Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2018
Wait times are not the problem! Detailed analysis of unsolicited patient complaints from a metropolitan Australian emergency department.
To describe characteristics of ED admissions that resulted in unsolicited complaints and compare with overall ED admissions. The site utilised is an inner city tertiary hospital, with 630 beds, with approximately 82 600 annual presentations, where 32.5% were children. ⋯ As seen in this study the vast majority of patient complaints were associated with treatment and communication issues and skewed towards doctors. It may be feasible for medical staff to undertake communication training as clinician-patient communication in the ED is an important aspect in the improvement of patient satisfaction and in decreasing patient complaints as waiting times and triage categories had no major influence on patient complaints.
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Emerg Med Australas · Oct 2018
Observational StudyAortic dissection detection risk score has high sensitivity with moderate inter-rater reliability.
To retrospectively assess the accuracy and inter-rater reliability of the aortic dissection detection risk score (ADD-RS). ⋯ The ADD-RS was highly sensitive in our cohort. Further work to evaluate the score prospectively and in combination with a D-Dimer is required.
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Emerg Med Australas · Oct 2018
Observational StudyOut-of-hospital arrests attending an Australian tertiary paediatric emergency department over 13 years: An observational study.
In paediatric cardiopulmonary arrest, International Liaison Committee on Resuscitation (ILCOR) states, 'there are no simple guidelines to determine when resuscitative efforts become futile'. Considerations to assist this decision-making include cause of arrest, pre-existing medical conditions, age, site of arrest, duration of untreated cardiopulmonary arrest, witnessed arrest and presence of shockable rhythm. Outcomes are poor in out-of-hospital cardiac arrests (OHCA), particularly for infants. This single-centre observational study describes the characteristics and outcomes of the subgroup of children presenting to our hospital's ED following OHCA still receiving cardiac compressions, to assist development of guidelines for future resuscitation efforts in our ED, particularly for cessation of cardiopulmonary resuscitation (CPR). ⋯ Children presenting to ED still receiving cardiac compressions following OHCA had a universally poor outcome, regardless of age and underlying cause. This implies resuscitative efforts could be discontinued earlier in this subgroup. A national, multicentre study is needed to determine if this finding is reproducible with a larger population.
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Emerg Med Australas · Oct 2018
oneED: Embedding a mindfulness-based wellness programme into an emergency department.
ED staff are subject to many stressors, but there are few descriptions of collective approaches to enhancing wellness in this setting. We aim to describe a programme developed to address these issues at department level, to report the feasibility and sustainability of the programme, and its impact on staff. ⋯ A departmental wellness programme embedding mindfulness practice is feasible and sustainable. Potential for success is enhanced by an approach that is open to modification according to each institution's culture.
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Emerg Med Australas · Oct 2018
Routine screening and related interventions significantly improve the effectiveness of emergency department detection and management of alcohol withdrawal syndrome.
To evaluate the effectiveness of a routine screening and triage tool for alcohol withdrawal syndrome (AWS) in improving clinical care delivery in an ED setting. ⋯ Detection and appropriate management of AWS and documentation of alcohol use can be improved significantly through adoption of a brief screening and triage tool, and related interventions to increase awareness of alcohol-related problems.