Emergency Medicine Australasia最新文献

{"title":"Correction to ‘Evaluation of a team-based approach for emergency department patients with time critical intracranial conditions’","authors":"","doi":"10.1111/1742-6723.70045","DOIUrl":"https://doi.org/10.1111/1742-6723.70045","url":null,"abstract":"<p>Macleod S, Melville G, Samimi-Duncan A <i>et al</i>. Evaluation of a team-based approach for emergency department patients with time critical intracranial conditions. Emerg Med Australas 2025; 37: e70026. https://doi.org/10.1111/1742-6723.70026</p><p>In the Abstract Methods section, the first sentence should read:</p><p><b>Method:</b> Quasi-experimental study, involving retrospective analyses of data of all potential Critical Head patients presenting to Wollongong ED from 1 January 2018 to 26 May 2023, with the protocol go-live on 7 March <b>2020</b>.</p><p>In the Abstract Results section, the first sentence should read:</p><p><b>Results:</b> Two hundred and <b>forty-two</b> patients were included (123 control/preintervention, 119 intervention).</p><p>We apologise for this error.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using feedback from paediatric resuscitation team members to improve quality of care","authors":"Erin Mills BMedSci, MBBS, FRACP-PEM,&nbsp;Jessica Nooney CCRN, MN, PhD,&nbsp;Annmarie Bermundo CCRN, BN,&nbsp;Phyllis Lin MSBA,&nbsp;Celia Bagshaw MBChB, FACEM,&nbsp;Tobias van Hest MBBS, FACEM-PEM,&nbsp;Adam West MBBS, FACEM, MHSM,&nbsp;Shameera Navaratnam MBBS, DrEmMed,&nbsp;Clifford Connell PhD, BN(Hons), RN,&nbsp;Harshika Herath MBBS,&nbsp;Simon Craig MBBS, FACEM, MPH, MHPE, PhD","doi":"10.1111/1742-6723.70044","DOIUrl":"https://doi.org/10.1111/1742-6723.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Paediatric resuscitations in the ED are high-pressure events in unpredictable settings. Traditionally, only cases with poor outcomes are reviewed to prevent future failures. Adopting a Safety-II mindset allows teams to reflect on both positive and negative experiences, enhancing care quality. The present study aimed to identify themes from staff feedback after paediatric resuscitations in the ED and describe system changes as a result.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective quality improvement study was conducted over 31 months in a tertiary paediatric ED. Surveys were sent to clinical staff involved in paediatric resuscitations, requesting feedback on successes and suggestions for improvement. Responses were analysed using directed content analysis: initial coding using the London Protocol, a systems-focused review methodology, followed by inductive thematic analysis. Feedback was discussed in departmental Mortality and Morbidity and Quality and Safety Meetings, leading to systemic improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-nine paediatric resuscitation cases yielded 1320 specific feedback items from 256 staff members. Feedback covered all layers of the health system, with key themes focussed on the team, the environment and tasks/technology. Improvements included a transport checklist, a start-of-shift airway huddle and standardised medication preparation methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Asynchronous feedback from staff involved in paediatric resuscitations identified positive and constructive themes across the health system. This feedback was successfully translated into a number of systems-focused actions to improve patient safety and care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential length of stay reductions from emergency department use of a point-of-care high-sensitivity cardiac troponin assay: Pilot findings from Australia's first cardiac emergency department","authors":"Robert Meek MBBS, PhD,&nbsp;Georgina Hayden MBBS,&nbsp;Zhong X Lu MBBS, PhD,&nbsp;Adam Damianopoulos BNurs/BPsychSc, MSc,&nbsp;Louise Cullen MBBS, PhD,&nbsp;Evan Kumarakurusingham MBBS,&nbsp;Pavith Pathirana,&nbsp;Martin Than MBBS, PhD,&nbsp;John W Pickering BSc, PhD, BA,&nbsp;James Doery BSc, MSc, MD,&nbsp;Alex Duong MBBS,&nbsp;Diana Egerton-Warburton MBBS, MPH","doi":"10.1111/1742-6723.70041","DOIUrl":"https://doi.org/10.1111/1742-6723.