Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
Reframing leadership: Leader identity challenges of the emergency physician.
Emergency medicine (EM) leadership is often conceptualised as either administrative leadership within the structure (e.g. head-of-committee leader) or operational/functional leadership within a group (e.g. resuscitation-scenario team leader). While these bases of identity are practically useful, they often do not take into account the intricate, underlying challenges to one's leader identity presented by the dynamic, fluid and transient context of EM leadership. ⋯ Similarly, at an organisational level, there is an opportunity for formal and emergent leaders to create psychologically safe identity workspaces. The co-creation of EM leadership by leaders and followers would help emergent leaders navigate their leader identity, allowing them to simultaneously inspire confidence and exert influence as future-fit health professionals and leaders.
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Emerg Med Australas · Feb 2022
Magnetic resonance imaging cervical spine in trauma: A retrospective single-centre audit of patient outcomes.
Magnetic resonance imaging (MRI) is often used in practice to investigate for cord or discoligamentous injury following blunt trauma and a normal computed tomography (CT). This study investigates the MRI findings and surgical outcomes of patients in this cohort. ⋯ No alert neurologically intact patient with 'persistent tenderness only' received operative management following a normal CT examination. While MRI is sensitive for detecting soft tissue injuries, the prevalence for detecting clinically significant cervical spine injury in blunt trauma patients in the absence of neurology is low. The utility of MRI in this cohort is questionable considering prolonged spinal immobilisation is not without harm.
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Emerg Med Australas · Feb 2022
Observational StudyExamining emergency department inequities in Aotearoa New Zealand: Findings from a national retrospective observational study examining Indigenous emergency care outcomes.
There is increasing evidence that EDs may not operate equitably for all patients, with Indigenous and minoritised ethnicity patients experiencing longer wait times for assessment, differential pain management and less evaluation and treatment of acute conditions. ⋯ To our knowledge, this is the most comprehensive investigation of acute outcomes by ethnicity to date in New Zealand. We found ED mortality inequities that are unlikely to be explained by ED process measures or comorbidities. Our findings reinforce the need to investigate health professional bias and institutional racism within an acute care context.
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Emerg Med Australas · Feb 2022
Increased paediatric emergency mental health and suicidality presentations during COVID-19 stay at home restrictions.
Anecdotal reports indicate an increase in mental health presentations and acuity to EDs during the COVID-19 pandemic and associated stay at home restrictions. Paediatric and adolescent data to confirm this are unavailable in the Australian setting. ⋯ Despite an overall decrease in ED presentations, the absolute increase in mental health presentations for children and adolescents during the stay at home restriction period was pronounced. It is unclear how sustained this change and the impact on mental health resource use will be post-pandemic.