Emergency Medicine Australasia最新文献

{"title":"Exploring Inter-Rater Agreement in Classification of Radiological Features of Tension in Adults With Primary Spontaneous Pneumothorax","authors":"Anne-Maree Kelly,&nbsp;Matthew Birdsey,&nbsp;Rajesh Patel,&nbsp;Luigi Marino,&nbsp;Lidia Samcewicz-Parham,&nbsp;Sivashanth Gnanasekaran,&nbsp;Emma Duffett","doi":"10.1111/1742-6723.70311","DOIUrl":"10.1111/1742-6723.70311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore agreement between emergency physicians in classifying chest x-rays (CXR) of patients with primary spontaneous pneumothorax (PSP) as showing the presence/absence of so-called radiological tension features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Observational study. Five emergency physicians blinded to patient characteristics, radiologist report, patient outcome and other reviewers' classification assessed each of 80 PSP CXR and classified them as showing radiological tension features or not. Analysis using Krippendorff's Alpha (K-Alpha).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Inter-rater agreement was 0.524 (95% CI: 0.400–0.623)—consistent with poor agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Interpretation for radiological tension features had poor inter-rater reliability, which seriously changes their appropriateness as drivers for interventional management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535572","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":"Epidemiology of Patients With Chronic Liver Disease Presenting to Emergency Departments in Australia","authors":"Akmez Latona,&nbsp;Katherine Stuart,&nbsp;Patricia Valery,&nbsp;Alan Ho,&nbsp;Biswadev Mitra","doi":"10.1111/1742-6723.70310","DOIUrl":"https://doi.org/10.1111/1742-6723.70310","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the epidemiology, healthcare utilisation and outcomes of patients presenting to emergency departments (EDs) with chronic liver disease (CLD) in Queensland, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This statewide data linkage study included adult patients with CLD-related diagnoses across 104 Queensland Health EDs between 1 January 2016 and 31 August 2023. Emergency, inpatient and mortality data were linked. Patients were stratified by cirrhosis status and decompensation. Outcome was 30-day mortality. Poisson regression assessed trends, and Cox regression evaluated mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amongst 15,999,186 ED presentations, 23,578 (0.15%) were related to CLD, involving 11,961 patients. Presentations increased by 2% annually (IRR 1.02, 95% CI 1.02–1.03). Cirrhosis accounted for 18,735 presentations (79.5%). Overall, 20,312 presentations (86.1%) resulted in hospital admission, 918 (4.5%) were admitted to intensive care units (ICU), and 963 (4.1%) resulted in in-hospital death. Amongst patients with cirrhosis, 16,968 (90.6%) resulted in admission, 867 (5.1%) were admitted to ICU and 899 (4.8%) died in hospital. Predictors of 30-day mortality included cirrhosis (adjusted hazard ratio (aHR) 6.92, 95% CI 5.36–8.94), malignancy (aHR 3.21, 95% CI 2.90–3.55), hepatorenal syndrome (aHR 3.15, 95% CI 2.72–3.66), encephalopathy (aHR 2.03, 95% CI 1.78–2.32) and spontaneous bacterial peritonitis (aHR 1.47, 95% CI 1.20–1.80). Presentation to tertiary hospitals was associated with lower mortality (aHR 0.75, 95% CI 0.68–0.82).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CLD-related ED presentations are increasing and place substantial demand on hospital services in Queensland. Decompensation events strongly predict mortality and healthcare utilisation. ED-initiated risk stratification and coordinated care models to improve outcomes for patients with cirrhosis require development and evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467420","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 Adult Closed Head Injury in Rural Queensland Without Hospital-Based CT: A Retrospective Cohort Study","authors":"Thomas Maouris,&nbsp;Lachlan Clarke,&nbsp;Jasmyn Dew","doi":"10.1111/1742-6723.70307","DOIUrl":"10.1111/1742-6723.70307","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe management, imaging pathways and systems challenges for adult closed head injury presentations to a rural Queensland emergency department without hospital-based CT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted at Dalby Hospital from January 2022 to January 2023. Adult patients presenting with closed head injury were identified through manual Emergency Department Information System review. Demographic, clinical, imaging, disposition and documentation variables were extracted from medical records. CT access was categorised as local offsite private radiology or interhospital transfer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 118 patients were included; 73/118 (61.9%) were male and mean age was 48.6 years. CT head was performed in 60/118 (50.8%) patients. Of these, 30/60 (50.0%) underwent CT through an offsite private radiology provider and 30/60 (50.0%) required interhospital transfer. Intracranial haemorrhage was identified in 9/60 (15.0%) imaged patients, comprising 7 subdural and 2 subarachnoid haemorrhages. Documentation of observation and discharge advice was variable. A planned period of observation was documented in 55/118 (46.6%) cases. Among patients discharged from the emergency department or short-stay unit, written patient information was documented in 36/72 (50.0%), red-flag discussion in 32/72 (44.4%), and no-driving advice in 5/72 (6.