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare actual ED length of stay (LOS) using laboratory-based high-sensitivity cardiac troponin I (hs-cTnI) testing with the potential LOS that could result from using point-of-care (POC) hs-cTnI tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Baseline hs-cTnI tests were performed on the same blood sample in the laboratory (Access hsTnI assay) and in the ED (Atellica VTLi POC assay). Actual and potential LOS were compared for patients who were discharged after having a baseline laboratory hs-cTnI test only. Total LOS incorporated time from arrival to blood sample collection, blood sampling to result availability and result availability to discharge. For potential LOS, the blood sampling to result availability time with POC use was fixed at 10 min (2-min preparation and 8-min test-processing). The laboratory blood sampling to result availability time was from blood sample collection to result uploading on the pathology computer system. For the study, it was assumed that this was the only LOS component that would differ with POC use. Invalid POC result rates were monitored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For 152 patients discharged after having a single baseline laboratory hs-cTnI test, the median actual LOS was 195 (interquartile range [IQR]: 152–319) min, which included a median laboratory blood-sampling-to-result-availability time of 48 (IQR: 41–59) min. The potential LOS from POC use was 157 (IQR: 103–282) min, which included the fixed 10-min blood-sampling-to-result-availability time. The mean actual-potential LOS difference was 43 (95% confidence interval [CI]: 40–46) min. The POC invalid result rate was 11%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Atellica VTLi could deliver a mean ED LOS reduction of 43-min per patient for those discharged after a single baseline hs-cTnI test. Use in actual practice and the invalid result rate require further evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging for older patients with head impact at baseline conscious state","authors":"Biswadev Mitra MBBS, MHSM, PhD, FACEM,&nbsp;Nathan Ip MBBS,&nbsp;Dipen Khoosal MBBS, FACEM,&nbsp;Bernice Xin Er Lee MBBS,&nbsp;Gabriel Blecher MBBS, FACEM,&nbsp;Peter A. Cameron MBBS, MD, FACEM","doi":"10.1111/1742-6723.70046","DOIUrl":"https://doi.org/10.1111/1742-6723.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe CT brain (CTB) and neurosurgical management among head injured patients aged ≥ 85 years and minimal or no change in Glasgow Coma Scale (GCS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was undertaken using radiology and administrative data from two tertiary referral hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 3833 patients included and 40% were taking anticoagulant or antiplatelet medications. Acute intracranial abnormalities were detected in 225 (5.9%) patients, and 5 (0.13%) underwent neurosurgical procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among older patients with head trauma, CTB could be targeted to individuals likely to be considered for neurosurgical intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geospatial mapping of emergency department presentations in New South Wales Australia (2015 and 2021): Trends in rural and metropolitan areas—A data linkage study","authors":"Yingbin Chui MBBS,&nbsp;Pejman Adily BSc (Mathematics), MEStud,&nbsp;Thomas Stefoulis MD,&nbsp;Radhika Seimon BSc, BSc (Hons), PhD,&nbsp;Michael Dinh MBBS, MPH, PhD","doi":"10.1111/1742-6723.70042","DOIUrl":"https://doi.org/10.1111/1742-6723.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the relationship between the frequency of presentations to EDs among metropolitan, regional and rural areas in New South Wales (NSW).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective geospatial data linkage cohort study; analysis of total ED presentation rates based on statistical area level 2 (SA2), a standardised geographic unit defined by the Australian Bureau of Statistics (ABS) to represent populations that interact socio-economically. The participants were patients presenting to NSW hospital EDs in 2015 and 2021, based on all hospitals included in the NSW ED Data Collection (EDDC). The main outcomes measured were the relationships at the SA2 level between total ED presentation rates (counting all presentations), total number of different patients who presented at least once per calendar year, and the ratio of total presenters to unique individual presenters (as a marker of repeated presentations).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total presentations to ED per 10 000 population in metropolitan areas decreased by 0.4% (12/2813). In inner regional Australia, there was instead a 10.6% (535/5051) increase. In outer regional Australia, there was a 20.7% (1189/5747) increase. In remote Australia and very remote Australia, ED presentations per 10 000 population increased by 94.6% (5989/6331). Changes were consistent geospatially, demonstrating large increases in presentations in rural and regional areas, but almost no change in metropolitan areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was an increase in total ED presentation rates in regional and remote areas between 2015 and 2021, while metropolitan areas saw a slight decrease in presentation rates. Further analysis should be conducted to determine the cause of this increase.