Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2019
ReviewReview article: Managing medical emergencies in rural Australia: A systematic review of the training needs.
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. ⋯ However, many of the studies were performed by training providers that may benefit from deficient results. Given that the data was over 10 years old and that advances have been made in knowledge, training opportunities and technology, the implications for current training needs of rural doctors in Australia could not be accurately assessed. Thus there is a need for further research to identify current training needs.
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Emerg Med Australas · Feb 2019
Impact of the four-hour National Emergency Access Target on 30 day mortality, access block and chronic emergency department overcrowding in Australian emergency departments.
Previous research reported strong associations between ED overcrowding and mortality. We assessed the effect of the Four-Hour Rule (4HR) intervention (Western Australia (WA) 2009), then nationally rolled out as the National Emergency Access Target (Australia 2012) policy on mortality and patient flow. ⋯ The 4HR was introduced as a means of driving hospital performance by applying a time target. Patient flow improved, but the evidence for mortality benefit is controversial with improvement only in WA. Further research with more representative data from a larger number of hospitals over a longer time across Australia is needed to increase statistical power to detect long-term effects of the policy.
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Emerg Med Australas · Feb 2019
Multicenter Study Observational StudyThe Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan.
There is uncertainty about the optimal i.v. fluid volume and timing of vasopressor commencement in the resuscitation of patients with sepsis and hypotension. We aim to study current resuscitation practices in EDs in Australia and New Zealand (the Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis [ARISE FLUIDS] observational study). ⋯ This multicentre, observational study will provide insight into current haemodynamic resuscitation practices in patients with sepsis and hypotension as well as estimates of practice variation and patient outcomes. The results will inform the design and feasibility of a multicentre phase III trial of early haemodynamic resuscitation in patients presenting to ED with sepsis and hypotension.
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Emerg Med Australas · Feb 2019
Building a research-ready database of rural emergency presentations: The RAHDaR pilot study.
A small amount of data from rural emergency facilities is collated with large urban datasets, but there are no dedicated rural emergency datasets. ⋯ The RAHDaR dataset includes high-risk presentations managed entirely at low resource sites and, as further sites are added, will tackle the biases that can misrepresent the performance of small rural hospitals.
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Emerg Med Australas · Feb 2019
ACEM involvement in a successful African emergency medicine programme.
In the past 5 years Botswana graduated its first home-grown doctors and emergency medicine specialists for the country. The postgraduate emergency medicine specialist training arrangement between Botswana and South Africa was challenging in development, implementation and maintenance. Numerous varied supports from ACEM and its International Emergency Medicine Network were integral to these successes. This article encourages further investment of ACEM grants and scholarships in Africa by describing how ACEM supported significant advances in Botswana emergency medicine.