Emergency Medicine Australasia最新文献

{"title":"Factors associated with extended length of stay for paediatric mental health presentations to EDs in South Western Sydney, Australia","authors":"Jahidur Rahman Khan BS (Applied Statistics), MS (Applied Statistics), PhD,&nbsp;James Rufus John BDS, MPH, PhD,&nbsp;Paul M. Middleton RGN, MBBS, DipIMCRCS(Ed), MMed(Clin Epi), MD, FRCS(Eng), FACPara, FRCEM, FACEM,&nbsp;Yao Huang BE, MEng, PhD,&nbsp;Ping-I (Daniel) Lin MD, MHS, PhD,&nbsp;Nan Hu BSc, MSc, PhD,&nbsp;Bin Jalaludin MBBS, MPH, PhD,&nbsp;Paul Chay MBBS, FRACP,&nbsp;Raghu Lingam MBChB, DTMH, MSc, PhD,&nbsp;Valsamma Eapen MBBS, DPM, PhD, FRCPsych, FRANZCP","doi":"10.1111/1742-6723.70003","DOIUrl":"https://doi.org/10.1111/1742-6723.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine the factors associated with extended length of stay (LOS) for paediatric mental health (MH)-related presentations to the EDs in South Western Sydney (SWS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed electronic medical records (eMRs) of 7444 MH-related ED encounters of children and young people (CYP) aged up to 18 years from all six public hospitals in SWS from January 2016 to April 2022. Extended LOS was defined as encounters of more than 4 h. We assessed factors associated with extended LOS using a multi-level logistic regression model, accounting for hospital-level clustering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately, 57.6% of all paediatric MH-related ED presentations involved extended LOS. ED presentations by adolescents, patients with a culturally and linguistically diverse background, and those with ambulance arrival had increased odds of extended LOS compared to their counterparts. The odds of extended LOS were lower for encounters that occurred on weekends compared to weekdays, but the odds were higher for presentations that happened at night than during the day. Deliberate self-harm, eating disorder, and schizophrenia spectrum disorders/psychosis-related presentations had higher odds of extended LOS than other MH-related presentations. Patients with MH presentations that required urgent evaluation (triage levels 1–2) had higher odds of extended LOS. Further, the odds of extended LOS were considerably lower during the COVID-19 period compared to the pre-COVID-19 period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings highlight the need for equitable distribution of resources directed towards at-risk CYP to improve MH outcomes and reduce health system burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380540","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":"A three-step programme to treat locum addiction","authors":"Volha Pankevich FRCGP (UK), FACEM, PEM, FRCEM (UK),&nbsp;Christopher Maclain RN, GradDip (Critical Care), MSc Nursing Practice","doi":"10.1111/1742-6723.70008","DOIUrl":"https://doi.org/10.1111/1742-6723.70008","url":null,"abstract":"<p>The three-step programme to treat locum addiction locum dependency in rural EDs is a pervasive issue, leading to significant financial strain and impacting clinical care and staff morale. This article outlines a three-step programme to mitigate this dependency. Step one involves government intervention to provide financial incentives for permanent rural doctors and visa regulation for foreign doctors who mandate service in rural communities. Step two suggests that the Australian College for Emergency Medicine (ACEM) mandate rural training for trainees and further integration of nurse practitioners (NPs) into emergency medicine. Step three emphasises the role of individual hospitals in effective recruitment, highlighting the benefits of rural living and the potential of NPs to provide departmental continuity and reduce turnover. These reforms, although independent, collectively aim to enhance the quality of care in rural EDs and optimise resource allocation.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380795","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":"A pilot trial exploring the use of music in the emergency department and its association with delirium and other clinical outcomes","authors":"Danielle Ní Chróinín MB BCh BAO, BMedSc MD (research),&nbsp;Sandra Wang MBBS,&nbsp;Guruprasad Nagaraj MBBS,&nbsp;Shiquan Ren BSc, MSc, PhD,&nbsp;Paul M Middleton RGN MBBS DipIMCRCS (Ed) MMed(Clin Epi), MD(Imp Lond),&nbsp;Alison Short BMus (Music Therapy), MA (Music Therapy), PhD","doi":"10.1111/1742-6723.70004","DOIUrl":"https://doi.org/10.1111/1742-6723.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess potential feasibility of a targeted music intervention trial in older ED patients and association with clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective pragmatic trial of adults aged ≥65 years in the ED, with prevalent delirium or increased risk of incident delirium, receiving either 2-h music intervention via headphones or usual care. The primary outcomes were (i) feasibility as assessed by actual use of the intervention (target 70% of offered patients) and (ii) incident delirium in delirium-free patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 211 initially screened patients, 44 were included. The initially planned randomised controlled trial proved difficult due to poor intervention adherence, resulting in a move to patient self-selection to routine care or 2-h music intervention. There were 19 control (13 prevalent delirium) and 25 intervention participants (20 prevalent delirium); 2-h target intervention duration was achieved in 17/25 (68%) patients (8/25 achieving &lt;2 h). Among those without prevalent delirium, incident delirium occurred in 1/6 of control and 4/5 of intervention (<i>P</i> = 0.08). There were no between-group differences in terms of improved or resolved delirium, pain scores or agitation/sedation scores (all <i>P</i> &gt; 0.