Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
Observational StudyEvaluation of older patients with minor blunt head trauma to identify those who do not have clinically important traumatic brain injury and can be safely managed without cranial computed tomography.
Our primary aim was to identify a low-risk subgroup of older adults (aged 65 and older) presenting to ED with minor head trauma which can be safely managed without a cranial CT (cCT). ⋯ Alert, haemodynamically stable, older ED adults with suspected head trauma had a low incidence of ciTBI in the present study. Abnormal physical examination findings were consistently present in patients with ciTBI. Shared decision-making prior to cCT may be the pragmatic way ahead in the management of this patient cohort, especially among those from RACFs.
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Emerg Med Australas · Feb 2025
ReviewReview article: Somatization Disorders in emergency department: A critical overview of current challenges and future directions.
Individuals with Somatization Disorders present frequently to the ED with non-cardiac chest pain, non-specific abdominal pain, headaches and a range of other non-specific symptoms. Somatization Disorder presentations are ubiquitous within the healthcare system. ⋯ The current review explores the scope of the problem and, the challenges inherent in diagnosing and treating these disorders in ED environments. Based on available evidence and the essential character of these disorders, future directions are suggested for more effective emergency management and possible referral from ED.
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Emerg Med Australas · Feb 2025
Factors associated with extended length of stay for paediatric mental health presentations to EDs in South Western Sydney, Australia.
This study aimed to determine the factors associated with extended length of stay (LOS) for paediatric mental health (MH)-related presentations to the EDs in South Western Sydney (SWS). ⋯ Our findings highlight the need for equitable distribution of resources directed towards at-risk CYP to improve MH outcomes and reduce health system burden.
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Emerg Med Australas · Feb 2025
ReviewReview article: Scoping review of interventions that reduce mechanical restraint in the emergency department.
Mechanical restraints are known to be associated with many undesirable outcomes in clinical settings. Our objective was to examine the current literature to explore possible interventions that would reduce the use of mechanical restraints in the ED. ⋯ Evidence supports further exploration of interventions that include: designing an agitation guideline; training staff in assessment, attitudinal and de-escalation skills; addition of a crisis team; and environmental changes in the form of adding a dedicated clinical space. Although these strategies may reduce mechanical restraint in the ED setting, further high-quality studies are needed before definitive conclusions may be drawn.
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Emerg Med Australas · Feb 2025
Multicenter Study Observational StudyHospitalisations for non-specific low back pain in people presenting to South Australian public hospital emergency departments.
The present study sought to investigate predictors of hospitalisation in adults diagnosed with non-specific low back pain (LBP) and/or sciatica from an ED. ⋯ Certain patient characteristics and ED clinical activity are associated with hospitalisations for LBP. Understanding these factors will better inform the design and delivery of appropriate high-quality care.