Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
ReviewReview article: Primary aeromedical retrievals in Australia: An interrogation and search for context.
Primary aeromedical retrievals are a direct scene response to patients with a critical injury or illness using a medically equipped aircraft. They are often high-acuity taskings. In Australia, information on primary retrieval taskings is housed by service providers, of which there are many across the country. ⋯ However, there are several areas for research action and service outcome improvements suggested, all of which would be facilitated through the creation of a national pre-hospital and retrieval registry. The creation of a registry would enable consideration of the frequency and context of retrievals, comparison across services, more sophisticated data interrogation. Most importantly, it can lead to service and pre-hospital and retrieval system strengthening.
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Emerg Med Australas · Dec 2019
Multicenter Study Observational StudyHeterogeneous emergency department management of published recommendation defined hypotension in patients with acute traumatic spinal cord injury: A multi-centre overview.
Evidence-based management for patients with acute traumatic spinal cord injury (TSCI) in the ED has a critical impact on long-term outcomes. Acute hypotension post-injury may compromise spinal cord perfusion and extend neurological damage. Published guidelines recommend mean arterial blood pressure (BP) maintenance between 85 and 90 mmHg for 7 days post-injury; the extent to which this is followed in Australia is unknown. ⋯ Hypotensive patients' post-TSCI experienced heterogeneous ED care discordant with published guidelines; varying by hospital type. Specialist care and more severe injury increased likelihood of guideline adherence. Lack of adherence may influence patient outcomes. Level 1 evidence is needed along with consistent guideline implementation and clinician training to likely improve TSCI management and outcomes.
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Emerg Med Australas · Dec 2019
Multicenter Study Observational StudyDirect cost of alcohol-related presentations to Royal Perth Hospital emergency department.
To quantify the direct cost of alcohol-related presentations to Royal Perth Hospital ED, as part of the binational Alcohol Harm in Emergency Departments study. ⋯ Alcohol-related presentations to the ED are a significant public health burden. If the study week is representative, the annual cost is substantial. Although the direct mean cost of presentations to the ED is similar between alcohol-positive and alcohol-negative patients, these presentations would not have occurred without the influence of alcohol.
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Emerg Med Australas · Dec 2019
Non-traumatic musculoskeletal pain in Western Australian hospital emergency departments: A clinical audit of the prevalence, management practices and evidence-to-practice gaps.
Musculoskeletal pain (MSP) conditions are a leading cause of morbidity worldwide and a common reason for ED presentation. Little is currently known about non-traumatic MSP (NTMSP) presenting to EDs. The present study described the prevalence and management practices of NTMSP in EDs. ⋯ NTMSP is a relatively common reason for ED presentation. Documented management practices are discordant with guideline recommendations. Strategies to improve the concordance between management and guideline recommendations are needed.
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Emerg Med Australas · Dec 2019
Observational StudyCharacteristics and outcomes of patient presentations made by police to an Australian emergency department.
To describe and compare characteristics and outcomes of patient presentations brought in by police (BIBP) with those not BIBP (NBIBP) to one Australian ED. ⋯ Patients BIBP were different to those NBIBP. Despite comprising a small proportion of overall ED attendances, they are a group where mental health and drug and alcohol issues are over-represented. Differences in ED care delivery for those BIBP highlights potential opportunities for pre-hospital healthcare interventions.