Emergency Medicine Australasia最新文献

{"title":"Does frailty scoring help to predict outcomes in older patients with major trauma? A retrospective study at a major trauma centre","authors":"Charlotte G Underwood MBChB,&nbsp;Andrew McCombie BSc BA(Hons)(Cant), PhD(Otago),&nbsp;Maria Nonis MBChB,&nbsp;Laura R Joyce FACEM, AFRACMA, MBChB, BMedSc(Hons), MMedEd","doi":"10.1111/1742-6723.70053","DOIUrl":"https://doi.org/10.1111/1742-6723.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of the present study was to evaluate the impact of frailty on outcomes for older patients presenting with major trauma to a tertiary ED in Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study of patients 65 years and older who presented to Christchurch ED, New Zealand, with major trauma between 1 January and 31 December 2022. The primary outcome was a composite of in-hospital mortality or increased care requirements on discharge from hospital. Demographic details, in-hospital management, and outcomes were retrieved. Clinical Frailty Scale scoring had prospectively been recorded at the time of admission. Univariable analysis of discrete dependent variables was carried out. Mediation analysis was undertaken, wherein frailty was the mediator between age and the primary outcome variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After exclusion criteria were applied, 134 patients were included for analysis. Even after controlling for age, for every additional point on the Clinical Frailty Scale, the odds of in-hospital mortality or increased care requirements on discharge increased by 36.4% (95% confidence interval: 9.4–85). Only 33% of these major trauma patients were appropriately identified at presentation and so received a trauma team activation, with worsened activation rates with increasing frailty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of significant injuries in older trauma patients is under-recognised. Frailty scoring could be used in the ED for early identification of those patients at high risk of poor outcomes, so that active management strategies can be put in place to optimise their care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926134","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":"Atrial fibrillation patients presenting to an emergency department successfully managed with a next-day community follow-up pathway: A before-and-after cohort study","authors":"Finn Brokenshire,&nbsp;John W Pickering BMedSc(Hons), PhD, BA(Hons),&nbsp;Ibrahim S Al-Busaidi FRNZCGP, MBChB, BMedSc(Hons), PGDip Obesity Weight Management,&nbsp;Martin Than FACEM, MBBS,&nbsp;Richard Troughton MBChB, PhD,&nbsp;Kaleb Addy MBChB,&nbsp;Laura R Joyce FACEM, AFRACMA, MBChB, BMedSc(Hons), MMedEd","doi":"10.1111/1742-6723.70049","DOIUrl":"https://doi.org/10.1111/1742-6723.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the effectiveness and safety of the new clinical pathway for patients presenting to an ED with AF, incorporating community next-working-day follow-up and more specific clinician guidance around medication prescribing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A before-and-after, retrospective cohort study comparing patients presenting to Christchurch ED with acute uncomplicated AF in the year before (‘hospital-based’ follow-up) and after (‘community-based’ follow-up) implementation of a new AF management approach. The ‘community’ pathway replaced hospital-based review with a next-day community follow-up and introduced more specific anticoagulation recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1065 patients met inclusion criteria, with 531 presenting during the ‘hospital-based’ pathway period and 534 during the ‘community’ pathway period. The spontaneous reversion rate was approximately 61% in both cohorts. Following the implementation of the community pathway, there was no increase in cardioversions (16.6% <i>vs</i> 20%, difference 3.5% [95% CI −1.4 to 8.3]), admission rates (32.8% <i>vs</i> 32.2%, difference − 0.6% [95% CI −6.4 to 5.3]), or AEs (60-day all-cause mortality 1.3% <i>vs</i> 0.9%, difference − 0.7% [95% CI −2.3 to 1]). Attendance at a follow-up AF clinic improved from 92.9% to 98.1% (difference 5.2% [95% CI 0.7–9.7]). Clinician adherence to anticoagulation guidelines increased by 7% (95% CI 1.6–12.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A ‘rate-and-wait’ strategy for managing acute uncomplicated AF continues to allow a significant proportion of patients to self-revert to sinus rhythm, without requiring hospital admission or cardioversion procedures. Transitioning to an off-site, community AF clinic is both safe and effective, demonstrating increased clinic attendance and improved adherence to anticoagulation guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919353","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 incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia","authors":"Gerard M O'Reilly MBBS, FACEM, MPH, MBiostat, AStat, PhD,&nbsp;Afsana Afroz PhD,&nbsp;Kate Curtis RN, PhD, Grad Dip Crit Care Nurs, MNurs(Hons), FCENA,&nbsp;Biswadev Mitra MBBS, MHSM, PhD, FACEM,&nbsp;Yesul Kim BA, Grad Dip Psychol, PhD,&nbsp;Emma Solly PhD,&nbsp;Courtney Ryder BScBEng(Biomed)(Hons), PhD,&nbsp;Kate Hunter BAppSc(Nursing), GradDipEd(Nurse Education), MPH, PhD,&nbsp;Delia V Hendrie BSc, BA, MA, PhD,&nbsp;Nick Rushworth BA(Hons), MA, AMusA,&nbsp;Jin Tee BMSC, MBBS, MD, FRACS,&nbsp;Mark C Fitzgerald MBBS, MD(Research), GradCertInet, FACEM, AFRACMA","doi":"10.1111/1742-6723.70051","DOIUrl":"https://doi.org/10.1111/1742-6723.