Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2024
Are emergency departments leader identity workspaces? A qualitative study of emergency physicians.
Emergency medicine is a discipline with complex leadership demands, which are experienced by junior and senior emergency physicians alike. In this environment, emergency physicians can struggle to work out what it means to be a leader and develop professional identities as leaders, necessitating a leader identity workspace. The aim of the present study is to explore whether emergency physicians view their work environment as leader identity workspaces. ⋯ Our results suggest that neither EDs nor hospitals more generally exhibit the properties of, or are experienced by emergency physicians, as leader identity workspaces.
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Emerg Med Australas · Apr 2024
ReviewReview article: Pre-hospital trauma guidelines and access to lifesaving interventions in Australia and Aotearoa/New Zealand.
The centralisation of trauma services in western countries has led to an improvement in patient outcomes. Effective trauma systems include a pre-hospital trauma system. Delivery of high-level pre-hospital trauma care must include identification of potential major trauma patients, access and correct application of lifesaving interventions (LSIs) and timely transport to definitive care. ⋯ Variation in more advanced LSI was evident between EMS. Optimising trauma triage guidelines is an important aspect of a robust and evidence driven trauma system. The lack of consensus in trauma triage identified in the present study makes benchmarking and comparison of trauma systems difficult.
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Emerg Med Australas · Apr 2024
Presence of alcohol and other drug use within youth mental health presentations to the emergency department: A single-site retrospective observational study.
Youth mental health is a growing issue, which can be worsened by alcohol and other drug (AOD) use. The present study aimed to characterise the association of AOD use in youth presenting to an ED with a mental health crisis. ⋯ In New Zealand, it is not legal to sell alcohol to persons under 18 years; however, this was the most commonly identified drug impacting on youth mental health presentations. There is a known association between alcohol use and adverse mental health symptoms; therefore, efforts to decrease access to alcohol in this age group must continue, and harm reduction interventions to reduce clinically significant overdoses recommended.
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Emerg Med Australas · Apr 2024
Benchmarking blood culture quality in the emergency department: Contamination, single sets and positivity.
To benchmark blood culture (BC) quality in an Australian ED, explore groups at risk of suboptimal BC collection, and identify potential areas for improvement. ⋯ BC quality standards in the ED such as false positive rate <3% and single culture rate <20% are required to facilitate benchmarking and prospective quality improvement. The sensitivity and specificity of this common and critical test can be improved. Patient subgroups associated with poor-quality BC collection can be identified and should be a focus of future work.
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Emerg Med Australas · Apr 2024
Clinical and longitudinal patterns of frequent presenters to emergency departments: A multi-centre data linkage analysis.
To describe clinical characteristics and longitudinal patterns of representation in a cohort of patients who frequently present to EDs for care. ⋯ Representations associated with MHDAS have a different trajectory of representation episodes compared to non-MHDAS group. Escalating number of presentations and clustering are important predictors of future representation numbers. Those 'did not waits' who appear to be representing would be the highest risk of ongoing and persistent representations in the future and should be the target of early interventions to ensure they are accessing appropriate care before this happens.