Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2024
Trauma team activation for older patients with pelvic fractures: Are current criteria adequate?
The present study aimed to identify the impact of age on current trauma team activation (TTA) processes and outcomes for patients with pelvic fractures. ⋯ Current TTA criteria based on higher energy mechanisms and traditional vital sign thresholds are inadequate for identifying injury in older patients. Sensitive triage criteria and increased clinician awareness are required to enhance injury recognition and improve outcomes in older trauma patients.
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Emerg Med Australas · Dec 2024
Observational StudyFactors associated with difficult intravenous access in the paediatric emergency department: A prospective cohort study.
Although it is the most performed invasive procedure, peripheral intravenous catheter (PIVC) insertion in children can be difficult. The primary objective of the study was to identify the factors associated with difficult intravenous access (DIVA) in the paediatric ED, including patient, proceduralist and situational factors. ⋯ The present study identified multiple patient, proceduralist and situational factors that were associated with DIVA in the paediatric ED. Future studies should explore the development and implementation of a package to address DIVA in children, with the patient-centred goals of reducing pain and improving success.
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Emerg Med Australas · Dec 2024
Australia's first cardiac emergency department: Patient profile, activity and performance in the initial 6 months.
To profile the initial 6-month experience at the Victorian Heart Hospital (VHH) cardiac emergency (CE). The primary objective was to describe VHH CE patient characteristics, including presenting complaint, final diagnosis and disposition. Secondary objectives were to report on patient numbers, patient source and quality indicator performance including ambulance off-load by 40 min, waiting time and length of stay (LOS). ⋯ The population predominantly had cardiovascular disease as expected. Some performance indicators, including ED LOS, were identified as requiring intervention.
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Emerg Med Australas · Dec 2024
Assessing the predictors for paediatric intensive care unit for inter-hospital transfer patients on high-flow nasal cannula or continuous positive airway pressure ventilation at a tertiary Australian paediatric hospital.
The aim of the present study was to assess the predictors of need for paediatric intensive care unit (PICU) admission for inter-hospital transfer patients to a tertiary paediatric hospital ED on high flow (HF) or continuous positive airway pressure (CPAP) ventilation. ⋯ We have demonstrated that children who require CPAP to manage their respiratory disease are more likely to require PICU care on transfer to the tertiary paediatric hospital. In addition, those patients being transferred from secondary metropolitan hospitals after a trial of HF are also likely to require PICU care. This suggests that these patients should be directly admitted to PICU, allowing for improved patient experience and flow as well as reducing unnecessary ED resource utilisation.