Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
ReviewReview article: Scoping review of interventions that reduce mechanical restraint in the emergency department.
Mechanical restraints are known to be associated with many undesirable outcomes in clinical settings. Our objective was to examine the current literature to explore possible interventions that would reduce the use of mechanical restraints in the ED. ⋯ Evidence supports further exploration of interventions that include: designing an agitation guideline; training staff in assessment, attitudinal and de-escalation skills; addition of a crisis team; and environmental changes in the form of adding a dedicated clinical space. Although these strategies may reduce mechanical restraint in the ED setting, further high-quality studies are needed before definitive conclusions may be drawn.
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The aim of the present study was to quantify research outputs after completing a Coursework Pathway (CP). ⋯ A substantial proportion of trainees who completed the CP published subsequent research. This provides a measure for emergency clinicians undertaking research projects after completing the CP.
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Emerg Med Australas · Feb 2025
Adverse events and paramedic interventions during extended ground transport in a rural pharmaco-invasive STEMI program.
Although guidelines recommend angiography and coronary intervention occur within 24 h of thrombolysis when percutaneous coronary intervention (PCI) is not available within 120 min, this target is difficult to achieve in rural and remote areas of New South Wales (NSW), Australia. ⋯ The primary study showed a significant reduction in time from first clinical contact to arrival at the PCI hospital. In this secondary analysis, we demonstrate that the rate of adverse events during long-distance road transport is low, the adverse events are mostly minor in nature and are within the scope of paramedic practice to manage.
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Emerg Med Australas · Feb 2025
The use and impact of pathology tests in emergency department patients with mental health-related complaints: A cross sectional study.
To evaluate the use and impact of pathology tests in patients who present to the ED with mental health-related complaints. The primary objective is to measure the proportion of patients undergoing pathology tests and assess whether these tests trigger a change in management. ⋯ Pathology tests should be reserved for patients with high-risk features and based on clinical assessment. Strategic use of pathology tests could avoid unnecessary delays and costs, enhancing patient care in mental health-related ED presentations.
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Emerg Med Australas · Feb 2025
A cluster of multi-drug intoxications involving xylazine, benzimidazole opioids (nitazenes) and novel benzodiazepines in South Australia.
To highlight the detection of xylazine and nitrazolam in conjunction with benzimidazole opioids (nitazenes) and other novel benzodiazepines in a cluster of patients after putative heroin use. ⋯ This is the first signal of xylazine and nitrazolam use in Australia. These results demonstrate toxico-surveillance programmes with analytical confirmation of drugs are invaluable in monitoring illicit drug use.