Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2014
Peripheral intravenous catheter duration and failure in paediatric acute care: A prospective cohort study.
Children admitted to hospital commonly require peripheral intravenous catheters (PIVCs) for treatment. This study sought to address a gap in the literature about current practice in the securement and dressing of PIVCs in paediatric acute care, and to ascertain the duration and failure of these devices. ⋯ Observed failure rates were high for a clinically essential device; however, there is no established rate of acceptability against which the results can be benchmarked against to facilitate effectiveness of practice. Many PIVCs appeared to remain in place longer than needed. Dressing and securement practice was homogenous. PIVC placement in the antecubital fossa should be minimised to reduce the risk of paediatric PIVC failure.
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Emerg Med Australas · Dec 2014
Observational StudyChallenges in arranging interhospital transfer from a non-tertiary hospital emergency department in the Perth metropolitan area.
To describe the organisational demands on staff when arranging interhospital transfers (IHTs) from an ED. ⋯ While most IHTs are straightforward, critically ill transfers require considerable time, effort and teamwork to arrange.
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Emerg Med Australas · Dec 2014
Clearing emergency departments and clogging wards: National Emergency Access Target and the law of unintended consequences.
To assess ED length of stay (EDLOS), access block, inpatient length of stay (IPLOS) and waiting times before and after the implementation of the National Emergency Access Target (NEAT). ⋯ At the current institution NEAT success has been guarded, likely secondary to availability of inpatient beds. The implementation of NEAT appears to have reduced emergency waiting times. These early results suggest concurrent a detrimental effect on IPLOS; however, some of this effect may be a result of a large increase in short stay admissions.
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Emerg Med Australas · Dec 2014
Psychological distress, burnout level and job satisfaction in emergency medicine: A cross-sectional study of physicians in China.
Chinese physicians are not only facing heavy work overloads, but also abuse and injury because of patient mistrust of physicians. The primary objective of the present study was to measure psychological distress, burnout levels and job satisfaction among Chinese emergency physicians. ⋯ Psychological distress is prevalent in this group of ED physicians, and it deserves attention from the whole society. Burnout and job satisfaction among ED physicians are at a 'moderate' level. Burnout is negatively associated with higher job satisfaction.
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Emerg Med Australas · Dec 2014
Clinical decision rule to prevent unnecessary chest X-ray in patients with blunt multiple traumas.
Since the diagnostic yield of chest X-ray (CXR) is not high enough, when it is ordered for all the multiple trauma patients, this study was aimed to evaluate the relationship between clinical and CXR findings in order to formulate a clinical decision rule to prevent unnecessary CXR in these patients. ⋯ Based on TIRC, it seems that CXR in stable multiple blunt trauma patients who are conscious and under 60 and have no decrease in pulmonary sounds, no dyspnea, no thoracic skin abrasion, and no crepitation can be ignored.