Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Eligibility criteria for extracorporeal cardiopulmonary resuscitation at Auckland City Hospital: A retrospective cohort study.
Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising adjunct to routine advanced cardiac life support. Growing worldwide interest in ECPR-use has seen more tertiary centres offering ECPR programmes. New Zealand's nationwide extracorporeal membranous oxygenation service is provided at Auckland City Hospital (ACH). Despite the potential benefits of ECPR, it is currently only offered on an ad hoc basis. It remains unknown whether ACH would manage sufficient numbers of patients to warrant an ECPR programme. ⋯ An ECPR programme at ACH using standardised and agreed criteria may benefit a small number of patients and improve rates of survival to hospital discharge with preservation of neurological function. An ECPR guideline would help clarify for referring services cases that are appropriate for extracorporeal membranous oxygenation consideration, rather than discussing on an ad hoc basis.
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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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Emerg Med Australas · Dec 2020
Early lessons from COVID-19 that may reduce future emergency department crowding.
The COVID-19 pandemic has produced significant changes in emergency medicine patient volumes, clinical practice, and has accelerated a number of systems-level developments. Many of these changes produced efficiencies in emergency care systems and contributed to a reduction in crowding and access block. In this paper, we explore these changes, analyse their risks and benefits and examine their sustainability for the future to the extent that they may combat crowding. We also examine the necessity of a system-wide approach in addressing ED crowding and access block.
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Emerg Med Australas · Dec 2020
Interventions to support Choosing Wisely for coagulation studies in the emergency department.
To evaluate the effectiveness of two different strategies designed to facilitate implementation of Choosing Wisely Australia guidelines, aiming to reduce unnecessary coagulation study blood tests in patients presenting to a metropolitan hospital ED. ⋯ Physically removing coagulation pathology tubes from the trolleys was found to be effective at reducing unnecessary testing.
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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.