Emergency medicine Australasia : EMA
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Emerg Med Australas · Apr 2022
Gender equity in emergency medicine: Five years on, where are we headed?
The challenge of addressing gender inequality was highlighted in the 2016 Trainee Focus of Emergency Medicine Australasia. Despite increasing numbers of female medical graduates, including increasing female trainees in emergency medicine (EM), this has not yet translated to equal representation in formal leadership roles. Five years later, as the Australasian College for Emergency Medicine (ACEM) welcomes the second female college president, this article explores the gendered leadership gap in EM from an organisational and intersectional feminist perspective and recommends high-level strategies for change. ⋯ It has also achieved gender parity in provisional trainees and improved women's representation on the ACEM Board. However, broader organisational processes that ensure work-life integration, transparent leadership development pathways and equitable recruitment, promotion, retention and evaluation remain critical. Creating a local evidence-base to support diversity in leadership development remains a priority.
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Emerg Med Australas · Apr 2022
Observational StudyVascular injury is an infrequent finding following non-fatal strangulation in two Australian trauma centres.
Non-fatal strangulation assessment is challenging for clinicians as clear guidelines for evaluation are limited. The prevalence of non-fatal strangulation events, clinical findings, frequency of injury on computed tomography angiogram (CTA) and outcomes across two trauma centres will be used to improve this assessment process. ⋯ In non-fatal strangulation presentations, the majority have subtle signs of neck injury on examination with inconsistent documentation of findings. Low rate of vascular injury overall (0.7%), and entirely in hanging events. No longer-term vascular sequalae identified. Improving documentation focusing on hypoxic insult and evidence of airway trauma is warranted, rather than a reliance on computed tomography imaging to delineate a traumatic event in non-fatal strangulation.
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Emerg Med Australas · Apr 2022
Conservative management of traumatic pneumothoraces: A retrospective cohort study.
Traumatic pneumothoraces (T-PTXs) are traditionally managed with an intercostal catheter (ICC), despite little evidence for this. Success with conservative management of primary spontaneous PTX has been demonstrated, and our ED has adopted a conservative approach where safe for all PTX. ⋯ Our data support conservative management of selected T-PTXs and shows a need for a prospective randomised trial to further examine this intervention.
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Emerg Med Australas · Apr 2022
Emergency department usage by adults with cerebral palsy: A retrospective cohort study.
To retrospectively profile the ED usage for a cohort of adults with cerebral palsy (CP). ⋯ The high rates of respiratory diagnoses and epilepsy/convulsions, both ambulatory care-sensitive conditions, may be indicative of transitional challenges between paediatric and adult healthcare, potentially highlighting difficulties in accessing primary care services. Relatively low rates of 'low urgency' presentations may suggest perceived medical fragility in this vulnerable population. People with CP who present to ED and were not admitted may be underrepresented in this data. National expansion of this research will aid the development of an evidence-based model of care for CP in Australia.