Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2021
ReviewReview article: Paramedic pain management of femur fractures in the prehospital setting: A systematic review.
Femur shaft and neck of femur (NOF) fractures are often undertreated in the prehospital setting. These injuries can present unique clinical and logistical concerns in the prehospital setting. This systematic review aimed to investigate paramedic prehospital pain management of patients who had suffered NOF or femur fractures, and to investigate which interventions are effective. ⋯ Alternative analgesics such as auricular acupressure, transcutaneous electrical nerve stimulation (TENS) and fascia iliaca compartment block were found to be effective techniques that could be safely and competently employed by paramedics, reducing pain for patients with limited adverse events. NOF and femur shaft fractures are an undertreated injury in the prehospital setting. Traction splinting and IV analgesia remain the traditional methodologies of treatment for these injuries; however, there are alternatives such as TENS, auricular acupressure and fascia iliaca compartment block that appear to be emerging as safe and effective options for the prehospital setting.
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Emerg Med Australas · Aug 2021
Spatiotemporal characteristics of asthma emergency department presentations in diverse geographical and climatic regions, Queensland, Australia.
Sudden acute episodes of asthma exacerbation are often treated by hospital EDs. It is hypothesised that determinants of acute asthma would differ across geographic regions. The objective of the present study was to detail seasonality, trends and spatiotemporal patterns of asthma ED presentations across Queensland (QLD), Australia, a state covering 1.8 million square kilometres, spanning multiple climates. ⋯ Asthma-related ED presentations exhibit spatiotemporal variation across QLD, which appears to be related to climate. Furthermore, aeroallergens and respiratory viruses may be responsible for asthma ED peaks outside the winter period. Socioeconomic status may influence asthma ED presentation rates between regions. This knowledge can guide ongoing management and assist public health policy response.
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Emerg Med Australas · Aug 2021
Prehospital Resuscitation Decision Making: A model of ambulance personnel experiences, preparation and support.
This paper presents the first Naturalistic Decision Making model of prehospital resuscitation decision-making, which has clear implications for education, practice and support. ⋯ This research project is the first to comprehensively explore and model ambulance personnel perspectives on decisions to start, continue or stop resuscitation. The decision-making process is complex and difficult to simply formularise. Education and supports must assist ambulance personnel in navigating this complexity. Where resuscitation is withheld or terminated, ambulance personnel need to feel confident that they can effectively provide after-death care.
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Emerg Med Australas · Aug 2021
Development, implementation and evaluation of a process to recognise and reduce aggression and violence in an Australian emergency department.
In 2018, we developed and implemented a novel approach to recognition and response to occupational violence and aggression (OVA). It included routine use of the Brøset Violence Checklist for all ED patients integrated with a score-based notification and response framework. The present study evaluated the impact of the new process on staff knowledge, perceptions and confidence regarding OVA in ED and the rate of security events related to OVA. ⋯ A process including routine OVA risk assessment and a notification and response framework reduced unplanned security events due to OVA and increased staff confidence in recognition and management of OVA. This approach may be suitable for use more broadly in ED.
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Emerg Med Australas · Aug 2021
Observational StudyAssociation between shift work and cognitive performance on the Trail Making Test in emergency department health officers.
Shift work has been proposed to disturb alertness and decrease cognitive efficiency. However, studies so far have had varied findings. The aim of the present study was to compare cognitive function following shifts at different times of the day in an Australian ED context. ⋯ Night shift work was associated with a longer TMT time. This may indicate a decrease in cognitive performance, in particular, visual attention, processing speed, task switching and executive function and may implicate the quality of care for patients and worker safety.