Emergency Medicine Australasia最新文献

{"title":"SAFE: Safety of procedural sedation and analgesia administration in the fast-track area of the emergency department","authors":"Ned Freeman BSc, MD,&nbsp;Ammara Doolabh BSc, MBBS, FACEM,&nbsp;Ellie Maas BMedLabSc (Hons), PhD,&nbsp;Braden Cupitt BSc, MD,&nbsp;Aaron Shap MBBS,&nbsp;Claire Bertenshaw BN, MBBS (Hons), CCPU, FACEM,&nbsp;Gary Mitchell MB BAO, FACEM","doi":"10.1111/1742-6723.14515","DOIUrl":"10.1111/1742-6723.14515","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether undertaking procedural sedation in the low-acuity fast-track area is safe and effective in improving patient flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study reviewed patients who underwent procedural sedation in the Royal Brisbane and Women's Hospital Emergency and Trauma Centre between December 2020 and December 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 411 cases were included. Performing sedation in the fast-track area was not associated with increased complication rates but was associated with reduced time to sedation (difference = 44.24 min, <i>P</i> &lt; 0.001) and length of stay (difference = 60.64 min, <i>P</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The sedation of patients outside a high-acuity area is safe and significantly improves patient flow.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388958","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":"Risk–benefit analysis of a multi-site radiographer comment model for emergency departments","authors":"Ingrid Klobasa MSc, BSc, Dip Teach, Ass Dip Med Rad, FIR,&nbsp;Gary Denham BMedRadSc, MMedRadSc,&nbsp;Derek J Roebuck BMedSc, MBBS, DMRD, FRANZCR,&nbsp;Jenny Sim PhD, MSc, PGDip Medical Imaging, PGDip Medical Imaging, DCR,&nbsp;Marilyn Baird PhD, MEdPrelim, BA(SocSc), DCR(London),&nbsp;Dennis Petrie PhD(Health Economics), BSc BEcon(Hons),&nbsp;Joshua Best BMedRadSc,&nbsp;James Abood BAppSc, GCertMRI,&nbsp;Alexandra Tonks BMedRadSc, MSc,&nbsp;Caitlin Tu MMedRadSc, BMed Imaging Science, GrCert ClinEd,&nbsp;Christopher Jones BMedRadSc","doi":"10.1111/1742-6723.14503","DOIUrl":"10.1111/1742-6723.14503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Critical/urgent X-ray findings are not always communicated in an appropriate time frame to ED physicians. The practice of radiographers alerting referrers to clinically significant image findings (verbally, via image flags or written comment) is noted internationally but risk assessment data is unavailable in the literature. A hybrid radiographer comment and alert model was piloted in New South Wales and a risk–benefit assessment conducted for timely and safe communication of abnormal X-ray appearances to ED physicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Radiographer comments (<i>n</i> = 1102) were provided to five New South Wales EDs by 69 radiographers for a period of 3–12 months. Site auditors classified comments as true positive (TP), false positive (FP) or indeterminate (ID) with respect to the radiology report. FP comments were investigated with ED referrers and a low-medium-high-risk assessment was provided by two independent reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 42 FP (3.9%; 95% confidence interval [CI] 2.9–5.3) comments were analysed for any adverse outcomes. Risk assessments demonstrated 37 low, 5 low-moderate and no high-risk cases. A total of 282 direct or potential patient benefits were identified (26.4%; 95% CI 23.8–29.1). A total of 42 radiology report discrepancies were incidentally found: (3.9%; 95% CI 2.9–5.3). Audit results demonstrated areas where the radiographer comment could mitigate risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The provision of radiographer alerts with a written comment for ED was found to be low risk to patients in the pilot study. Radiographers communicating directly with the emergency team when abnormal image appearances are detected can reduce diagnostic error and improve patient safety and health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388957","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":"What proportion of women presenting to the emergency department with early pregnancy bleeding receive appropriate care?","authors":"Baylie Trostian RN, RM, MNurs, PhD Candidate,&nbsp;Andrea McCloughen RN, MNurs (MH), PhD,&nbsp;Kate Curtis RN, MNurs (Hons), PhD","doi":"10.1111/1742-6723.14507","DOIUrl":"10.1111/1742-6723.14507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the proportion of women presenting to EDs across a regional health district, with early pregnancy bleeding, who received appropriate care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort review of linked data from five data sets: ED, pathology, radiology, costs and non-admitted/outpatient. Data collected from five EDs between January 2011 and December 2020, across one health district in NSW, Australia, with 150 000 annual ED presentations. Management received by women of reproductive age, with early pregnancy (&lt;20 weeks gestation) bleeding was compared to seven indicators for recommended care. Indicators included blood tests, psychosocial support, administration of Rhesus D immunoglobulin and US. Indicators were determined by a systematic analysis of published primary research, expert consensus clinical practice guidelines and literature reviews on initial assessment, intervention and diagnostics for women with early pregnancy bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no evidence of almost one third of women (<i>n</i> = 3661, 29.4%) receiving any indicators and 54 (0.4%) received five or more indicators of appropriate care. Presentations to rural facility had the lowest number and proportion