Emergency Medicine Australasia最新文献

{"title":"Impact of Clinician Education on Emergency Department Mechanical Restraint: An Interrupted Time-Series Study","authors":"Daiv Lown,&nbsp;Anne-Maree Kelly,&nbsp;Joseph Miller,&nbsp;Ellis Keddie,&nbsp;Paul Buntine,&nbsp;Ainslie Senz,&nbsp;Judith Hope,&nbsp;Patrick J. Owen","doi":"10.1111/1742-6723.70104","DOIUrl":"https://doi.org/10.1111/1742-6723.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Examine the impact of an education-based intervention co-designed with clinicians on attitudes towards and skills in caring for people with behaviours of concern in an emergency department (ED).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This 20-month interrupted time-series study (and nested 8-month before-and-after study) was conducted at a metropolitan hospital ED in Melbourne, Australia. The primary outcome was episodes of mechanical restraint before (1 January 2023 to 31 January 2023) and after (1 March 2024 to 30 September 2024) exposure of staff to an educational intervention. Secondary outcomes were staff injuries caused by patients, rate of offering voluntary medication for agitation, and medication timing before (1 October 2023 to 31 January 2024) and after (1 March 2024 to 30 June 2024) the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Episodes of mechanical restraint were lower after the intervention (mean [SD] before: 5.5 [3.4] episodes per week; mean [SD] after: 2.5 [1.6] episodes per week; mean difference [95% CI]: 3.0 [1.7, 4.4] episodes per week, <i>p</i> &lt; 0.001). There was a change in the level (β [95% CI] episodes per week: 2.22 [−4.35, −0.09], <i>p</i> = 0.041), but not a pre-existing downward trend (−0.00 [−0.07, 0.06], <i>p</i> = 0.960), of mechanical restraint. Staff sustained injuries caused by patients were lower after the intervention (<i>φ</i> = 0.138, <i>p</i> = 0.032). No significant difference was observed for offers of voluntary medication (φ = 0.049, <i>p</i> = 0.717) nor time to medication (mean difference [95% CI]: 67.08 [−83.87, 218.03] minutes, <i>p</i> = 0.374).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A multifaceted educational intervention was associated with fewer episodes of emergency department mechanical restraint and fewer staff injuries caused by patients. Further work is needed to determine generalisability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717004","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":"Evacuation of Extradural Haematomas by Rural Non-Neurosurgeons Is Not Futile, but More Than a Burr Hole Will Be Required","authors":"Michael J. Stuart,&nbsp;Rachel E. Colbran,&nbsp;Eric P. Guazzo","doi":"10.1111/1742-6723.70107","DOIUrl":"https://doi.org/10.1111/1742-6723.70107","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714767","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":"10.1111/1742-6723.70106","DOIUrl":"https://doi.org/10.1111/1742-6723.70106","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714768","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":"Perceived Impact of a Sonographer Educator in the Emergency Department (SEED) on Emergency Ultrasound (EUS) Training","authors":"Benjamin Taylor,&nbsp;Wai Chung Tse,&nbsp;Joshua Monester,&nbsp;Oriana Tolo,&nbsp;Adam Bystrzycki,&nbsp;Vijay Manivel,&nbsp;Peter Cameron,&nbsp;Elissa Kennedy Smith","doi":"10.1111/1742-6723.70094","DOIUrl":"https://doi.org/10.1111/1742-6723.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>ACEM supports Emergency Ultrasound (EUS) training for all emergency physicians and recommends every department has a Clinical Lead for Ultrasound (CLUS) and, ideally, a Sonographer Educator in the Emergency Department (SEED). There remains an ongoing paucity of SEEDs in Australian EDs. To improve training, an ED-funded SEED was introduced at Alfred Health EDs in mid-2023. This study aimed to explore the SEED's impact 1 year later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sequential cross-sectional REDCap surveys were distributed to emergency clinicians across two Australian EDs within a single healthcare service before and 1 year after the implementation of a SEED programme. Respondents' attitudes, use, confidence, and credentialling in EUS were compared before and 1 year after SEED implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After exclusion of Registrars and HMOs due to extremely high turnover rates (75% and 100% respectively) during the study period, a total of ~90 staff members (~85% FACEMs, ~1% Fellows and ~14% Nurse Practitioners, with retention rates &gt; 95%) were included in this sequential cross-sectional survey study. There were 43 responses in 2023 and 55 in 2024, response rates of 46.7% and 61.1% respectively. We found a statistically significant reduction in the number of respondents lacking confidence in all core modules, improvement in eFAST confidence, access to proctored scanning time and a large uptake in credentialling with over 50% undergoing credentialling by 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found improvements in several domains over a one-year period and has demonstrated an effective pathway to improve EUS training in departments with low numbers of appropriately credentialled staff.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695737","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":"The Impact of the COVID-19 Pandemic on Cardiac Related Emergency Department Presentations in Queensland: A Retrospective Cohort Study","authors":"Emma J. Hall,&nbsp;Gerben Keijzers,&nbsp;Jamie Ranse,&nbsp;Amy L. Sweeny,&nbsp;Julia Crilly,&nbsp; COVERED-COVID Study Investigators","doi":"10.1111/1742-6723.70096","DOIUrl":"https://doi.org/10.1111/1742-6723.