Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
The Pacific Emergency Medicine Mentoring Program: A model for medical mentoring in the Pacific region.
To describe the development and implementation of a Pacific medical mentoring programme and to evaluate the programme after the first year. ⋯ The present study suggests a new model of Pacific mentoring that recognises the centrality of the mentoring relationship, and allows for flexible communication, shared responsibility of mentors and mentees as co-drivers and a broad understanding of goals and timelines. Future programmes should incorporate funding for in-person meetings and educational opportunities to enhance contextual and cultural understanding. These lessons can inform future medical mentorship programmes across the Pacific.
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Emerg Med Australas · Dec 2019
Characteristics of short-term re-presentations to a regional emergency department.
The present study aims to describe the characteristics of early ED re-presentations in a regional hospital in New South Wales, Australia. ⋯ Re-presentations were common, but did not lead to increased admissions. The regional hospital in the present study had a higher 72 h ED re-presentation rate than the comparative major city hospital. In particular, paediatric and psychiatric re-presentations were a greater burden to the regional ED. This may be secondary to a lack of alternative services, particularly for these patient groups. Improving these outpatient services may help to reduce the burden of 72 h ED re-presentations.
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Emerg Med Australas · Dec 2019
Picking the low-hanging fruit: Why not choose oral antibiotics for skin and soft-tissue infections in the emergency department.
Skin and soft-tissue infections are a common presentation to EDs in Australasia. In the absence of sepsis or decreased oral absorption, substantial supportive data exists that shows oral antibiotics are non-inferior to intravenous antibiotics for uncomplicated skin and soft-tissue infections. ⋯ This perspective reviews the relevant literature, discusses barriers to the implementation of this more parsimonious approach and also proposes several potential solutions. It is important that ED clinicians are encouraged to use oral antibiotics for uncomplicated infections, as this would lead to similar clinical outcomes but with fewer resources for staff and patient, as well as increased patient satisfaction.
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Emerg Med Australas · Dec 2019
Influence of cognitive impairment on pain assessment and management in the emergency department: A retrospective cross-sectional study.
To quantify the impact of cognitive impairment on pain assessment and management practices in the ED. ⋯ Pain is inadequately and inappropriately assessed for elderly patients with a cognitive impairment in the ED, resulting in delays in initiation of pain management.
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Emerg Med Australas · Dec 2019
Clinical risk for substance-affected patients attending an emergency department in the Northern Territory with police: A quality improvement initiative.
Determine clinical risk for patients presenting to Royal Darwin Hospital ED when they cannot be cared for at the police watch-house (WH) or sobering-up-shelter (SUS) because of a medical concern. ⋯ This is a common presentation at Royal Darwin Hospital ED by a patient group with high levels of comorbidity, homelessness and alcohol dependence. Nearly half self-discharged prior to medical assessment. These patients frequently re-attend the same facilities and enter into a cycle of non-intervention. Case management across services is needed to improve the opportunity that these patients receive appropriate medical, social and addiction interventions.