Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2019
ReviewReview article: Environmental heatstroke and long-term clinical neurological outcomes: A literature review of case reports and case series 2000-2016.
Global temperatures are rising; extreme environmental heat can result in adverse health effects including heatstroke. Acute effects of heat are well recognised, but there is less understanding of potential long-term adverse outcomes. Our aim was to review recent medical literature for clinical cases of environmental heatstroke with a focus on neurological outcome. ⋯ Cerebellar injury was common suggesting cerebellar structures are vulnerable to heat. These findings highlight that people of all ages and pre-morbid states are at risk of severe heat-related illness. In the face of climate change, effective interventions for heat-related illness, including both treatment and prevention are necessary.
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Emerg Med Australas · Apr 2019
New Fellows Early Career Survey 2014-2017: Shift of trends in emergency medicine workforce.
Within the complex and dynamic emergency medicine workforce setting, the Australasian College for Emergency Medicine (ACEM) New Fellows (FACEMs) Early Career Survey was established in 2014 to capture information on the work profiles, future career plans and challenges experienced among new FACEMs. ⋯ A shift in the employment profile of early career Fellows was observed between 2014 and 2017, with the potential push factor of limited specialist positions in metropolitan areas now starting to result in an increase in new FACEMs choosing to work in regional and rural areas and in the number working across multiple workplaces.
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Emerg Med Australas · Apr 2019
Observational StudyPatients admitted via the emergency department to the intensive care unit: An observational cohort study.
Timely and appropriate assessment and management within the ED impacts patient outcomes including in-hospital mortality and length of stay (LOS). Within the ED, several processes facilitate timely recognition of the need for intensive care unit (ICU) admission. This study describes characteristics and outcomes for patient presentations admitted to ICU from ED, categorised by Australasian Triage Score (ATS), ICU admission time and ICU admission source. ⋯ Most patients are appropriately identified in ED as requiring ICU admission, although around one in four were triaged ATS 3/4. Patients admitted to the ward first tended to have poorer outcomes than those directly admitted to ICU. Factors predicting the need for ICU admission should be identified to support clinical decision-making.
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Emerg Med Australas · Apr 2019
Why do paramedics choose to bring patients to a private emergency department?
While prior experience, favourable location and anticipation of high quality care are known to influence patient choice to attend a private ED, it is likely that decision-making is also influenced by other persons. In particular, patients arriving by ambulance are under the care of paramedics, whose values towards healthcare and rationale for choosing one ED over another have not been studied. This study aimed to describe reasons why paramedics choose to bring patients to a private ED. ⋯ Paramedics take into consideration when possible patient's wishes and are more likely to bring a patient to a private ED if they have specific direction from the patient or the patient's family or GP. The likelihood of presenting to a private ED is increased if the patient has an allegiance with the facility and the paramedics perceive favourably the hospital logistics and systems as well as service ethos.