Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2021
Case series and review of emergency front-of-neck surgical airways from The Australian and New Zealand Emergency Department Airway Registry.
An emergency front-of-neck access (eFONA), also called can't intubate, can't oxygenate (CICO) rescue, is a rare event. Little is known about the performance of surgical or percutaneous airways in EDs across Australia and New Zealand. ⋯ Most cases demonstrated deviations from standard difficult airway practice, which may have increased the likelihood of performance of a surgical airway, and its increased likelihood out of hours. Our findings may inform training strategies to improve care for ED patients requiring this critical intervention. We recommend further discussion of proposed standard terminology for emergency surgical or percutaneous airways, to facilitate clear crisis communication.
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Emerg Med Australas · Jun 2021
Implementation of point-of-care ROTEM® into a trauma major haemorrhage protocol: A before and after study.
The aim of the present study was to assess transfusion practices with the implementation of a targeted viscoelastic haemostatic assay (VHA) (ROTEM®) guided coagulation management programme into a major haemorrhage protocol for trauma patients requiring ICU admission, starting from time of arrival in the ED. ⋯ Although there was no overall reduction of packed red blood cell usage, a change in the pattern of administration of other blood products was observed with the implementation of a targeted VHA (ROTEM®) guided coagulation management programme. Larger studies are needed to further define the role of early VHA testing to guide correction of trauma-induced coagulopathy and the effect on clinical outcomes.
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Emerg Med Australas · Jun 2021
Emergency Physicians' Role in Telemedicine Care during the Coronavirus Disease Pandemic: Experiences from Taiwan.
Taiwan's response to the coronavirus disease pandemic received international recognition. Among various epidemic control measures, telemedicine services are provided for people under home quarantine. Although this service presents no policy, cost or equipment problems, the medical needs of people under home quarantine are diverse. ⋯ Emergency physicians (EPs) have unique experiences in crisis management and can provide a number of effective public health measures. We advocate that EPs should be the first specialists to contact patients in a multidisciplinary team. Currently, there is a lack of literature on this subject, and Taiwan's epidemic control experience is used as an example to prove our viewpoint and provide recommendations for future EPs.
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Emerg Med Australas · Jun 2021
Forgotten first responders: Australian surf lifesavers and lifeguards.
First responders often face traumatic and emotionally-taxing incidents in their role. Understanding their mental health and coping capacity is important for wellbeing and continued service delivery. ⋯ However, a significant literature gap exists regarding mental health of surf lifesavers and lifeguards in both the international and Australian context. Here we propose a strategy to address this gap, at the individual, organisational and community level.
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Emerg Med Australas · Jun 2021
Displaying emergency patient estimated wait times: A multi-centre, qualitative study of patient, community, paramedic and health administrator perspectives.
EDs have the potential ability to predict patient wait times and to display this to patients and other stakeholders. Little is known about whether consumers and stakeholders would want this information and how wait time predictions might be used. The aim of the present study was to gain perspectives from consumers and health services personnel regarding the concept of emergency wait time visibility. ⋯ Consumers and paramedics want wait time information visibility. They would use the information in a variety of ways, both pre-hospital and while waiting for care.