Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2023
Disposition of patients utilising the virtual emergency department service in southeast region of Melbourne (SERVED-1).
Supported by the state government, three health networks partnered to initiate a virtual ED (VED), as part of a broader roll-out of emergency telehealth services in Victoria. The aim of the present study (Southeast Region Virtual Emergency Department-1 [SERVED-1]) was to report the initial 5-month experience and included all patients assessed through the service over the first 5 months (1 February 2022 to 30 June 2022). ⋯ Initial experience demonstrated a significant increase in adoption of the service and an overall avoidance of physical ED attendance by a majority of patients. These results support ongoing VED consultations, complemented by follow up and health economic evaluations.
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Emerg Med Australas · Aug 2023
Final year medical students as Assistants in Medicine in the emergency department: A pilot study.
To evaluate the Assistant in Medicine (AiM) programme and its impact on physician burden and productivity in the ED. ⋯ The present study demonstrates the strong potential the AiM programme has to improve productivity, workflow and efficiency in the ED.
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Emerg Med Australas · Aug 2023
Triage to electrocardiogram sign-off time in patients with acute coronary syndrome at a metropolitan Sydney hospital.
To compare the time from triage to ECG sign-off in patients with acute coronary syndrome, before and after the introduction of an electronic medical record-integrated ECG workflow system (Epiphany). Additionally, to assess for any correlation between patient characteristics and ECG sign-off times. ⋯ The introduction of the Epiphany system has significantly reduced the triage to ECG sign-off time in the ED. Despite this, there remains a large proportion of patients with acute coronary syndrome who do not have an ECG signed-off within the guideline-recommended 10 min.
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Emerg Med Australas · Aug 2023
Planning for the next pandemic: Reflections on lessons from the uncontained transmission phases of the COVID-19 pandemic and their impacts on emergency departments in Australia.
Australia was a world leader in managing the earlier waves of the COVID-19 pandemic. Subsequently, three major turning points changed the trajectory of the pandemic: mass vaccinations, emergence of more transmissible variants and re-opening of Australia's borders. However, there were also concomitant missteps and premature shifts in pandemic response policy that led to mixed messaging, slow initial vaccination uptake and minimal mitigation measures in response to the Omicron variant. ⋯ This led to an exponential increase in cases and significant impacts on the health system, particularly, EDs. This paper reflects on this phase of the pandemic to urge for system-level changes that instal better safeguards for ED capacity, safety and staff well-being for future pandemics. This is essential to strengthening our health system's resilience and to better protecting our communities against such emergencies.
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Emerg Med Australas · Aug 2023
Randomized Controlled Trial Multicenter StudySodium chloride or plasmalyte-148 for patients presenting to emergency departments with diabetic ketoacidosis: A nested cohort study within a multicentre, cluster, crossover, randomised, controlled trial.
To test the hypothesis that fluid resuscitation in the ED with plasmalyte-148 (PL) compared with 0.9% sodium chloride (SC) would result in a lower proportion of patients with diabetic ketoacidosis (DKA) requiring intensive care unit (ICU) admission. ⋯ Patients with DKA treated with PL compared with SC in the EDs had similar rates of requiring ICU admission.