Emergency medicine Australasia : EMA
-
Emerg Med Australas · Oct 2021
ReviewContemporary evaluation of adverse outcome risks associated with 'did not wait' emergency department presentations.
Did not wait (DNW) is a frequently cited ED key performance indicator. We conducted a network-based observational study of consecutive DNW presentations. ⋯ While a proportion of DNW patients re-presented within 72 h, an excess prevalence of poor outcomes were not observed.
-
Emerg Med Australas · Oct 2021
Debriefing immediately after intubation in a children's emergency department is feasible and contributes to measurable improvements in patient safety.
In 2013, our intubations highlighted a safety gap - only 49% achieved first-pass success without hypoxia or hypotension. NAP4 recommended debriefing after intubation, but limited published methods existed. Primary aim is to implement a feasible process for immediate debriefing and feedback for emergency airway management. Secondary aims are to contribute to reduced frequency of adverse intubation-related events and implement qualitative improvements in patient safety through team reflection and feedback. ⋯ Structured and targeted debriefing after intubating children in the ED is feasible and contributes to measurable and qualitative improvements in patient safety.
-
Emerg Med Australas · Oct 2021
Observational StudyDrug- and alcohol-related emergency department patient presentations during the 2018 Commonwealth Games: A multi-site retrospective analysis.
To examine the impact of the 2018 Commonwealth Games on ED patient presentations related to drug(s) and/or alcohol. ⋯ During the 2018 Commonwealth Games, minimal impact on the ED was noted pertaining to drug and alcohol misuse. Further research is required to understand whether this held true for other types of ED presentations and during other types and locations of mass gathering events.
-
Emerg Med Australas · Oct 2021
Current airway management practices after a failed intubation attempt in Australian and New Zealand emergency departments.
The aims of the present study were to describe current airway management practices after a failed intubation attempt in Australian and New Zealand EDs and to explore factors associated with second attempt success. ⋯ The majority of second intubation attempts were undertaken by emergency consultants and registrars. A change from a non-consultant intubator to a consultant intubator of any specialty for the second attempt and intubation episodes where laryngoscopy was predicted to be non-difficult were associated with a higher success rate at intubation. Participation in routine collection and monitoring of airway management practices via a Registry may enable the introduction of appropriate improvements in airway procedures and reduce complication rates.
-
Emerg Med Australas · Oct 2021
Are we overlooking the rural patient journey when it comes to sepsis diagnosis and management?
Surviving Sepsis Campaign guidelines have progressively moved towards faster time-based treatment targets over recent years despite international data consistently showing low protocol adherence. A key stakeholder in Australian healthcare remains overlooked in sepsis research: the under-resourced rural ED. ⋯ Greater representation of rural patients and EDs in Australian sepsis research is paramount in guiding future sepsis treatment protocols. This perspective piece explores current international sepsis literature, recognising significant barriers to sepsis protocol adherence specific to rural Australian EDs.