Emergency Medicine Australasia最新文献

{"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}

{"title":"Paediatric Research in Emergency Departments International Collaborative (PREDICT) at 20 years: Challenges of an emergency research network","authors":"Elyssia M Bourke MBBS,&nbsp;Libby Haskell PhD,&nbsp;Natalie Phillips MBBS,&nbsp;Stuart R Dalziel PhD,&nbsp;Franz E Babl MD,&nbsp;Paediatric Research in Emergency Departments International Collaborative (PREDICT)","doi":"10.1111/1742-6723.70039","DOIUrl":"https://doi.org/10.1111/1742-6723.70039","url":null,"abstract":"<p>The Paediatric Research in Emergency Departments International Collaborative (PREDICT) has operated as an emergency research network in Australia and Aotearoa New Zealand for 20 years. A focus on both knowledge generation and, over the last decade, knowledge translation research has produced more than 200 network publications. Active research sites have increased from the original 12 sites to 47, with enhanced representation of where children with acute illness present in both countries. We outline ongoing challenges across the network, which will be relevant for those providing acute paediatric care and to other emergency clinicians interested in multicentre research collaboration.</p>","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":"143762245","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":"Evaluating the satisfaction of patients utilising the virtual emergency department service in southeast region of Melbourne","authors":"Muhuntha Sri-Ganeshan MBBS, BSc, DTMH, FACEM,&nbsp;Amanda Harris BBioMedSc,&nbsp;Christopher Thuring MD,&nbsp;Gerard O'Reilly MBBS, MPH, MBiostat, Astat, FACEM, PhD,&nbsp;Biswadev Mitra MBBS, MHSM, FACEM, PhD,&nbsp;Andrew Underhill MBBS, FACEM,&nbsp;Claire Charteris MBBS, FACEM,&nbsp;Diana Egerton-Warburton MBBS, FACEM, PhD,&nbsp;Peter A Cameron MBBS, MD, FACEM,&nbsp;the Southeast Region Virtual Emergency Department (SERVED) Research Group","doi":"10.1111/1742-6723.70034","DOIUrl":"https://doi.org/10.1111/1742-6723.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Evaluate patient satisfaction with paramedic and residential aged care facility (RACF) staff-initiated tele-emergency care through the Southeast Melbourne Virtual ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient satisfaction surveys were conducted across two of the constituent virtual EDs (VEDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 452 responses, 427 (94.5%) had no negative comments, with 341 (75.4%) rating the service 8 out of 10 or higher, and 83.4% would recommend the service to family or friends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Emergency telehealth services were favoured by patients, with ratings comparable to satisfaction scores in physical EDs. Upskilling of emergency clinicians for telehealth consultations and educational programmes could provide further improvements to patient experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749352","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":"High dose insulin is an inodilator, not an antidote in the poisoned patient!","authors":"Katherine Z Isoardi BMed, PhD,&nbsp;Betty Chan MBBS, PhD,&nbsp;Angela L Chiew MBBS, PhD","doi":"10.1111/1742-6723.70035","DOIUrl":"https://doi.org/10.1111/1742-6723.70035","url":null,"abstract":"<p>High dose insulin therapy has become an increasingly popular treatment for poisonings over the last two decades. It is often mistakenly considered an antidote for poisonings of multiple drug classes, including beta-blocker and calcium channel blocker overdose. This misconception has encouraged overzealous and, at times, inappropriate use, particularly in patients who have vasoplegic shock following poisonings from drugs such as dihydropyridine calcium channel blockers. High dose insulin is not an antidote, but rather an inodilator. Its relatively slow onset of action, compared to catecholamine-based inotropes, of 15–60 min makes it best suited to second-line therapy for cardiogenic shock in poisonings. It has no role in isolated vasoplegic shock where it may exacerbate toxicity. It should be used concurrently with noradrenaline to counteract insulin-induced vasodilation. High dose insulin has predictable adverse effects of hypoglycaemia and electrolyte disturbances, particularly hypokalaemia, which can persist long beyond cessation.