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To (i) describe and compare rates, demographics, ED characteristics and outcomes for cardiac-related presentations to Queensland EDs before, during and after periods of government restrictions, (ii) determine if and which cardiac conditions were impacted by COVID-19 restrictions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort study of all adult presentations in 105 Queensland public EDs who were diagnosed with a cardiac condition or chest pain. Four periods were compared: ‘pre-pandemic’ (January 2018–March 2020), ‘statewide restrictions’ (11 March–30 June 2020), ‘easing of restrictions’ (1 July 2020–12 December 2021) and ‘outbreak’ (13 December 2021–30 June 2022). ED presentation rates (per 10,000 person-years) and incident rate ratios were calculated for chest pain, ischaemic heart disease, arrhythmias, heart failure, inflammatory conditions, cardiac arrest, and ‘other’ acute cardiac conditions. Proportions of presentations by demographic group, ED characteristics and outcomes were also compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 609,485 acute cardiac-related presentations. All-cause acute cardiac presentations decreased by 4% from ‘pre-pandemic’ to ‘statewide restrictions’, then increased by 20% and 25% in the ‘easing of restrictions’ and ‘outbreak’ periods, respectively. Ischaemic heart disease presentation rates decreased during ‘statewide restrictions’. Weekly chest pain presentations dropped early during ‘statewide restrictions’ but increased in each consecutive period. Weekly heart failure presentations appeared to follow seasonal patterns. Compared to ‘statewide restrictions’, inflammatory presentations increased during ‘easing of restrictions’ and ‘outbreak’ periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The COVID-19 pandemic impacted acute cardiac-related ED presentations in Queensland in various ways. Public health messaging for people to seek timely medical care for urgent conditions and symptoms should be emphasised in future pandemics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695738","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":"The Utility of Point-Of-Care Ultrasound for Paediatric Lumbar Puncture: A Narrative Review","authors":"Jacinta Trang,&nbsp;Dominic Ku,&nbsp;Peter J. Snelling","doi":"10.1111/1742-6723.70103","DOIUrl":"https://doi.org/10.1111/1742-6723.70103","url":null,"abstract":"<p>Lumbar punctures (LPs) are an invasive procedure that can be challenging with frequent traumatic or failed attempts in paediatric patients. Point-of-care ultrasound (POCUS) is a non-invasive tool frequently used for procedural guidance. The objective of this narrative review was to evaluate the current literature surrounding the use of ultrasound-assisted (marking for blind needle insertion) or ultrasound-guided (direct needle visualisation) techniques when performing paediatric LPs. A literature review was conducted using PubMed, Embase, and Google Scholar, with findings described in narrative format. Ultrasound can improve the identification of a suitable LP insertion site. POCUS increases first-pass success rates of LP attempts in infants with an assisted technique. Due to the lack of bone ossification in infants, the conus medullaris and depth of the thecal sac can be identified. The presence of a haematoma in the setting of failed LP may indicate the need to delay further attempts. However, there is currently a lack of evidence that POCUS routinely aids LPs in older children. The use of ultrasound in older children may be reserved for difficult LPs, such as abnormal anatomy or impalpable spinous processes. The ultrasound-guided technique improves LP success rates in all ages, but is an advanced technique mostly performed by radiologists. There is growing evidence that POCUS can assist with infant LP success. It may also have a role in difficult LPs in older children, but direct guidance requires a higher level of expertise. High-quality research is still required to determine the exact role of ultrasound for paediatric LPs.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681115","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":"An Inexpensive and Ultrasound-Compatible Lumbar Puncture Model Using SCOBY as an Effective Simulation Tool: The DIY LP Study","authors":"Gisela A. Kristono,&nbsp;Henry Li,&nbsp;Peter Watts,&nbsp;Melita Macdonald,&nbsp;Alice Rogan,&nbsp;Brad Peckler","doi":"10.1111/1742-6723.70101","DOIUrl":"https://doi.org/10.1111/1742-6723.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Lumbar puncture (LP) simulators have high costs and suboptimal realism. This study aimed to develop an affordable, high-fidelity and ultrasound-compatible model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We created a LP Simulator using three-dimensional printing, silicon, ballistic gel and symbiotic culture of bacteria and yeast (SCOBY). This was an observational study comparing the DIY-LP to a commercial simulator. Pre- and post-surveys were done.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 18 emergency medicine doctors (12 junior and six senior) participated in the study. Ten participants (56%; five junior doctors and five consultants) were successful with the DIY-LP simulator within the first two attempts without ultrasound guidance, compared with 13 participants (72%; seven junior doctors and six consultants) for the commercial simulator (<i>p</i>-value 0.49). The majority of participants agreed that both models were useful as educational tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study has demonstrated a low-cost and ultrasound-compatible LP model that is comparable to a commercial LP simulator.