Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
Observational StudyImpact of lockdowns on critical care service demand in a metropolitan hospital in Melbourne, Australia.
There is a growing recognition of the impact of lockdowns on non-COVID-19 demand for critical care services. While a reduction in demand has been postulated, there remains a paucity of quantitative data on the extent and nature of this reduction. The present study aims to quantify the impact of lockdown on critical care services, namely ED, intensive care unit (ICU), medical emergency team (MET) and emergency theatre (ET) demand, during the lockdown in Victoria, Australia. ⋯ Lockdowns lead to a significant reduction in ICU, MET call and ED demand, and to a lesser extent ET demand. This pattern should be considered in surge capacity and workforce redeployment planning. There are also impacts on public health epidemiology, with potential adverse consequences on mental health and chronic disease management. Further research on the impact of lockdowns on long-term disease outcomes is needed.
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Emerg Med Australas · Feb 2022
Length of stay outcomes in patients receiving ketamine sedation versus Bier's block anaesthesia for procedural closed fracture reduction: A retrospective audit of paediatric emergency department patients.
To compare length of stay (LOS) for paediatric patients receiving ketamine sedation or Bier's block anaesthesia for procedural closed fracture reduction. ⋯ Bier's block anaesthesia is a safe alternative to ketamine sedation for paediatric patients presenting to the ED with closed fractures. It is associated with reduced LOS and need for post-procedural observation. However, ketamine may remain preferable for younger paediatric patients, on whom it places fewer demands for cooperation.
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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.