Emergency Medicine Australasia最新文献

{"title":"Prehospital Emergency Care for Traumatic Brain Injury Patients in Hanoi: A Multicenter Study of Outcomes and Quality of Care","authors":"Bui Hai Hoang,&nbsp;Thi Linh Tran,&nbsp;Thanh Nguyen,&nbsp;Quoc Chinh Luong,&nbsp;Michael M. Dinh","doi":"10.1111/1742-6723.70338","DOIUrl":"https://doi.org/10.1111/1742-6723.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate prehospital care quality and outcomes for traumatic brain injury (TBI) patients in Vietnam.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective multicentre audit at three tertiary Hanoi hospitals (January–August 2025), including adults with moderate–severe TBI. Prehospital care was assessed against five EPIC-TBI standards and in-hospital mortality recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 80 cases, 45 (56.3%) were transported by EMS; 14 (17.5%) received oxygen or saturation monitoring and 11 (13.8%) had blood pressure management. In-hospital mortality was 22/80 (27.5%), with 14/22 (63.6%) of deaths potentially preventable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Major prehospital TBI care gaps support the need for enhanced resources, training and quality assurance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849129","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":"Clinical Yarning in Acute Coronary Syndrome Care: Culturally Safe, Person-Centred, Better for All","authors":"Jennie Hutton,&nbsp;Glenn Harrison,&nbsp;Nicole Watt","doi":"10.1111/1742-6723.70340","DOIUrl":"https://doi.org/10.1111/1742-6723.70340","url":null,"abstract":"&lt;p&gt;In this issue Stephensen et al. and Greenslade et al. reiterate the need for early and accurate diagnosis for Aboriginal and Torres Strait Islander patients with ACS [&lt;span&gt;1, 2&lt;/span&gt;]. This need has been previously reported across multiple stages of Indigenous patients' healthcare journey from diagnosis to treatment. For Aboriginal and Torres Strait Islander peoples this includes the increased incidence of disease at a younger age, delay in presentation and diagnosis, lower rates of intervention, lower rates of the prescription of secondary prevention medications and higher rates of patient-initiated leave events, all culminating in higher rates of mortality from ACS [&lt;span&gt;3&lt;/span&gt;]. From 2015 to 2019 cardiovascular disease was the leading cause of the gap in death rates between Indigenous and non-Indigenous Australians [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Stephensen et al. from Turrabul, Yugara Country focus on the failings of current descriptions of ‘typical’ chest pain such as left-sided or radiating chest pain to predict ACS for Aboriginal and Torres Strait Islander peoples [&lt;span&gt;1&lt;/span&gt;]. In describing ACS-associated chest pain, Aboriginal and Torres Strait Islander patients were more likely to report nausea, vomiting and ‘other’ symptoms.&lt;/p&gt;&lt;p&gt;These findings are extended by Greenslade et al. who use a different methodology with a larger population at a single site to identify symptom clusters associated with AMIs. Although this paper reports that anginal symptoms cluster is a strong predictor of AMI, both numbness and infectious clusters were also associated with increased risk, and no clusters could be used to rule in or rule out ACS.&lt;/p&gt;&lt;p&gt;Results of these studies add to the recognition that has been supported by recent guidelines to discard the terms ‘typical’ and ‘atypical’ chest pain [&lt;span&gt;5&lt;/span&gt;]. This is not solely due to the inaccuracies for under-represented groups. In the Stephenson study both groups found no association with pain that had been described as ‘typical’ [&lt;span&gt;1&lt;/span&gt;]. It has been recognised that there is a two-fold increase in odds of mortality with atypical or no chest pain as compared with typical presentations [&lt;span&gt;6&lt;/span&gt;]. Both the studies by Stephensen et al. and Greenslade et al. identify that standardised symptom checklists are inadequate, as recognised in the ACS guidelines from 2025 [&lt;span&gt;1, 2, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Although not analysed further within the Stephenson paper, ‘Other’ symptom descriptions are detailed in table 2 of the paper and occur almost twice as frequently in non-Indigenous patients [&lt;span&gt;1&lt;/span&gt;]. The authors refer to previous qualitative papers that support this paper's findings that pain was related to gastrointestinal symptoms or was difficult to describe [&lt;span&gt;7, 8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Both studies by Stephensen and Greenslade et al. highlight an important limitation in clinical assessment with the finding in Stephenson et al. that 4.5% of Indigenous patient reported ‘No chest pain’ at","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849130","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":"Indirect