Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2020
Patients with mental health conditions in the emergency department: Why so long a wait?
Patients presenting with a mental health disorder (MHD) wait longer in the ED compared to those presenting for other reasons, potentially placing vulnerable patients at further risk for deterioration. The present study identified factors associated with a long ED stay for patients with a MHD. ⋯ Some factors predictive of a long ED stay for patients presenting to the ED and diagnosed with a MHD varied based on their disposition. For admissions, the most urgent presentations were likely to stay longest. Strategies to reduce ED stay for both admissions and discharges should consider addressing modifiable aspects, including the need for certain investigations, and non-modifiable aspects, including the need for further access to after-hours mental health services in hospital and in the community.
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Emerg Med Australas · Dec 2020
The impact of patient isolation on emergency department length of stay: a retrospective cohort study using the Registry for Emergency Care (REC-1).
The number of patients with suspected COVID-19 presenting to Australian EDs continues to impose a burden on healthcare services. Isolation is an important aspect of infection prevention and control, but has been associated with undesirable consequences among hospital inpatients. The aim of the present study was to determine if isolation is associated with an increased length of stay (LOS) in the ED. ⋯ Consistent with the anecdotal experience of Australian ED clinicians, the present study demonstrated an increased ED LOS for patients managed in isolation. Enhanced infection prevention and control precautions will be required during and beyond the current pandemic, creating significant ongoing challenges for emergency care systems.
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Emerg Med Australas · Dec 2020
Eligibility criteria for extracorporeal cardiopulmonary resuscitation at Auckland City Hospital: A retrospective cohort study.
Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising adjunct to routine advanced cardiac life support. Growing worldwide interest in ECPR-use has seen more tertiary centres offering ECPR programmes. New Zealand's nationwide extracorporeal membranous oxygenation service is provided at Auckland City Hospital (ACH). Despite the potential benefits of ECPR, it is currently only offered on an ad hoc basis. It remains unknown whether ACH would manage sufficient numbers of patients to warrant an ECPR programme. ⋯ An ECPR programme at ACH using standardised and agreed criteria may benefit a small number of patients and improve rates of survival to hospital discharge with preservation of neurological function. An ECPR guideline would help clarify for referring services cases that are appropriate for extracorporeal membranous oxygenation consideration, rather than discussing on an ad hoc basis.
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Emerg Med Australas · Dec 2020
Chronic disease management in emergency department patients presenting with dyspnoea.
Guideline recommended treatments for chronic conditions are thought to reduce ED presentations. ⋯ Prescription of guideline recommended therapies for chronic conditions in patients presenting to the ED in Australasia with acute dyspnoea is similar or higher than reported previously.
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Emerg Med Australas · Dec 2020
Workplace violence in emergency departments: The health professionals and security personnel alliance.
Violence in the health sector is a widespread worldwide phenomenon. Emergency nurses and emergency physicians are among the most exposed. ⋯ Sharing some data from our 2016 Italian National Survey on Violence towards Emergency Nurses, further elements are provided on this issue. The different perspectives of healthcare professionals and security personnel can converge in an alliance to counteract violence in the ED.