Emergency medicine Australasia : EMA
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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
Burden of primary care-type emergency department presentations using clinical assessment by general practitioners: A cross-sectional study.
To compare methods of assessment of the burden of primary care-type ED (PCTED) presentations against clinical assessment by general practitioners (GPs) in ED. ⋯ Previous methods determining the burden of PCTED presentations have not been validated. Many presentations excluded by previous methods were identified as manageable in general practice by GPs clinically assessing patients in ED. Improved validation of criteria used to identify PCTED presentations will enable appropriately designed interventions to reduce such events.
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Emerg Med Australas · Oct 2019
Australian private emergency departments can assist ambulance services by taking public emergency patients during surge and disasters.
We describe a novel ambulance diversion programme, piloted in Victoria. This article discusses creating increased emergency capacity during surge or disasters by utilising private EDs, tested during a recent thunderstorm asthma disaster and an influenza epidemic. ⋯ It is feasible to create surge capacity in private EDs for public ambulance patients. Other states could consider this option to help manage health disasters.
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Emerg Med Australas · Oct 2019
Observational StudySub-optimal treatment of paediatric migraine in an emergency department: An observational study.
To describe treatment of children presenting to an Australian ED with a final ED diagnosis of migraine. ⋯ Treatment of migraine in children was not consistent with the available evidence regarding agents' relative effectiveness. The use of opiates is concerningly high.
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Emerg Med Australas · Oct 2019
Enhancing intern emergency medicine education using a combined didactic and web-based learning curriculum: The EDGE programme.
To assess the effectiveness of an education programme that integrates web-based learning into classroom sessions. ⋯ This blended curriculum that integrates a web-based resource into classroom learning shows promise in enhancing intern emergency medicine education.