Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2021
Impact of the modifiable areal unit problem in assessing determinants of emergency department demand.
To examine the impact of the modifiable areal unit problem (MAUP) in an investigation of factors associated with ED demand in Perth, Western Australia, in 2016. Furthermore, to advocate a means of avoiding this impact. ⋯ When formulating interventions targeting reduced ED utilisation, policy planners should be guided by evidence based on analysis of appropriate spatial units. This ideal is undermined by the widespread lack of acknowledgement of the MAUP in studies examining drivers of ED demand using spatially aggregated data. To avoid the MAUP, only estimates obtained through examining a minimal geographic unit should be relied upon.
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Emerg Med Australas · Oct 2021
Regional anaesthesia for rib fractures: A pilot study of serratus anterior plane block.
Rib fractures are not only painful but are associated with morbidity and mortality, especially in older patients. The serratus anterior plane block (SAPB) is a plane block distant from major neurovascular bundles and may provide anaesthesia to a substantial area of the hemithorax. This pilot study was designed to assess if the SAPB can be safely and efficiently incorporated to the trauma reception workflow of an adult, level 1 trauma centre. ⋯ The present study demonstrated the feasibility of ultrasound-guided SAPB among patients with multiple rib fractures in the ED. No complications were observed. Further prospective evaluation of analgesic effects in a larger cohort is indicated.
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Emerg Med Australas · Oct 2021
Advancing leadership in Australasian emergency medicine: Taking stock and looking ahead.
Since 2018, the Australasian College for Emergency Medicine has collaborated with the Swinburne University of Technology on a research project to understand and enhance the leadership capacity of emergency physicians, beginning with Australasian Directors of Emergency Medicine (DEMs). Over the last 3 years, this research programme has revealed the complexity of leadership in emergency medicine, illuminating the strengths and limitations of extant research and suggesting promising new directions for emergency medicine leadership and leadership development research. This programme has also shed new light on the knowledge, skills and abilities that DEMs need to develop to catalyse change in the systems where DEMs practice both medicine and leadership. We propose that an approach to leadership development that reflects the diversity of DEMs' leadership challenges and the complexity of leadership in emergency medicine would go a long way to enhancing the sophistication, effectiveness and impact of the leadership in emergency medicine.