Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Review Meta AnalysisReview article: Pre-hospital provider clinical judgement upon arrival to the emergency department: A systematic review and meta-analysis.
Pre-hospital providers (PHPs) undertake initial patient assessment, often spending considerable time with patients prior to arrival at ED. However, continuity of this assessment with ongoing care of patients in the ED is limited, with repeated assessment in the ED, starting with the process of triage in hospital. A systematic review of the literature was conducted to assess the ability of PHPs to predict patient outcomes in the ED. ⋯ Triage score application had weighted kappa variables of 0.409 and 0.452 indicating moderate agreement on assessment priority between PHPs and triage nurses. The ability of PHPs to assign triage scores, predict clinical course and predict disposition from the ED have mild concordance with clinical assessment by ED staff. This is an area of potential expansion in PHPs' role; however, training would be required prior to implementation.
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Emerg Med Australas · Dec 2020
Personal Protective Equipment in the Paediatric Emergency Department during the COVID-19 pandemic. Estimating requirements based on staff numbers and patient presentations.
To estimate the personal protective equipment (PPE) required in a paediatric ED during the COVID-19 pandemic comparing the use per patient to use per patient zone, based on the NSW Clinical Excellence Commission (CEC) guidelines in place at the time of the study. ⋯ This study has demonstrated the considerable requirement for PPE in a paediatric ED, which varies according to presentation type and the background prevalence of COVID-19 in the community.
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Emerg Med Australas · Dec 2020
Randomized Controlled TrialEffect of personalised, mobile-accessible discharge instructions for patients leaving the emergency department: A randomised controlled trial.
This pilot study assessed the efficacy of personalised, printed and mobile-accessible discharge instructions for pain relief for patients discharged from the ED. ⋯ Patients who received personalised printed and mobile-accessible ED discharge instructions for pain relief reported higher levels of satisfaction with their instructions, had better recall of their pain relief medications advice and received more information on medication side-effects.
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Emerg Med Australas · Dec 2020
ReviewReview article: Rapid review of the emergency department-initiated buprenorphine for opioid use disorder.
Opioid-related harms have been increasing in Australia over the last 5 years. Patients with opioid use disorder are over-represented in ED presentations. Opioid agonist treatment is the most effective community-based treatment. ⋯ Eight observational studies, one with a comparator group reported positive results for this intervention. There is strong evidence that clinicians should consider commencing buprenorphine in the ED for patients with opioid use disorder when combined with a direct and supported referral or 'warm handover' to community care. Further implementation studies and investigation of long-acting injectable buprenorphine treatment are required.