ICU Admissions From an Australian Emergency Department: Risk Factors and Outcomes","authors":"Daniel McLennan,&nbsp;Cliff Reid,&nbsp;Rhodri Martin,&nbsp;Susannah Olive,&nbsp;Guy Eslick","doi":"10.1111/1742-6723.70337","DOIUrl":"10.1111/1742-6723.70337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Indirect Intensive Care Unit (ICU) admissions, where patients admitted via the Emergency Department (ED) to a non-critical care ward subsequently require ICU admission, may reflect missed recognition or underestimation of deterioration. This study aimed to:</p>\u0000 \u0000 <p>(1) Compare the frequency of indirect ICU admissions in an Australian hospital with international literature.</p>\u0000 \u0000 <p>(2) Describe this cohort according to ED care factors, reason for ICU admission, and hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Observational cohort study of indirect ICU admissions occurring within 24 h of ED arrival between 1 June 2019 and 31 May 2022. Postoperative ICU admissions were excluded. Data were extracted from electronic medical records by two independent reviewers using a validated Data Collection Template (DCT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 701 indirect ICU admissions, 148 met inclusion criteria. Indirect admissions accounted for 11.3% of all ED-to-ICU admissions. The most common reason for ICU admission was circulatory insufficiency, representing 43% of cases. Approximately half of patients were discussed with or reviewed by a Fellow of the Australasian College for Emergency Medicine (FACEM). 53% had normal observations (44% without supplemental oxygen); 20% were outside normal limits and a further 22% had altered calling criteria. Hospital mortality was 12.8%, higher than that of a reference Australian ICU population. Presentations between midnight and 08:00 were overrepresented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unplanned indirect ICU admissions occurred less frequently than reported internationally but were associated with high in-hospital mortality. Given their association with adverse outcomes, quality improvement should focus on patients with abnormal vital signs, particularly circulatory insufficiency, and those presenting overnight.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839469","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":"Transport to Hospital Without Sustained Return of Spontaneous Circulation After Out-of-Hospital Cardiac Arrest: Outcomes From Western Australia","authors":"David Majewski,&nbsp;Jason Belcher,&nbsp;Stephen Ball,&nbsp;Judith Finn","doi":"10.1111/1742-6723.70335","DOIUrl":"https://doi.org/10.1111/1742-6723.70335","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816537","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":"Trauma in Pregnancy: A 5-Year Multi-Centre Retrospective Registry Analysis in South Australia","authors":"Dieter Linde,&nbsp;Monique Pisaniello,&nbsp;Elena Andreea Popa,&nbsp;Dimitrios Nikos,&nbsp;Blaise Bird,&nbsp;Cindy Harrington","doi":"10.1111/1742-6723.70324","DOIUrl":"10.1111/1742-6723.70324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to describe characteristics, assessments and outcomes of pregnant trauma patients (PTP) in South Australia (SA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SA Trauma Registry was utilised to identify PTP from 1 July 2018–30 June 2023. Registry data and patient electronic medical records were analysed using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred two patients were included. The mean maternal and gestational ages were 28 years and 27 weeks, respectively. 80% had no comorbidities. Blunt trauma accounted for 98% of injury type. The mechanism of injury for 60% of patients was Motor Vehicle Crash; 16% were uninjured; 58% sustained minor soft tissue injuries only. Despite the low mean ISS (1.6, SD 2.87), trauma teams were activated in 95% of cases. A primary survey was documented in 34%. An obstetric clinician was documented as present in 4% of cases. 96% did not require a medical procedure; three patients underwent emergency Lower Segment Caesarean Section. 