Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2023
Missed presentations, missed opportunities: A cross-sectional study of mental health presentation undercounting in the emergency department.
The burden of mental illness is increasing across developed countries. EDs are often used as access points by people experiencing mental health crises, with such rising demand in Australasia. Accurate data is critical to track and address this need, but research suggests that current data collection methods undercount mental health presentations to the EDs. The present study aimed to quantify and characterise ED mental health presentations that were not identified by usual clinical coding processes. ⋯ The present study demonstrates that ED mental health presentations may be underestimated by nearly 5%, revealing greater mental health demand than current figures suggest.
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EDs are highly demanding workplaces generating considerable potential for occupational stress experiences. Previous research has been limited by a focus on specific aspects of the working environment and studies focussing on a range of variables are needed. The aim of the present study was to describe the perceptions of occupational stress and coping strategies of ED nurses and doctors and the differences between these two groups. ⋯ The present study found organisational stressors adversely impact the well-being of ED nurses and doctors. Organisational-focused interventions including leadership development, strategic recruitment, adequate staffing and resources may mitigate occupational stress and complement individual coping strategies. Expanding this research to understand broader perspectives and especially the impact of COVID-19 upon ED workers is recommended.
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Emerg Med Australas · Apr 2023
Observational StudyRaising the D-dimer threshold for ruling out pulmonary embolism: A single-site, observational study with a historical comparison.
The objective of this study was to assess the impact of introduction of a new pulmonary embolism (PE) diagnostic guideline with a raised D-dimer threshold. ⋯ The introduction of the new guideline was associated with a reduction in overall imaging rates without evidence of missed PE. Further evaluation in other settings is recommended.
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Emerg Med Australas · Apr 2023
Management of paediatric acute severe behavioural disturbance in emergency departments across Australia: A PREDICT survey of senior medical staff.
Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in EDs. It poses a significant risk to the patient and those around them. Little is known about the epidemiology or most effective management in the paediatric population. The aim of the present study is to clarify the practice of senior emergency doctors in Australia when managing paediatric ASBD. ⋯ Within Australia, there is considerable variation in paediatric ASBD practice, in particular regarding medication provision. Further prospective research is required to inform best clinical practice.
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Emerg Med Australas · Apr 2023
High-dose vasoactive agents in aeromedical retrievals for septic shock: A role for vasopressin?
To determine the number of patients retrieved by aeromedical teams for septic shock requiring vasopressor support who meet criteria for vasopressin therapy under the Surviving Sepsis Campaign 2021 guidelines. ⋯ A sufficient percentage of patients on vasopressors for septic shock require vasopressin therapy to meet current best treatment guidelines, and the inclusion of vasopressin in retrieval drug kits should be considered by Australian aeromedical services.