Emergency medicine Australasia : EMA
-
Emerg Med Australas · Apr 2020
ReviewReview article: Prevalence of burnout in paramedics: A systematic review of prevalence studies.
Paramedic wellness is an increasing priority within the profession. Burnout has been described as having areas of 'emotional exhaustion, depersonalisation and reduced personal accomplishment'. Prevalence of burnout is unclear, hampering evaluation of protective initiatives. ⋯ Included studies were of low to moderate quality. The prevalence of burnout in paramedics varies from 16% to 56%. Existing evidence describing burnout in paramedics is weak; research of good methodological rigour is needed to quantify prevalence of burnout, providing a reliable baseline against which protective interventions could be measured.
-
Emerg Med Australas · Apr 2020
Multicenter Study Observational StudyImaging and admission practices in paediatric head injury across emergency departments in Australia and New Zealand: A PREDICT study.
Variation in the management of paediatric head injury has been identified worldwide. This prospective study describes imaging and admission practices of children presenting with head injury across 10 hospital EDs in Australia and New Zealand. ⋯ Across the 10 largely tertiary EDs included in this study, the overall CTB rate was low with no significant variation between sites when adjusted for ciTBIs.
-
Emerg Med Australas · Apr 2020
Initiation of vasopressor infusions via peripheral versus central access in patients with early septic shock: A retrospective cohort study.
To assess whether the initiation of vasopressor infusions via peripheral venous catheters (PVC) compared to central venous catheters (CVC) in ED patients with early septic shock was associated with differences in processes of care and outcomes. ⋯ The practice of commencing a vasopressor infusion via a PVC was common in the ARISE trial and more frequent in trial participants with higher severity of illness. Commencement of a vasopressor infusion via a PVC was associated with some improvements in processes of care and, after adjustment, was not associated with an increased risk of death.
-
Emerg Med Australas · Apr 2020
When a health policy cuts both ways: Impact of the National Emergency Access Target policy on staff and emergency department performance.
To explore the impact of the Four-Hour Rule/National Emergency Access Target (4HR/NEAT) on staff and ED performance. ⋯ There was strong evidence of an association between high stress and low morale and the implementation of the 4HR/NEAT across all levels of performance. These adverse consequences of the 4HR/NEAT implementation indicate that a more nuanced approach to efficiency improvements is required. This would balance processes measured by 4HR/NEAT against a range of other clinical and organisational performance measures.
-
Emerg Med Australas · Apr 2020
Observational StudyEmergency healthcare delivery for young adults during a planned mass gathering: A retrospective observational study.
To describe patient presentation characteristics and outcomes for people aged 16-18 years pre, during and post a planned youth mass gathering event (MGE): 'Schoolies week' on the Gold Coast, Queensland, Australia. ⋯ Establishment of an in-event model of care for 1 week during Schoolies served as an effective hospital avoidance strategy for a planned youth MGE. Such in-event models of care may be considered for other similar future MGE.