Rural Remote Health
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Rural Remote Health · Jul 2005
Challenges in preventing pyelonephritis in pregnant women in Indigenous communities.
⋯ Aboriginal women have worse pregnancy outcomes than the non-Indigenous population of Australia. Pyelonephritis is a preventable condition in pregnancy. In these rural and remote communities, pyelonephritis has not been prevented due, in part, to a failure to follow the local guidelines. Structural problems were identified and need to be addressed in order to improve compliance with guidelines and hence pregnancy outcomes for rural and remote Indigenous women.
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Rural Remote Health · Jul 2005
Comparative StudyEffect of an on-site emergency physician in a rural emergency department at night.
The problem of emergency department (ED) overcrowding is an issue of some concern and staffing profile has been identified as a contributing factor. The aim of this study was to assess the effect of having an emergency physician on-site at night in a rural base hospital ED in terms of the ED length of stay, waiting times, admissions, specialist consultations, the use of diagnostic tests, and ED representations within 7 days. ⋯ The presence of an on-site emergency physician resulted in a significantly shorter ED length of stay, lower admission rate, less initial pathology tests, and fewer telephone consultations.
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Irukandji syndrome, a potentially life-threatening condition that follows the sting of small carybdeid jellyfish, occurs along the northern Australian coastline from Broome, Western Australia in the west to Rockhampton, Queensland in the east. Much of this area is classified rural or remote. Because correct patient management is essential to avoid unnecessary fatality, and stings are relatively uncommon in any specific location, it was considered important to document current approaches to Irukandji syndrome management throughout coastal northern Australia, comparing urban and more rural health facilities, and to assess the availability of management guidelines for health staff. ⋯ Although monitoring and pain management of patients with Irukandji syndrome were generally appropriate, a variety of inappropriate first aid and hypertension management approaches were found. In general, appropriate practice was associated with the presence of guidelines but, unfortunately, guidelines were less often present in remote health facilities. This is particularly important because the majority of respondents who reported no experience of managing Irukandji syndrome were located in more remote settings. There is a need for uniform, evidence-based guidelines, and mechanisms for effective dissemination of these guidelines with training for all health staff who may be required to manage Irukandji syndrome, particularly in remote areas of northern Australia.