Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2021
Observational StudyParamedic streaming upon arrival in emergency department: A prospective study.
The role of paramedics in hospital triage or streaming models has not been adequately explored and is potentially a missed opportunity for enhanced patient flow. The aim of the present study was to assess the concordance between a streaming decision by paramedics with the decision by nurses after arrival to the ED. ⋯ Despite limited knowledge of patient load within the ED, paramedics can allocate a streaming destination with high accuracy and this appears to be associated with low clinical risks. Early pre-hospital notification of streaming destination with proactive allocation of ED destination presents a real opportunity to minimise off-load times and improve patient flow.
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Emerg Med Australas · Apr 2021
Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children.
Children frequently present with head injuries to acute care settings. Although international paediatric clinical practice guidelines for head injuries exist, they do not address all considerations related to triage, imaging, observation versus admission, transfer, discharge and follow-up of mild to moderate head injuries relevant to the Australian and New Zealand context. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) set out to develop an evidence-based, locally applicable, practical clinical guideline for the care of children with mild to moderate head injuries presenting to acute care settings. ⋯ The PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children provides high-level evidence and practical guidance for front line clinicians.
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Emerg Med Australas · Apr 2021
Is waiver of consent for the use of health information for research acceptable to emergency department patients?
Some emergency medicine research, especially retrospective studies using medical records review, rely on waiver of consent for use of personal health information (PHI) contained in clinical records. This is a secondary use of PHI and waiver of consent raises ethical, legal and practical issues. ⋯ In part, this involves a balancing of the public interest versus the risk to privacy and an evaluation of whether subjects would, mostly likely, have agreed to the use of their PHI had they been asked. To date, there are no robust data about whether use of PHI without consent for research would be acceptable to people who attend Australasian EDs for care.
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Antifragility is a property of things that benefit from shocks, randomness and uncertainty and love adventure and risk. This describes emergency medicine. Improving evidence-based medicine requires a learning health system, where the whole system is constructed to advance patient care via research driven excellence. ⋯ Unfortunately, the human brain is hard wired for simplicity, making us disinclined to challenge the status quo. Yet probably <10% of our practice is supported by high-level evidence. Research is altruistic and a form of kindness for our patients, which includes having a culture of research within a learning health system, so that we can be thoughtful!
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Emerg Med Australas · Apr 2021
Prescription medication use by emergency department doctors to improve work and academic performance, and to manage stress and anxiety.
To determine medications used by ED doctors to improve work and academic performance, and to manage stress and anxiety. ⋯ Medication use is common and support for some doctors may be required.