Emergency medicine Australasia : EMA
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Over recent years, emergency telehealth has developed rapidly in Australasia. From the patient's perspective, establishing trust with a healthcare provider is uniquely challenging when using the audio and video modalities commonly used in telehealth. ⋯ These include ensuring privacy and an appropriate setting for the consultation; considering how eye contact and expressions are best used; providing alternative options to telehealth; and clearly identifying names, roles and qualifications. We describe how these methods can best be employed in the virtual emergency care setting.
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Emerg Med Australas · Feb 2025
Somatic symptom and related disorders in a tertiary paediatric hospital: Characteristics of ED use prior to admission.
Somatic symptom and related disorders (SSRDs) are complex disorders that are commonly encountered in tertiary paediatric settings. Despite this, little is known about ED use prior to hospital admission. We aimed to describe the pattern of ED use in a cohort of children and adolescents who were subsequently admitted to hospital with SSRD and to identify factors associated with ED presentations. ⋯ Children and adolescents with SSRD who go on to have a hospital admission present frequently to EDs, especially in the setting of pain symptoms. Training of ED clinicians in diagnosing SSRD appears indicated, as is the development of local care pathways that may obviate the need for hospital admission in at least some patients.
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Ambulance ramping, the delay to transfer of a patient arriving at an ED by ambulance into an ED treatment space and handover of care to ED clinicians, is a problem in all Australian states and territories and New Zealand. It is a symptom of ED overcrowding and access block and has been associated with adverse health outcomes for some patient groups. The questions arise, who might be legally responsible for the care of patients who are ramped and does their physical location matter? The short answers are 'everyone' and 'no', however, whether there will be a breach of duty depends on the reasonableness of responses and resource allocation considerations.
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Emerg Med Australas · Feb 2025
Historical ArticleAdvanced Paediatric Life Support: A 25-year journey in Australia.
Over twenty-five years ago the first Advanced Paediatric Life Support (APLS) course was held in Australia. Through the lens of quality culture in educational organisations, we can identify factors which have underpinned the evolution, sustainability and success of this course.
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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.