of indicators being performed (<i>n</i> = 603, 58.0% for no indicators). Cost increased with the number of indicators. Over the study period, the proportion of all indicators being performed increased, and indicator six – psychosocial support referral or care had the biggest growth (almost 500%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Variation in care for women presenting with early pregnancy bleeding to ED was identified. There is an evidence-practice gap and need for inquiry into barriers and facilitators to prescribed clinical practice for this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388959","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":"Prehospital use of spinal precautions by emergency medical services in children and adolescents","authors":"Natalie Phillips MBBS MPhil,&nbsp;Nitaa Eapen MD MPH,&nbsp;Catherine L Wilson MPH,&nbsp;Ziad Nehme PhD,&nbsp;Franz E Babl MD MPH","doi":"10.1111/1742-6723.14499","DOIUrl":"10.1111/1742-6723.14499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Limited evidence exists to guide the management of children with possible spinal injuries in the prehospital setting. As a first step to address this, we set out to describe the epidemiology and management of children &lt;18 years presenting with possible cervical spinal injuries to EMS in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective case record review of all children with concerns of head or neck trauma and/or documented cervical spine collar use presenting to the statewide Ambulance Victoria (AV) EMS service, Victoria, Australia, between 1 July 2019 and 30 June 2020. Demographic, clinical features, mechanism of injury and spinal immobilisation practices were extracted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>2100 children were included; 61% were male and the median age was 13 years (interquartile range: 9–15). Over half of the children were transported to suburban (32.2%) and rural/regional (22.9%) EDs, with 37.5% taken to designated trauma centres. The most common mechanisms of injury were sports/activity, motor vehicle accidents and falls in 35.4%, 27.9% and 26.3%, respectively. Spinal precaution use was recorded in 93.7% of cases; cervical collar use was the most common procedure recorded (87.1%). Younger age groups were less likely to have spinal precautions initiated; 51% of children aged 0–3 years, compared to 96.3% of children aged 12 and older (odds ratio = 23.8; 95% confidence interval = 14.5–37; <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prehospital spinal precautions were initiated commonly in children, with use increasing with age, and most were transported to suburban, regional and rural hospitals, not trauma centres. These data will inform the integration of emerging paediatric-specific evidence into prehospital guidelines to risk stratify children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371334","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":"Review article: Scoping review of interventions that reduce mechanical restraint in the emergency department","authors":"Joseph Lee,&nbsp;Daiv J Lown MBBS, FACEM,&nbsp;Patrick J Owen PhD,&nbsp;Judith Hope MBBS (Hons), MPM, PhD, FRANZCP","doi":"10.1111/1742-6723.14498","DOIUrl":"10.1111/1742-6723.14498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Mechanical restraints are known to be associated with many undesirable outcomes in clinical settings. Our objective was to examine the current literature to explore possible interventions that would reduce the use of mechanical restraints in the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this scoping review, we searched online databases Embase, MEDLINE and Cochrane CENTRAL for any studies published between the databases from 1 January 2007 to 19 September 2023. Studies were included if interventions were hospital- or staff-focused and reported measured outcomes before and after the introduction of the intervention. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Cohort Studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search strategy yielded 1937 studies across the three databases, of which 13 studies were extracted and included in the review. Interventions were categorised into four groups: provision of staff training, addition of a de-escalation team, creation of a dedicated unit and introduction of an agitation scale only. Most of the studies saw reduction in restraint rates or time in restraints. Only the two studies that used an agitation scale as a stand-alone intervention saw no significant reduction. Only one study had low risk of bias, whereas the remainder had high risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Evidence supports further exploration of interventions that include: designing an agitation guideline; training staff in assessment, attitudinal and de-escalation skills; addition of a crisis team; and environmental changes in the form of adding a dedicated clinical space. Although these strategies may reduce mechanical restraint in the ED setting, further high-quality studies are needed before definitive conclusions may be drawn.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371335","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":"Effect of case identification changes on pre-hospital intubation performance indicators in an Australian helicopter emergency medical service","authors":"Alan A Garner MBBS, FACEM, MSc, PhD,&nbsp;Andrew Scognamiglio MBBS,&nbsp;Sviatlana Kamarova MSc, PhD","doi":"10.1111/1742-6723.14508","DOIUrl":"10.1111/1742-6723.14508","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A 45-min interval from injury to intubation has been proposed as a performance indicator for severe trauma patient management. In the Sydney pre-hospital system a previous change in case identification systems was associated with activation delay. We aimed to determine if this also decreased the proportion of patients intubated within this benchmark.