Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2019
Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion.
Our objective was to examine the impact of a human factor-designed multimodal intervention on the proportion of unused peripheral i.v. cannula (PIVC) insertion in our ED. ⋯ Our multimodal intervention successfully reduced the number of unused PIVCs inserted in the ED, with a reduction in overall and unused PIVC insertions without any change in appropriate insertions.
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Emerg Med Australas · Jun 2019
Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective assessment of prognostic value.
Use of the Sequential Organ Failure Assessment (SOFA) score has been proposed by the Third International Consensus Definitions for Sepsis and Septic Shock. The utility in the ED is not yet well established. We retrospectively studied the application of a modified SOFA (mSOFA) score, to assess its ability to predict mortality. ⋯ For ED patients thought likely to have sepsis, the mSOFA score distinguished those with a high or low mortality risk. The high negative predictive value could be practically useful. Prospective study of the mSOFA score used in ED will be needed to validate these observations.
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Emerg Med Australas · Jun 2019
Aligning ambulance dispatch priority to patient acuity: A methodology.
In Victoria, Australia, Emergency Medical Service (EMS) demand has increased almost 5% per annum over the past 5 years. This may adversely affect response times to time-critical patients. Additionally, >55% of cases have received Code 1 (lights/sirens) responses. Primary telephone triage occurs using the Medical Priority Dispatch System (MPDS); however, MPDS is reported to be highly sensitive, with common over-triage. The present study describes the methodology applied to better align the response allocated to MPDS determinant codes with patient acuity. ⋯ Analysis of a large EMS dataset supported changes to the EMS response priority for a number of MPDS determinant codes. Such changes should improve the alignment between EMS response and patient acuity, and improve response times to time-critical patients. Other EMS with electronic data could consider testing this methodology.
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Emerg Med Australas · Jun 2019
Characteristics of accidental injuries from power tools treated at two emergency departments in Queensland.
Injuries are a major burden on the Australian healthcare system. Power tool usage is a common cause of accidental injury. A better understanding of the trends of power tool injuries will inform prevention strategies and potentially mitigate costs. ⋯ Accidental injuries from power tool use have a considerable impact on ED resources and can affect the long-term quality of life of those injured. Effective education about safe usage and protection may prevent many injuries.
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Emerg Med Australas · Jun 2019
Observational StudyExamining emergency department inequities: Do they exist?
Ethnic inequities in health outcomes have been well documented with Indigenous peoples experiencing a high level of healthcare need, yet low access to, and through, high-quality healthcare services. Despite Māori having a high ED use, few studies have explored the potential for ethnic inequities in emergency care within New Zealand (NZ). Healthcare delivery within an ED context is characterised by time-pressured, relatively brief, complex and demanding environments. When clinical decision-making occurs in this context, provider prejudice, stereotyping and bias are more likely. The examining emergency department inequities (EEDI) research project aims to investigate whether clinically important ethnic inequities between Māori and non-Māori exist. ⋯ The present study will provide the largest, most comprehensive investigation of ED outcomes by ethnicity to date in NZ.