Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
ReviewReview article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review.
Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn-over and burn-out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre-empt incidences of OV during ED episodes of care. ⋯ Although there was variation in, and differences between, staff-perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage.
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Emerg Med Australas · Oct 2019
Predictors of in-hospital cardiac arrest within 24 h after emergency department triage: A case-control study in urban Thailand.
This study describes the predictors of in-hospital cardiac arrest (IHCA) within 24 h of ED triage and evaluates their ability to predict patients at risk of IHCA. ⋯ We conclude that a combination of NEWS and four independent predictors identify patients at risk of IHCA more effectively than NEWS alone.
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Emerg Med Australas · Oct 2019
The World Health Organization trauma checklist versus Trauma Team Time-out: A perspective.
Time-out protocols have reportedly improved team dynamics and patients' safety in various clinical settings - particularly in the operating room. In 2016, the World Health Organization (WHO) introduced a Trauma Care checklist, which outlines steps to follow immediately after the primary and secondary surveys and prior to the team leaving the patient. ⋯ The WHO Trauma Care checklist, while likely to be successful in reducing errors of omission related to hospital admission, may be limited in its ability to reduce errors that occur in the initial 30 min of trauma reception - when most of the life-saving decisions are made. To address this limitation a Trauma Team Time-out protocol is proposed for initial trauma resuscitation, targeting the critical first 30 min of hospital reception.
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Emerg Med Australas · Oct 2019
Description and cost-analysis of emergency department attendances for hand and wrist injuries.
Injuries to the hand and wrist are estimated to account for between 10% and 30% of all ED presentations. The economic burden placed on the healthcare system can be extensive and rise sharply with increase in injury severity. ⋯ Acute hand and wrist injuries contribute to a significant volume of ED presentations each year in one Australian public health network leading to significant expenditure and health resources. Further research into how to best utilise resources and reduce avoidable injuries should be priority areas to reduce the cost of these injuries to the healthcare system and society.
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Emerg Med Australas · Oct 2019
Observational StudySub-optimal treatment of paediatric migraine in an emergency department: An observational study.
To describe treatment of children presenting to an Australian ED with a final ED diagnosis of migraine. ⋯ Treatment of migraine in children was not consistent with the available evidence regarding agents' relative effectiveness. The use of opiates is concerningly high.