Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2007
Randomized Controlled Trial Comparative StudyComparison of lignocaine and water-based lubricating gels for female urethral catheterization: a randomized controlled trial.
It is standard practice to use lignocaine gel during male urethral catheterization. However, it is commonly believed that topical anaesthetic confers no benefit during female catheterization hence lubricating gel alone is more commonly used. The present study aimed to determine whether lignocaine gel decreased pain compared with water-based lubricating gel for female urethral catheterization in the ED. ⋯ Lignocaine gel substantially reduces the procedural pain of female urethral catheterization by comparison with use of a water-based lubricating gel.
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Emerg Med Australas · Aug 2007
Multicenter StudyWhy patients attend emergency departments for conditions potentially appropriate for primary care: reasons given by patients and clinicians differ.
To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. ⋯ These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider - consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education.
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Increasing demand to reduce patient waiting times and improve patient flow has led to the introduction of a number of strategies such as fast track and patient streaming. The triage nurse is primarily responsible for identifying suitable patients, based on prediction of likely admission or discharge. The aim of the present study was to explore the accuracy with which triage nurses predict patient disposition. ⋯ Triage nurses can accurately predict likely discharge in specific subgroups of ED patients. This supports the role of triage nurses in appropriately identifying patients suitable for 'fast track' or streaming.
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Emerg Med Australas · Aug 2007
From emergency department to general practitioner: evaluating emergency department communication and service to general practitioners.
To survey general practitioners' (GPs) opinions of communication and service received from the ED of a tertiary metropolitan hospital. ⋯ Half of GPs surveyed supported the current system of patient delivered discharge letters and of those who did not the majority preferred faxed discharges. There was little support for email communication. GPs reported problems with the current communication system including discharge letters not reaching GPs and deficiencies in the discharge information. GP reported substantial difficulties in accessing outstanding investigation results. Most GPs felt that assessment and treatment of their patients in the ED was of above average quality, as was the overall service they received from the ED. There was GP support for the ED admitting officer role.