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681074","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":"Open and Closed Models of Emergency Care: Navigating Change in Rural Hospitals","authors":"Tim Baker,&nbsp;Tahnee Dunlop","doi":"10.1111/1742-6723.70099","DOIUrl":"https://doi.org/10.1111/1742-6723.70099","url":null,"abstract":"<div>\u0000 \u0000 <p>Emergency physicians are increasingly stepping into new roles in rural hospitals, where they may encounter unfamiliar service structures, blurred lines of responsibility, and conflicting expectations. The concept of open versus closed emergency department models, originally developed in intensive care medicine, provides a useful framework for navigating these challenges. In an open model, the emergency department is embedded within the broader hospital service, with clinical responsibility retained by senior decision makers outside the department. In a closed model, emergency physicians assume primary responsibility for patient care. Transitions to closed models should be implemented in stages to avoid disruption and support team cohesion. Both open and closed models are valid approaches, and each functions best when clinicians collaborate with mutual respect and shared purpose.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681075","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":"Predictors of ICU Admission in Intentional Overdose Presentations to the Emergency Department","authors":"Oliver Sutcliffe,&nbsp;Andrew McCombie,&nbsp;Calum Fisher,&nbsp;Maria Milkina,&nbsp;Tessa Burry,&nbsp;Jackie Hazelhurst,&nbsp;Rosalind Crombie,&nbsp;Laura R. Joyce","doi":"10.1111/1742-6723.70102","DOIUrl":"https://doi.org/10.1111/1742-6723.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify predictors of admission to ICU for patients attending the emergency department (ED) after intentional drug overdose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study examining factors predictive of ICU admission for adults &gt; 15 years presenting to Christchurch ED with intentional overdose between 1 July 2018 and 31 December 2020. Descriptive statistics were used by treating all presentations independently and on a per-patient basis to account for patients with repeat presentations or ICU admissions. Binary logistic models provided odds ratios with 95% confidence intervals. A multivariable logistic regression model which controlled for patients with ≥ 3 ED presentations in the past 365 days was used to determine predictors of ICU admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>There were 2682 presentations to ED with intentional overdose from 1795 individual patients, with 113 associated ICU admissions (4.2%) involving 103 patients. Overdose was more common in those who were younger, of female sex, or with a mental health history. The rate of overdose by Māori patients was double the rate expected. Older age, reduced level of consciousness, polypharmacy or cardiac drug overdose, and a history of depression, substance abuse or ADHD, ASD, learning difficulties or previous head injury were independently associated with an increased risk of ICU admission. Paracetamol ingestion and a history of ≥ 3 ED presentations in the preceding year were independently associated with a lower risk of ICU admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The need for ICU admission in patients presenting with intentional overdose should be identified early to prevent deterioration, promote flow through the hospital, and ensure that ICU beds are utilised appropriately.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681281","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":"Could Low-Value Diagnostic Tests be Compounding Access Block? A Single-Site, Cross-Sectional Study","authors":"Heidi Walker,&nbsp;Courtney West,&nbsp;Luke Lawton,&nbsp;Theophilus I. Emeto,&nbsp;Vinay Gangathimmaiah","doi":"10.1111/1742-6723.70100","DOIUrl":"https://doi.org/10.1111/1742-6723.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to evaluate the prevalence and impact of low-value diagnostic tests at a regional, major-referral, mixed Emergency Department (ED).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-site, cross-sectional study was conducted at Townsville University Hospital in April 2022. Adult patients (aged 18 years and above) who underwent one of 10 specified diagnostic tests were included. The tests encompassed coagulation studies, urine cultures, blood cultures, cranial computed tomography (CT) in syncope, cranial CT in minor head injury, cervical spine CT in neck trauma, ankle X-ray in acute ankle trauma, duplex lower extremity ultrasound in suspected deep vein thrombosis, CT pulmonary angiography in suspected pulmonary embolism, and CT kidney ureter bladder in renal colic. Tests were classified as low-value based on Choosing Wisely recommendations, with their value determined by a research assistant using clinical documentation, prior to the availability of test results. Emergency clinicians were blinded to the study conduct.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of all diagnostic tests performed, 48.2% (276/572) were deemed low-value, including 50.6% of laboratory tests (246/486) and 24.4% of imaging tests (21/86). The median ED length of stay was 6.1 h (IQR 3.9–8.5). Low-value imaging tests contributed to 152 lost bed-hours per 100 tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A substantial proportion of diagnostic tests were low-value, exacerbating access block and reducing the availability of ED beds, thereby delaying timely emergency care. The implementation of evidence-based, effective strategies is imperative to mitigate patient harm associated with low-value diagnostic tests.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666471","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}