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self-selected use of a targeted music intervention was feasible in a cohort of older ED patients. While we were likely underpowered to detect associations between intervention and outcome, collection of selected outcome measures proved feasible; these may be helpful in larger scale studies. Exploration of barriers and facilitators to use, as well as preferred delivery methods, are likely to be helpful in wider investigations of music therapy in this high-risk cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380539","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":"Self-reported knowledge and attitudes surrounding care of LGBTQIA+ patients in the emergency department","authors":"Katherine Pavlovic BNurs, MNursPrac, BHealthSc,&nbsp;Emily Thrower BSc (Hons), MD, SCHP, DRANZCOG,&nbsp;Jakob Malouf MBBS (Hons), EMC (ACEM),&nbsp;Joe Anthony Rotella MBBS, BSc, MMedTox, FACEM","doi":"10.1111/1742-6723.70010","DOIUrl":"https://doi.org/10.1111/1742-6723.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The ED is a common pathway for receiving care for all consumers. Little is known about staff perspectives about care of consumers who identify as LGBTQIA+ in an Australian setting. We sort to explore staff knowledge, attitude and behaviours around care of LGBTQIA+ consumers to identify potential barriers to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An anonymised electronic survey of staff from a community hospital ED was conducted. Medical, nursing, allied health and clerical staff were all invited to participate. The survey contained 33 questions in the form of multiple-choice questions and free-text commentary. Responses were pooled and analysed both as a whole and by role within the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred nine participants responded (response rate 25.3%). Over 50% of respondents were aged 44 years or less (74.4%), and predominantly identified as female (63.3%) and heterosexual (80.7%). Most respondents did not find treating or interacting with LGBTQIA+ consumers challenging, difficult, or uncomfortable irrespective of role. Most disagreed it was more difficult to undertake a clinical assessment compared to other consumers. Consumer-led education from people identifying as LGBTQIA+ was preferred for improving care (26.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study found that despite little or no formal training in provision of care for LGBTQIA+ consumers, respondents saw LGBTQIA+ consumers as a relatively small group within the wider ED consumer population and did not see the treatment of LGBTQIA+ consumers as more challenging with respect to interaction, assessment and provision of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362380","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":"From other journals","authors":"Sierra Beck,&nbsp;Tahnee Dunlop,&nbsp;Bridget Honan,&nbsp;Abhishek Mitra,&nbsp;Muhuntha Sri-Ganeshan,&nbsp;Joseph Ting","doi":"10.1111/1742-6723.70007","DOIUrl":"https://doi.org/10.1111/1742-6723.70007","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112147","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":"How useful was a paediatric physical abuse screening project in a rural Australian emergency department?","authors":"John van Bockxmeer ADEM, FACRRM,&nbsp;Lesley Enzor FRACGP,&nbsp;Marshall Makate PhD,&nbsp;Suzanne Robinson PhD","doi":"10.1111/1742-6723.70000","DOIUrl":"10.1111/1742-6723.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Children with non-accidental injuries have increased risk of future death. There is insufficient evidence for widespread physical abuse screening tool use in the ED. This study assesses the utility of a physical abuse project that includes the implementation of a screening tool with case-matching from multiple sources. It aims to confirm whether risk-screening in a medium-sized rural Australian ED is reliable and will improve outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a 16-month ED retrospective pre-/post-implementation study of all injury, burn or poisoning cases 16 years and under during a paediatric physical abuse safety project which included a screening tool. Presentations with potential physical abuse were filtered by ICD-10 codes and reviewed. Multivariable logistic regression models compared pre- and post-implementation cases. Analyses examined outcomes, trends and interrogated the screening tool which formed a Clinical Pathway Algorithm (CPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1469 presentations underwent investigation: 747 pre-implementation and 722 post-implementation. Pearson's <i>χ</i>² test showed statistically insignificant differences. If tool used, documentation improved (odds ratio [OR] 7.73; 95% confidence interval [CI] 4.91–12.18), child protection service referrals increased (OR 5.50; 95% CI 1.82–16.61) and hospital admissions decreased (OR 0.42; 95% CI 0.22–0.79). Re-presentation rates stayed the same. Increased physical abuse was associated with screening factors including carer behavioural concerns, inadequate supervision, delayed presentation, repeat and unexplained injuries (ORs/CIs in an accompanying Table 4). Screening tool sensitivity was 62.3% and specificity 79.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing this ED paediatric physical abuse project improved safety behaviours and best-practice documentation. The tool improved medical decision making without increased re-presentations. ED clinicians may use similar CPAs to help review safety concerns and facilitate discharge; however, resources are needed to investigate referrals flagged due to false-positive rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064538","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: Coaching in emergency medicine: A systematic review and future research agenda","authors":"Andrew Rixon B.Sc (hons), GCLT, FCHSM, PhD,&nbsp;Samuel Wilson BA, BCom, MPsych, PhD,&nbsp;Lee Yung Wong MBBS (hons), GradDipClinEd, FACEM, PhD,&nbsp;Elizabeth Elder BA, BN,MAdvPrac, MNurs, PhD","doi":"10.1111/1742-6723.70001","DOIUrl":"10.1111/1742-6723.70001","url":null,"abstract":"<p>Coaching as a discipline has seen significant growth in medicine over the last decade, especially in medical education, but is at the early stages of recognition in emergency medicine. The objective of this systematic review was to provide insight into the state of coaching practice and research in emergency medicine and outline a future research