Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2020
Anxiety and alcohol in the working-age population are driving a rise in mental health-related emergency department presentations: 15 year trends in emergency department presentations in Western Australia.
To evaluate age, gender and disease-specific trends in ED for mental health presentations over 15 years. ⋯ The present study demonstrates that increased rates of mental health-related ED presentations are driven by increased rates of presentation for stress and anxiety-related and alcohol-related presentations in both genders across the working-age population.
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Emerg Med Australas · Feb 2020
Coles and Woolworths have installed public access defibrillators in all their stores: It is time other Australian businesses followed their lead.
We welcome the recent announcement by Coles and Woolworths that public access defibrillators (PADs) are now available in their stores, as early defibrillation with PADs is associated with significantly increased survival from out-of-hospital cardiac arrests (OHCAs). From 2008 to 2018 there were 120 OHCAs in Victorian supermarkets, overall 26.6% survived; however, when defibrillated by a PAD 66.6% survived. ⋯ In Victoria last year there were 421 potentially viable OHCAs in public locations, of these 132 patients survived; however, had PADs been available an additional 101 patients could have survived. We therefore strongly encourage local businesses to install PADs, to safeguard the well-being of their employees, customers and local communities.
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Emerg Med Australas · Feb 2020
Clinical clearance and imaging for possible cervical spine injury in children in the emergency department: A retrospective cohort study.
While cervical spine injuries (CSIs) are rare in the paediatric population, presentations to EDs with possible neck injuries are common. Based on a lack of Australian data we set out to determine how many possible injuries are clinically cleared, what imaging is used on the remainder and the incidence and characteristics of confirmed paediatric CSIs. ⋯ While two-thirds of children with potential CSIs undergo radiological evaluation, actual injuries are rare (<4%). These data suggest that there is a potential for improved targeting of cervical spine imaging for trauma. The development of a clinical decision tool may help reduce neck radiography.
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Intubation of critically ill children is an infrequent procedure, and is associated with significant risk. We set out to describe intubations carried out by the Children's Health Queensland Retrieval Service (CHQRS), with the intention to identify areas for improvement in the performance of intubation in the retrieval setting. ⋯ Paediatric endotracheal intubation is an infrequent procedure in our service. An airway registry could improve documentation and gather information to identify specific training requirements and areas for practice improvement.
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Emerg Med Australas · Feb 2020
Proactive review by the emergency department before inter-hospital transfer (the PREVENT study).
To determine the population of patients where patient transfer may be prevented by assessment of a senior ED registrar at the referring hospital. ⋯ This proof-of-concept study suggests that strategies to expand the provision of acute care to outreach within specialist networks and reduce patient transfers should be further explored. An outreach programme for improved acute assessment of patients at the referring hospital particularly after acute trauma may prevent transfers, improving care pathways.