Emergency medicine Australasia : EMA
-
Emerg Med Australas · Jun 2023
Mid-Arm Point in PAEDiatrics (MAPPAED): An effective procedural aid for safe pleural decompression in trauma.
Life-threatening thoracic trauma requires emergency pleural decompression and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe site for pleural decompression in children can be challenging. We assessed whether the Mid-Arm Point (MAP) technique, a procedural aid proposed for use with injured adults, would also identify a safe site for pleural decompression in children. ⋯ The MAP technique reliably determines a safe site for pleural decompression in children, albeit with an age-based adjustment, the Mid-Arm Point in PAEDiatrics (MAPPAED) rule: 'in children aged ≥4 years, use the MAP and go up one ICS to hit the safe zone. In children <4 years, use the MAP.' When together with this rule, the MAP technique will identify a site within the 'safe zone' in 9 out of 10 children.
-
We sought to define the rate of unexpected death from acute coronary syndrome or arrhythmia in chest pain patients directly discharged from the ED. ⋯ Unexpected death is very uncommon after ED discharge of chest pain patients.
-
Emerg Med Australas · Jun 2023
'Burr holes in the bush': Clinician preparedness for undertaking emergency intracranial haematoma evacuation surgery in rural and regional Queensland.
Delayed inter-hospital transfers of deteriorating neurotrauma patients from rural and regional hospitals to tertiary centres have seen the need for non-neurosurgeons to undertake emergency intracranial haematoma evacuation surgery locally. In the present study, the authors contributed to the paucity in the literature regarding the widespread availability of cranial access equipment in non-tertiary centres and patient outcomes in Queensland. ⋯ The availability of cranial access equipment outside Queensland tertiary centres has been limited. Inter-hospital transfers are likely to persist in Queensland and haematoma evacuation surgery has been a life-saving endeavour, so improving access to cranial access equipment in hospitals where it is currently lacking is highly warranted.
-
Emerg Med Australas · Jun 2023
Qualitative study using grounded theory examining collegiality among emergency physicians.
Collegiality is considered to be any extra-role behaviour that is discretionary, not recognised by a formal reward system and that promotes the effective functioning of the organisation. Although there is much literature on the concept of collegiality, there are few studies examining collegiality in the medical profession and none looking at collegiality among emergency physicians (EPs). The aim of the present study is to explore the perceptions of different ED healthcare professionals on the meaning of collegiality among EPs, the benefits of collegiality and behaviours they identify as indicative of collegiality. ⋯ The present study identified distinct themes and behaviours indicative of collegiality among EPs. Promoting these behaviours could improve staff well-being, ED efficiency, patient safety and productivity.