Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
ReviewReview article: A primer for clinical researchers in the emergency department: Part X. Understanding economic evaluation alongside emergency medicine research.
In this series we address research topics in emergency medicine. While traditionally there was an almost exclusive focus on the efficacy and effectiveness of interventions in emergency research, analysis of the costs and the societal impact of different approaches and pathways have become increasingly important. In this paper we will address what health economics means and discuss the different types and key features of economic evaluation relevant for clinical researchers.
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Emerg Med Australas · Oct 2019
Review Meta AnalysisReview article: Impact of 12-lead electrocardiography system of care on emergency medical service delays in ST-elevation myocardial infarction: A systematic review and meta-analysis.
To assess the impact of prehospital 12-lead electrocardiography (PH ECG) on emergency medical service (EMS) delay in patients with ST-elevation myocardial infarction (STEMI), we systematically searched five online electronic databases, including MEDLINE, Embase, Emcare, Cochrane Library and CINAHL, between 1990 and August 2017. Controlled trials and observational studies comparing EMS time delays with and without PH ECG in STEMI patients were eligible. Two reviewers independently screened studies for eligibility, extracted data and appraised study quality. ⋯ PH ECG had no effect on transport or call-to-hospital intervals, although both measures showed evidence of heterogeneity. In patients with STEMI, PH ECG is associated with a modest increase in EMS delays. Measurement and improvement of EMS system delays may help to expedite treatment for STEMI.
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Emerg Med Australas · Oct 2019
ReviewReview article: Interventions for people presenting to emergency departments with a mental health problem: A systematic scoping review.
The number of people presenting to EDs with mental health problems is increasing. To enhance and promote the delivery of safe and efficient healthcare to this group, there is a need to identify evidence-based, best-practice models of care. This scoping review aims to identify and evaluate current research on interventions commenced or delivered in the ED for people presenting with a mental health problem. ⋯ The effectiveness of interventions varied. There is considerable, yet disconnected, evidence around ED interventions to support people with mental health problems. A lack of integrated, multifaceted, person-centred interventions is an important barrier to providing effective care for this vulnerable population who present to the ED.
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Emerg Med Australas · Oct 2019
Predictors of in-hospital cardiac arrest within 24 h after emergency department triage: A case-control study in urban Thailand.
This study describes the predictors of in-hospital cardiac arrest (IHCA) within 24 h of ED triage and evaluates their ability to predict patients at risk of IHCA. ⋯ We conclude that a combination of NEWS and four independent predictors identify patients at risk of IHCA more effectively than NEWS alone.
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Emerg Med Australas · Oct 2019
Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth.
To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16-64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether this is associated with in-hospital mortality. ⋯ Older adults who were not transported to the trauma centre had an increased odds of in-hospital mortality. However, older age was associated with a significantly reduced likelihood of trauma centre transport. With the aging population, the development of specific prehospital triage criteria to enable the complexities of this higher-risk population to be identified is important.