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Other Journals","authors":"Sierra Beck,&nbsp;Tahnee Dunlop,&nbsp;Bridget Honan,&nbsp;Abhishek Mitra,&nbsp;Muhuntha Sri-Ganeshan,&nbsp;Joseph Ting","doi":"10.1111/1742-6723.70043","DOIUrl":"https://doi.org/10.1111/1742-6723.70043","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and predictors of severe outcomes of COVID-19 cases presenting to the emergency department of a major Australian referral hospital: A record linkage study","authors":"Katrina Boldt BNurs, MPH,&nbsp;Nectarios Rose MBBS, MPH, MSc, MBiostat, MHM,&nbsp;Sandra Ware BSc. MScMed, MBiostat,&nbsp;Michael M Dinh MBBS, MPH, PhD,&nbsp;Kishor Kumar Paul MBBS, MPH, PhD,&nbsp;Yvonne Ho BPsychSc, PhD,&nbsp;David J Muscatello BSc, MPH, PhD","doi":"10.1111/1742-6723.70040","DOIUrl":"https://doi.org/10.1111/1742-6723.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the characteristics, outcomes and predictors of a severe outcome of patients presenting with a SARS-CoV-2 infection to the ED of a major urban referral hospital in New South Wales, Australia, from January 2020 through February 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Linked healthcare and death registration records were used and included any person assigned a diagnosis potentially related to an acute respiratory infection in the ED and that had a linked positive COVID-19 detection. Logistic regression was used to determine predictors of a severe outcome (ICU admission or death) within 28 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2081 included COVID-19 patients, 238 (11.4%) had a severe outcome within 28 days of arrival at the ED. Among adults, the odds of a severe outcome increased with age, although the rate of increase in odds within age groups was statistically significant only in 30–64-year-olds (4% per year of age; confidence interval [CI] 2–6). Ambulance arrival (odds ratio [OR] 2.85; CI 1.76–4.78), higher triage urgency (category 1 or 2 compared with 4 or 5: OR 8.63; CI 4.41–18.12), and presentation during the pre-Delta (OR 6.18; CI 3.59–10.66) and Delta (OR 3.64; 95% CI 2.49–5.35) variant periods (compared with Omicron) were independently associated with increased risk of a severe outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Age, ambulance arrival, higher triaged urgency, and presentation earlier in the pandemic were predictors of a severe COVID-19 outcome. Aged care measures and prioritising vaccination of older persons and aged care workers may have reduced severe outcomes in the elderly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an evidence-based sepsis pathway on paediatric hospital clinical practice: A quality improvement study","authors":"Bernard McCarthy MBChB, FRACP, Paediatric Emergency Physician,&nbsp;Natalie Middleton MCN, GradCert ClinNurs – PaedICU, BN,&nbsp;Fenella J Gill FACCCN, GradCert Tert Teach, Paed Cert, MN, BN PhD, RN,&nbsp;Zoy Goff PGDipClin Pharm, BPharm,&nbsp;Zoe Paterson,&nbsp;Christopher C Blyth PhD, FRACP, FRCPA, MBBS,&nbsp;the CAHS Sepsis Working Group","doi":"10.1111/1742-6723.70036","DOIUrl":"https://doi.org/10.1111/1742-6723.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the impact of implementing a sepsis pathway and education program on key sepsis outcomes and performance targets in a tertiary paediatric hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A quality improvement study using a multi-modal screening process and pragmatic clinical definitions. Treatment of all children with septic shock and sepsis without shock 4 months prior to pathway/education package launch was compared with those meeting definitions 8 months post-launch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the study period, 1483 episodes were screened; 517 episodes met study definitions (171 pre-launch; 346 post-launch). Eighty-two episodes met septic shock definitions (15.9%) and 435 met sepsis without shock definitions (84.1%). A total of 143 episodes pre-launch and 271 episodes post-launch were managed exclusively at Perth Children's Hospital (PCH). Post intervention, the pathway form was utilised in 146 of 271 episodes (53.9%). Pathway/education package introduction was associated with a reduction in the median time from recognition to antibiotic administration (60 [IQR: 26; 115] to 45 min [IQR: 16; 75] for those with septic shock and/or sepsis without shock treated exclusively at PCH; <i>P</i> &lt; 0.001). The proportion receiving antibiotic therapy within recommended timeframes significantly increased (septic shock within 60 min: 70.0% to 92.5%, <i>P</i> &lt; 0.03; sepsis without shock within 180 min; 86.2% to 94.8%, <i>P</i> = 0.005). No statistically significant change in length of stay, intensive care admission, mortality or antibiotic consumption was observed following pathway launch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Paediatric sepsis pathway and education package implementation can reduce time to antibiotics in sepsis and aid local data collection and surveillance of patients treated for sepsis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid overdoses following use of cocaine and methamphetamine in New South Wales, and the public health responses","authors":"Peter Chisholm MBBS, B Med Sc, MPH,&nbsp;Jared Brown BPharm, MPH,&nbsp;Thanjira Jiranantakan MD, MPH, FAFPHM, FACOEM,&nbsp;Mary Ellen Harrod PhD,&nbsp;Catherine McDonald BSc,&nbsp;Una Cullinan BSc,&nbsp;Darren M Roberts MBBS, PhD, FRACP, FAChAM","doi":"10.1111/1742-6723.70038","DOIUrl":"https://doi.org/10.1111/1742-6723.