Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
ReviewReview article: Interventions for people presenting to emergency departments with a mental health problem: A systematic scoping review.
The number of people presenting to EDs with mental health problems is increasing. To enhance and promote the delivery of safe and efficient healthcare to this group, there is a need to identify evidence-based, best-practice models of care. This scoping review aims to identify and evaluate current research on interventions commenced or delivered in the ED for people presenting with a mental health problem. ⋯ The effectiveness of interventions varied. There is considerable, yet disconnected, evidence around ED interventions to support people with mental health problems. A lack of integrated, multifaceted, person-centred interventions is an important barrier to providing effective care for this vulnerable population who present to the ED.
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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
Predictors of in-hospital cardiac arrest within 24 h after emergency department triage: A case-control study in urban Thailand.
This study describes the predictors of in-hospital cardiac arrest (IHCA) within 24 h of ED triage and evaluates their ability to predict patients at risk of IHCA. ⋯ We conclude that a combination of NEWS and four independent predictors identify patients at risk of IHCA more effectively than NEWS alone.
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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.