Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2022
Pleural decompression procedural safety for traumatic pneumothorax and haemothorax: Kelly clamps versus fine artery forceps.
The present study aimed to determine the difference in force required to puncture simulated pleura comparing Kelly clamps to fine artery forceps. The treatment of symptomatic traumatic pneumothorax and haemothorax involves puncture of the parietal pleura to allow decompression. This is usually performed using Kelly clamps or fine artery forceps. Over-puncture pulmonary injury risk increases with the force used. ⋯ A significantly increased force was required to puncture simulated parietal pleura using Kelly clamps compared to fine artery forceps. This higher puncture force will be associated with increased instrument acceleration at the time of pleural puncture, which may result in an increased risk of injury to the underlying lung. Based on these data, clinicians may reduce the risk of pulmonary injury by using fine artery forceps rather than Kelly clamps when performing pleural decompression.
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This qualitative study explores whether Australian mass casualty and disaster plans explicitly acknowledge or implicitly draw upon ethical principles. ⋯ In Australian government documents for mass casualty and disaster management, although ethics is definitely considered, the ethical principles on which decisions are made are rarely explicit. Mass casualty and disaster decision-making could be improved by making the ethical basis for decision-making clear, transparent and comprehensively reasoned.
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Emerg Med Australas · Dec 2022
From little things, big things grow: An exploratory analysis of the national cost of peripheral intravenous catheter insertion in Australian adult emergency care.
To estimate the total economic impact of peripheral intravenous catheter (PIVC) or cannula insertion and use in adult Australian EDs, including those cannulas that remain unused for therapeutic purposes. ⋯ The figures developed in the present study represent an important educational opportunity to encourage thoughtful consideration of all interventions, no matter how small. ED cannula insertion represents a large economic and health cost to Australia's health system, many of which remain unused. There are no national data sets that record complications associated with PIVCs and we highlight the urgent need for improved data.
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Emerg Med Australas · Dec 2022
Structured evaluation of a virtual emergency department triage model of care: A study protocol.
A new virtual ED service was introduced into a hospital network in the northern suburbs of Melbourne in response to changing needs during the COVID-19 pandemic. The 'virtual ED' utilises a telehealth model as a means of assessment for appropriately selected patients to facilitate either complete care or navigation into streamlined pathways for ongoing care, in some cases bypassing the ED entirely where appropriate. The proposed study aims to evaluate the implementation of the model and identify future improvement opportunities, assess the impact on traditional health service delivery processes and patient experience, and determine the acceptability of the 'virtual ED' model of care. ⋯ This project will support the delivery of care to ED patients by evaluating the 'virtual ED' model of care.