Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2008
Optimizing triage consistency in Australian emergency departments: the Emergency Triage Education Kit.
The Emergency Triage Education Kit was designed to optimize consistency of triage using the Australasian Triage Scale. The present study was conducted to determine the interrater reliability of a set of scenarios for inclusion in the programme. ⋯ All scenarios that showed good levels of agreement have been included in the Emergency Triage Education Kit and are recommended for testing purposes; those that showed moderate agreement have been incorporated for teaching purposes. Both scenario sets are accompanied by explanatory notes that link the decision outcome to the Australasian College for Emergency Medicine Guidelines on the Implementation of the Australasian Triage Scale. Future analysis of the scenarios is required to identify how task-related factors influence consistency of triage.
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Emerg Med Australas · Jun 2008
ReviewReview article: Non-invasive assessment of cardiac output with portable continuous-wave Doppler ultrasound.
Cardiac output is considered an important parameter when assessing the cardiovascular status of a critically ill patient. Both non-invasive (e.g. bioimpedance, echocardiography) and invasive methods (Swan Ganz catheter) have been used to measure cardiac output. ⋯ In this short review article, we will introduce this new technique, discuss the required skills and compare it with methods already in use. In particular, a critical comparison with the 'gold standard', the invasive measurement of cardiac output with the pulmonary artery catheter, will be given.
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Emerg Med Australas · Jun 2008
Comparative StudyStreaming by case complexity: evaluation of a model for emergency department Fast Track.
To evaluate a patient flow streaming system within a teaching hospital's ED, using functional principles to separate patients into two streams on the basis of complexity rather than acuity, severity or disposition. ⋯ Key features in the success of the system included use of dedicated senior staff for Fast Track patients, and quarantining of clinical resources. The ED aiming to improve their waiting times and throughput should consider using complexity as a key criterion for triaging patients into separate streams. A low-complexity patient stream in the ED provides an ideal focus for advanced nursing practice.
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Emerg Med Australas · Jun 2008
Comparative StudyVariables that predict admission to hospital from an emergency department observation unit.
To determine factors predictive for patients requiring ongoing hospital admission from the emergency department observation unit (EDOU). ⋯ Variables exist that predict a 'failed' short stay admission. These might be used to identify patients less suitable for admission to the EDOU and better suited to admission directly under a hospital team.
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Emerg Med Australas · Apr 2008
Prevalence of morphine use and time to initial analgesia in an Australian emergency department.
To explore the association of morphine use with factors influencing time to initial analgesia (T-A). ⋯ T-A is an important indicator of the quality of ED services. Severity of illness and patient volume were significant factors associated with extended T-A. Strategies for improving pain management in the complex ED environment are discussed.