Emergency medicine Australasia : EMA
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Trauma is one of the most common contributors to maternal and foetal morbidity and mortality. The aim of the present study was to describe the characteristics and outcomes of major trauma in pregnant patients using a population-based registry. ⋯ The present study demonstrated road transport injury was the most common mechanism of injury and both maternal survival rates and foetal survival rates were high. This information is essential for trauma care system planning and public health initiatives to improve the clinical management and outcomes of pregnant women with major trauma.
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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
Observational StudyMisleading medical literature: An observational study.
Language that implies a conclusion not supported by the evidence is common in the medical literature. The hypothesis of the present study was that medical journal publications are more likely to use misleading language for the interpretation of a demonstrated null (i.e. chance or not statistically significant) effect than a demonstrated real (i.e. statistically significant) effect. ⋯ Among a random selection of sentences in prestigious journals describing P-values close to 0.05, 1 in 10 are misleading (n = 44, 11%) and this is more prevalent when the P-values are above 0.05 compared to below 0.05. Caution is advised for researchers, clinicians and editors to align with the context and purpose of P-values.
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Emerg Med Australas · Feb 2022
Recent amendments to Queensland legislation make mental health presentations to hospital emergency departments more difficult to scrutinise.
The Queensland Police Service (QPS) and Queensland Ambulance Service may detain and transport persons experiencing major disturbances in their mental capacity to an ED for urgent care. Queensland's new mental health legislation (March 2017) makes this legal intervention difficult to scrutinise. For a large non-metropolitan region, QPS records for emergency examination orders (EEOs) and emergency examination authorities (EEAs) were compared with annual reports of Queensland's Director of Mental Health and Chief Psychiatrist. ⋯ Annual reports declared 1803 EEAs in total for this period, without distinguishing those registered by QPS from the Queensland Ambulance Service. Past year proportions of EEOs, however, indicate perhaps ~1100 originated with QPS (84% fewer). Information crucial for considered emergency mental healthcare responses for thousands of people is no longer readily available.
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Emerg Med Australas · Feb 2022
Telehealth training: Interprofessional mixed reality simulation in a retrieval service setting.
The use of Telehealth is well established in Australian retrieval service settings to aid assessment and management of patients requiring aeromedical transportation and to provide support to clinicians at remote facilities. Telehealth ensures prompt advice and treatment for critically ill and injured patients and can facilitate a resuscitation until the retrieval team arrives. ⋯ We share the experiences of the South Australia Ambulance Service MedSTAR Emergency Medical Retrieval Service preparing an education programme focussed on the psychometric skills in Telehealth. Our programme realistically simulates Telehealth and coordination systems in use across South Australia, provides in-depth hands-on practice for medical and nursing staff that incorporates teamwork, communication, technical and critical thinking skills and culminates with a mixed-reality simulation scenario and formal debrief.