Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
Development and evaluation of a code frame to identify potential primary care presentations in the hospital emergency department.
A major challenge in evaluating the appropriateness of ED presentations is the lack of a universal and workable definition of patients who could have received primary care instead. Our objective was to develop a standardised code frame to identify potential primary care patients in the ED. ⋯ This standardised code frame enables accurate retrospective local and national data estimations. The code frame could be used prospectively to evaluate interventions such as diverting patients to primary care settings, and to identify populations for specifically targeted interventions. The conservative nature of the code frame ensures that only those that can safely receive care in a primary care setting are identified as potential primary care.
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Emerg Med Australas · Dec 2019
Gaming National Emergency Access Target performance using Emergency Treatment Performance definitions and emergency department short stay units.
To evaluate potential gaming of the 4 h ED length of stay metric known as the National Emergency Access Target (NEAT) in Australia and Emergency Treatment Performance (ETP) in New South Wales (NSW). ⋯ The opportunity of NEAT may be squandered unless gaming of the definitions and use of ED short stay beds is addressed. We argue that the longstanding issue of 'departure time' should be defined as 'physically leaving' the department, in accordance with the Australasian College for Emergency Medicine (ACEM) definition. Patient occupancy is a real measure of ED resource use and NSW and national recommendations should be adjusted. ACEM accreditation of EDs should include review of their application of NEAT definitions to ensure they truly reflect patient flow processes.
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Emerg Med Australas · Dec 2019
Observational StudyAccuracy of parental estimate of child's weight in a paediatric emergency department.
To determine the accuracy of using parental estimate of a child's weight compared to actual weight in a paediatric emergency setting. ⋯ Parent estimate is an accurate weight estimation method when parents are willing to give an estimate. There is ethnic variation in accuracy that should be taken into account when applying this method.
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Emerg Med Australas · Dec 2019
Role and impact of brain computed tomography in the management of drug overdoses and guideline recommendations.
Patients presenting with overdoses commonly receive computed tomography brain (CTB) scans in their assessment. There is no current guideline or validated decision support tool for neuroimaging in overdose patients. We investigated the proportion of overdose patients who received a CTB scan and its impact on management. ⋯ A high proportion of overdose patients received CTB scans. There was only a low yield in terms of management alteration. We propose that clinicians adopt a guided approach using a decision support tool to minimise unnecessary CTB scans.