Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2022
Observational StudyPre-hospital emergency anaesthesia in trauma patients: An observational study from a state-wide Australian pre-hospital and retrieval service.
To assess the performance of an Australian pre-hospital and retrieval medicine (PHRM) service against the National Institute for Health and Care Excellence (NICE) standard which recommends that pre-hospital emergency anaesthesia (PHEA) in trauma patients should be conducted within 45-min of first contact with emergency services. ⋯ In a cohort of 337 patients treated by a dedicated PHRM service in South Australia, the median time to PHEA was 54 (38-80) min with only 37% of patients receiving PHEA within 45 min from the activation of the team. Despite differing patient demographics, the percentage of patients receiving PHEA within the recommended time frame was greater than a similar cohort from the UK. However, both data sets still fall short of recommended targets.
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Emerg Med Australas · Oct 2022
Observational StudyHyperkalaemia in the emergency department: Epidemiology, management and monitoring of treatment outcomes.
To describe the epidemiology, treatment and monitoring of treatment outcomes of patients presenting to the ED with hyperkalaemia. ⋯ Most ED patients with hyperkalaemia have identifiable clinical and medication-related risk factors. Variations in care were widespread and monitoring for iatrogenic adverse events was suboptimal.
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Emerg Med Australas · Oct 2022
Sydney 'lockout' liquor licensing law restrictions have been associated with a sustained reduction in emergency department presentations from assaults over 5 years.
The present study assessed the impact of changes to the New South Wales Liquor Act in 2014 on assault-related presentations to the ED of St Vincent's Hospital. This hospital is the primary receiving hospital for the area affected by these laws. ⋯ There has been a significant reduction in assault-related presentations to St Vincent's Hospital following the changes to the liquor licensing laws that has been sustained for 5 years with no significant decrease in the those with severe assault injuries.
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Emerg Med Australas · Oct 2022
Trends in computed tomography aortography and acute aortic syndrome in an emergency department within Aotearoa New Zealand.
Acute aortic syndrome (AAS) comprises a triad of life-threatening aortic conditions that are difficult to diagnose because of their non-specific clinical presentations. Contrast-enhanced computed tomography aortography (CTA) has a high sensitivity and specificity for these conditions. However, under- and over-investigation of patients with suspected AAS using CTA carries significant risk. The aim of the present study was to evaluate the diagnostic imaging practices of CTA use for patients presenting to an ED with suspected AAS. ⋯ Thoracic CTA use for investigating suspected AAS in our ED has recently increased. However, the annual incidence of AAS did not increase over the same period, but was higher than reported in overseas institutions.
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Emerg Med Australas · Oct 2022
Potential role of general practice in reducing emergency department demand: A qualitative study.
To inform local, state and national strategies intended to reduce demand for ED care, the present study aimed to identify key factors influencing the current provision of acute care within primary healthcare (PHC) and explore the policy and system changes potentially required. ⋯ The present study suggested that while PHC has the potential to attenuate the demands for ED services, a whole-of-system approach focusing on realignment of priorities and integrated changes are needed.