Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
Trends of emergency department presentations with a mental health diagnosis by age, Australia, 2004-05 to 2016-17: A secondary data analysis.
The present study aims to explore for Australia: (i) the trends of ED presentations with a mental health (MH) diagnosis by age group; and (ii) whether those trends differ from all ED presentations. ⋯ The Australian Institute of Health and Welfare should consider expanding the breadth of MH diagnoses they report to better identify the impact of MH on ED presentations. Between 2004-05 and 2016-17, high ED utilisation by children and older persons, and the increasing burden of MHdx presentations for youth, younger adults and children suggest that healthcare planning strategies for urgent and emergency care cannot afford to overlook the growing impact of these sub-groups.
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Emerg Med Australas · Dec 2019
Time from arrest to extracorporeal cardiopulmonary resuscitation and survival after out-of-hospital cardiac arrest.
The association between the time from arrest to extracorporeal cardiopulmonary resuscitation (ECPR) and survival from out-of-hospital cardiac arrest (OHCA) is unclear. The aim of this study was to determine whether time to ECPR is associated with survival in OHCA. ⋯ Early initiation of ECPR is associated with improved survival after OHCA. Because we analysed a nationwide OHCA registry, which lacks uniform selection criteria for ECPR, further prospective study is warranted.
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Emerg Med Australas · Dec 2019
COACHRED: A protocol for the safe and timely incorporation of focused echocardiography into the rhythm check during cardiopulmonary resuscitation.
Focused echocardiography may be a useful tool in cardiopulmonary resuscitation for prognostication, to identify certain reversible causes of cardiac arrest, and to guide further management and procedures. Nonetheless, many clinicians have reservations regarding its widespread adoption due to evidence that it leads to prolonged interruption of cardiac compressions. ⋯ This approach incorporates the best strategies identified to date that minimise interruptions to chest compressions. We demonstrate that, in a simulation environment, it is achievable to incorporate focused echocardiography into the rhythm check while keeping the interruption to chest compressions within the timeframe prescribed by international guidelines.
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Emerg Med Australas · Dec 2019
Development and evaluation of a code frame to identify potential primary care presentations in the hospital emergency department.
A major challenge in evaluating the appropriateness of ED presentations is the lack of a universal and workable definition of patients who could have received primary care instead. Our objective was to develop a standardised code frame to identify potential primary care patients in the ED. ⋯ This standardised code frame enables accurate retrospective local and national data estimations. The code frame could be used prospectively to evaluate interventions such as diverting patients to primary care settings, and to identify populations for specifically targeted interventions. The conservative nature of the code frame ensures that only those that can safely receive care in a primary care setting are identified as potential primary care.
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Emerg Med Australas · Dec 2019
Comparative StudyComparison of emergency physiotherapy practitioner prescribers versus existing emergency department prescribers for musculoskeletal injuries.
The scope of selected emergency physiotherapy practitioners (EPP) in this Australian non-tertiary ED has recently extended to include the prescription of a limited drug formulary, including paracetamol, some NSAIDs and opioids, an anti-emetic, a benzodiazepine and nitrous oxide. Although there are large-scale studies investigating prescription errors made by doctors, there is a lack of data on prescribing practices of physiotherapists in the ED setting. The aim of present study is to compare the prescribing practices of EPP to their medical and nursing colleagues within the setting of treating musculoskeletal injuries in the ED. ⋯ In the management of ED patients with musculoskeletal complaints, prescription-trained EPP appear to perform similarly if not better than their medical and nursing colleagues with regards to NIMC audit tool results.