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify the determinants of death occurring outside of hospital following moderate to severe traumatic brain injury (msTBI) across Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Design, setting: Retrospective observational study using National Coronial Information System (NCIS) data. Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. The odds of death occurring outside <i>any</i> medical service area (e.g. hospital, rehabilitation, nursing home) were higher for: younger adults (OR 3.6, 95% CI: 1.0–12.7), those with penetrating injuries (OR 8.9, 95% CI: 4.5–17.3), and where the time between injury and death was less than 24 h. The odds of death outside any medical service area were less for people with msTBI in South Australia (OR 0.1, 95% CI 0.0–0.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Approximately, one in six msTBI deaths occurred outside of any medical service area. Opportunities exist to improve access to emergency care for people sustaining msTBI across Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897164","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":"Review article: Use of prehospital early warning scores to predict short-term mortality: A systematic review","authors":"David Naylor MPhil,&nbsp;Bridget Dicker PhD,&nbsp;Graham Howie PhD,&nbsp;Verity Todd PhD","doi":"10.1111/1742-6723.70047","DOIUrl":"https://doi.org/10.1111/1742-6723.70047","url":null,"abstract":"<p>Early Warning Scores (EWS) have been developed to identify patients at risk of deterioration. Although the application of EWS has become increasingly established in the prehospital setting, their use remains contentious. The aim of this systematic review is to summarise the most recent evidence on the predictive accuracy of the EWS for short-term mortality in adults in the prehospital setting. A systematic search was conducted using the Medline, CINAHL, and Scopus databases. Studies that evaluated the diagnostic accuracy of the prehospital Modified Early Warning Score, National Early Warning Score or National Early Warning Score 2 in predicting mortality were included. Secondary outcomes were intensive care unit (ICU) admission and hospital admission. The review included 16 studies published between 2012 and 2023, with the number of patients totalling 311 932. The literature indicated that prehospital EWS demonstrated a moderate to good diagnostic performance in predicting short-term mortality with an area under receiver operating characteristic curve ranging from 0.68 (95% confidence interval [CI]: 0.64–0.73) to 0.90 (95% CI: 0.82–0.97). Overall, diagnostic performance was higher for predicting mortality in short time frames (up to 48 h). The need to use relatively high cut-off points to identify at-risk patients may limit its use for the unselected patient populations found in the prehospital setting. The potential for under-triage and over-triage limits their use further. EWS should not replace structured clinical evaluation and judgement but may be useful as complementary and objective tools to aid the identification of patients at risk.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897047","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":"Clinical characteristics of mental health presentations of children and young adults to the emergency department during the COVID-19 pandemic in Sydney, Australia","authors":"Saartje Berendsen Russell BHscNsg, MEd,&nbsp;Shanti Pun BN,&nbsp;Farina Jeyaraj BN, MN,&nbsp;Margaret Murphy MHlscEd, PhD,&nbsp;Nicole Bohlken BN,&nbsp;Emma Jenkins BN,&nbsp;Kerrie Bubb BN,&nbsp;Naomi Derrick BN,&nbsp;William Royle MPH,&nbsp;Radhika V Seimon PhD,&nbsp;Kendall Bein MBBS,&nbsp;Michael M Dinh MBBS, MPH, MD, PhD","doi":"10.1111/1742-6723.70050","DOIUrl":"https://doi.org/10.1111/1742-6723.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Recent studies have demonstrated the prevalence of children and young adults with mental health (MH)-related problems presenting to EDs is increasing in Australia and overseas. The present study aimed to examine clinical characteristics and contributing factors in relation to MH ED presentations of children and young adults, aged 10–24 years, before and after the long Sydney COVID-19 lockdown period in 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective chart review of electronic medical records (eMR) of MH presentations to three metropolitan EDs during January to April 2021 (phase 1) and October to December 2021 (phase 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1748 total ED presentations, 19% were ≤16 years, over half were female (63%) and 60% presented after hours. A third (37%) were detained under the Mental Health Act. The most common presenting problems were ‘suicidal ideation’ (33%), followed by drug or alcohol poisoning or intoxication (18%) and ‘self-harm’ (15%). COVID-19 as a contributing factor for presentation increased in phase 2 (from 5% to 25%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this multicentre retrospective study of children and young adults, we found a relatively high re-presentation rate and an increase in COVID-19-related issues as specific contributing factors to ED presentation during the COVID-19 pandemic in 2021.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897198","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":"Performance characteristics and complications of an Inter-Changeable Operator Model for intubation in an Australian helicopter emergency medical service","authors":"Alan A Garner MBBS, FACEM, MSc, PhD,&nbsp;Andrew Scognamiglio MD,&nbsp;Dr Anna Lee BPharm, MPH, PhD","doi":"10.1111/1742-6723.70052","DOIUrl":"https://doi.org/10.1111/1742-6723.