Emergency medicine Australasia : EMA
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The COVID-19 pandemic has led to the development of alternative means of accessing unplanned care in order to avoid unnecessary ED presentations and hospital admissions. We explore the definition of emergency medicine, which patients are better served by accessing unplanned hospital care via alternative pathways, and the concept of emergency care completion.
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Emerg Med Australas · Aug 2022
Daily reality of violence in a rural emergency department: Is violence becoming the new normal?
Violence in emergency healthcare is a persistent and concerning problem. The objective of the present study was to explore and understand rural nurses' views on the daily experience and impact of violence, and its perpetrators. ⋯ The present study shows that rural workers, like metropolitan workers, feel experiences of violence are a routine part of their roles. Violence in healthcare is a societal issue, that cannot be solved without a multifactor approach that considers the characteristics of the perpetrators.
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Emerg Med Australas · Aug 2022
Case ReportsSengstaken-Blakemore tube in critical upper gastrointestinal bleeding: Implications for aeromedical retrieval.
Sengstaken-Blakemore tubes (SBTs) are rarely used in Australia, because of improved access to endoscopy and interventional radiology, as well as overall lower rate of variceal haemorrhage from improvements in primary prophylaxis. SBT's use is associated with significant rate of serious complications, such as oesophageal perforation, mucosal necrosis, aspiration pneumonia and respiratory compromise secondary to external compression of the trachea. As such, SBT is currently only recommended for use in life-threatening variceal haemorrhage, where endoscopic, embolization and pharmacologic therapy have been unsuccessful or are unavailable. ⋯ We present a case of SBT insertion in retrieval medicine and discuss placement in the management of an unstable upper gastrointestinal bleed, complicating factors such as lack of radiology to confirm balloon position, the impact of flight altitude on balloon pressures, the maintenance of traction in flight and logistics of long flight times across the state of Queensland. This is the first case report of SBT use in the Australian aeromedical environment. It is also the first one where SBT has been used for duodenal bleeding, although the source of bleeding was unknown prior to insertion.
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Emerg Med Australas · Aug 2022
Unusual 2020 RSV bronchiolitis season in Western Australia: Not explained by weather.
To describe and explore the relationship between weather and the unusual 2020 bronchiolitis season in Western Australia during the COVID-19 pandemic. ⋯ The bronchiolitis outbreak showed no relationship to local weather patterns. State-mandated COVID-19 public health measures appear as the likely rationale.