Emergency medicine Australasia : EMA
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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.
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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.
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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.
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Emerg Med Australas · Oct 2021
Establishing the protocols for the South Australian Emergency Department Admission Blood Psychoactive Testing (EDABPT) programme for drug surveillance.
ED presentations because of illicit use of psychotropic drugs and pharmaceuticals result in significant medical harm and resource consumption. Patient assessment is complicated by the regular emergence of new psychoactive substances, difficulties associated with their identification and a lack of information about their effects. Here we report the protocol for the Emergency Department Admission Blood Psychoactive Testing (EDABPT) programme, an observational study utilising clinical data capture and definitive drug identification to assess the medical impact and patterns of illicit drug use in the community, and their geographic and temporal fluctuations. The study provides data to an early warning system targeting an improved public health response to emerging drugs of concern. ⋯ The study pairs city-wide patient enrolment with analytically confirmed toxicology results to allow broad sampling and identification of illicit drugs causing medical harm. It provides a mechanism for the identification of new agents as they emerge in the community, delivers a relevant and reliable source of information for public health agencies and clinicians and supplements existing local early warning mechanisms.
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Emerg Med Australas · Oct 2021
Observational StudyRetrospective validation of a risk stratification tool developed for the management of patients with blunt chest trauma (the STUMBL score).
To assess validity of the STUMBL score in New Zealand for complications of blunt chest trauma without multi-trauma and immediate life-threatening injuries. ⋯ The STUMBL score at a cut-off of <12 did not predict all complications sufficiently well to recommend for general use in our population. However, a score >15 predicted prolonged LOS and a score >18 predicted mortality sufficiently to be clinically useful for these outcomes. The score is more accurate in New Zealand Pākehā and needs to be used with caution in Māori and Pasifika populations. A larger prospective validation is required to further assess the score.