Emergency medicine Australasia : EMA
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Emerg Med Australas · Oct 2019
ReviewReview article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review.
Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn-over and burn-out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre-empt incidences of OV during ED episodes of care. ⋯ Although there was variation in, and differences between, staff-perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage.
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Emerg Med Australas · Oct 2019
Utility of weight-bearing radiographs compared to computed tomography scan for the diagnosis of subtle Lisfranc injuries in the emergency setting.
The goal of the present study was to compare the diagnostic yield of weight-bearing radiographs with non-weight-bearing computed tomography (CT) scan for subtle Lisfranc (LF) injuries in the ED. ⋯ CT provides limited benefit in the diagnosis and initial management of suspected subtle LF injuries in the ED. We advocate for the use of bilateral weight-bearing radiographs as a first-line investigation.
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Emerg Med Australas · Oct 2019
The World Health Organization trauma checklist versus Trauma Team Time-out: A perspective.
Time-out protocols have reportedly improved team dynamics and patients' safety in various clinical settings - particularly in the operating room. In 2016, the World Health Organization (WHO) introduced a Trauma Care checklist, which outlines steps to follow immediately after the primary and secondary surveys and prior to the team leaving the patient. ⋯ The WHO Trauma Care checklist, while likely to be successful in reducing errors of omission related to hospital admission, may be limited in its ability to reduce errors that occur in the initial 30 min of trauma reception - when most of the life-saving decisions are made. To address this limitation a Trauma Team Time-out protocol is proposed for initial trauma resuscitation, targeting the critical first 30 min of hospital reception.
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Emerg Med Australas · Oct 2019
Diagnoses, damned diagnoses and statistics: Dealing with disparate diagnostic coding systems within the New South Wales Emergency Department Data Collection.
The aims of the present study were to describe the distribution of Systematised Nomenclature of Medicine - Clinical Terms (SNOMED-CT) codes used in the current New South Wales Emergency Department Data Collection (NSW EDDC) and classify duplicate and redundant terms into clinically meaningful sub-groups for future analyses. ⋯ The use of SNOMED-CT in the NSW EDDC has resulted in substantial use of non-specific, duplicate and redundant codes, limiting the capacity of the NSW EDDC to be used for effective data analysis.
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Emerg Med Australas · Oct 2019
Does ambulatory and fast track allocation reduce immersion in acute and resuscitation training, and impair career satisfaction and job longevity for emergency medicine registrars?
Although dedicated sections for non-acute care in the ED is recognised to improve patient flow and reduce ED congestion, there is anecdotal feedback that it detracts from work satisfaction and potentially career longevity and sustainability. Although allocation to fast track shifts reflects contemporary emergency medicine as practiced in Australasia, it may reduce registrar immersion on acute and resuscitation training.