Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Intubation practices for children in emergency departments and intensive care units across Australia and New Zealand: A survey of medical staff.
Intubation of children in the emergency setting is a high-risk, low incidence event. Standardisation of clinical practice has been hampered by a lack of high-quality evidence to support one technique over another. The aim of the present study is to determine clinician preference in intubation practice of children in EDs and ICUs in Australia and New Zealand to provide baseline information to allow future targeted research focused on improving the safety and efficacy of paediatric emergency airway management. ⋯ Within Australia and New Zealand there is considerable variation in paediatric emergency airway clinical practice, in particular with respect to pre-oxygenation, apnoeic oxygenation and use of video laryngoscopy. Definitive clinical trials are required to best inform clinical practice in this area.
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Emerg Med Australas · Dec 2020
The impact of patient isolation on emergency department length of stay: a retrospective cohort study using the Registry for Emergency Care (REC-1).
The number of patients with suspected COVID-19 presenting to Australian EDs continues to impose a burden on healthcare services. Isolation is an important aspect of infection prevention and control, but has been associated with undesirable consequences among hospital inpatients. The aim of the present study was to determine if isolation is associated with an increased length of stay (LOS) in the ED. ⋯ Consistent with the anecdotal experience of Australian ED clinicians, the present study demonstrated an increased ED LOS for patients managed in isolation. Enhanced infection prevention and control precautions will be required during and beyond the current pandemic, creating significant ongoing challenges for emergency care systems.
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Emerg Med Australas · Dec 2020
Chronic disease management in emergency department patients presenting with dyspnoea.
Guideline recommended treatments for chronic conditions are thought to reduce ED presentations. ⋯ Prescription of guideline recommended therapies for chronic conditions in patients presenting to the ED in Australasia with acute dyspnoea is similar or higher than reported previously.
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Homeless individuals face many barriers to accessing healthcare, and EDs are often their primary entry point to the healthcare system. The COVID-19 pandemic has the potential to exacerbate existing social inequities and health disparities, including barriers to accessing social services and healthcare. Addressing the complex social and chronic health issues associated with homelessness can be challenging within the acute care environment. This perspective reflects upon the delivery of emergency healthcare to patients experiencing homelessness, and highlights strategies for optimising health outcomes during and beyond the pandemic.
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Emerg Med Australas · Dec 2020
Establishing a hospital-based ultrasound-guided peripheral intravenous catheter training programme: A narrative of a 5-year experience.
Despite ultrasound-guided peripheral intravenous catheter insertion being a well-established method for patients with difficult intravenous access, currently there are limited hospital-based training programmes. We describe the training programme that was established in our hospital over 5 years ago and how it can be replicated in other centres.