Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Lost capacity in emergency departments and its economic implications: A simulation study and economic analysis.
To determine the effect of lost bed capacity (LBC) on the overall capacity of an ED, and to estimate the costs attributable to excess stay in the ED beyond that required for actual emergency care. ⋯ A substantial amount of ED length of stay is due to patients remaining in the ED for time after their emergency care is concluded. This likely represents a substantial overall monetary cost to the Australian healthcare system.
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Emerg Med Australas · Dec 2020
Examining the association between triage streamed treatment location and time to appropriate antibiotics in emergency department patients with septic shock.
Early recognition and treatment for sepsis is critical in improving patient outcomes. The present study sought to examine whether triage location was associated with time to appropriate antibiotics in a cohort of ED patients with septic shock. ⋯ We identified a sub-group of septic shock patients triaged to a lower acuity treatment location who received significant delays to antibiotics. This research area deserves closer examination to potentially recognise septic shock earlier in the continuum.
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Emerg Med Australas · Dec 2020
Management of patients with low back pain in the emergency department: Is it feasible to follow evidence-based recommendations?
Low back pain is frequently seen in patients visiting the ED, but many patients receive medical care with no demonstrable benefits. We studied the clinical characteristics of patients visiting two EDs in Santiago, Chile, and their management to evaluate how it adheres to evidence-based recommendations. ⋯ Older age, the presence of red flags and pain intensity influenced the management of patients with low back pain in the ED. Future strategies should emphasise avoiding costly and ineffective management in these patients.
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Emerg Med Australas · Dec 2020
Observational StudyImpact of COVID-19 State of Emergency restrictions on presentations to two Victorian emergency departments.
To determine if COVID-19 State of Emergency (SOE) restrictions were associated with a reduction in presentations to two urban EDs in Melbourne, Victoria. ⋯ SOE restrictions were associated with a significant reduction in ED presentations across a range of triage categories and diagnoses. Public health messaging should emphasise the importance of timely ED attendance for acute illness and injury.
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Emerg Med Australas · Dec 2020
Patients with mental health conditions in the emergency department: Why so long a wait?
Patients presenting with a mental health disorder (MHD) wait longer in the ED compared to those presenting for other reasons, potentially placing vulnerable patients at further risk for deterioration. The present study identified factors associated with a long ED stay for patients with a MHD. ⋯ Some factors predictive of a long ED stay for patients presenting to the ED and diagnosed with a MHD varied based on their disposition. For admissions, the most urgent presentations were likely to stay longest. Strategies to reduce ED stay for both admissions and discharges should consider addressing modifiable aspects, including the need for certain investigations, and non-modifiable aspects, including the need for further access to after-hours mental health services in hospital and in the community.