Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2012
Is the increase in emergency short-stay admissions sustainable? Trends across Melbourne, 2000 to 2009.
To describe the trends in emergency admissions over 10 years in terms of volume, age-specific rates, hospital length of stay (LOS) and clinical reasons. ⋯ Emergency hospital admissions have risen over the last decade even after adjustment for population changes. There was a disproportionate rise in same day/overnight admissions, with overrepresentation of the elderly. This is possibly related to changes in ED models of care, including introduction of short-stay units, improved diagnostic and therapeutic capability, and risk-averse management to optimise safe discharge, within the context of time-based performance targets.
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Suprapubic aspiration (SPA) is the gold standard for obtaining uncontaminated urine specimens in young febrile children. The use of real-time ultrasound (RTUS) has been shown to increase the success rate of SPA. The BladderScan (BSUS) Verathon(®) is an alternative portable ultrasound device designed to provide automated measurement of bladder volume. Although simple and requiring minimal training, there are no data on the success rate of SPA using the device. ⋯ The success rate of SPA in 'real-life' non-standardised clinical practice was low at 53% overall. The BSUS-assisted SPA success rate was higher in patients with readings ≥20 mL. These rates are lower than success rates reported using RTUS. Parameters for using BSUS to assist SPA should be established.
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Emerg Med Australas · Oct 2012
Prevalence of suicidality in asymptomatic adolescents in the paediatric emergency department and utility of a screening tool.
Many authorities recommend screening adolescents for risk of suicide. The ED is a potential setting for such screening. The aim of this study is to explore the use of the Risk of Suicide Questionnaire (RSQ) as a screening tool for suicidality in patients who come to the ED without mental health concerns and without recent mental health history. The Suicide Ideation Questionnaire (SIQ) was the comparison standard. ⋯ The prevalence of suicidal ideation in asymptomatic patients presenting to this paediatric ED is very low. Using this selection method, the RSQ could not be validated, but would be unlikely to be suitable for screening this low-risk population with a high false positive rate.
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Emerg Med Australas · Oct 2012
Capacity building in emergency care: An example from Madang, Papua New Guinea.
Divine Word University (DWU) is an emerging national university of Papua New Guinea (PNG) based in the provincial capital of Madang, providing training for Health Extension Officers (HEOs). HEOs form the backbone of healthcare delivery in PNG as clinicians, public health officers and health centre managers. Both campus-based and clinical teaching at the nearby Modilon Hospital is limited because of significant resource constraints. ⋯ This programme provides positive models of both emergency care capacity building in a resource-constrained setting and training in international EM for Australasian clinicians.