Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2015
Use of a telenursing triage service by Victorian parents attending the emergency department for their child's lower urgency condition.
The Victorian Nurse-On-Call (NOC) service has been in use for over 8 years, though little research has been conducted investigating the service. The present study aimed to explore whether parents in Victoria presenting with their child to the ED for lower urgency conditions use the NOC before ED arrival and whether the advice given impacts their decision to attend the ED. ⋯ The findings of our study show that use and awareness of NOC is low in parents attending the ED for their child's lower urgency condition. The success of NOC in the goal of deferring non-urgent conditions from presenting to the ED appears limited. Telenursing triage services in Australia should consider assessment of their algorithms to increase the likelihood that where appropriate, lower urgency conditions are directed to primary care services rather than the ED.
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Emerg Med Australas · Dec 2015
Management of mental health patients in Victorian emergency departments: A 10 year follow-up study.
Despite efforts to restructure mental health (MH) services across Victoria, the social and economic burden of MH illness continues to grow. This study compares MH presentations to EDs with a study undertaken 10 years earlier. ⋯ Despite increasing MH-related presentations, changes in ED practice have allowed improvements in delivery of care through a shortened ED length of stay and the virtual elimination of very long stays over 24 h. However, there continues to be significant variability in management and performance across hospital sites. Identifying which interventions lead to standout site performance, and subsequent application more broadly, may improve future ED delivery of care.
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Emerg Med Australas · Dec 2015
Applying palliative care principles and practice to emergency medicine.
Only recently has the potential (unmet) palliative care (PC) workload in the ED been recognised. While confident in PC symptom management, we underestimate the role of a palliative approach in non-cancer diagnoses and seek education in areas such as individual patient care pathways, ethical and legal issues and difficult conversations at the end of life. PC is best introduced early for a range of life-limiting cancer and non-cancer diagnoses. ⋯ This patient-centred, rather than disease-centred approach, is the essence of PC, and one that is easily incorporated into emergency practice. PC and disease-specific treatments can comfortably coexist, and with meticulous symptom management, may actually prolong life. PC is everyone's business, and emergency medicine needs to be part of it.