Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2023
Introduction of QScript real-time prescription monitoring system was associated with a fall in pregabalin poisoning presentations to a clinical toxicology unit.
To investigate the impact of QScript implementation on pregabalin-related poisoning presentations to the ED. ⋯ The introduction of QScript was associated with a reduction in pregabalin-related poisoning presentations.
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Emerg Med Australas · Oct 2023
Emergency short stay area improves access and flow in a rural hospital.
Shoalhaven District Memorial Hospital is a rural (MM3) 150-bed hospital in Nowra, New South Wales, whose ED has evolved to a FACEM-led model of care (MOC). It has never had an emergency short stay area (ESSA). The objective of the present study was to pilot an ESSA and determine whether this MOC would increase the operational performance of the ED. ⋯ The introduction of the ESSA significantly improved the ETP of admitted patients. Ongoing refinement of the ESSA admission processes, as well as the lifting of certain COVID-19 restrictions, could show even greater improvements in this and other areas. Ongoing research in this field is necessary, as well as a more detailed cost-benefit analysis.
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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
Rational clinical approach to transient ischaemic attack, stroke and associated mimics: A retrospective cohort study.
The present study was performed to identify the individual clinical features and risk factors most strongly associated with the diagnosis of transient neurological symptoms with a cerebrovascular cause (transient ischaemic attack (TIA) or stroke), as compared to common TIA mimics (including retinal ischaemia, migraine and seizure). ⋯ The present study demonstrated that specific clinical features and risk factors were associated with the final diagnosis at TIA clinic. These clinical features may assist with diagnosis of TIA in centres without access to a vascular neurologist.
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Emerg Med Australas · Oct 2023
Timing of antibiotics in febrile children meeting sepsis criteria at a paediatric emergency department.
Delay in antibiotic administration in paediatric sepsis is associated with increased mortality and prolonged organ dysfunction. This pre-intervention study evaluated performance in paediatric sepsis management. ⋯ There was frequent delay in administering antibiotics in children meeting local sepsis criteria, more commonly in young infants. Reasons contributing to delay were specific to young children along with departmental factors that will require addressing through targeted quality improvement interventions.