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with closed head injury in this rural emergency department had substantial neuroimaging needs despite the absence of hospital-based CT. Imaging was obtained through either local offsite private radiology or interhospital transfer, requiring clinicians to consider both imaging need and pathway safety. Variable documentation of observation and discharge advice highlights an opportunity to strengthen safety-netting in rural head injury care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454765","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":"Caregiver and Care Recipient Perspectives on Paediatric ED Mental Health Presentations: A Qualitative Study","authors":"Manissa Sufian,&nbsp;Yao Xu,&nbsp;Marietta John-White,&nbsp;Frank Muscara,&nbsp;Franz E. Babl,&nbsp;Vicki Anderson,&nbsp;Catherine L. Wilson,&nbsp;Meredith L. Borland,&nbsp;Bruce J. Tonge,&nbsp;Kylie M. Gray,&nbsp;Glenn A. Melvin,&nbsp;Amit Kochar,&nbsp;Rohan Borschmann,&nbsp;Richard Haslam,&nbsp;Emma Tavender,&nbsp;Michael S. Gordon,&nbsp;Stuart Dalziel,&nbsp;Karen Smith,&nbsp;Simon Craig","doi":"10.1111/1742-6723.70309","DOIUrl":"10.1111/1742-6723.70309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore <i>care recipients</i> (patients' and their caregivers) and <i>care providers</i> (healthcare providers' and law enforcement officers') perspectives on paediatric mental health presentations to emergency departments, to identify challenges to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary qualitative analysis of free-text responses from a Delphi study conducted within the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network in 2022. The original Delphi process aimed to identify research themes and key data points for child and adolescent mental health ED presentations; however, a large number of additional free-text responses were received. The primary aim of this specific study was to identify major categories using the General Inductive Approach (GIA) of these free-text responses to explore the experiences, service delivery and perceived challenges of care recipients and care providers. Patients were recruited from 12 EDs across three Australian states, and pre-hospital services (two police and three ambulance departments) across four Australian states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 184 participants provided responses (36 care recipients and 148 care providers). Three main categories are described: (1) care continuity and communication gaps, (2) challenges in the ED environment and (3) need for improved training and education and behavioural support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Care recipients and care providers identified challenges in service coordination, clinician readiness and the ED environment. Strengthening communication, expanding training, reducing sensory overload and improving privacy in physical EDs and improving links to community care could enhance patient experiences and outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435643","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":"Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs. Macintosh","authors":"Andrew Wallace,&nbsp;Hatem Alkhouri,&nbsp;Helen Badge,&nbsp;Toby Fogg,&nbsp;Elliot Long","doi":"10.1111/1742-6723.70306","DOIUrl":"10.1111/1742-6723.70306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Optimal initial laryngoscope blade selection for paediatric emergency intubation is uncertain. We examined whether Miller or Macintosh blades are associated with differences in first-pass success (FPS) and adverse events in children &lt; 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospectively collected data from the Australia and New Zealand ED Airway Registry (ANZEDAR) between March 2010 and March 2024 were analysed for children under 5 years of age. We report demographics, FPS and adverse events by initial blade type. Multivariable models examined factors associated with FPS and hypoxia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 201 children, 88 (43.8%) were intubated with a Miller blade and 113 (56.2%) with a Macintosh blade. In unadjusted analyses, children intubated with Miller blades were younger (median 0.4 years, IQR 0.08–1.35 vs. median 1.6 years, IQR 0.75–2.00), <i>p</i> &lt; 0.001), had lower FPS (63.6% vs. 80.5%; OR 0.42, 95% CI 0.22–0.80; <i>p</i> = 0.008) and had a higher incidence of hypoxia (33.0% vs. 17.7%; OR 2.28, 95% CI 1.19–4.46; <i>p</i> = 0.01) compared with children intubated with Macintosh blades. Hypotension rates did not differ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this cohort of young children intubated in the ED, Macintosh blade use was associated with higher FPS and fewer hypoxic events compared with Miller blade. Age was a significant confounder and should be considered when choosing which laryngoscope blade to use in young children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430140","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":"Implementation of Electronic Clinical Decision Support for Radiology Referrals: The Role of Governance, Clinician Engagement and Education","authors":"Bruno Di Muzio,&nbsp;Saman Salaran,&nbsp;Ben Morgan,&nbsp;Andrew Woo,&nbsp;Christopher Perry,&nbsp;Alex Jarema,&nbsp;Philippa Hawkings,&nbsp;Peter Cameron,&nbsp;Meng Law","doi":"10.1111/1742-6723.70305","DOIUrl":"https://doi.org/10.1111/1742-6723.70305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Medical imaging utilisation continues to increase globally, raising concerns regarding sustainability, workforce capacity, patient safety and environmental impact. Electronic Clinical Decision Support (eCDS) systems have been proposed as a strategy to improve imaging appropriateness; however, international experience suggests that technology alone is insufficient for successful adoption. This study describes an organisational implementation strategy for an eCDS programme for imaging referrals and examines early changes in imaging utilisation associated with clinician engagement and education strategies preceding system go-live.