Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2012
Perspectives of emergency department staff on the triage of mental health-related presentations: Implications for education, policy and practice.
To explore ED staff perceptions of the factors that influence accuracy of triage for people with mental health problems. ⋯ Clinical guidelines and training have been developed to support the use of the Australasian Triage Scale. Further evaluation of the application of this scale to assess mental health problems is indicated. Additional work is also required to reduce variance in urgency assignment based on staff knowledge and attitudes about the causes, assessment and early management of psychiatric disorders.
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Emerg Med Australas · Oct 2012
Unravelling relationships: Hospital occupancy levels, discharge timing and emergency department access block.
To investigate the effect of hospital occupancy levels on inpatient and ED patient flow parameters, and to simulate the impact of shifting discharge timing on occupancy levels. ⋯ Modern hospital systems have the ability to operate efficiently above an often-prescribed 85% occupancy level, with optimal levels varying across hospitals of different size. Operating over these optimal levels leads to performance deterioration defined around occupancy choke points. Understanding these choke points and designing strategies around alleviating these flow bottlenecks would improve capacity management, reduce access block and improve patient outcomes. Effecting early discharge also helps alleviate overcrowding and related stress on the system.
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Emerg Med Australas · Oct 2012
Morbidity associated with amphetamine-related presentations to an emergency department: A record linkage study.
Amphetamine use is a global public health problem. We examined hospitalisations in a cohort of 138 patients who presented with an amphetamine-related problem to an ED in 2005. ⋯ Amphetamine-related presentations to the ED are associated with a significant cluster of hospitalisations around that episode. This is most prominent for psychiatric diagnoses, with a large increase in the total LOS in the year following cohort entry. Counselling less risky behaviour might decrease the burden of illness.
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Emerg Med Australas · Oct 2012
Case ReportsInterstitial ectopic pregnancy presenting after failed termination of pregnancy.
Pregnant women frequently present to the ED for complaints related to the first trimester of pregnancy. The emergency physician must confirm the presence of an intrauterine pregnancy for many such complaints. ⋯ The ED physician identified an inappropriately thin endomyometrial mantle raising suspicion for the diagnosis of an interstitial pregnancy. The case illustrates the importance of this uterine wall measurement given the otherwise normal appearance of a pregnancy within the uterus.