Emergency medicine Australasia : EMA
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As an emerging country with the fourth largest population in the world, Indonesia's purchasing power has strengthened, leading to socioeconomic changes that affect its healthcare system. Additionally, there is a surge of healthcare utilisation after the implementation of a new national insurance scheme, particularly within emergency departments. Similar to other low- to middle-income countries, Indonesia has not prioritised the progress of emergency medicine despite existing evidence that suggests that the early intervention of many acute conditions lowers the rates of morbidity and mortality. This article will review the past and current state of emergency medicine in Indonesia. ⋯ The development of emergency medicine in Indonesia is in its infancy and will require rapid improvement to meet its country's demand. Academic, private and government sectors need to collaborate to promote and invest in emergency medicine.
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Emerg Med Australas · Dec 2018
Observational StudyExternal validation of the Rapid Assessment Prioritisation and Referral Tool for multidisciplinary teams in medical assessment and planning units.
The Rapid Assessment Prioritisation and Referral Tool (RAPaRT) was developed for identifying appropriate referrals to allied members of the multidisciplinary team in hospital medical assessment and planning units (MAPUs). This study examined the performance of the RAPaRT for identifying appropriate referrals as well as predicting requirement for admission to hospital and length of stay. ⋯ Findings supported the external validation of the RAPaRT. In addition, this investigation made a novel contribution in demonstrating that positive RAPaRT responses were associated with requirement for admission to an acute hospital ward and length of stay.
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Emerg Med Australas · Dec 2018
Routine cervical spine immobilisation is unnecessary in patients with isolated cerebral gunshot wounds: A South African experience.
Routine immobilisation of the cervical spine in trauma has been a long established practice. Very little is known in regard to its appropriateness in the specific setting of isolated traumatic brain injury secondary to gunshot wounds (GSWs). ⋯ Patients who sustain an isolated low velocity cerebral GSW are highly unlikely to have concomitant CSI. Routine cervical spine immobilisation is unnecessary, and efforts should be directed at management strategies aiming to prevent secondary brain injury. Further studies are required to address the issue in the setting of high velocity GSWs.
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There is a paucity of any long-term follow up of trainees' career pathways or organisational outcomes from medical education registrar posts in emergency medicine training. We report on the experience of a selected group of medical education trainees during and subsequent to their post and reflect on the value added to emergency medical education at three institutions. ⋯ Our findings suggest that medical education trainees in emergency medicine progress to educational roles, and most respondents attribute their career progression to the medical education training experience. We recommend that medical education registrar programmes need to be valued within the clinical service, supported by faculty and a 'community of practice', to support trainees' transition to clinician educator leadership roles.