Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2019
Comparative Study Observational StudyComparison of emergency department time performance between a Canadian and an Australian academic tertiary hospital.
To compare performance and factors predicting failure to reach Ontario and Australian government time targets between a Canadian (Sunnybrook Hospital) and an Australian (Austin Health) academic tertiary-level hospitals in 2012, and to assess for change of factors and performance in 2016 between the same hospitals. ⋯ Austin outperformed Sunnybrook for Ontario and Australian government time targets. Both hospitals failed the Australian targets. Factors predicting failure to achieve targets were different between hospitals, but were mainly clinical resources. Sunnybrook focussed on increasing human resources. Austin focussed on increasing human resources, observation unit and hospital beds. Intrinsic hospital characteristics and infrastructure influenced target success.
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Programmes that reduce the time to defibrillation are likely to improve overall survival rates from out-of-hospital cardiac arrests (OHCAs). This research sought to identify human factors common among community responders taking an automated external defibrillator (AED) to a victim of an OHCA that are either barriers or enablers of desired behaviour. ⋯ Prospective programmes may be able to be designed to increase the likelihood that community members with AEDs will respond in advance of emergency medical services by targeting common human factors, such as leadership behaviour, training, competency and experience in managing emergencies, leading to better overall survival rates from OHCA.
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Emerg Med Australas · Aug 2019
Homeless status documentation at a metropolitan hospital emergency department.
This study compared the prevalence of homelessness in consecutive patients presenting to a metropolitan hospital ED measured via a prospective housing screen with the prevalence of homelessness determined via retrospective audit of hospital data. Factors that altered the odds of patients being homeless and service outcomes that differed were examined for screened patients. ⋯ Hospital ED administrative data substantially under-recognises the prevalence of homelessness in presenting patients. Standardised use of brief housing screens could improve identification of and provision of support to this often highly vulnerable population.
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Emerg Med Australas · Aug 2019
One hundred and counting: Centenarian use of emergency departments in New South Wales.
To study ED utilisation by people aged 100 years and over with a focus on patient demographics, reasons for presentation and patient flow factors. ⋯ Centenarians ED presentations are increasing over time with injuries as the most common reason for presentation. Most patients have prolonged ED length of stay and many require hospital admission. Early streaming of these patients through specialised geriatric assessment units may be more appropriate to reduce the demand on EDs and improve patient care. Models that facilitate rapid access to supported living arrangements and improved advanced care planning may be more realistic for many centenarians and different models of care need to be considered for this age group.