Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2017
Critical thinking, curiosity and parsimony in (emergency) medicine: 'Doing nothing' as a quality measure?
Current medical decision-making is influenced by many factors, such as competing interests, distractions, as well as fear of missing an important diagnosis. This can result in ordering tests or providing treatments that can be harmful. Unnecessary tests are more likely to lead to false positive diagnosis or incidental findings that are of uncertain clinical relevance. ⋯ The 'Choosing Wisely' campaign has identified many of these wasteful tests and treatments. This perspective proposes some suggestions to focus on our critical thinking, embrace shared decision-making and stay curious about the patient we are treating. Most importantly, 'doing nothing' could be a quality indicator for EDs, and ACEM supported audits and research to develop benchmarks for certain tests and procedures in the ED are important to achieve a cultural change.
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Emerg Med Australas · Jun 2017
Review Meta AnalysisReview article: Workplace violence in the emergency department: A systematic review and meta analysis.
Patient or visitor perpetrated workplace violence (WPV) has been reported to be a common occurrence within the ED. No universal definition of violence or recording of such events exists. In addition ED staff are often reluctant to report violent incidents. ⋯ WPV in the ED was commonly reported. There is wide heterogeneity across the study methodology, definitions and rates. More standardised recording and reporting may inform preventive measures and highlight effective management strategies.
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Emerg Med Australas · Jun 2017
Observational StudyTwo Hour Evaluation and Referral Model for Shorter Turnaround Times in the emergency department.
The objective of this study was to assess the implementation of a novel ED model of care, which combines clinical streaming, team-based assessment and early senior consultation to reduce length of stay. ⋯ A facilitated team leader role for senior doctors can help to reduce length of stay by via early disposition, without significant risks to the patient.
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Emerg Med Australas · Jun 2017
Paediatric lumbar punctures: How do paediatric and emergency doctors differ?
The objective of the study was to identify any differences between emergency physicians and emergency trainees and paediatricians and paediatric trainees in performing paediatric lumbar punctures (LPs). ⋯ Paediatricians and paediatric trainees are more likely to be confident in performing LP in very young children than are emergency physicians and emergency trainees. They are more likely to perform fundoscopy prior to the procedure, but are much less likely to encourage parental presence during the LP.