Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
Low-acuity emergency department presentation characteristics and their association with Medicare-subsidised general practitioner services across New South Wales: A data linkage study.
Identify clinical and demographic characteristics of low-acuity presentations (LAPs) to the ED and analyse correlations between population rates of LAPs to ED and rates of Medicare-subsidised general practitioner (GP) services across statistical areas. ⋯ A relationship between LAPs to ED and Medicare-subsidised GP episodes of care exists for non-metropolitan but not metropolitan areas.
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Emerg Med Australas · Feb 2025
Factors associated with extended length of stay for paediatric mental health presentations to EDs in South Western Sydney, Australia.
This study aimed to determine the factors associated with extended length of stay (LOS) for paediatric mental health (MH)-related presentations to the EDs in South Western Sydney (SWS). ⋯ Our findings highlight the need for equitable distribution of resources directed towards at-risk CYP to improve MH outcomes and reduce health system burden.
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Emerg Med Australas · Feb 2025
Triage gap? Analysis of admission rates, service utilisation and mortality for First Nations patients compared to non-First Nations patients, stratified by ED triage category.
First Nations patients often experience poorer health outcomes than non-First Nations patients. Despite emergency triage primarily focusing on severity, implying comparable outcomes for patients in the same triage group regardless of demographics, the precision of triage for First-Nations Australians may be undermined by multiple factors, although research in this area is scarce. ⋯ First Nations patients appear to have worse outcomes than non-First Nations patients in the same triage category. Socio-economic factors and high discharge against advice rates from wards may explain the significantly higher admission rate. Under-recognition of serious illness at triage could be attributed to communication issues or a 'well bias'. The results raise many questions and further investigation is required.
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Emerg Med Australas · Feb 2025
We can do better: Recommendations for mental health crisis care from people with lived experience.
The ED is increasingly the first point of contact for people who have no alternative when they are in a mental health crisis. However, there is mounting evidence of inadequate and negative responses to mental health crises in the ED, which has been identified as a 'human rights flashpoint'. ⋯ These key messages arise from a phenomenological analysis of in-depth interviews with 31 users of ED services, a PhD study conducted by a lived experience researcher. The paper concludes with six recommendations that combine collective wished-for responses with tangible examples of how these desired responses can be translated into crisis care practice.
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Emerg Med Australas · Feb 2025
How useful was a paediatric physical abuse screening project in a rural Australian emergency department?
Children with non-accidental injuries have increased risk of future death. There is insufficient evidence for widespread physical abuse screening tool use in the ED. This study assesses the utility of a physical abuse project that includes the implementation of a screening tool with case-matching from multiple sources. It aims to confirm whether risk-screening in a medium-sized rural Australian ED is reliable and will improve outcomes. ⋯ Implementing this ED paediatric physical abuse project improved safety behaviours and best-practice documentation. The tool improved medical decision making without increased re-presentations. ED clinicians may use similar CPAs to help review safety concerns and facilitate discharge; however, resources are needed to investigate referrals flagged due to false-positive rates.