93% were discharged directly from ED. Admitted patients had a mean hospital LOS of 21.8 h. There were no maternal deaths. Two patients suffered trauma-related intrauterine foetal demise. The mean gestational age at delivery was 38 weeks; 12% had preterm delivery. No trauma-related neonatal deaths were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PTP presentations in SA are infrequent, primarily resulting in minor injuries. Trauma assessments are incompletely documented, and along with investigations, often do not adhere to local guidelines. Good trauma care for PTPs should involve an obstetrician and follow ATLS principles. Guidelines should be implemented and followed to ensure standardised comprehensive care of PTPs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677557","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":"Manufactured Clinical Risk: Why Better Decisions Matter More Than Faster Investigations","authors":"Daniel Stewart,&nbsp;Geoffrey Hardacre","doi":"10.1111/1742-6723.70320","DOIUrl":"10.1111/1742-6723.70320","url":null,"abstract":"<div>\u0000 \u0000 <p>Accurate emergency care depends not only on selecting appropriate investigations and treatments, but also on recognising when they are unnecessary. This article introduces Manufactured Clinical Risk (MCR), a cognitive phenomenon in which non-instrumental information generated by low-utility investigations is reinterpreted as genuine clinical risk and incorporated into subsequent decision making. MCR is proposed as the predictable consequence of relief-based decision making, whereby clinicians seek relief from uncertainty rather than rational assessment of clinical probability. Once established, MCR initiates ambiguity cascades that generate further investigations, referrals, admissions and treatments despite little meaningful change in the patient's underlying probability of disease. This framework provides a plausible explanation for why strategies that accelerate clinical activity do not always produce proportional improvements in emergency department performance. Improving threshold-based decision making may represent an alternative model of performance improvement by safely reducing unnecessary clinical activity before it occurs.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677603","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":"An Extraordinary Wet Season and a Surge of Melioidosis: A Retrospective Case Series From a Tropical Emergency Department","authors":"Colin Banks,&nbsp;Amanda McConnell,&nbsp;Christopher S. Heather,&nbsp;Maisie Stephen,&nbsp;Kristen-Jürgen Schroeder,&nbsp;Isaac Tredinnick,&nbsp;Shannon Wong,&nbsp;Vinay Gangathimmaiah","doi":"10.1111/1742-6723.70325","DOIUrl":"10.1111/1742-6723.70325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Townsville, North Queensland, experienced record rainfall in the 2024–2025 wet season with an associated surge in the number of patients with melioidosis. A large proportion presented to the Townsville University Hospital (TUH) emergency department (ED), presenting an opportunity to assess the surge from an ED perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective case series of all patients with melioidosis that presented to TUH ED between 1 November 2024 and 30 April 2025. Cases for the entire region were sourced from the Statewide Reference Laboratory, and then individually assessed to ascertain whether they first presented to the TUH-ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 57 patients with confirmed melioidosis that presented to the TUH ED in the 2024–2025 wet season, 40 males and 17 females. Risk factors for melioidosis were present in 51 (88%), with diabetes being the most common (47%). ED blood cultures were taken in 54 patients and were positive in 36 (67%). All patients were admitted, with a median length of stay of 11 days; 12 (21%) patients had an intensive care admission, and hospital mortality was eight (14%). Pulmonary involvement was evident in 79% and prostatic involvement in 30% of males. Meropenem was administered in ED to 53% overall, and 80% of those with severe illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The surge of patients with melioidosis demonstrated a wide spectrum of infection foci and severity of illness. In melioidosis endemic regions following significant rainfall, we recommend to culture widely, administer meropenem for severe infections and consider melioidosis as a cause for unusual presentations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673127","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":"Reliability of Contactless Vital Sign Monitoring Posttriage in Emergency Department Walk-In Patients: A Single-Site, Prospective, Observational, Pilot Study","authors":"Courtney West,&nbsp;Hollis Hopkins,&nbsp;Samuel Teague,&nbsp;Danyi Wang,&nbsp;Titilayo Ogunwa,&nbsp;Javaan Chahl,&nbsp;Eloise Bletsas,&nbsp;Hayley Muller,&nbsp;Vinay Gangathimmaiah","doi":"10.1111/1742-6723.70323","DOIUrl":"10.1111/1742-6723.70323","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate camera-based, advanced sensor technology for contactless vital sign monitoring (versus standard monitoring) posttriage in adult emergency department patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-site, prospective, observational study was conducted at Townsville University Hospital Emergency Department between May 2025 and August 2025. Adult (≥ 18 years) walk-in patients were eligible. A convenience sample of consenting participants was recruited. Two sets of vital signs—blood pressure, heart rate, respiratory