Emergency medicine Australasia : EMA
-
There has been great interest regarding tele-emergency care (TEC) and its utility following the COVID-19 pandemic. We have seen a roll out of multiple TEC services across Australia, operating in isolation, without coordination and under differing models of care, creating the potential for an uncoordinated, inefficient healthcare system. We outline a potential framework under which TEC services might function as part of the current system, defining potential strategies that may be used to appropriately coordinate the acute care of select patients outside of the ED as well as improve the efficiency of the physical ED itself.
-
Emerg Med Australas · Dec 2022
Evaluating Stroke Code Activation Pathway in Emergency Departments study.
To describe the clinical characteristics and outcomes of Code Stroke activations in an ED and determine predictors of a final diagnosis of stroke or transient ischemic attack (TIA) diagnosis. ⋯ In a cohort of patients requiring Code Stroke activation in an ED, increased age, systolic blood pressure and weakness and speech impairment increased the risk of stroke. Prehospital notification was associated with lower door to needle times for patients undergoing thrombolysis.
-
Emerg Med Australas · Dec 2022
Structured evaluation of a virtual emergency department triage model of care: A study protocol.
A new virtual ED service was introduced into a hospital network in the northern suburbs of Melbourne in response to changing needs during the COVID-19 pandemic. The 'virtual ED' utilises a telehealth model as a means of assessment for appropriately selected patients to facilitate either complete care or navigation into streamlined pathways for ongoing care, in some cases bypassing the ED entirely where appropriate. The proposed study aims to evaluate the implementation of the model and identify future improvement opportunities, assess the impact on traditional health service delivery processes and patient experience, and determine the acceptability of the 'virtual ED' model of care. ⋯ This project will support the delivery of care to ED patients by evaluating the 'virtual ED' model of care.
-
Emerg Med Australas · Dec 2022
Clean the skin: Reducing blood culture contamination in the emergency department.
To determine whether blood culture contamination (BCC) rates could be decreased in the ED by an educational programme. ⋯ This educational intervention focusing on skin clean time did not significantly decrease BCC rates in a setting of an already low (<3%) BCC rate.
-
Emerg Med Australas · Dec 2022
Pleural decompression procedural safety for traumatic pneumothorax and haemothorax: Kelly clamps versus fine artery forceps.
The present study aimed to determine the difference in force required to puncture simulated pleura comparing Kelly clamps to fine artery forceps. The treatment of symptomatic traumatic pneumothorax and haemothorax involves puncture of the parietal pleura to allow decompression. This is usually performed using Kelly clamps or fine artery forceps. Over-puncture pulmonary injury risk increases with the force used. ⋯ A significantly increased force was required to puncture simulated parietal pleura using Kelly clamps compared to fine artery forceps. This higher puncture force will be associated with increased instrument acceleration at the time of pleural puncture, which may result in an increased risk of injury to the underlying lung. Based on these data, clinicians may reduce the risk of pulmonary injury by using fine artery forceps rather than Kelly clamps when performing pleural decompression.