Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
Multicenter StudyStaff perceptions of the emergency department working environment: An international cross-sectional survey.
The aims of this study were to describe clinical staff perceptions of their ED working environment and to explore associations between staff demographics, coping styles and the work environment. ⋯ Employees engaging in positive coping strategies had more positive perceptions of the work environment, while those engaging in maladaptive coping strategies reported negative perceptions of the work environment. These data suggest that strategies that promote the use of active coping and positive thinking should be encouraged and warrant further research in the ED.
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Emerg Med Australas · Dec 2019
Observational StudyCharacteristics and outcomes of patient presentations made by police to an Australian emergency department.
To describe and compare characteristics and outcomes of patient presentations brought in by police (BIBP) with those not BIBP (NBIBP) to one Australian ED. ⋯ Patients BIBP were different to those NBIBP. Despite comprising a small proportion of overall ED attendances, they are a group where mental health and drug and alcohol issues are over-represented. Differences in ED care delivery for those BIBP highlights potential opportunities for pre-hospital healthcare interventions.
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Emerg Med Australas · Dec 2019
Time from arrest to extracorporeal cardiopulmonary resuscitation and survival after out-of-hospital cardiac arrest.
The association between the time from arrest to extracorporeal cardiopulmonary resuscitation (ECPR) and survival from out-of-hospital cardiac arrest (OHCA) is unclear. The aim of this study was to determine whether time to ECPR is associated with survival in OHCA. ⋯ Early initiation of ECPR is associated with improved survival after OHCA. Because we analysed a nationwide OHCA registry, which lacks uniform selection criteria for ECPR, further prospective study is warranted.
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Emerg Med Australas · Dec 2019
COACHRED: A protocol for the safe and timely incorporation of focused echocardiography into the rhythm check during cardiopulmonary resuscitation.
Focused echocardiography may be a useful tool in cardiopulmonary resuscitation for prognostication, to identify certain reversible causes of cardiac arrest, and to guide further management and procedures. Nonetheless, many clinicians have reservations regarding its widespread adoption due to evidence that it leads to prolonged interruption of cardiac compressions. ⋯ This approach incorporates the best strategies identified to date that minimise interruptions to chest compressions. We demonstrate that, in a simulation environment, it is achievable to incorporate focused echocardiography into the rhythm check while keeping the interruption to chest compressions within the timeframe prescribed by international guidelines.
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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.