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741453","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":"Evaluation of a team-based approach for emergency department patients with time critical intracranial conditions","authors":"Skye Macleod FACEM, M.Med (Crit Care), BSc (Hons),&nbsp;Geoffrey Melville PhD, BAppSc,&nbsp;Aden Samimi-Duncan DMed,&nbsp;Shanawaz Khan MBBS, AFIH, FACEM,&nbsp;Simon Binks FACEM, BMedSci, BM, BS,&nbsp;Daniel Hernandez MBChB, FANZCA,&nbsp;Ravi Cherukuri MBBS, MCh, DNB (Neurosurgery), FRACS (Neurosurgery),&nbsp;Simon Keane FACEM, BSc (Aerospace Phys), MBBS,&nbsp;Kate Curtis RN, PhD, FCENA, FAAN","doi":"10.1111/1742-6723.70026","DOIUrl":"https://doi.org/10.1111/1742-6723.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Many time-critical neurosurgical brain conditions do not meet traditional ED major trauma or stroke team activation criteria and thus do not benefit from the associated expedited imaging and specialist review. To address this, a “Critical Head” protocol was developed. The aim was to determine the effect of this on time to CT scan, neurosurgical intervention (if indicated) and specialist team review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>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 2023. Descriptive statistics and study outcomes were compared before and after protocol implementation. R Studio 2024 was used for analyses and alpha was set to 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and two patients were included (123 control/pre-intervention, 119 intervention). There was no significant difference in age, sex or presence of intracranial conditions between groups. Median time from triage to CT decreased in the intervention group by 15% (7 min, 47[33,95] to 40[25,66], <i>P</i> = 0.020). There was a 33% (67 min) reduction to surgery start time in the intervention (204[621752] to 137[108247] min, <i>P</i> = 0.042) (urgent neurosurgery). Reductions in time to specialist team reviews were observed in ICU (<i>n</i> = 86, 132[58192] to 42[6103] min, <i>P</i> &lt; 0.001) and neurosurgery (<i>n</i> = 158, 104[69 202] to 44[16111] min, <i>P</i> &lt; 0.001). ICU and hospital length of stay did not differ significantly, nor did Glasgow Coma Outcome Scale score at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Critical Head protocol for patients with time-critical intracranial conditions reduced time to CT scan, operative intervention and specialist team review.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689751","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":"Scoping a paediatric emergency medicine unit*","authors":"Marita S Bolic MBBS,&nbsp;Jamie Lew MBChB, FACEM PEM,&nbsp;Drew B Richardson BMedSc, MBBS (Hons), FACEM, GradCertME, MD","doi":"10.1111/1742-6723.70033","DOIUrl":"https://doi.org/10.1111/1742-6723.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the characteristics and potential patient cohorts suitable for a paediatric emergency medicine unit (PEMU), otherwise known as a short stay unit, at Canberra Hospital, a tertiary mixed adult/paediatric ED treating 98 000 patients annually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Retrospective descriptive study of paediatric (aged &lt;16) presentations to Canberra Hospital ED between May and August 2022. Patients discharged from ED with a length of stay exceeding 4 h and those admitted non-surgically for less than 2 nights were deemed PEMU suitable; those requiring admission for &gt;2 nights were classed as inpatient ward admission (IWA) patients. Royal children's hospital clinical practice guidelines were used where available to classify the severity of disease via features apparent in ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight thousand three hundred and forty episodes were identified as paediatric ED presentations, with 1377 (64.8%, 95%CI 62.8–66.9) retrospectively PEMU suitable. This winter sample identified an average of 11.9 potential PEMU suitable cases daily. Chart review showed clinically mild bronchiolitis, mild asthma, anaphylaxis, mild gastroenteritis, afebrile seizure – no known seizure diagnosis, and simple febrile seizures had an excellent profile for PEMU, with subsequent ward admission rates of 17% or less. A mean 7-h stay would require 5 beds with 66% occupancy over 24 h.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several common paediatric diagnoses are well-suited to a PEMU unit, with reasonable occupancy and length of stay. The low inpatient admission rate suggests less common diagnoses should also be regarded as suitable. Further research is required to identify other paediatric patients and diagnoses suitable for PEMU, and to ratify findings in a whole-of-year sample.