Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2023
Suspected myocardial infarction in the emergency department: An evaluation of clinical thresholds for the Beckman Coulter Access hsTnI high-sensitivity cardiac troponin I assay.
The primary objective was to determine rapid rule-out (RRO) criteria for the outcome of myocardial infarction (MI) using the Beckman Coulter Access high-sensitivity cardiac troponin I (hs-cTnI) assay. Secondary objectives were to explore cut-points for rapid rule-in (RRI) and amount of change at 3-h (3-h delta) indicative of MI. ⋯ For the Beckman Coulter Access hs-cTnI assay, RRO criteria of baseline hs-cTnI <6 ng/L (females) or <11 ng/L (males) plus symptom onset >2 h met our performance benchmark. A 3-h delta cut-point >35 ng/L met the performance benchmark, but poor precision means further adequately powered research is required.
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Emerg Med Australas · Dec 2023
Barriers to identification and reporting of child abuse and neglect experienced by medical officers and nursing staff in emergency departments of the Nepean Blue Mountains Local Health District.
This structured survey sought to identify barriers to recognising and reporting potential child abuse by medical officers and nursing staff in the EDs of three Western Sydney hospitals. These include a large metropolitan teaching hospital, a small metropolitan hospital and a rural hospital. ⋯ The combination of hospital, departmental and individual staff issues such as time limitations, lack of resources, education and support are potential barriers to reporting suspected child abuse. We recommend tailored teaching sessions, improved reporting procedures and increased support from senior staff to overcome these barriers.
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Emerg Med Australas · Dec 2023
Geographic variation in emergency department presentations among youth (10-24 years), New South Wales 2019: An epidemiological study.
To characterise ED presentations among youth in New South Wales (NSW) by geographic remoteness for 2019 and determine if intra-regional (inland vs coastal) variations exist. ⋯ Patterns of ED utilisation between major city, regional and remote youth were distinctly different, but not so between coastal and inland regional youth. Further research could better understand ED utilisation among youth and the drivers of higher presentation rates in regional and remote areas.
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Emerg Med Australas · Dec 2023
Comment Observational StudyOpioid poisoning in Newcastle over the last three decades: From heroin to prescription opioids.
Opioid-related harm has risen in recent decades, but limited research describes the clinical burden of opioid poisoning to Australian EDs. We aimed to investigate hospital presentations with opioid poisoning over three decades. ⋯ Opioid presentations increased in number and severity over three decades as the type of opioid changed. Oxycodone is currently the main opioid of concern. Methadone poisoning was the most severe.