Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2021
Advancing leadership in Australasian emergency medicine: Taking stock and looking ahead.
Since 2018, the Australasian College for Emergency Medicine has collaborated with the Swinburne University of Technology on a research project to understand and enhance the leadership capacity of emergency physicians, beginning with Australasian Directors of Emergency Medicine (DEMs). Over the last 3 years, this research programme has revealed the complexity of leadership in emergency medicine, illuminating the strengths and limitations of extant research and suggesting promising new directions for emergency medicine leadership and leadership development research. This programme has also shed new light on the knowledge, skills and abilities that DEMs need to develop to catalyse change in the systems where DEMs practice both medicine and leadership. We propose that an approach to leadership development that reflects the diversity of DEMs' leadership challenges and the complexity of leadership in emergency medicine would go a long way to enhancing the sophistication, effectiveness and impact of the leadership in emergency medicine.
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Emerg Med Australas · Oct 2021
Observational StudySafety of rapid sequence intubation in an emergency training network.
Rapid sequence intubation (RSI) is a core critical care skill. Emergency medicine trainees are exposed to relatively low numbers of RSIs. We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence. ⋯ Implementation of an evidence-based care bundle and audit of practice has created a safe environment for trainees to learn the core critical care skill of RSI. In our setting, checklist use was associated with fewer complications.
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Emerg Med Australas · Oct 2021
Introduction of point-of-care ROTEM testing in the emergency department of an Australian level 1 trauma centre and its effect on blood product use.
To assess whether the introduction of point-of-care rotational thromboelastometry (ROTEM) analysis influences blood product transfusion and coagulation management in a modern Australian level 1 trauma centre. ⋯ Point-of-care ROTEM was performed in a small proportion of patients, mainly those with a higher ISS. ROTEM introduction in the ED altered blood product transfusion practices for major trauma patients with an ISS >12, leading to a potentially safer transfusion strategy and cost savings for key blood products.
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Emerg Med Australas · Oct 2021
Evaluation of an augmented emergency department electronic medical record-based sepsis alert.
Electronic medical records-based alerts have shown mixed results in identifying ED sepsis. Augmenting clinical patient-flagging with automated alert systems may improve sepsis screening. We evaluate the performance of a hybrid alert to identify patients in ED with sepsis or in-hospital secondary outcomes from infection. ⋯ The hybrid alert performed modestly in identifying ED sepsis and secondary outcomes from infection. Not all infected patients with a secondary outcome were identified by the alert or mSOFA score ≥2 threshold. Augmenting clinical practice with auto-alerts rather than pure automation should be considered as a potential for sepsis alerting until more reliable algorithms are available for safe use in clinical practice.