Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2021
To intubate or not to intubate? Predictors of inhalation injury in burn-injured patients before arrival at the burn centre.
Inhalation injury occurs in approximately 10-20% of burn patients and is associated with increased mortality. There is no clear method of identifying patients at risk of inhalation injury or requiring intubation in the pre-hospital setting. Our objective was to identify pre-burn centre factors associated with inhalation injury confirmed on bronchoscopy, and to develop a prognostic model for inhalation injury. ⋯ A model to predict inhalation injury in burn-injured patients was developed with excellent discrimination. This model requires prospective testing but could form an integral part of clinician decision-making.
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Emerg Med Australas · Apr 2021
Innovative pathway for managing children and adolescents with mental health concerns in the emergency department: An intervention feasibility study.
To investigate if an innovative clinical pathway for managing child and adolescent mental health (MH) ED presentations reduces average length of stay (LOS) and improves carer satisfaction. ⋯ This study provides valuable information about the benefits of the KALM pathway in managing child and adolescent MH presentations to ED. This new pathway reduces the LOS in ED and improves carer experience compared to the usual care pathway.
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Emerg Med Australas · Apr 2021
Observational StudyAfter-hours emergency department care: Does time or day of arrival affect survival?
To determine whether after-hours presentation to EDs is associated with differences in 7-day and 30-day mortality. The influence of patient case-mix and workforce staffing differences are also explored. ⋯ After-hours presentation on the weekend to an ED is associated with higher 7-day mortality even after controlling for case-mix.
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Emerg Med Australas · Apr 2021
Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children.
Children frequently present with head injuries to acute care settings. Although international paediatric clinical practice guidelines for head injuries exist, they do not address all considerations related to triage, imaging, observation versus admission, transfer, discharge and follow-up of mild to moderate head injuries relevant to the Australian and New Zealand context. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) set out to develop an evidence-based, locally applicable, practical clinical guideline for the care of children with mild to moderate head injuries presenting to acute care settings. ⋯ The PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children provides high-level evidence and practical guidance for front line clinicians.
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Emerg Med Australas · Apr 2021
Is waiver of consent for the use of health information for research acceptable to emergency department patients?
Some emergency medicine research, especially retrospective studies using medical records review, rely on waiver of consent for use of personal health information (PHI) contained in clinical records. This is a secondary use of PHI and waiver of consent raises ethical, legal and practical issues. ⋯ In part, this involves a balancing of the public interest versus the risk to privacy and an evaluation of whether subjects would, mostly likely, have agreed to the use of their PHI had they been asked. To date, there are no robust data about whether use of PHI without consent for research would be acceptable to people who attend Australasian EDs for care.