Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2013
Design and roll out of standardised approach to paediatric procedural sedation in Victorian emergency departments.
Children sometimes require minor procedures in the ED for which sedation is needed. Information from Victorian EDs indicated that processes for paediatric procedural sedation were variable, both within and between health services. The aims of this project were to improve safety and reduce variation in practice with respect to paediatric procedural sedation in EDs by rolling out a standardised paediatric sedation programme in Victorian EDs. ⋯ This multi-modal implementation strategy has achieved clinical practice improvement across organisational boundaries.
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Emerg Med Australas · Dec 2013
Involuntary admissions under the Mental Health Act 2007 (New South Wales): A comparison of patients detained by ambulance officers, medical practitioners and accredited persons in an emergency department.
The Mental Health Act (MHA) 2007 (New South Wales [NSW]) is used to transport to, detain and treat individuals in a mental health facility. Patients are frequently taken to EDs under the MHA or detained in the ED for a mental health assessment. In NSW, medical practitioners, accredited persons, police and more recently ambulance officers, are authorised to write certificates under the MHA. There is an absence of research on the use of the MHA in NSW EDs. The primary research question for this study was: 'What is the involuntary admission rate for persons detained under the MHA in an NSW tertiary referral ED?' ⋯ Ambulance officer certification was a poor predictor of involuntary psychiatric admission in the Royal Prince Alfred Hospital Emergency Department. ED physicians should have the authority to revoke the certificate if, following assessment and treatment, the patient no longer fulfils criteria for detention under the MHA.
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Emerg Med Australas · Dec 2013
Randomized Controlled Trial Multicenter StudyRationale and methodology for a multicentre randomised trial of fibrinolysis for pulmonary embolism that includes quality of life outcomes.
Submassive pulmonary embolism (PE) has a low mortality rate but can degrade functional capacity. ⋯ An investigator-initiated, FDA-regulated, multicentre trial of fibrinolysis for submassive PE was conducted, but was limited by screening costs and a low mortality rate. Quality of life measurements might represent a more important patient-centred end-point.
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Emerg Med Australas · Dec 2013
Characteristics of Aboriginal and Torres Strait Islander presentations to three Victorian emergency departments.
Aboriginal and Torres Strait Islander (ATSI) people have significant health disparity compared with other Australians. The present study examines the characteristics of ATSI patients presenting to three EDs of a single healthcare network to determine whether any healthcare disadvantages exist. ⋯ ATSI people living in Melbourne's south-east have social and health utilisation inequities, which might have an impact on their health status.