agenda. Based on PRISMA guidelines, a structured electronic literature search of Embase, Scopus and EBSCOhost was conducted. Studies were included if they met all three criteria for population (‘clinicians’), concept (‘coaching’), context (‘emergency medicine’) and were published in peer-reviewed empirical studies between 2004 and 2024. Data extraction was performed by one investigator and checked for accuracy by a second investigator. A quality assessment was conducted. Of the 1441 unique articles identified in the initial search, 13 studies met the inclusion criteria. Our review revealed three key findings: coaching is examined in relation to clinician well-being and resilience, non-technical skills, and clinician technical skills, however its influence upon non-technical skills is the main focus; coaching studies are predominantly outcome studies, with process studies receiving little attention and; a range of theories and models are used in studies of coaching in emergency medicine. This review revealed that coaching research in emergency medicine is in its infancy, highly fragmented and largely disconnected from the wider coaching research literature. Nevertheless, despite the early stages of the current research base of coaching in emergency medicine, this nascent field is rich with opportunities for future research.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064541","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":"Use of accurate and effective terminology in trauma studies: ‘Seriously injured patients’ and ‘high-energy impact’ instead of ‘major trauma’","authors":"Sarper Yilmaz,&nbsp;Gülbin Aydoğdu Umaç","doi":"10.1111/1742-6723.70002","DOIUrl":"10.1111/1742-6723.70002","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064542","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":"Adverse events and paramedic interventions during extended ground transport in a rural pharmaco-invasive STEMI program","authors":"Steven C Faddy MScMed,&nbsp;Sarah Edwards MFDS,&nbsp;Georgina Luscombe PhD,&nbsp;Estelle Ryan MNg (Cardiac),&nbsp;Ruth Arnold FRACP","doi":"10.1111/1742-6723.70005","DOIUrl":"10.1111/1742-6723.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Although guidelines recommend angiography and coronary intervention occur within 24 h of thrombolysis when percutaneous coronary intervention (PCI) is not available within 120 min, this target is difficult to achieve in rural and remote areas of New South Wales (NSW), Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this is secondary analysis we examine the impact of extending the existing 90-min road transport limit for patients in rural and remote areas of western NSW who have received initial treatment for ST-elevation myocardial infarction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient cohort consisted of 86 patients who were transported by road ambulance with transport times more than 90 min. Adverse events occurred in 20% of patient transports and rates were similar in patients transported directly from the scene or from a community hospital. The most common adverse events were hypotension and bradycardia. There was one cardiac arrest, four minor bleeding events and no major bleeding events. The main treatments provided were morphine analgesia, nitrates and anti-emetic medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The primary study showed a significant reduction in time from first clinical contact to arrival at the PCI hospital. In this secondary analysis, we demonstrate that the rate of adverse events during long-distance road transport is low, the adverse events are mostly minor in nature and are within the scope of paramedic practice to manage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064502","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":"Triage gap? Analysis of admission rates, service utilisation and mortality for First Nations patients compared to non-First Nations patients, stratified by ED triage category","authors":"Lucinda Parsonage BMed,&nbsp;Stephen Gourley MBBS,&nbsp;Shahid Ullah PhD,&nbsp;Richard Johnson MBBS","doi":"10.1111/1742-6723.14558","DOIUrl":"10.1111/1742-6723.14558","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>First Nations patients often experience poorer health outcomes than non-First Nations patients. Despite emergency triage primarily focusing on severity, implying comparable outcomes for patients in the same triage group regardless of demographics, the precision of triage for First-Nations Australians may be undermined by multiple factors, although research in this area is scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare admission rates, service utilisation and mortality for First Nations and non-First Nations patients, based on their triage categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study utilised data for all adults presenting between January 2016 and May 2021, to Alice Springs Hospital; totalling 175 199 presentations from 39 882 individual patients. Data were analysed for differences between First Nations and non-First nations patients for outcomes including 30-day mortality, admission to hospital and admission to ICU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>First Nations patients had significantly higher admission than non-First Nations patients across all triage categories (<i>P</i> &lt; 0.001). First Nations patients in categories 3 and 4 had a significantly higher 30-day mortality (<i>P</i> = 0.039, <i>P</i> = 0.045, respectively). First Nations patients in categories 2 and 3 were significantly more likely to be admitted to ICU (<i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>First Nations patients appear to have worse outcomes than non-First Nations patients in the same triage category. Socio-economic factors and high discharge against advice rates from wards may explain the significantly higher admission rate. Under-recognition of serious illness at triage could be attributed to communication issues or a ‘well bias’. The results raise many questions and further investigation is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046002","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}