Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2025
Rate and yield of imaging for acute pyelonephritis in the emergency department: A retrospective cohort study.
The role of imaging in acute pyelonephritis (APN) in the ED is poorly understood, with variability among clinical guidelines for when patients should be imaged, and the modality of imaging. The objective of this study was to identify the proportion of patients with APN being imaged, the proportion abnormal findings, and the association between abnormal imaging and discharge disposition. ⋯ Among patients with APN, abnormalities on imaging were common and both imaging and abnormalities on imaging were associated with hospital ward admission. This suggests that there is possible utility of early and routine imaging for patients with APN to allow clinicians to efficiently make decisions about patient disposition.
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Emerg Med Australas · Feb 2025
We can do better: Recommendations for mental health crisis care from people with lived experience.
The ED is increasingly the first point of contact for people who have no alternative when they are in a mental health crisis. However, there is mounting evidence of inadequate and negative responses to mental health crises in the ED, which has been identified as a 'human rights flashpoint'. ⋯ These key messages arise from a phenomenological analysis of in-depth interviews with 31 users of ED services, a PhD study conducted by a lived experience researcher. The paper concludes with six recommendations that combine collective wished-for responses with tangible examples of how these desired responses can be translated into crisis care practice.
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Emerg Med Australas · Feb 2025
Children exposed to family and domestic violence perpetrated against their mother are at an increased risk of emergency department attendance in childhood.
To determine the association between family and domestic violence (FDV) exposure and ED attendance in Australian children. ⋯ Exposure to FDV is associated with an increased risk of ED attendance in childhood. The findings add to the limited literature providing further support that FDV exposure impacts children's health service utilisation and further supports that children's exposure to FDV as an area of public health concern. Attendance at the ED presents an opportunity for intervention.
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Emerg Med Australas · Feb 2025
Effects of a Virtual Trauma Clinic on admissions and length of stay for minor to moderate trauma.
To investigate the feasibility of a Virtual Trauma Clinic (VTC) for patients with minor to moderate trauma, and evaluate patient satisfaction and outcomes. ⋯ Patients with minor to moderate trauma have ongoing care needs with high rates of pain, psychological distress and disability remaining prevalent long after discharge. VTC provided an innovative strategy for hospital avoidance with high levels of patient satisfaction and no adverse effects on safety. The overall quality of care for these patients was enhanced through the provision of standardised, patient-centred and multidisciplinary follow-up.
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Emerg Med Australas · Feb 2025
How useful was a paediatric physical abuse screening project in a rural Australian emergency department?
Children with non-accidental injuries have increased risk of future death. There is insufficient evidence for widespread physical abuse screening tool use in the ED. This study assesses the utility of a physical abuse project that includes the implementation of a screening tool with case-matching from multiple sources. It aims to confirm whether risk-screening in a medium-sized rural Australian ED is reliable and will improve outcomes. ⋯ Implementing this ED paediatric physical abuse project improved safety behaviours and best-practice documentation. The tool improved medical decision making without increased re-presentations. ED clinicians may use similar CPAs to help review safety concerns and facilitate discharge; however, resources are needed to investigate referrals flagged due to false-positive rates.