Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2016
Multicenter Study Observational StudyOutcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department.
Primary: to determine incidence of 30 day major adverse cardiac events (MACE) in patients discharged from the ED following assessment using an accelerated diagnostic pathway (ADP). Secondary: to determine incidence of 30 day MACE for all ADP patients. ⋯ The ADP supports safe, early discharge of low-risk chest pain patients from the ED.
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Emerg Med Australas · Jun 2016
Multicenter StudySystemic inflammatory response syndrome-based severe sepsis screening algorithms in emergency department patients with suspected sepsis.
Systemic inflammatory response syndrome (SIRS)-based severe sepsis screening algorithms have been utilised in stratification and initiation of early broad spectrum antibiotics for patients presenting to EDs with suspected sepsis. We aimed to investigate the performance of some of these algorithms on a cohort of suspected sepsis patients. ⋯ We found the Ireland and JFK Medical Center sepsis algorithms performed modestly in stratifying suspected sepsis patients into high-risk groups. Algorithms with lactate levels thresholds of >2 mmol/L rather than >4 mmol/L performed better. ED sepsis registry-based characterisation of patients may help further refine sepsis definitions of the future.
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Emerg Med Australas · Feb 2016
Multicenter StudyIs a national time target for emergency department stay associated with changes in the quality of care for acute asthma? A multicentre pre-intervention post-intervention study.
There is debate whether targets for ED length of stay introduced to reduce ED overcrowding are helpful or harmful, as focus on a process target may divert attention from clinical care. Our objective was to investigate the effect of a national ED target in Aotearoa New Zealand on the recommended care for acute asthma as this is known to suffer in overcrowded departments. ⋯ Introduction of the target was not associated with a change in times to steroids in ED, although more patients received steroids in ED indicating closer adherence to recommended practice.
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Emerg Med Australas · Jun 2015
Multicenter StudyImproved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed.
To describe and compare characteristics and outcomes of patients who arrive by ambulance to the ED. We aimed to (i) compare patients with a delayed ambulance offload time (AOT) >30 min with those who were not delayed; and (ii) identify predictors of an ED length of stay (LOS) of >4 h for ambulance-arriving patients. ⋯ Patients arriving to the ED via ambulance and offloaded within 30 min experience better outcomes than those delayed. Given that offload delay is a modifiable predictor of an ED LOS of >4 h, targeted improvements in the ED arrival process for ambulance patients might be useful.
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Emerg Med Australas · Apr 2014
Multicenter StudySmall rural emergency services still manage acutely unwell patients: A cross-sectional study.
Examine the range of clinical situations encountered at small rural emergency care services. We hypothesised that over a 12 month period, small rural emergency services would encounter almost the entire range of clinical situations described at designated EDs. ⋯ The five small rural emergency facilities encountered most of the clinical problems seen in full EDs. They saw almost all categories of emergency presentation, saw almost all diagnostic categories, treated critically ill and injured patients, and performed most procedures.