Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2016
Multicenter Study Observational StudyOutcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department.
Primary: to determine incidence of 30 day major adverse cardiac events (MACE) in patients discharged from the ED following assessment using an accelerated diagnostic pathway (ADP). Secondary: to determine incidence of 30 day MACE for all ADP patients. ⋯ The ADP supports safe, early discharge of low-risk chest pain patients from the ED.
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Emerg Med Australas · Jun 2016
Comparative Study Observational StudyMedical scribes in emergency medicine produce financially significant productivity gains for some, but not all emergency physicians.
The present study aims to determine if a scribe in an Australian ED can assist emergency physicians to work with increased productivity and to investigate when and where to allocate a scribe and to whom. ⋯ In the present study, scribe usage was associated with overall improvements in primary consultations per hour of 13% per scribed hour, and this varied depending on the physician. There is an economic argument for allocating scribes to some emergency physicians on days, evenings and weekends, not to trainees.
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Emerg Med Australas · Jun 2016
Multicenter StudySystemic inflammatory response syndrome-based severe sepsis screening algorithms in emergency department patients with suspected sepsis.
Systemic inflammatory response syndrome (SIRS)-based severe sepsis screening algorithms have been utilised in stratification and initiation of early broad spectrum antibiotics for patients presenting to EDs with suspected sepsis. We aimed to investigate the performance of some of these algorithms on a cohort of suspected sepsis patients. ⋯ We found the Ireland and JFK Medical Center sepsis algorithms performed modestly in stratifying suspected sepsis patients into high-risk groups. Algorithms with lactate levels thresholds of >2 mmol/L rather than >4 mmol/L performed better. ED sepsis registry-based characterisation of patients may help further refine sepsis definitions of the future.
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Emerg Med Australas · Jun 2016
Perceived incivility during emergency department phone consultations.
Perceived incivility during ED medical phone consultations is poorly researched. We aimed to determine frequency and factors influencing perceived incivility during ED phone consultations. ⋯ Perceived incivility occurs infrequently during ED phone consultations. ED female medical staff are at an increased risk of perceived incivility during phone consultations with non-ED medical professionals. Health organisations should actively pursue programmes to investigate the occurrence of incivility during healthcare consultations and implement programmes to mitigate the risk of developing a negative workplace culture.
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Emerg Med Australas · Jun 2016
Emergency department 'undercrowding' is associated with decreased waiting times.
To evaluate the effect of a sudden and sustained decrease in patient presentations on waiting times and other measures of workload and flow following the opening of a large, greenfields ED adjacent to our own. ⋯ Patient presentation numbers are strongly associated with and likely impact on median waiting time. Understanding that controlling demand can lead to significant benefits in patient processing, flow and overall patient perceived level of care and satisfaction is relevant to any discussion on ED overcrowding and the deleterious effects of access block.