Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2023
Exploring Australian emergency department clinicians' knowledge, attitudes and adherence to the national peripheral intravenous catheter clinical care standard: A cross-sectional national survey.
This study aimed to (i) capture clinicians' knowledge, attitude and adherence to the first Australian national peripheral intravenous catheter (PIVC) Clinical Care Standard, (ii) examine the instrument performance of the knowledge related questions and (iii) explore the educational needs for, and barriers to, Standard adherence among Australian ED clinicians. ⋯ The findings of the survey suggest that the Standard may need modification to align with the needs of ED clinicians. Future studies need to explore the applicability and relevancy of some recommendations in the ED settings as they may cause low adherence to the Standard.
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Emerg Med Australas · Oct 2023
Characteristics of paediatric pre-hospital intubation by Intensive Care Paramedics.
Emergency intubation in children is an infrequent procedure both in the pre-hospital and hospital setting. The anatomical, physiological and situational challenges together with limited clinician exposure can make this a difficult procedure with high risk of adverse events. The aim of this collaborative study between a state-wide ambulance service and a tertiary children's hospital was to describe the characteristics of pre-hospital paediatric intubations by Intensive Care Paramedics. ⋯ Pre-hospital intubation in children is performed infrequently in an extremely unwell patient group. Continued high-level paramedic training is required to prevent adverse events and ensure patient safety.
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Emerg Med Australas · Oct 2023
Evolving swabbing practices for COVID-19 in a New Zealand emergency department during the early stages of an emerging pandemic.
To review if tests for suspected COVID-19 were performed according to the Ministry of Health (MoH) case definitions, identify patterns associated with testing outside of the case definition, and discuss the potential impacts on hospital services. ⋯ There were associations found between testing outside of criteria and specific variables potentially perceived as high-risk. Poor alignment of testing with case definitions can impact hospital services through the (mis)use of limited laboratory testing capacity and implications for resource management. Improved communication and feedback between clinicians and policymakers may improve case definition implementation in a clinical setting.
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Emerg Med Australas · Oct 2023
Definitive management of near-hanging at major versus non-major trauma centres.
The Victorian State Trauma System recommends that all major trauma patients receive definitive care at a major trauma service (MTS). The aim of the present study was to assess the outcomes of patients with major trauma after near-hangings who received definitive management at an MTS compared to a non-MTS. ⋯ After major trauma sustained from near-hanging, definitive management at an MTS did not offer a mortality benefit or better functional outcomes. Consistent with current practice, these findings suggest that most near-hanging related major trauma patients could be managed safely at a non-MTS.
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Emerg Med Australas · Oct 2023
Time to embrace sepsis pathways and antibiotic prescribing decision support in the emergency department: Observations from a retrospective single site clinical audit.
To compare clinician documentation of sepsis for infective presentations in the ED against a formal sepsis pathway in the ED and to assess appropriateness of the initial parenteral antibiotic prescription for adult patients in ED. ⋯ Our observations demonstrate that use of a formal sepsis pathway may improve the screening and early diagnosis of sepsis and septic shock and that there is a need for antibiotic prescribing guidance in the ED.