and (ii) open reduction internal fixation (ORIF) group who needed surgical interventions in the theatre...
February 28, 2018: Emergency Medicine Australasia: EMA
Danika Thiemt
No abstract text is available yet for this article.
February 26, 2018: Emergency Medicine Australasia: EMA
Kevin H Chu, Nathan J Brown, Anita Pelecanos, Anthony Ft Brown
Gender equality and workforce diversity has recently been in the forefront of College discussions. Reasons for the difference between various groups may not be as they initially appeared. The results of comparing the outcome between two groups can sometimes be confounded and even reversed by an unrecognised third variable. This concept is known as Simpson's Paradox, and is illustrated here using a renowned case study on potential gender bias for acceptance to Graduate School at the University of California, Berkeley...
February 26, 2018: Emergency Medicine Australasia: EMA
Danielle Blouin
OBJECTIVES: Informal learning includes all occurrences during one's life when learning is not deliberate. Prior research on informal learning in healthcare contexts examined learning happening outside of the formal curriculum, yet still in the workplace. This study explores residents' perceptions about extracurricular factors outside of the workplace that contribute to their learning and development of professional identity, whether interpersonal relations are recognised as such factors, and positive and negative impacts of interpersonal relations...
February 26, 2018: Emergency Medicine Australasia: EMA
Katherine Gridley
No abstract text is available yet for this article.
February 26, 2018: Emergency Medicine Australasia: EMA
Tarsh Pandit, Robin Ray, Sabe Sabesan
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. Only peer-reviewed articles, available in full-text that focussed on the training needs of rural doctors were reviewed...
February 22, 2018: Emergency Medicine Australasia: EMA
Atefeh Soltanifar, Elham Pishbin, Negin Attaran Mashhadi, Mona Najaf Najafi, Maryam Siahtir
OBJECTIVE: The challenging and stressful nature of emergency medicine place the practitioners of this young branch of medicine at risk of burnout. In Iran, the number of women choosing the specialty of emergency medicine has been increasing in recent years. No studies have focused on burnout among female emergency medicine physicians. We conducted this study to evaluate the level of burnout in female emergency medicine physicians in Iran. METHODS: In this cross-sectional study, all Iranian female emergency medicine physicians with more than 2 years of work experience as specialists, received a questionnaire containing 22-item Maslach Burnout Inventory scales and 7-item Cassidy social support scale, as well as questions about workload and career satisfaction...
February 13, 2018: Emergency Medicine Australasia: EMA
Anja A Ebker-White, Kendall J Bein, Michael M Dinh
OBJECTIVE: The present study aims to prospectively validate the Sydney Triage to Admission Risk Tool (START) to predict ED disposition. METHODS: This was a prospective validation study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated. The primary outcome was patient disposition (discharge or inpatient admission) from the ED. Multivariable logistic regression was used to estimate area under curve of receiver operator characteristic (AUC ROC) for START scores as well as START score in combination with other variables such as frailty, general practitioner referral, overcrowding and major medical comorbidities...
February 8, 2018: Emergency Medicine Australasia: EMA
Cristina Roman, Michael Dooley, Biswadev Mitra
No abstract text is available yet for this article.
February 5, 2018: Emergency Medicine Australasia: EMA
Kevin H Chu, Ibrahim Mahmoud, Xiang-Yu Hou, Craig D Winter, Rosalind L Jeffree, Nathan J Brown, Anthony Ft Brown
OBJECTIVES: To determine: (i) incidence and outcome of subarachnoid haemorrhage (SAH) in the general population; and (ii) proportions of SAH in both the general ED population and in ED patients presenting with headache. METHODS: A population-based study in Queensland from January 2010 to December 2014 was conducted. Data were sourced from the Australian Bureau of Statistics, Queensland Hospital Admitted Patient Data Collection linked to the Queensland death registry and ED Information System...
February 5, 2018: Emergency Medicine Australasia: EMA
Louisa J Abraham, Ogilvie Thom, Jaimi H Greenslade, Marianne Wallis, Amy Nb Johnston, Eric Carlström, Donna Mills, Julia Crilly
OBJECTIVE: Clinical staff in EDs are subject to a range of stressors. The objective of this study was to describe and compare clinical staff perceptions of their ED's working environment across two different Australian EDs. METHODS: This was a cross-sectional, descriptive, research design that included distribution of three survey tools to clinical staff in two Australian EDs in 2016. Descriptive statistics were reported to characterise workplace stressors, coping styles and the ED environment...
January 23, 2018: Emergency Medicine Australasia: EMA
Anna Gunn, Janet McLeod, Rebecca Chapman, Hayley Ball, Mark Fitzgerald, Teresa Howard, Peter Cameron, Biswadev Mitra
OBJECTIVE: The Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) Program at The Alfred uses vivid clinical reality to build resilience and prevent injury by following a trauma patient's journey through hospital. The present study aims to analyse the effect of P.A.R.T.Y. on safety perceptions of driving after alcohol, seat belt use and risk-taking activities. METHODS: Pre-programme, immediately post-programme and 3-5 months post-programme surveys with questions focused on the programme aims were distributed to all consented participants...
January 21, 2018: Emergency Medicine Australasia: EMA
Judy Lowthian, Lyle Turner, Angela Joe, Christopher Pearce, Bianca Brijnath, Colette Browning, Marianne Shearer, Danielle Mazza
OBJECTIVE: To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. METHODS: Retrospective analysis of ED presentations by patients ≥70 years for 2008 and 2012. Metropolitan Melbourne public hospital data were obtained from the Victorian Emergency Minimum Dataset. Outcomes were characteristics of PAGP-type and non-PAGP-type presentations as defined by the Australian Institute of Health and Welfare; numbers and rates per 1000 population ≥70 years of repeat (×2-3/year) and frequent (≥ ×4/year) PAGP-type and non-PAGP-type presentations...
January 18, 2018: Emergency Medicine Australasia: EMA
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Shoulder injuries are a commonly presenting complaint to the ED. In the absence of an obvious deformity, they can be difficult to assess and definitively diagnose because of the multiple structures that cause shoulder pain, the acuity and severity of pain and the lack of range of motion in the ED setting. The quality of ED care provided to patients with musculoskeletal shoulder pain is crucial to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common shoulder injuries and conditions in the ED...
January 18, 2018: Emergency Medicine Australasia: EMA
Viet Tran, Joanne Cobbett, Lisa Brichko
No abstract text is available yet for this article.
January 16, 2018: Emergency Medicine Australasia: EMA
Gerben Keijzers, Louise Cullen, Diana Egerton-Warburton, Daniel M Fatovich
It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted...
January 12, 2018: Emergency Medicine Australasia: EMA
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