Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2018
Observational StudyInfluenza-associated delays in patient throughput and premature patient departure in emergency departments in New South Wales, Australia: A time series analysis.
Influenza outbreaks cause overcrowding in EDs. We aimed to quantify the impact of influenza on the National Emergency Access Targets and premature patient departure in New South Wales, Australia. ⋯ Circulating influenza was associated with sustained increases and peaks in delayed patient throughput and premature patient departures. Influenza surveillance information may assist with development of health system and hospital workforce planning and bed management activities.
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Emerg Med Australas · Feb 2018
ReviewReview article: Best practice management of low back pain in the emergency department (part 1 of the musculoskeletal injuries rapid review series).
Low back pain (LBP) is a common presentation to the ED, and a frequent cause of disability globally. The ED management is often associated with high rates of imaging, misuse and overuse of pharmacology and subsequent financial implications. Given this, improved quality of care for patients with LBP in ED is essential. ⋯ The search revealed 1538 articles, of which 38 were included in the review (n = 8 primary articles, n = 13 systematic reviews and n = 17 guidelines). This rapid review provides clinicians managing LBP in the ED a summary of the best available evidence to risk stratify and enhance the quality of care, optimising patient outcomes. Consistent evidence was found to support the use of 'red flags' to screen for serious pathologies, diagnostic tests being reserved for use only in the presence of red flags, the judicious prescribing of opioids, identification of psychosocial risk factors as predictors of poorer outcome and promotion of early return to work and function.
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Emerg Med Australas · Feb 2018
Trauma case review: A quality and safety feature of the Victorian State Trauma System.
The aim of the present study was to describe the trauma case review process and its role in a regionalised trauma system. Victoria has a population of 5.9 million people, accounting for 26% of Australia's population. Victoria has been serviced by an inclusive, organised trauma system since 2000 comprising 138 health services with trauma designations and three major trauma services. ⋯ The trauma case review process is an embedded feature of the Victorian State Trauma System that aims to improve compliance with major trauma guidelines by reviewing major trauma cases that have been managed outside of established triage and transfer guidelines. All trauma-designated Victorian health services, Ambulance Victoria and Victorian adult and paediatric patient retrieval services might receive trauma cases for review. The process is also an integral component of trauma system clinical governance, which enables the identification of system-level issues for escalation to the State Trauma Committee and the Victorian Department of Health and Human Services.
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Emerg Med Australas · Feb 2018
Observational StudyImpact of ladder-related falls on the emergency department and recommendations for ladder safety.
To describe the characteristics of patients who presented to the ED from a ladder-related fall and their injuries, highlight the impact of ladder-related falls on the ED, identify contributing factors of ladder falls and draw recommendations to improve ladder safety. ⋯ Ladder-related falls carry a considerable burden to the ED. Recommendations include ladder safety interventions that target ladder users most at risk of falls: men, ≥50 years old and performing domestic tasks. Safety interventions should emphasise task avoidance, education and training, utilisation of safety equipment and appropriate ladder setup.