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The Inter-Changeable Operator Model (ICOM) enables paramedics and flight nurses to perform intubations interchangeably with team physicians in prehospital critical care. However, literature on ICOM characteristics and performance is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective, observational study of an ICOM operating within an Australian Helicopter Emergency Medical Service over a nine-year period. First pass success, major complication rates and clinically important time intervals were compared between first intubator groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 413 patients met the inclusion criteria, with paramedics performing the majority of first intubation attempts (379/413, 91.8%). Physicians primarily conducted second intubation attempts and managed high-risk patients. In unadjusted analysis, the risk of major complication in the paramedic/supervised registrar group was not lower than the most senior physician intubator group (relative risk [RR] 0.59, 95% confidence interval [CI]: 0.26–1.32; <i>P</i> = 0.198) and after adjustment the risk was also not lower (RR 0.60, 95% CI: 0.24–1.54; <i>P</i> = 0.289). First pass failure occurred in 12 (3.1%) and 1 (4.8%) patients intubated by paramedic/supervised registrar and most senior physician groups, respectively (<i>P</i> = 0.498). The median (95% CI) adjusted difference in contact to intubation time between paramedic/supervised registrar first intubator and most senior physician groups was −2 min (−7 to 3; <i>P</i> = 0.392). Total adjusted scene time was also not significantly different between groups (median difference 2 min, 95% CI: −3 to 7; <i>P</i> = 0.500).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Paramedics conducting most intubations within an ICOM are both safe and efficient. Larger studies are required to examine differences between physician subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896820","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":"Evaluation of a virtual emergency care service to avoid unnecessary emergency department presentations and provide specialist-led definitive care","authors":"Laura R Joyce FACEM, AFRACMA, MBChB, BMed Sc(Hons), MMedEd,&nbsp;Marc Gutenstein FACEM, FDRHMNZ, BMBCh, MA(Hons),&nbsp;Mark Gilbert FACEM, MBChB,&nbsp;James Weaver FACEM, MBChB,&nbsp;Scott Pearson FACEM, MBChB,&nbsp;John W Pickering BSc(Hons), PhD, BA(Hons),&nbsp;Martin Than FACEM, MBBS","doi":"10.1111/1742-6723.70048","DOIUrl":"https://doi.org/10.1111/1742-6723.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A quantitative and qualitative evaluation of the impact of a peer-to-peer telehealth service called Specialist Telehealth Aotearoa (STAR) on transfers to the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This mixed-methods study reviewed STAR between 31 July 2023 and 31 October 2023. Reasons for presentation and outcomes were analysed. Thematic analysis was used to examine responses to an electronic survey from referrers to the STAR service, exploring the benefits and barriers to engagement with the service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight hundred and sixty-seven consultations occurred, with hospital transfer avoided for 500 (58%) patients. Fifty-one patients (10.2%) re-presented to Christchurch Hospital within 7 days with the same/related issue, similar to the overall hospital 7-day re-presentation rate of 9.5%. Survey responses were received from 130 ambulance staff and rural practitioners, with 97% reporting a ‘very good’ or ‘excellent’ experience with STAR. Thematic analysis of responses from referrers identified four main benefits: local FACEMs who understand the local context, mutual trust built on pre-existing relationships, empowering pre-hospital and rural clinicians and putting the patient first: providing right care–right place–right time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>STAR prevented unnecessary transfers to ED with a 7-day representation rate comparable to the wider hospital. Referrers reported a number of benefits to the service, as well as identifying potential barriers to engagement. The integration of a specialist emergency care telehealth service into the health system could alleviate pressure on EDs in Aotearoa New Zealand.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896819","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":"Establishing research priorities in emergency medicine telehealth","authors":"Muhuntha Sri-Ganeshan Bsc, MBBS, DTMH, FACEM,&nbsp;Ruth Large MBBS, FACEM, FDRHM, ANZCPHM, CHIA,&nbsp;Michael Ben-Meir MBBS, FACEM, MHlthEthics, eMBA, AFRACMA,&nbsp;Frances Kinnear Bsc (Hons), MBChB (Glasgow), PhD, FACEM","doi":"10.1111/1742-6723.70054","DOIUrl":"https://doi.org/10.1111/1742-6723.70054","url":null,"abstract":"<p>Australia's healthcare system faces significant strain from rising ED presentations, driven by multiple factors. Telehealth has emerged as a potential solution to alleviate these pressures and, with the appropriate infrastructure, may facilitate access to specialist expertise in remote areas, advise community and ambulance services on patient distribution and reduce inpatient demand by expanding home care services. However, research gaps remain regarding its safety, efficacy, intent and cost-effectiveness. Robust evaluation of existing services is required to ensure this tool is utilised to its full potential.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897199","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":"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}