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Recent years have seen sporadic reports in Australia of stimulants being contaminated with opioids. Since late 2023, there has been an increase in opioid overdoses among individuals in New South Wales (NSW) using substances believed to be cocaine or methamphetamine. We analysed the frequency and characteristics of these cases and describe our public health responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Prescription, Recreational &amp; Illicit Substance Evaluation (PRISE), operated by NSW health since July 2018, is a statewide surveillance, epidemiology, and toxicity response programme. We did a retrospective analysis of each case of opioid toxicity following use of cocaine or methamphetamine submitted to the PRISE programme from January 2022 to June 2024, categorising cases into confirmed, probable, and suspected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four cases were found, 19 involving cocaine and 15 involving methamphetamine. Twenty-two (65%) were classified as confirmed, and 12 (35%) as probable. There were two deaths (6%). Twenty-three cases (68%) were in Sydney. Multiple stakeholders reviewed trends and formulated public health responses, leading to the distribution of public drug warnings and media releases in November 2023 and February 2024 because of ongoing case detections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The increase in detections, which continued in the months following the public health responses, underscores the need for comprehensive surveillance, response, monitoring, and reporting of this phenomenon in NSW. Engagement with clinicians and the community is essential for the success of this programme.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequent attendance to paediatric emergency departments: Steps towards prevention","authors":"Helen Parry MBBS, FRACGP, MPH,&nbsp;Emily Roxburgh BA, BMBS, FRACGP,&nbsp;Lani Maier RN, BSN,&nbsp;Jennie Louise PhD, M.Biostat,&nbsp;Morgan Hill RN, BSN,&nbsp;Christine Berry DipMC","doi":"10.1111/1742-6723.70037","DOIUrl":"https://doi.org/10.1111/1742-6723.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To improve understanding of sociodemographic characteristics, underlying medical conditions, and healthcare factors contributing to persistent frequent attendance to paediatric emergency departments (PED), and to explore opportunities for prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of patients attending a PED &gt;5 times per year for 2 years (persistent frequent attendance) was conducted with an analysis of sociodemographic characteristics, underlying health conditions, PED attendance factors, and evidence of General Practitioner (GP) continuity of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-two paediatric patients (0.1% of PED patients) attended the PED frequently for two consecutive years (median 18.5 visits) accounting for 1.9% (<i>n</i> = 1914) of total PED presentations. Of these patients, 55.6% resided in disadvantaged areas, 13.8% were Aboriginal people and 52.8% had an identified GP. 100% had chronic health conditions. 40% had primarily medical conditions (median age 4.6 years) and 33.3% had primarily mental health conditions (median 15.8 years). 26.4% of patients had co-morbid chronic mental health and medical conditions (median 16.4 years) and attended the most frequently (median 33.0 presentations). Of the two groups with chronic mental health conditions, 55.8% of patients were under Guardianship (Child Protection Services).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Chronic health conditions, socio-economic disadvantage, child protection involvement, Aboriginal background, and lack of GP continuity contribute to persistent frequent PED attendance. Preventative strategies that increase community support and improve the underlying health and wellbeing of patients experiencing, or at risk of, frequent PED attendance would be beneficial for patients, caregivers, and clinicians. Research exploring frameworks that connect these patients with GPs for continuity of care is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}