Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2014
ReviewReview article: Emergency department data sharing to reduce alcohol-related violence: A systematic review of the feasibility and effectiveness of community-level interventions.
The present paper aims to review current evidence for the effectiveness and/or feasibility of using inter-agency data sharing of ED recorded assault information to direct interventions reducing alcohol-related or nightlife assaults, injury or violence. Potential data-sharing partners involve police, local council, liquor licensing regulators and venue management. A systematic review of the peer-reviewed literature was conducted. ⋯ Negative logistic feasibility concerns were minimal, with general consensus among authors being that data-sharing protocols and partnerships could be easily implemented into modern ED triage systems, with minimal cost, staff workload burden, impact to patient safety, service and anonymity, or risk of harm displacement to other licensed venues, or increase to length of patient stay. However, one study reported a potential harm displacement effect to streets surrounding intervention venues. In future, data-sharing systems should triangulate ED, police and ambulance data sources, and assess intervention effectiveness using randomised controlled trials that account for variations in venue capacity, fluctuations in ED attendance and population levels, seasonal variations in assault and injury, and control for concurrent interventions.
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Emerg Med Australas · Aug 2014
Overdose with modified-release paracetamol (Panadol Osteo®) presenting to a metropolitan emergency medicine network: A case series.
There are currently no large cases series documenting poisoning with paracetamol modified-release (Panadol Osteo®, GlaxoSmithKline, Sydney, NSW, Australia). Management guidelines recommend at least two serum paracetamol concentrations 4 h apart and initiating treatment with N-acetylcysteine (NAC) if more than 10 g is ingested. ⋯ Most patients presenting with Panadol Osteo® poisoning requiring NAC treatment had an initial serum paracetamol concentration indicating need for treatment. A small number of late treatment nomogram line-crossers was seen on repeat paracetamol estimation. The current guideline for Panadol Osteo® poisoning would have detected all cases requiring NAC treatment.
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Emerg Med Australas · Aug 2014
Randomized Controlled TrialSenior work-up assessment and treatment team in an emergency department: A randomised control trial.
To evaluate the impact of a senior early assessment model of care on performance measures in a single ED. ⋯ A senior early assessment model of care was not associated with improved overall NEAT performance and ED length of stay. However, there is evidence that improvements were made in the subgroup of discharged patients. There was no difference in overall NEAT performance among the three study groups.
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Emerg Med Australas · Aug 2014
Observational StudyPredicting admission of patients by their presentation to the emergency department.
The present study aims to determine the importance of certain factors in predicting the need of hospital admission for a patient in the ED. ⋯ Certain characteristics of patients as they present to hospital predict their admission. The accuracy of the triage nurses' prediction for disposition of patients is the same as that afforded by a model constructed from these characteristics. Blood test results improve disposition accuracy only slightly so admission decisions should not always wait for these results.
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Emerg Med Australas · Aug 2014
Demand for emergency department services in the elderly: An 11 year analysis of the Greater Sydney Area.
To describe trends in population-based rates of ED presentations in the Greater Sydney Area (GSA) and compare these between the elderly and non-elderly age groups. ⋯ A disproportionate increase in ED presentation rates and in-patient admission rates in patients aged 80 years and over was demonstrated over 11 years in the GSA. ED models of care and system wide strategies to address these demographic changes are required.