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An eCDS system was implemented within the electronic medical record at a quaternary referral centre in Melbourne, Australia. The initiative included governance structures, clinician engagement and targeted education to support integration into clinical workflows. Imaging utilisation data, including computed tomography (CT) examinations per emergency department (ED) presentation, were obtained from hospital activity records and analysed descriptively across engagement and deployment phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prior to eCDS go-live, CT utilisation increased from 32 to 44 examinations per 100 ED presentations. During the engagement phase preceding system deployment, CT ordering declined by 9.1%, coinciding with clinician engagement and education activities. Following eCDS deployment, imaging utilisation trends stabilised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Successful implementation of eCDS requires more than technological deployment. Governance, clinician engagement and sustained education appear important for supporting adoption of decision support systems and may facilitate early cultural change in imaging utilisation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343357","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 Physicians as Inpatient Specialists: Evolving Models of Trauma Care","authors":"Joshua I. Smith,&nbsp;Thomas A. G. Shanahan","doi":"10.1111/1742-6723.70281","DOIUrl":"10.1111/1742-6723.70281","url":null,"abstract":"<div>\u0000 \u0000 <p>Models of trauma care are actively evolving across Australasia in response to changing trauma epidemiology. Emergency physicians interested in longitudinal trauma care are well-established as inpatient trauma specialists and directors of trauma services in Australia, and these roles may become available in New Zealand. This <i>Trainee Focus</i> editorial compares trauma service medical staffing models, noting the expansion of a multi-specialty approach. The strengths and limitations of FACEM training as preparation for inpatient trauma specialist work are discussed. Interested trainees should seek broad clinical exposure, engage with trauma quality improvement or research activities, and network across specialty boundaries.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301480","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":"Coordinating Expertise: Defining the Role of the Modern Trauma Specialist","authors":"Jennifer Jamieson,&nbsp;Adam Mahoney","doi":"10.1111/1742-6723.70290","DOIUrl":"10.1111/1742-6723.70290","url":null,"abstract":"<div>\u0000 \u0000 <p>The nature of the ideal trauma specialist has evolved as a consequence of the heterogeneity and complexity of trauma patients. Treatment of the injured patient now is often minimally-invasive or non-operative and combines challenges such as complex medical comorbidities, timing of anticoagulation and polypharmacy, not infrequently overlaid by social vulnerability, substance misuse and poor mental health. Historically it may have been true that a single specialty training programme could equip a clinician with all the knowledge, skills and attitudes needed to deliver optimal trauma care. Today, best trauma specialists optimise patient outcomes by prioritising the right treatments, by the right teams, at the right time. A trauma specialist does not need to do everything; rather they must ensure that everything that is important is done. A good trauma specialist is less a virtuoso and more an effective conductor of the trauma orchestra.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301485","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":"The Future of Trauma Care in Aotearoa New Zealand: Towards a Collaborative Model","authors":"Max Raos,&nbsp;James E. Moore","doi":"10.1111/1742-6723.70280","DOIUrl":"10.1111/1742-6723.70280","url":null,"abstract":"<div>\u0000 \u0000 <p>Trauma care in Aotearoa New Zealand has evolved into a coordinated national system with strong foundations in data-informed practice and multidisciplinary care. At the same time, the epidemiology of trauma is changing, with increasing numbers of older patients with multimorbidity, frailty and complex recovery needs. These shifts have important implications for models of inpatient care and the broader trauma system. While surgical expertise remains central, there is a growing rationale for collaborative models that integrate surgical and non-surgical clinicians to better meet the needs of modern trauma populations. Future system development is likely to include more clearly defined regional networks, strengthened rehabilitation pathways and a continued focus on equity. For trainees, trauma care represents a shared clinical space across multiple specialties, with opportunities to contribute to an evolving, patient-centred system focused not only on survival but on recovery and wellbeing.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276386","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":"Optimal Care for the Polytrauma Patient: The Importance of Surgical Leadership","authors":"Katherine Martin","doi":"10.1111/1742-6723.70291","DOIUrl":"10.1111/1742-6723.70291","url":null,"abstract":"<div>\u0000 \u0000 <p>Trauma is a team sport in which surgeons remain central to the management of severely injured patients, from resuscitation and operative decision-making through inpatient care, discharge and follow-up. Contemporary trauma systems in Australia and Aotearoa New Zealand are guided by surgical society standards that emphasise verification, quality improvement and adaptable models of service delivery across metropolitan and regional settings. Effective trauma leadership requires not only clinical expertise but also coordination across specialties, governance, education, research and advocacy. As trauma services evolve, surgeons continue to play key leadership roles within hospitals, professional bodies and training pathways, supported by initiatives such as the Australian and New Zealand Association for the Surgery of Trauma and the Post-Fellowship Education and Training Program in Trauma. Sustaining optimal outcomes for polytrauma patients will depend on strengthening multidisciplinary collaboration while ensuring robust surgical leadership across the trauma continuum.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276425","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}