Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2020
Delphi assessment of audit and research priorities in an emergency department.
Audit and research projects in the ED are important to improve patient care but can be time and resource consuming. We identified and prioritised audit and research topics among multidisciplinary ED staff to fill perceived knowledge gaps, encourage engagement, reduce duplication and facilitate translation of evidence into clinical practice. ⋯ This Delphi study has provided departmental audit and research priorities that are perceived to be of importance across the multidisciplinary ED team. This methodology allows strategic allocation of limited resources and may increase staff engagement.
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COVID-19 has massively changed the health landscape around the world. Wide-ranging changes to healthcare delivery have occurred, especially in hospitals and EDs. ⋯ In Australia, civil liability Acts provide protection for professionals when the criterion of having undertaken 'competent' practice that would be 'widely accepted' 'in the circumstances' is met. There is doubt how courts, and the medical experts who advise them, will evaluate clinical care provided during the pandemic when health services have developed local care pathways and there is no nationally accepted standard.
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Emerg Med Australas · Aug 2020
COVID-19 and spinal cord injuries: the viewpoint from an emergency department resident with quadriplegia.
Spinal cord injuries (SCIs) present distinct physiological and social considerations for the emergency physician. During the COVID-19 pandemic, these considerations may generate unique challenges for emergency physicians managing patients with SCIs. Physiological disruptions may alter the way SCI patients present with COVID-19. ⋯ The reliance on caregivers for activities of daily living can, as an example, increase the human resource requirement of an ED. Considering the vulnerabilities and complexities of patients with SCI, the community should prioritise prevention of COVID-19 infections in this group. In the event that they do present to an ED, planning for and understanding their complexities will facilitate optimal management.
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Emerg Med Australas · Aug 2020
Directors of emergency medicine's beliefs about, barriers to, and enablers of solutions to emergency department crowding and access block.
To identify opportunities for directors of emergency medicine (DEMs) to lead change efforts to address ED crowding and access block. ⋯ Addressing the political and cultural forces that sustain ED crowding and access block are key adaptive challenges requiring DEM leadership.
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Emerg Med Australas · Aug 2020
Emergency department resuscitative thoracotomy at an adult major trauma centre: Outcomes following a training programme with standardised indications.
The objective of this study was to report the procedural incidence and patient outcomes after the 2009 introduction of an institutional resuscitative thoracotomy (RT) programme. Emergency physicians, general surgeons and emergency nursing trauma team members were trained to perform RT on thoracic trauma patients with an unresponsive systolic blood pressure (SBP) <70 mmHg within 30 min of arrival, prior to cardiothoracic team back-up. ⋯ A formal training and credentialing programme was associated with a low incidence of the procedure, yet achieved a survival rate of 25%, which is comparable to other reported literature.