Emergency medicine Australasia : EMA
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The COVID-19 pandemic has led to the development of alternative means of accessing unplanned care in order to avoid unnecessary ED presentations and hospital admissions. We explore the definition of emergency medicine, which patients are better served by accessing unplanned hospital care via alternative pathways, and the concept of emergency care completion.
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Emerg Med Australas · Aug 2022
Observational StudyRetrospective study of the prevalence and characteristics of adverse drug events in adults who present to an Australian emergency department.
To determine the burden, on the ED, of harm from unintentional adverse drug events (ADEs) in the community. ⋯ There is a high burden on emergency care because of unintended medication harm in the community. Interventions to reduce such harm are likely to require a co-ordinated primary, acute and public healthcare response. The high proportion of presentations with potential ADEs indicates opportunity for harm mitigation in the ED.
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Emerg Med Australas · Aug 2022
Observational StudyCOMBED: Rapid non-invasive Cardiac Output Monitoring Baseline assessment in adult Emergency Department patients with haemodynamic instability.
The application of rapid, non-operator-dependent, non-invasive cardiac output monitoring (COM) may provide early physiological information in ED patients with haemodynamic instability (HI). Our primary objective was to assess the feasibility of measuring pre-intervention (baseline) cardiac index (CI) and associated haemodynamic parameters. ⋯ Rapid, non-operator-dependent, non-invasive COM was possible in >90% of ED patients presenting with HI. Compared with tachycardia alone, patients with hypotension had lower CI, MAP and heart rate, while those with suspected infection had a lower SVRI. This technology provides novel insights into the early state of the circulation in ED patients with HI.
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Emerg Med Australas · Aug 2022
Is headache during pregnancy a higher risk for serious secondary headache cause? A HEAD study report.
Pregnancy is defined as a 'red flag' in headache assessment. We aimed to describe the prevalence and causes of serious secondary headache in pregnant ED patients. ⋯ Inclusion of pregnancy as a 'red flag' in ED headache assessment is not supported by these data.
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Emerg Med Australas · Aug 2022
Diagnoses and trends in use of imaging for low back pain in four Australian emergency departments between 2012 and 2019.
We aimed to determine, in those who present to the ED with low back pain (LBP): (i) the prevalence of four key diagnostic categories, (ii) trends in lumbar imaging from 2015 to 2019 and (iii) the effect of a new model of care on lumbar imaging in the ED. ⋯ Most presentations to the ED for LBP are for non-specific LBP. Around 2% will have specific spinal pathology. Use of imaging in those diagnosed with non-specific LBP remains high and was unaffected by implementation of a state-wide model of care.