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort study of patients intubated by a helicopter emergency medical service (HEMS) over two time periods. Period 1 dispatch was via HEMS crew directly screening the computerised dispatch system, and period 2 was via paramedics in a central control room. Times from emergency call to intubation were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the HEMS crew screening period 46/58 (79.31%) intubations met the target, compared with 137/314 (43.6%) in the central control period (<i>P</i> &lt; 0.001). The median (interquartile range) time to intubation in the direct crew screening period was 33 (25–41) min, <i>versus</i> the central control period at 47 (38–60) min (<i>P</i> &lt; 0.001).</p>\u0000 \u0000 <p>On multivariate modelling, distance to the scene was related to time to intubation (<i>P</i> &lt; 0.001; Incident Rate Ratio = 1.018, 95% confidence interval 1.015–1.020) as was dispatch system, entrapment/access difficulty and indication for intubation (all <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Time from emergency call to intubation was significantly shorter in the HEMS screening period where all non-trapped cases less than 50 km distant were intubated within the 45-min benchmark. There was no distance where intubation within 45 min could be assured for non-trapped patients in the central control period due to dispatch delays.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361342","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":"Utility of computed tomography brain scans in intubated patients with overdose","authors":"Michael Lousick BBiomedSc (Hons), MD,&nbsp;Serena Edwards BMedSc, MD,&nbsp;Gerben Keijzers MSc, MBBS, FACEM, PhD,&nbsp;Richard A F Pellatt MBChB, BA (Hons), FACEM","doi":"10.1111/1742-6723.14510","DOIUrl":"10.1111/1742-6723.14510","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Describe the yield of computed tomography brain (CTB) scans in patients intubated for drug overdose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective descriptive study using existing registry data from two Australian EDs between February 2021 and June 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and six patients were intubated; 159 (77%) received a post-intubation CTB scan. Of these, 38 out of 159 (24%) had a documented indication (i.e. head injury and seizure) for their scans, with a yield of 5.3% (95% confidence interval [CI] = 1.5–17%). Of the 121 out of 159 (76%) patients without an indication, the yield of CTB was 0% (95% CI = 0–3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Routine imaging of patients intubated for overdose without clinical indication is unjustified.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343840","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":"Implementing the electronic HEEADSSS screening tool in a paediatric emergency department","authors":"Jessica WS Wong,&nbsp;Nicolene Shipton,&nbsp;Matthew Edwards,&nbsp;Kate Bradman","doi":"10.1111/1742-6723.14509","DOIUrl":"10.1111/1742-6723.14509","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"36 6","pages":"993-994"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343837","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":"Review article: A primer for clinical researchers in the emergency department: Part XIII. Strategies to engage staff and enhance participant recruitment in emergency department research","authors":"Sharon O'Brien BN, PhD,&nbsp;Catherine Wilson MPH, Ms,&nbsp;Megan Duck BN, GDipHlthRes,&nbsp;Gaby Nieva BNurs, GradDipNurs,&nbsp;Medhawani P Rao BHSc (Nsg) and PGDip AdvNsg,&nbsp;Libby Haskell NP, PhD","doi":"10.1111/1742-6723.14505","DOIUrl":"10.1111/1742-6723.14505","url":null,"abstract":"<p>Conducting research in ED is important and necessary to improve emergency care. Effective recruitment is an essential ingredient for the success of a research project and must be carefully monitored. Research coordinators are focused on optimising recruitment to research studies while also ensuring that the needs of participants and their families are met, and the research is acceptable to ED staff. In this paper, a group of experienced research coordinators from Australia and New Zealand have shared their strategies to engage staff and enhance recruitment of participants in emergency research. Although this paper is from a paediatric research network, the findings are applicable for EDs in general, both in Australasia and elsewhere.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"36 6","pages":"834-840"},"PeriodicalIF":1.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343839","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":"Prisoners in the emergency department: Lessons from a recent inquest","authors":"Anne-Maree Kelly MD, FACEM MHealth&MedLaw","doi":"10.1111/1742-6723.14502","DOIUrl":"10.1111/1742-6723.14502","url":null,"abstract":"<p>The recent coronial finding in Victoria into the death of Joshua (Josh) Kerr highlights some of the challenges of treating patients who are in custody and under the supervision of custodial staff (prison officers or police) in the ED. Issues include ED clinicians' duty of care, roles and responsibilities of ED staff and custodial staff and the need for processes that facilitate collaboration and communication between ED clinicians and custodial staff.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343838","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}