Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2022
Observational StudyHigher quality of care in emergency departments with physiotherapy service models.
To investigate the quality of care provided by EDs with physiotherapy services compared to those without, using established musculoskeletal process and outcome quality indicators (QIs). ⋯ EDs with physiotherapists provide at least equivalent or higher quality of care for patients with musculoskeletal injuries than those EDs with limited access to physiotherapists. This may be because of their specialised training in musculoskeletal diagnosis and treatment, as well as the impact of teaching and mentoring for other ED clinicians.
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Emerg Med Australas · Apr 2022
Chlorhexidine skin cleaning to reduce clean-catch urine contamination in infants: A pilot study.
Clean-catch urine (CCU) samples are frequently contaminated. Our aim was to determine if cleaning with 0.1% chlorhexidine before CCU is a safe and feasible method to reduce contamination. ⋯ Cleaning with chlorhexidine solution before CCU is safe and feasible.
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Emerg Med Australas · Apr 2022
Retrospective identification of latent subgroups of emergency department patients: A machine learning approach.
This research aims to (i) identify latent subgroups of ED presentations in Australian public EDs using a data-driven approach and (ii) compare clinical, socio-demographic and time-related characteristics of ED presentations broadly using the subgroups. ⋯ Clustering Large Applications is effective in finding latent groups in large-scale mixed-type data, as demonstrated in the present study. Six types of ED presentations were identified and described using clinically relevant characteristics. The present study provides evidence for policy makers in Australia to develop alternative ED models of care tailored around the care needs of the differing groups of patients and thereby supports the sustainable delivery of acute healthcare.
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Emerg Med Australas · Apr 2022
Management of patients presenting with low back pain to a private hospital emergency department in Melbourne, Australia.
Recent studies suggest many patients with non-specific low back pain presenting to public hospital EDs receive low-value care. The primary aim was to describe management of patients presenting with low back pain to the ED of a private hospital in Melbourne, Australia, and received a final ED diagnosis of non-specific low back pain. We also determined predictors of hospital admission. ⋯ We observed high rates of imaging, pathology tests and hospital admissions compared with previous public hospital studies, while medication use was similar. Implementation of strategies to optimise evidence-based ED care is needed to reduce low-value care and improve patient outcomes.
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Emerg Med Australas · Apr 2022
Observational StudyCharacteristics and outcome of patients transported by police to emergency departments under section 351 of the Mental Health Act 2014 (Vic).
To determine characteristics, precipitating circumstances, clinical care, outcome and disposition of patients brought to the ED under section 351 (s351, police detention and transport) powers of the Mental Health Act 2014 (Vic) (MHAV). ⋯ Most patients brought to ED under s351 of the MHAV had expressed intention to self-harm, did not require medical intervention and were discharged home. It could be questioned whether the current application of s351 is consistent with the least restrictive principles of the MHAV, especially as there is no apparent monitoring or reporting of the use of these powers. There were a concerning number of patients with multiple s351 events over a short period.