Emergency medicine Australasia : EMA
-
Emerg Med Australas · Feb 2018
Lessons learnt from incidents involving the airway and breathing reported from Australasian emergency departments.
To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. ⋯ Recommendations for improving preparedness of ED staff and facilities have been made for each of the problem areas identified with respect to clinical practice, equipment, communication and clinical process. Analysis of incidents from the Australasian Emergency Medicine Events Register allows clusters of like-events to be identified and characterised, providing the possibility of getting a better idea of how problems present and progress, with some information about contributing factors, characteristics and context. This will pave the way for earlier and better detection of life-threatening problems and the development and reinforcement of preventive and corrective strategies.
-
Emerg Med Australas · Feb 2018
Multicenter Study Observational StudyEffect of known history of heart disease on survival outcomes after out-of-hospital cardiac arrests.
We aimed to investigate the effect of known heart disease on post-out-of-hospital cardiac arrest (OHCA) survival outcomes, and its association with factors influencing survival. ⋯ Known heart disease independently predicted poorer post-OHCA survival. This study may provide information to guide future prospective studies specifically looking at family education for patients with heart disease and the effect on OHCA outcomes.
-
Emerg Med Australas · Feb 2018
Temporal trends (2002-2014) of incidence and shockable status of adult emergency medical service attended out-of-hospital cardiac arrest of presumed cardiac aetiology in Queensland.
To describe trends in incidence and shockable status of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014. ⋯ Age-standardised incidence has reduced with a period of stagnation in the middle age and early older years. These factors require consideration in data interpretation and strategy planning.
-
Emerg Med Australas · Feb 2018
Trauma case review: A quality and safety feature of the Victorian State Trauma System.
The aim of the present study was to describe the trauma case review process and its role in a regionalised trauma system. Victoria has a population of 5.9 million people, accounting for 26% of Australia's population. Victoria has been serviced by an inclusive, organised trauma system since 2000 comprising 138 health services with trauma designations and three major trauma services. ⋯ The trauma case review process is an embedded feature of the Victorian State Trauma System that aims to improve compliance with major trauma guidelines by reviewing major trauma cases that have been managed outside of established triage and transfer guidelines. All trauma-designated Victorian health services, Ambulance Victoria and Victorian adult and paediatric patient retrieval services might receive trauma cases for review. The process is also an integral component of trauma system clinical governance, which enables the identification of system-level issues for escalation to the State Trauma Committee and the Victorian Department of Health and Human Services.
-
Emerg Med Australas · Feb 2018
ReviewReview article: Best practice management of low back pain in the emergency department (part 1 of the musculoskeletal injuries rapid review series).
Low back pain (LBP) is a common presentation to the ED, and a frequent cause of disability globally. The ED management is often associated with high rates of imaging, misuse and overuse of pharmacology and subsequent financial implications. Given this, improved quality of care for patients with LBP in ED is essential. ⋯ The search revealed 1538 articles, of which 38 were included in the review (n = 8 primary articles, n = 13 systematic reviews and n = 17 guidelines). This rapid review provides clinicians managing LBP in the ED a summary of the best available evidence to risk stratify and enhance the quality of care, optimising patient outcomes. Consistent evidence was found to support the use of 'red flags' to screen for serious pathologies, diagnostic tests being reserved for use only in the presence of red flags, the judicious prescribing of opioids, identification of psychosocial risk factors as predictors of poorer outcome and promotion of early return to work and function.