rate, oxygen saturation, temperature—were obtained. The first set was measured immediately after triage using a dual-camera system comprising a thermographic camera and a second camera with proprietary software. The second set was obtained immediately posttriage using standard monitoring equipment. Reliability and acceptability were the primary and secondary outcomes respectively. Reliability (accuracy and precision) was determined through a Bland–Altman analysis to assess agreement between the two sets of vital signs. Acceptability of technology was assessed using a participant questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 300 patients were recruited, of whom 288 had complete data on paired vital signs and were included in the Bland–Altman analysis. Minimal bias was observed across most vital signs, indicating limited systematic error. Respiratory rate, oxygen saturation and temperature showed the closest agreement, whereas systolic blood pressure and heart rate exhibited the widest limits of agreement. Acceptability was high, with most participants reporting comfort, ease of use and overall satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with standard vital sign monitoring, camera-based technology demonstrated good accuracy but variable precision across vital signs. Further algorithm refinement is required before reliable clinical integration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673132","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":"Correction to ‘Medical Staffing Models of Inpatient Major Trauma Services in Australia and New Zealand’","authors":"","doi":"10.1111/1742-6723.70319","DOIUrl":"10.1111/1742-6723.70319","url":null,"abstract":"<p>\u0000 <span>H. Abbasi</span>, <span>E. M. Bourke</span>, <span>M. Ejaz</span>, and <span>A. Buck</span>, “ <span>Medical Staffing Models of Inpatient Major Trauma Services in Australia and New Zealand</span>,” <i>Emergency Medicine Australasia</i> <span>38</span>, no. <span>3</span> (<span>2026</span>): e70289, https://doi.org/10.1111/1742-6723.70289.\u0000 </p><p>In the originally published article, the last column in row 17 of Table 1 is incorrect. The director is a surgeon, not a FACEM, as previously written. The term ‘FACEM Director’ should be corrected to ‘Surgeon Director’, as shown below:</p><p>State: QUEENSLAND\u0000 </p><p>We apologize for this error.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663547","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":"Inhaled Methoxyflurane in Australian Emergency Departments-A Cost-Minimisation Analysis.","authors":"Julius Ohrnberger, Ashley Milkop, George Braitberg, Biswadev Mitra, Paul M Middleton, Sue Anne Yee, Julianne Alexander","doi":"10.1111/1742-6723.70326","DOIUrl":"https://doi.org/10.1111/1742-6723.70326","url":null,"abstract":"<p><strong>Background: </strong>Around 60% of emergency department (ED) patients present with pain. With growing ED-demand, there is need for analgesic options that reduce resource use and cost. We estimate the potential cost-savings from broader use of inhaled methoxyflurane in Australian EDs compared with standard-of-care (SOC) analgesics or procedural sedation. The analysis focused on non-admitted patient presentations requiring analgesia or procedural sedation to treat dislocations, burns, fractures and other injuries.</p><p><strong>Methods: </strong>We conducted a cost-minimisation analysis to assess differences in resource use and costs between methoxyflurane, and SOC. Model inputs were informed by a literature review, consultation with ED-clinicians and Australian Institute of Health and Welfare data, adjusted to 2024/25 population estimates. Costs are reported in 2024/25 Australian dollars, per use case and on aggregate across Australian EDs. Intravenous ketamine, identified by clinicians as the most common comparator, was presented by indication. Sensitivity analyses were undertaken to assess robustness.</p><p><strong>Results: </strong>Methoxyflurane use could have been associated with lower per-patient costs than SOC, driven primarily by reduced ED length of stay and staff time. Estimated cost per use case ranged from $62-$283 compared with intranasal fentanyl and $339-$560 compared with intravenous ketamine. At a national level, this equated to potential annual ED-operational efficiency gains of $9.5-$42.9 million and $34.6-$85.0 million, respectively. Methoxyflurane used for shoulder dislocations contributed an estimated $1.9-$4.8 million when compared to intravenous ketamine.</p><p><strong>Conclusion: </strong>Broader use of methoxyflurane for the management of pain and minor procedures in Australian EDs could deliver meaningful operational efficiency gains.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70326"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789692","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}