Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2021
Observational StudyDrug- and alcohol-related emergency department patient presentations during the 2018 Commonwealth Games: A multi-site retrospective analysis.
To examine the impact of the 2018 Commonwealth Games on ED patient presentations related to drug(s) and/or alcohol. ⋯ During the 2018 Commonwealth Games, minimal impact on the ED was noted pertaining to drug and alcohol misuse. Further research is required to understand whether this held true for other types of ED presentations and during other types and locations of mass gathering events.
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Emerg Med Australas · Oct 2021
Current airway management practices after a failed intubation attempt in Australian and New Zealand emergency departments.
The aims of the present study were to describe current airway management practices after a failed intubation attempt in Australian and New Zealand EDs and to explore factors associated with second attempt success. ⋯ The majority of second intubation attempts were undertaken by emergency consultants and registrars. A change from a non-consultant intubator to a consultant intubator of any specialty for the second attempt and intubation episodes where laryngoscopy was predicted to be non-difficult were associated with a higher success rate at intubation. Participation in routine collection and monitoring of airway management practices via a Registry may enable the introduction of appropriate improvements in airway procedures and reduce complication rates.
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Emerg Med Australas · Oct 2021
Are we overlooking the rural patient journey when it comes to sepsis diagnosis and management?
Surviving Sepsis Campaign guidelines have progressively moved towards faster time-based treatment targets over recent years despite international data consistently showing low protocol adherence. A key stakeholder in Australian healthcare remains overlooked in sepsis research: the under-resourced rural ED. ⋯ Greater representation of rural patients and EDs in Australian sepsis research is paramount in guiding future sepsis treatment protocols. This perspective piece explores current international sepsis literature, recognising significant barriers to sepsis protocol adherence specific to rural Australian EDs.
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Emerg Med Australas · Oct 2021
Impact of the modifiable areal unit problem in assessing determinants of emergency department demand.
To examine the impact of the modifiable areal unit problem (MAUP) in an investigation of factors associated with ED demand in Perth, Western Australia, in 2016. Furthermore, to advocate a means of avoiding this impact. ⋯ When formulating interventions targeting reduced ED utilisation, policy planners should be guided by evidence based on analysis of appropriate spatial units. This ideal is undermined by the widespread lack of acknowledgement of the MAUP in studies examining drivers of ED demand using spatially aggregated data. To avoid the MAUP, only estimates obtained through examining a minimal geographic unit should be relied upon.
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Emerg Med Australas · Oct 2021
Regional anaesthesia for rib fractures: A pilot study of serratus anterior plane block.
Rib fractures are not only painful but are associated with morbidity and mortality, especially in older patients. The serratus anterior plane block (SAPB) is a plane block distant from major neurovascular bundles and may provide anaesthesia to a substantial area of the hemithorax. This pilot study was designed to assess if the SAPB can be safely and efficiently incorporated to the trauma reception workflow of an adult, level 1 trauma centre. ⋯ The present study demonstrated the feasibility of ultrasound-guided SAPB among patients with multiple rib fractures in the ED. No complications were observed. Further prospective evaluation of analgesic effects in a larger cohort is indicated.