Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
ReviewReview article: A primer for clinical researchers in the emergency department: Part X. Understanding economic evaluation alongside emergency medicine research.
In this series we address research topics in emergency medicine. While traditionally there was an almost exclusive focus on the efficacy and effectiveness of interventions in emergency research, analysis of the costs and the societal impact of different approaches and pathways have become increasingly important. In this paper we will address what health economics means and discuss the different types and key features of economic evaluation relevant for clinical researchers.
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Emerg Med Australas · Oct 2019
Burden of primary care-type emergency department presentations using clinical assessment by general practitioners: A cross-sectional study.
To compare methods of assessment of the burden of primary care-type ED (PCTED) presentations against clinical assessment by general practitioners (GPs) in ED. ⋯ Previous methods determining the burden of PCTED presentations have not been validated. Many presentations excluded by previous methods were identified as manageable in general practice by GPs clinically assessing patients in ED. Improved validation of criteria used to identify PCTED presentations will enable appropriately designed interventions to reduce such events.
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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.
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Emerg Med Australas · Oct 2019
Description and cost-analysis of emergency department attendances for hand and wrist injuries.
Injuries to the hand and wrist are estimated to account for between 10% and 30% of all ED presentations. The economic burden placed on the healthcare system can be extensive and rise sharply with increase in injury severity. ⋯ Acute hand and wrist injuries contribute to a significant volume of ED presentations each year in one Australian public health network leading to significant expenditure and health resources. Further research into how to best utilise resources and reduce avoidable injuries should be priority areas to reduce the cost of these injuries to the healthcare system and society.
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Emerg Med Australas · Oct 2019
Utility of weight-bearing radiographs compared to computed tomography scan for the diagnosis of subtle Lisfranc injuries in the emergency setting.
The goal of the present study was to compare the diagnostic yield of weight-bearing radiographs with non-weight-bearing computed tomography (CT) scan for subtle Lisfranc (LF) injuries in the ED. ⋯ CT provides limited benefit in the diagnosis and initial management of suspected subtle LF injuries in the ED. We advocate for the use of bilateral weight-bearing radiographs as a first-line investigation.