Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
Review Meta AnalysisReview article: Impact of 12-lead electrocardiography system of care on emergency medical service delays in ST-elevation myocardial infarction: A systematic review and meta-analysis.
To assess the impact of prehospital 12-lead electrocardiography (PH ECG) on emergency medical service (EMS) delay in patients with ST-elevation myocardial infarction (STEMI), we systematically searched five online electronic databases, including MEDLINE, Embase, Emcare, Cochrane Library and CINAHL, between 1990 and August 2017. Controlled trials and observational studies comparing EMS time delays with and without PH ECG in STEMI patients were eligible. Two reviewers independently screened studies for eligibility, extracted data and appraised study quality. ⋯ PH ECG had no effect on transport or call-to-hospital intervals, although both measures showed evidence of heterogeneity. In patients with STEMI, PH ECG is associated with a modest increase in EMS delays. Measurement and improvement of EMS system delays may help to expedite treatment for STEMI.
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Emerg Med Australas · Oct 2019
Multicenter Study Observational StudyTreatment and outcome of adult patients with acute asthma in emergency departments in Australasia, South East Asia and Europe: Are guidelines followed? AANZDEM/EuroDEM study.
Asthma exacerbations are common presentations to ED. Key guideline recommendations for management include administration of inhaled bronchodilators, systemic corticosteroids and titrated oxygen therapy. Our aim was to compare management and outcomes between patients treated for asthma in Europe (EUR) and South East Asia/Australasia (SEA) and compliance with international guidelines. ⋯ The data suggests that compliance with guideline-recommended therapy in both regions, particularly corticosteroid administration, is sub-optimal. It also suggests over-use of antibiotics.
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Emerg Med Australas · Oct 2019
ReviewReview article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review.
Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn-over and burn-out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre-empt incidences of OV during ED episodes of care. ⋯ Although there was variation in, and differences between, staff-perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage.