Emergency Medicine Australasia最新文献

{"title":"Guanfacine exposure in paediatric and adolescent patients: A multicentre retrospective review","authors":"Emma Peters MBBS, FACEM,&nbsp;Sarah E Hodgson MBChB, BSc, FACEM,&nbsp;Rohan Elliott BPharm, BPharmSc(Hons), MClinPharm, PhD, FANZCAP,&nbsp;Shaun L Greene MBChB, MSc, FACEM, FACMT","doi":"10.1111/1742-6723.70018","DOIUrl":"https://doi.org/10.1111/1742-6723.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe the frequency, severity, management and complications of guanfacine exposures in paediatric and adolescent patients referred to a state Poisons Information Centre or presenting to two EDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentre, retrospective review of guanfacine exposures from July 2017 to October 2023 in patients aged ≤19 years that were discussed with the Victorian Poisons Information Centre or presented to the Royal Children's Hospital or Austin Health EDs, Melbourne. Demographic, clinical, management and outcome data were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 275 guanfacine exposures reported to the Poisons Information Centre, with a 16-fold increase in exposures over the study period. Of these, 173 (63%) were unintentional therapeutic errors, the majority (103) involving accidental double-dosing. Twenty-four cases presented to either of the study EDs and 38 cases from other hospitals were discussed with a clinical toxicologist. Of these 62 cases with a medical assessment, 32 reported lone guanfacine exposure. Hypotension, bradycardia and drowsiness were present in 9/32, 17/32 and 13/32 cases, respectively. Five (16%) patients received i.v. fluids. No patients required intubation, inotropic or vasopressor support. One patient who was co-exposed to marijuana required atropine. Prolonged orthostatic hypotension was observed in three of 32 cases, lasting a median of 36 h (range 24–42 h).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Paediatric guanfacine exposures increased significantly over the study period. Isolated guanfacine ingestions were well tolerated, seldom requiring specific intervention. Clinicians need to be cognisant of the risk of prolonged orthostatic hypotension, and this must be excluded prior to discharge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533343","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":"Just because we can, does not mean we should: Over investigation and low-value care in our emergency departments","authors":"Adelene Hilbig MBBS(Hons), DipLibArts, MPHTM","doi":"10.1111/1742-6723.70013","DOIUrl":"https://doi.org/10.1111/1742-6723.70013","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533408","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":"Effect of change of high-sensitivity troponin I assay on emergency department diagnosis and disposition of patients with possible acute coronary syndrome","authors":"John W Pickering PhD,&nbsp;Scott Kelland MBChB,&nbsp;Otis Williams BMedSci(Hons),&nbsp;Jamin Kim MBChB,&nbsp;Sally Aldous MD,&nbsp;Laura R Joyce MBChB,&nbsp;Martin P Than MBBS","doi":"10.1111/1742-6723.70022","DOIUrl":"https://doi.org/10.1111/1742-6723.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Changing cardiac troponin (cTn) assays may affect a hospital's admission and myocardial infarction rates. The effect of changing from a contemporary to high-sensitivity (hs) cTnI assay has been well described, but the real-life impact on disposition and diagnosis of changing from one hs-cTnI assay to another has not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients who received a troponin measurement in the ED during 16 weeks were adjudicated to identify those the attending physician investigated for possible acute coronary syndrome (ACS) and for clinical outcomes. The Abbott ARCHITECT hs-cTnI assay was in use for the first 8 weeks, followed by the Beckman Coulter hs-cTnI assay for the second 8 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fewer patients were investigated with the Abbott assay (2213), than the Beckman assay (2683). A larger proportion were investigated for ACS in the Abbott (64.8%) than the Beckman (60.3%) arm. Among those investigated for ACS the rate of myocardial infarction decreased on changing from Abbott (12.8%) to Beckman (8.8%). Adjusted odds of a myocardial infarction were lower for the Beckman arm, Odds Ratio 0.69 (95% CI 0.55 to 0.88). A lower proportion of Abbott than Beckman had myocardial injury (at least one ED cTnI ≥ upper reference limit) 26.4% compared with 29.8%. The proportion admitted to hospital decreased from the Abbott arm (42.5%) to the Beckman arm (36.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A change in cTnI assay resulted in a decreased rate of myocardial infarction and admission despite an increase in rate of myocardial injury among patients investigated for ACS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539339","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":"ICS prescribing practices in the emergency department: Addressing gaps in asthma management","authors":"Samuel Ford,&nbsp;Nikesh Gopalkumar","doi":"10.1111/1742-6723.70024","DOIUrl":"https://doi.org/10.1111/1742-6723.70024","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533345","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":"Accuracy of colour Doppler ultrasound for nasogastric tube placement in emergency department: A prospective observational study","authors":"Ming Yee Ong MMed Emergency,&nbsp;Ahmad Zulkarnain Ahmad Zahedi MMed Emergency,&nbsp;Aliyah Zambri MMed Emergency,&nbsp;Muhaimin Noor Azhar MMed Emergency,&nbsp;Aida Bustam MMed Emergency,&nbsp;Rabiha Mohd Alip MMed Emergency,&nbsp;Mohammad Fadhly Yahya MMed Emergency,&nbsp;Khadijah Poh MMed Emergency","doi":"10.1111/1742-6723.70020","DOIUrl":"https://doi.org/10.1111/1742-6723.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Nasogastric tube (NGT) placement is a common procedure in EDs. Successful NGT placement reduces complications such as aspiration pneumonia, pneumothorax and mortality. While chest radiography is the gold standard for confirmation, colour Doppler ultrasonography (CDU) has demonstrated high accuracy. As its applicability in the ED remains underexplored, the present study evaluates the accuracy of CDU in confirming NGT placement in the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective observational study was conducted in a tertiary hospital ED from October 2022 to October 2023. Adult patients requiring NGT insertion were eligible. NGT placement was performed using a standardised protocol and confirmed with CDU and chest radiography. Accuracy of CDU was assessed against chest radiography, and procedural times for confirmation were compared using the Kruskal–Wallis <i>H</i> test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 157 patients screened, 144 were included. CDU demonstrated 92.45% (95% confidence interval 85.67–96.69) sensitivity, 80.56% (63.98–91.81) specificity, positive predictive value 0.93 (0.88–0.96), negative predictive value 0.78 (0.64–0.88), positive likelihood ratio 4.75 (2.44–9.27) and negative likelihood ratio 0.09 (0.05–0.19). The median (interquartile range) confirmation times were 3.0 min (2.0–3.0) for CDU and 42.0 min (30.0–55.0) for radiography (<i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CDU should not currently be used as a standalone method for confirming NGT placement due to its limitations and risk of false-positive results. Further research is required to address these challenges before considering its clinical implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533340","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":"Quality and usability of photographs of skin conditions taken in emergency departments for dermatology consultation","authors":"Sophie Walter,&nbsp;James Koutsis,&nbsp;Mahdieh Gorji,&nbsp;Ashod Kherlopian,&nbsp;Terence Wong,&nbsp;Serigne N Lo,&nbsp;Angela L Chiew,&nbsp;Linda K Martin","doi":"10.1111/1742-6723.70019","DOIUrl":"https://doi.org/10.1111/1742-6723.70019","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446891","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":"Criteria for early discharge of drowning patients from the emergency department","authors":"Ogilvie Thom MBBS,&nbsp;Kym Roberts MN, BN,&nbsp;Susan Devine PhD,&nbsp;Richard C Franklin PhD","doi":"10.1111/1742-6723.70012","DOIUrl":"https://doi.org/10.1111/1742-6723.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Clinical factors previously shown to independently predict safe discharge were applied at ED presentation to determine whether we could identify a group of drowning patients who do not require treatment and are thus safe for rapid discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a retrospective study of drowning presentations to EDs of the Sunshine Coast Hospital and Health Service in Queensland, Australia between 1 January 2015 and 31 December 2022. Rapid discharge criteria (RDC) were defined as a normal spontaneous respiratory rate (adjusted for age), a normal peripheral blood saturation (≥94%) on room air, an Alert measurement on the Alert, Voice, Pain, Unresponsive scale, clear chest auscultation and the absence of any requirement for oxygen or other ventilatory assistance from Emergency Medical Services. Primary outcome was the requirement for treatment (oxygen, ventilation or airway intervention).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred and seventy-seven drowning presentations were included. Two hundred and fifty-five (44.2%) patients met RDC at ED presentation. Patients meeting RDC were more likely to be younger (median 9 years, IQR 3–21 <i>vs</i> 20 years, IQR 4–44, <i>P</i> &lt; 0.016) than those with not meeting RDC. Eight patients meeting RDC had received bystander CPR. There were no deaths in the RDC group (0/255 (0%) <i>vs</i> 17/322 (5.3%), <i>P</i> &lt; 0.016). No patient meeting RDC required treatment (0/255 (0%) <i>vs</i> 145/322 (45.0%), <i>P</i> &lt; 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Drowning patients who meet rapid discharge criteria at ED presentation will not require treatment for their drowning and may be considered for discharge from the ED without further investigation or mandatory period of observation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of socioeconomic status on utilisation of a Virtual Emergency Department: An exploratory analysis","authors":"Jason Talevski PhD,&nbsp;Shady Rizk BSc,&nbsp;Loren Sher MBBCh, DCH, FACEM, PEM,&nbsp;Rebecca L Jessup BPod, MPH, PhD,&nbsp;Adam I Semciw GDip, GCert, BApplSci, PhD,&nbsp;James H Boyd PhD,&nbsp;Suzanne M Miller MD, FACEP, FACEM, GAICD,&nbsp;Jennie Hutton MBChB, MPH, FACEM","doi":"10.1111/1742-6723.70011","DOIUrl":"https://doi.org/10.1111/1742-6723.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore whether utilisation of a Virtual Emergency Department (VVED) differs according to socioeconomic status (SES).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was undertaken of data from the VVED – a telehealth service that provides care for patients across Victoria, Australia with non-life-threatening emergencies. The study included all individuals who presented to the VVED between July 2022 and June 2023 through the two most common referral pathways (self-referral and ambulance referral). Area-level SES was ascertained by matching residential postcodes to the corresponding Australian Bureau of Statistics (ABS) Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) decile. IRSAD scores were divided into quintiles (1 = lowest SES, 5 = highest SES) and multivariable logistic regression modelling was used to analyse associations between the SES quintile and referral pathway, presented as odds ratios (ORs) with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 68 598 participants included in the analyses (mean age: 36.6 years; 58.4% female). Compared to SES quintile 3, higher odds of self-referral to the VVED were observed in the two most advantaged SES groups (Quintile 4; adjusted OR [aOR] = 1.16; 95% CI: 1.06–1.26; <i>P</i> = 0.001) (Quintile 5; aOR = 1.38; 95% CI: 1.25–1.52; <i>P</i> &lt; 0.001). Conversely, lower odds of self-referral were observed in the most disadvantaged SES group (Quintile 1; aOR = 0.82; 95% CI: 0.75–0.90; <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study demonstrated a relatively even utilisation of the VVED service across SES population groups. The use of healthcare provider pathways, such as ambulance paramedics, may increase equitable access to telehealth. Clinical attention should be directed toward specific social groups in the emergency care setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404427","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":"Comparison of mechanical restraint use in a metropolitan ED after system change: A before and after analysis","authors":"Jaislie La Barrass MBBS, GCHProfEd,&nbsp;James L Mallows MBBS, MEd, FACEM,&nbsp;Mark D Salter MBBS (Hons), PgDip (Med Tox), FACEM,&nbsp;Megan Budek RN","doi":"10.1111/1742-6723.70006","DOIUrl":"https://doi.org/10.1111/1742-6723.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior to 2020, Nepean ED had high rates of restraint of mental health (MH) patients compared to peer hospitals. Restraint can cause emotional and physical trauma to patients and staff and should be used as seldom as possible. The ED undertook a project to reduce the number and duration of restraint episodes, involving telepsychiatry, culture change, staff education, increasing use of sedation and bedside engagement in de-escalation techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the differences in mechanical restraint episodes between 2019 and 2021 calendar years, after a year of change implementation in 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A single-centre retrospective cohort analysis of patients requiring mechanical restraint for MH complaints in 2019 and 2021 was conducted. Presentations of all MH patients were identified from the electronic medical record. Episodes of restraint were identified from the ED restraint register, and a file review of the electronic medical record was conducted to obtain data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, there was a 11.5% increase in total MH presentations (2705 <i>vs</i> 3056). There was a decrease in the proportion of MH patients experiencing restraint from 8.8% to 6.3% (difference 2.5%; 95% CI 1.1%–3.8%). Mean duration of restraint decreased from 385 to 229 min (difference 145; 95% CI 93.3–196.2) and use of sedation in restrained patients increased from 58.6% to 72.9% (difference 16%; 95% CI 6.8%–25.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After a year of change implementation, there was a reduction in the use of restraints and an increase in the use of sedation in 2021 when compared to 2019.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389386","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: Somatization Disorders in emergency department: A critical overview of current challenges and future directions","authors":"Vidula Garde BA, MA, M.Phil, MHA,&nbsp;Meryl Churchill BSc (Hons), MSc, MPHTM, PhD,&nbsp;Jaimi Greenslade B.Psych (Hons), M. Sci (Stats), PhD,&nbsp;Kerrianne Watt BSc (Hons), PhD,&nbsp;Andrew J Mallett MBBS, MMed, PhD, CF, AFRACMA, FASN, FRCP, FRACP,&nbsp;Douglas Morel MBBS, FACEM, FCHSM, CHE","doi":"10.1111/1742-6723.70009","DOIUrl":"https://doi.org/10.1111/1742-6723.70009","url":null,"abstract":"<p>Individuals with Somatization Disorders present frequently to the ED with non-cardiac chest pain, non-specific abdominal pain, headaches and a range of other non-specific symptoms. Somatization Disorder presentations are ubiquitous within the healthcare system. Seen as belonging to ‘no man's land’, these disorders, are often diagnosed and treated by different medical subspecialities. This characteristic of Somatization Disorders creates challenges regarding their diagnosis and management across emergency care settings. The current review explores the scope of the problem and, the challenges inherent in diagnosing and treating these disorders in ED environments. Based on available evidence and the essential character of these disorders, future directions are suggested for more effective emergency management and possible referral from ED.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389387","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}