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645716","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":"Emergency department presentations by trans and gender diverse people in Sydney, Australia: Retrospective case series","authors":"Emily Symes MBBS, FACEM,&nbsp;Naomi Derrick BN,&nbsp;Thomas Hicks BN, MNurs,&nbsp;Rhys Ross-Browne MBBS, FACEM,&nbsp;Louisa Degenhardt PhD,&nbsp;Rachel Sutherland PhD,&nbsp;Radhika Seimon PhD,&nbsp;Michael Dinh MBBS, MPH, PhD, FACEM","doi":"10.1111/1742-6723.70031","DOIUrl":"https://doi.org/10.1111/1742-6723.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Comprehensively describe patient and presentation characteristics of trans and gender diverse (TGD) people attending the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective case series that evaluated TGD people of all ages presenting to a tertiary, inner-city ED in Sydney, New South Wales, over a 5-year period. TGD people were identified using the ED patient tracking system, triage text and clinical notes in the electronic medical records (eMR). Patient and presentation data were extracted and descriptively analysed, including clinical characteristics, mismatches in registered gender and name, and use of non-affirming language in discharge letters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 340 TGD patients with 1519 ED presentations were identified. The number of ED presentations per year by TGD people increased by 74.2% over 5 years. Presentations were prioritised Australasian Triage Scale category 1–3 in 76.7%. Hospital admission was required in 25.5%, and 8.7% left prior to treatment completion. Suicidal ideation was the most common presenting problem (13.8%) and mental health was the most common ED diagnostic category (29.4%). The gender and name registered in the eMR correctly matched the patient's current identity in 47.1% and 56.8%, respectively. Misgendering and/or deadnaming occurred in 22.6% of those receiving an ED discharge letter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most TGD people identified by the present study had high acuity ED presentations, often presenting with acute mental health problems, and one-quarter were subsequently admitted to hospital. Mismatched patient details and misgendering and/or deadnaming on discharge letters were common. These findings highlight clear opportunities to improve the care of TGD people in the ED.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645717","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":"Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial)","authors":"Daniel Cudini BEx Sci, BEmergHlth (Paramedic), Grad Dip EmergHlth (ICP), MACPara,&nbsp;Karen Smith BSc(Hons), Grad Cert Exec BA, Grad Dip Epi and Biostats, PhD, OAM,&nbsp;Jeffery Shao BMedSc/MD,&nbsp;Stephen Bernard MBBS, MD, FACEM, FCICM, FCCM, ASM,&nbsp;Daniel Okyere MBBS, MPH,&nbsp;Ziad Nehme BEmergHlth(Paramedic)(Hons), Grad Cert Clin Research Methods, PhD, FACPara, ASM,&nbsp;Emily Nehme BSc(Biomedical), MBiostat, PhD Candidate,&nbsp;David Anderson MStJ, BSc, MBChB, MBioeth, DipPallMed, FCICM, ASM,&nbsp;Nicole Magnuson BSc, MPH,&nbsp;Karin Thursky MBBS, BSc, MD, FRACP,&nbsp;Dhruv Mori MBBS, FACEM,&nbsp;De Witt Oosthuizen M.B.ChB, Dip EM, AMC, FACRRM,&nbsp;Andrew Udy BSc(Hons), Grad Cert Exec BA, Grad Dip Epi and Biostats, PhD","doi":"10.1111/1742-6723.70027","DOIUrl":"https://doi.org/10.1111/1742-6723.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility of pre-hospital blood culture (BC) collection and intravenous (IV) antibiotic administration in patients with suspected sepsis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this open-label trial, BCs were collected in all participants, who were then randomised to ongoing care (control) or ongoing care plus 2 g IV ceftriaxone (intervention). Time to antibiotic administration was the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-five patients were enrolled and randomised (21 control, 14 intervention). BCs were obtained in 89% (<i>n</i> = 31/35) and grew a pathogen in 42% (<i>n</i> = 13/31). Intervention patients received antibiotics a median of 108 (95% CI 34 to 170) minutes earlier (<i>P</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BCs were successfully obtained by paramedics, and pre-hospital IV ceftriaxone resulted in expedited antibiotic administration.</p>\u0000 \u0000 <p>Clinical Trial Registration: ACTRN12618000199213.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638912","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":"Identity in emergency medicine: Who are we and what are we doing?","authors":"Thomas Hitchcock MBBS (UWA), MClinForMed (Monash), FACEM, FFAEM, FACLM, FFCFM","doi":"10.1111/1742-6723.70032","DOIUrl":"https://doi.org/10.1111/1742-6723.70032","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632919","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}