Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2022
Observational StudyValidity and reliability of the Interagency Integrated Triage Tool in a regional emergency department in Papua New Guinea.
The Interagency Integrated Triage Tool (IITT) is a novel, three-tier triage system recommended by the World Health Organization. The present study sought to assess the validity and reliability of a pilot version of the tool in a resource-limited ED in regional Papua New Guinea. ⋯ There is limited published data regarding the predictive validity and inter-rater reliability of the IITT. In this pragmatic study, the pilot version of the tool demonstrated adequate performance. Evaluation in other emergency care settings is recommended.
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Emerg Med Australas · Feb 2022
The HEART score to identify emergency department patients suspected of an acute coronary syndrome who can be removed from cardiac monitoring: A retrospective chart review.
Continuous cardiac monitoring has been recommended for ED patients being evaluated for possible acute coronary syndrome (ACS) due to concern for arrhythmia, although evidence suggests this risk is low. Indiscriminate use of monitored beds restricts access for other critically unwell patients and contributes to overcrowding. The objective of the present study was to determine if a low/intermediate-risk HEART score identified patients at very low risk for a clinically important arrhythmia who could be removed from cardiac monitoring. ⋯ Among ED patients presenting with a possible ACS, a low/intermediate-risk HEART score identified those at very low risk for having a clinically important arrhythmia while in ED.
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Trauma is one of the most common contributors to maternal and foetal morbidity and mortality. The aim of the present study was to describe the characteristics and outcomes of major trauma in pregnant patients using a population-based registry. ⋯ The present study demonstrated road transport injury was the most common mechanism of injury and both maternal survival rates and foetal survival rates were high. This information is essential for trauma care system planning and public health initiatives to improve the clinical management and outcomes of pregnant women with major trauma.
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Emerg Med Australas · Feb 2022
Reframing leadership: Leader identity challenges of the emergency physician.
Emergency medicine (EM) leadership is often conceptualised as either administrative leadership within the structure (e.g. head-of-committee leader) or operational/functional leadership within a group (e.g. resuscitation-scenario team leader). While these bases of identity are practically useful, they often do not take into account the intricate, underlying challenges to one's leader identity presented by the dynamic, fluid and transient context of EM leadership. ⋯ Similarly, at an organisational level, there is an opportunity for formal and emergent leaders to create psychologically safe identity workspaces. The co-creation of EM leadership by leaders and followers would help emergent leaders navigate their leader identity, allowing them to simultaneously inspire confidence and exert influence as future-fit health professionals and leaders.
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Emerg Med Australas · Feb 2022
Recent amendments to Queensland legislation make mental health presentations to hospital emergency departments more difficult to scrutinise.
The Queensland Police Service (QPS) and Queensland Ambulance Service may detain and transport persons experiencing major disturbances in their mental capacity to an ED for urgent care. Queensland's new mental health legislation (March 2017) makes this legal intervention difficult to scrutinise. For a large non-metropolitan region, QPS records for emergency examination orders (EEOs) and emergency examination authorities (EEAs) were compared with annual reports of Queensland's Director of Mental Health and Chief Psychiatrist. ⋯ Annual reports declared 1803 EEAs in total for this period, without distinguishing those registered by QPS from the Queensland Ambulance Service. Past year proportions of EEOs, however, indicate perhaps ~1100 originated with QPS (84% fewer). Information crucial for considered emergency mental healthcare responses for thousands of people is no longer readily available.