Articles: emergency-department.
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Emerg Med Australas · Dec 2022
Observational StudyCharacteristics, clinical findings and outcomes of acute aortic dissection: A comparison between an Australian emergency department and the International Registry of Acute Aortic Dissection.
Acute aortic dissection (AAD) is a rare, life-threatening condition for which the International Registry of Acute Aortic Dissection (IRAD) remains the most detailed clinical resource. The present study compared the characteristics, clinical findings and outcomes of patients presenting to Liverpool Hospital, NSW, Australia (LPOOL) with AAD to those in IRAD. Secondary aims were to identify LPOOL patient variables associated with 30-day mortality and to assess the impact of transfer times in the ED on 30-day mortality. ⋯ The characteristics, clinical features and outcomes of patients with AAD presenting to LPOOL appeared similar to those reported by IRAD. The identification of independent mortality predictors serves to improve the understanding of local AAD presentations. Reducing ED to ICU transfer times may increase 30-day survival and further interdisciplinary research should be considered.
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Emerg Med Australas · Dec 2022
Temporal changes in the epidemiology of sepsis-related intensive care admissions from the emergency department in Australia and New Zealand.
The Australasian Resuscitation in Sepsis Evaluation (ARISE) study researched septic shock treatment within EDs. This study aims to evaluate whether: (i) conduct of the ARISE study was associated with changes in epidemiology and care for adults (≥18 years) admitted from EDs to ICUs with sepsis in Australia and New Zealand; and (ii) such changes differed among 45 ARISE trial hospitals compared with 120 non-trial hospitals. ⋯ Sepsis-related admissions increased from 8.1% to 16.4%. During the ARISE study, there was more rapid ICU admission and decreased early ventilation. However, these changes were not sustained nor associated with decreased risk of death or duration of hospitalisation.
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Emerg Med Australas · Dec 2022
Prevalence and characteristics of frequent presenters to Auburn Hospital emergency department.
Frequent presenters (FPs) to the ED are common and contribute to ED overcrowding. Our aim was to identify the proportion of FPs over a 12-month period and to investigate the sociodemographic, clinical and attendance characteristics of FPs. ⋯ FPs represent a significant proportion of ED visits, yet a small proportion of ED patients. Our findings suggest that identifying ways to provide targeted services to older FPs may reduce the overall rates. The differences between language groups and FP highlights the importance of social context and culture when developing targeted interventions.
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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.