Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2022
Audit of ultrasound usage in emergency departments in greater metropolitan Brisbane.
The Australasian College for Emergency Medicine identifies five ultrasound applications which the College deem core to the practice of emergency medicine but there is scant information as to the uptake of ultrasound or the qualification of users. This study aims to determine the percentage of ED physicians in one metropolitan area who utilise ultrasound for core diagnostic and procedural applications in participating hospitals and the percentage of users who have been formally assessed in any ultrasound application. ⋯ While use of ultrasound in some applications is widespread, few users have had their skills assessed. Assessment being a routine part of structured training, it cannot be assumed that these users can competently use ultrasound for procedural or diagnostic applications.
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Emerg Med Australas · Apr 2022
Observational StudyMapping haemodynamic changes with rapid sequence induction agents in the emergency department.
Patients intubated in the ED are at an increased risk of post-intubation hypotension. However, evidence regarding the most appropriate induction agent is lacking. The present study aims to describe and compare the haemodynamic effect of propofol, ketamine and thiopentone during rapid sequence induction. ⋯ Propofol was associated with post-intubation hypotension and it is recommended clinicians consider using the lowest effective dose to reduce this risk. Reflecting its perceived haemodynamic stability, patients who received ketamine were more likely to have a higher shock index; however, there was also an association with post-intubation hypotension.
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Emerg Med Australas · Apr 2022
ReviewReview article: DINED (Delivery-related INjuries in the Emergency Department) part 1: A scoping review of risk factors and injuries affecting food delivery riders.
This scoping review describes the current state of research about two-wheeled delivery riders who have been injured while performing commercial food delivery. The key areas of interest are the patterns of injury, associated risk factors and current gaps in knowledge. Five databases were searched to identify key papers that describe injuries to two-wheeled food delivery riders. ⋯ There are very few publications describing food delivery rider injuries and risk factors. This is an emerging industry in which the worker population may be younger and more vulnerable. Given the different legal and cultural contexts across different countries, Australian-specific research is needed.
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Emerg Med Australas · Apr 2022
Randomized Controlled TrialEffects of mobile mindfulness on emergency department work stress: A randomised controlled trial.
High-occupational stress among ED staff has a detrimental impact on both staff wellness and patient care. The objective of the study is to determine whether 4 weeks of smartphone app-guided mindfulness practice reduces stress levels of ED staff. ⋯ Results of the present study demonstrate that brief mindfulness training via innovative digital technology had a small positive effect in improving emergency staff stress, burnout, mindfulness and wellbeing.
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Emerg Med Australas · Apr 2022
COVID-19 and involuntary detention - An emergency medicine or emergency management responsibility?
The COVID-19 pandemic has thrown up innumerable challenges throughout the world, especially evident in the healthcare system. In emergency medicine, there is a new urgency around the clinical and ethical dilemmas clinicians face as they make decisions that impact upon the lives of their patients. Emergency clinicians are accustomed to upholding duty of care and acting in the best interests of patients. ⋯ What is particularly fraught for clinicians is the lack of clarity around this potential duty of care to the community, and navigating the potential conflict with duty of care to the patient. How much danger does the community need to be in, and how definable, imminent and specific does that risk need to be? An attempt to protect the community may well constitute either a breach of confidentiality or a breach of duty of care. This paper will explore the complex issues of respect for autonomy and the principle of non-maleficence, in the setting of COVID-19 and public health orders and illustrate the uncomfortable uncertainty that exists surrounding care of some of the most vulnerable patients in the community when their actions are contrary to public health recommendations.