Emergency Medicine Australasia最新文献

{"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}

{"title":"Pericardial Decompression for Acute Traumatic Cardiac Tamponade-Pearls and Clamshells.","authors":"Mark Fitzgerald, Cecil Johnny, Chen Lew, Jeremy Hsu, Christopher Groombridge, Joseph Mathew, Malinda Weerasinghe, Silvana Morasco","doi":"10.1111/1742-6723.70328","DOIUrl":"10.1111/1742-6723.70328","url":null,"abstract":"<p><p>Acute traumatic cardiac tamponade is a time-critical-but potentially reversible-cause of circulatory collapse. The surgical, operative, nursing and anaesthesiology staff most capable and best trained to perform the procedure are often not immediately available, requiring emergency medical staff to perform this life-saving intervention. When tamponade causes refractory shock or peri-arrest, left anterolateral thoracotomy remains the preferred technique for definitive pericardial decompression, with extension to a clamshell thoracotomy when required.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70328"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701029","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":"Predictive Performance of Sepsis Scoring Tools for In-Hospital Mortality Among Patients With Suspected Sepsis Presenting to the Colonial War Memorial Hospital Emergency Department, Fiji.","authors":"Isaac V Singh, Georgina Phillips, Sabiha Khan","doi":"10.1111/1742-6723.70333","DOIUrl":"10.1111/1742-6723.70333","url":null,"abstract":"<p><strong>Objective: </strong>Fiji has a high morbidity and mortality sepsis burden, but little is known about the utility of prognostic tools for septic patients presenting to hospital in the limited-resource Fijian context. This study aims to compare the ability of the quick sequential organ failure assessment (qSOFA), systemic inflammatory response syndrome (SIRS) and national early warning score (NEWS) at predicting in-hospital mortality.</p><p><strong>Methods: </strong>A prospective observational study was conducted over 3 months in 2024 at a single Fijian tertiary hospital. Data was collected using an online tool from patients who presented to the Emergency Department with suspicion of sepsis and subsequently required admission. The prognostic accuracy at detecting in-hospital mortality was assessed and compared for qSOFA, SIRS and NEWS.</p><p><strong>Results: </strong>A total of 181 cases were included with an overall in-hospital mortality of 17.13%. In-hospital mortality in patients with a qSOFA ≥ 2 was 16 (34%), SIRS ≥ 2 was 25 (19.2%) and NEWS ≥ 7 was 23 (35.9%). qSOFA ≥ 2 yielded the highest specificity (79%, 95% CI 72%-86%) and SIRS ≥ 2 the highest sensitivity (81%, 95% CI 63%-93%). The NEWS ≥ 7 yielded intermediate sensitivity (74%, 95% CI 55%-88%) and specificity (73%, 95% CI 66%-80%). The AUROC for NEWS ≥ 7 was highest at 0.77 (0.68-0.87) with qSOFA ≥ 2 and SIRS ≥ 2 being 0.69 (0.58-0.79) and 0.62 (0.51-0.73) respectively.</p><p><strong>Conclusions: </strong>NEWS demonstrated higher prognostic accuracy compared to qSOFA and SIRS in predicting in-hospital mortality for suspected sepsis patients. Our study provides a benchmark for future ED-based sepsis research in the Pacific.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70333"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789697","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":"Emergency Department Presentations During Southwest Leavers Week 2022: A Retrospective Observational Study.","authors":"James Borshoff, Siena McQuillan, Emma Jamieson, Clare Willix","doi":"10.1111/1742-6723.70308","DOIUrl":"10.1111/1742-6723.70308","url":null,"abstract":"<p><strong>Objective: </strong>To inform in-event health service (IEHS) delivery and harm minimisation strategies for the planned youth mass gathering event (MGE) known as 'Leavers' in the Southwest region of Western Australia. This study aimed to describe patient emergency department (ED) presentation characteristics and outcomes for Leavers WA.</p><p><strong>Methods: </strong>A retrospective observational study of patient presentations by Leavers to the Busselton ED at the 2022 MGE. This included 4 days with IEHS operation (7 pm to 1 am), 2 days prior to and 3 days post the MGE. Data analysis included descriptive and inferential statistics.</p><p><strong>Results: </strong>Of 9621 Leavers, 121 (1.26%, PPR 12.6/1000) presented to ED: 12 prior to, 85 during and 24 post the MGE. The majority of presentations were from the community (n = 103, 85.1%). Of 557 Leavers who presented to the IEHS, 18 were transported to hospital (TTHR 1.87/1000). The majority of presentations were ATS 3 and ATS 4 (43.8%, 42.1%). Medical illness was the most common presentation category (n = 59, 48.8%). 51.2% of presentations were related to alcohol/illicit substance use. 85.6% of Leavers were seen and allocated a discharge disposition within 4 h.</p><p><strong>Conclusions: </strong>Leavers WA celebrations introduced a significant burden on the regional ED with over half the presentations drug and alcohol related and the majority of patients requiring urgent or semi-urgent assessment. The IEHS likely reduced this burden during operational hours. Future research should focus on standardisation of data collection, comparing IEHS and ED presentations, and measuring effectiveness of harm minimisation strategies.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70308"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758591","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":"Management of Patients With Critical Bleeding in Rural and Regional Victoria.","authors":"Madison Essery, Carolyn Field, Jacoba Von Wielligh, John Casey, Rae French, Robyn White, Amy Sheppard, Erica Wood, Biswadev Mitra","doi":"10.1111/1742-6723.70331","DOIUrl":"https://doi.org/10.1111/1742-6723.70331","url":null,"abstract":"<p><strong>Objectives: </strong>The Australian National Blood Authority published 'Patient Blood Management guideline for adults with critical bleeding' in 2023, which includes a major haemorrhage protocol (MHP) template designed for adapting by individual health services based on local constraints. The extent to which regional and rural healthcare services adapt the national guidelines remains unknown. The aim of this study was to establish the current status of MHPs at regional and rural healthcare services in Victoria, determining strategies to align local MHPs with available resources and the best available evidence where variations to national guidelines exist.</p><p><strong>Method: </strong>Data on the existence and content of MHPs from all rural and regional healthcare services in Victoria that manage critical bleeding were collated. Consistency of the alignment of MHPs with national guidelines was assessed using a mixed-methods survey of experts.</p><p><strong>Results: </strong>All 58 regional and rural health services in Victoria were contacted; 33 (56.8%) had blood components available on site for the management of critical bleeding. Of these, 26 (78.8%) had an MHP. Seventeen (65.4%) MHPs had at least one domain that was not consistent with national guidelines. The availability of blood components other than red cells alone was associated with greater consistency with guidelines.</p><p><strong>Conclusions: </strong>Despite strong recommendations that health services develop an MHP for the management of critical bleeding, some gaps remain. The contents of MHPs were variable, particularly for centres without blood components other than red cells, suggesting potential for the benefit of individualised review of MHPs and targeted education.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70331"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789674","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 Negative Suicide-Intent Entry Is Not a Stable Endpoint in Opioid Toxicovigilance.","authors":"Szu-Chieh Chiu, Lien-Chung Wei","doi":"10.1111/1742-6723.70332","DOIUrl":"10.1111/1742-6723.70332","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70332"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758480","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":"Artificial Intelligence and Academic Publishing.","authors":"Geoff Hughes, Daniel Fatovich","doi":"10.1111/1742-6723.70322","DOIUrl":"10.1111/1742-6723.70322","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":"e70322"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711429","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}