Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2021
Observational StudyOutcomes of laceration suture repair in the emergency department.
To assess patient satisfaction with laceration management, post-ED care, cosmesis and complication rates. ⋯ Most patients are very satisfied with their laceration management. However, there is scope for improvement, especially for follow-up and wound care advice. Complications are infrequent and not associated with overall satisfaction.
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Emerg Med Australas · Apr 2021
Observational StudyEffect of simulation training on nurse leadership in a shared leadership model for cardiopulmonary resuscitation in the emergency department.
Empowering a senior nurse in a shared leadership role has been proposed as a more efficient set up for the cardiac arrest team in ED. In this model, a senior nurse leads the cardiac arrest algorithm which allows cognitive off-loading of the lead emergency physician. The emergency physician is then more available to perform tasks such as echocardiography and exclude reversible causes. Simulation provides an opportunity for training and practice of this shared leadership model. We hypothesised that a structured simulation training programme that focused on implementing a nurse and doctor shared leadership model for cardiopulmonary resuscitation (CPR), would improve leadership and teamwork quality in the setting of cardiac arrest as measured by a Trauma Non-technical Skills (T-NOTECHS) teamwork scale. ⋯ The present study shows that a short simulation training programme improved nurse leadership and teamwork performance in the setting of a shared leadership model for CPR in the ED which could easily be replicated in other departments.
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Emerg Med Australas · Apr 2021
Lunacy in a tertiary emergency department: A 3-year cohort study of the association between moon cycles and occupational violence and aggression.
Occupational violence and aggression (OVA) in the ED is an issue of global concern and increasing incidence. The empirical evidence for the relationship between the lunar cycle and 'lunatics' remains equivocal. The present study aims to examine the association between OVA in ED and the full moon (FM). ⋯ Contrary to traditional beliefs, the FQ and TQ of the lunar cycle but not the FM were associated with OVA. This highlights a relatively unexplored relationship that has previously been overshadowed by the FM in the literature. Prediction models of violence in the ED could consider incorporating the FQ and TQ of the lunar cycle in their models.
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Emerg Med Australas · Apr 2021
Responding to the COVID-19 pandemic: The experiences of South Australia's Rescue, Retrieval and Aviation Services.
COVID-19 poses significant challenges to pre-hospital and retrieval medicine (PHRM) clinicians - and many are unique to this area of clinical practice. We share the experiences of the South Australian Ambulance Service (SAAS) MedSTAR Emergency Medical Retrieval Service in preparing for the COVID-19 pandemic in the pre-hospital and retrieval setting - including the role of a multidisciplinary leadership team; challenges and potential approaches to screening for COVID-19; personal protective equipment for pre-hospital and aeromedical taskings; issues arising with interstate retrievals; and the role of telehealth. Although novel solutions allowed SAAS MedSTAR to continue to deliver high-quality care, considering the resource implications involved in undertaking the transfer of patients with COVID-19, it is clear that significant community disease transmission threatens to overwhelm any PHRM service. Should Australia face a significant future outbreak, it is conceivable that some PHRM operations may need to be reduced or suspended entirely.
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Emerg Med Australas · Apr 2021
Observational StudyParamedic streaming upon arrival in emergency department: A prospective study.
The role of paramedics in hospital triage or streaming models has not been adequately explored and is potentially a missed opportunity for enhanced patient flow. The aim of the present study was to assess the concordance between a streaming decision by paramedics with the decision by nurses after arrival to the ED. ⋯ Despite limited knowledge of patient load within the ED, paramedics can allocate a streaming destination with high accuracy and this appears to be associated with low clinical risks. Early pre-hospital notification of streaming destination with proactive allocation of ED destination presents a real opportunity to minimise off-load times and improve patient flow.