Emergency Medicine Australasia最新文献

{"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}

{"title":"Response to ‘The Sedation Gap Conundrum: Where's the Awareness?’","authors":"Callum Barnden,&nbsp;Biswadev Mitra,&nbsp;Amit Maini,&nbsp;Christopher Groombridge","doi":"10.1111/1742-6723.70287","DOIUrl":"10.1111/1742-6723.70287","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203718","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":"Emergency Department Overcrowding: Towards a New Conceptual Framework","authors":"Michael Dinh","doi":"10.1111/1742-6723.70283","DOIUrl":"10.1111/1742-6723.70283","url":null,"abstract":"<div>\u0000 \u0000 <p>Emergency Department overcrowding has been traditionally framed as a combination of input, throughput and output factors. This perspective summarises the limitations to this framework and the need for a new approach that includes post-acute care capacity and broader demographic shifts. The conversation, research and advocacy must shift from the hospital to structural problems outside of it that determine whether vulnerable patients can safely move after their acute care needs are completed.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197880","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":"Analytically Confirmed Opioid Detections From the Emerging Drugs Network of Australia","authors":"J. Soderstrom,&nbsp;C. Weber,&nbsp;S. Greene,&nbsp;K. Isoardi,&nbsp;S. Alfred,&nbsp;V. Tran,&nbsp;P. Stockham,&nbsp;J. Schumann,&nbsp;A. Thompson,&nbsp;D. Fatovich,&nbsp;the EDNA Investigators","doi":"10.1111/1742-6723.70284","DOIUrl":"10.1111/1742-6723.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We describe analytically confirmed opioid-related presentations to emergency departments (EDs) in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Presentations with analytically confirmed opioid exposure, between January 2021 and December 2024, were identified from the Emerging Drugs Network of Australia (EDNA) Clinical Registry. Demographic data, clinical features, outcomes, naloxone dosing, and analytical toxicology results were extracted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Opioids were detected in 793 ED presentations. The majority were male (568, 71.6%) with a median age of 40 years (Q1–Q3: 30–48 years). Patients were unwell (Australasian Triage Score 1 or 2 = 700, 88.3%). Suicidal intent was noted in 55 (6.9%) presentations. Mono-opioid detections occurred in 550 (69.4%) presentations, most frequently heroin exposures (162, 29.5%). Novel opioids including nitazenes and U-Class synthetic opioids were uncommon (21, 2.6%). Illicit co-detections were common (547, 69.0%) especially with methylamphetamine (512, 64.6%), gamma-hydroxybutyrate (108, 13.6%), and diazepam (341, 43%). Naloxone was used in 498 (62.8%) presentations: median dose 400 μg (IQR: 200–600 μg). There was no difference in median naloxone dose for heroin (median 320 μg) and novel opioids (median 500 μg, <i>p</i> = 0.25). Intubation was more likely to occur in patients with novel opioids compared to heroin (8/21, 26/162, <i>p</i> = 0.020).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Heroin was the most common analytically confirmed illicit opioid detected among opioid-related ED presentations. Novel opioids were uncommon with no difference in median naloxone dose used. There were higher intubation rates for novel opioids. Polydrug exposure is common, complicating the clinical picture. Increased awareness of the national Take Home Naloxone program, particularly by emergency physicians, is a key element of harm reduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197791","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":"Identifying Symptom Clusters Predictive of Acute Myocardial Infarction for Aboriginal and Torres Strait Islander and Non-Indigenous Australians","authors":"Jaimi Greenslade,&nbsp;William Parsonage,&nbsp;Laura Stephensen,&nbsp;Jeremy Rigney,&nbsp;Katrina Starmer,&nbsp;Gregory Starmer,&nbsp;Virginia Campbell,&nbsp;Emma Hall,&nbsp;Niranjan Gaikwad,&nbsp;Siegfried Perez,&nbsp;Louise Cullen,&nbsp;the Legend investigators","doi":"10.1111/1742-6723.70269","DOIUrl":"10.1111/1742-6723.70269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study examines the symptoms experienced by patients investigated for Acute Coronary Syndrome (ACS). It aims to determine whether symptom clusters exist, whether these predict acute myocardial infarction (AMI), and whether symptom patterns differ between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis of the LEGEND trial included 2185 patients (22.7% of whom identified as Aboriginal and Torres Strait Islander). Data on presenting symptoms and outcomes were collected from patient medical records. Regression analyses examined whether individual symptoms predicted AMI for Aboriginal and Torres Strait Islander and non-Indigenous patients. Factor analysis identified symptom clusters. Regression analyses estimated the associations between each symptom cluster and AMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six symptom clusters were identified: pleuritic, numbness, anginal, palpitations, epigastric, and infectious. Anginal was most strongly associated with AMI (Risk ratio [RR] = 1.46; 95% CI: 1.31–1.62), while pleuritic was linked to a reduced risk (RR = 0.47; 95% CI: 0.35–0.62). Numbness (RR = 1.29; 95% CI: 1.11–1.49) and infectious (RR = 1.21; 95% CI: 1.05–1.41) were associated with an increased AMI risk. There were individual symptoms that differed for Aboriginal and Torres Strait Islander patients. However, cluster-level predictive performance was similar across groups. No symptom cluster provided sufficient discriminatory power to rule in or rule out AMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Symptom presentation in AMI is heterogeneous, and reliance on “classic” symptoms alone may miss at-risk patients. While some differences in individual symptom associations were observed for Aboriginal and Torres Strait Islander patients, overall cluster patterns were comparable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155616","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 ‘Time Trends in the Rates of ED Visits in Australia, an Age-Period-Cohort Approach’","authors":"","doi":"10.1111/1742-6723.70292","DOIUrl":"10.1111/1742-6723.70292","url":null,"abstract":"<p>\u0000 <span>I. Diouf</span>, <span>J. Boyle</span>, <span>H.-J. Yoon</span>, et al., “ <span>Time Trends in the Rates of ED Visits in Australia, an Age-Period-Cohort Approach</span>,” <i>Emergency Medicine Australasia</i> <span>38</span>, no. <span>1</span> (<span>2026</span>): e70220, https://doi.org/10.1111/1742-6723.70220.\u0000 </p><p>In the published version of this article, the statement in the ‘Funding’ section read:</p><p>‘This work was supported by the National Foundation of Emergency Medicine.’</p><p>This should be corrected to:</p><p>‘This work was supported by the Emergency Medicine Foundation (EMF).’</p><p>We apologise for this error.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155593","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":"Recent Onset Atrial Fibrillation: What's in a Name.","authors":"Joe Anthony Rotella, Diana Egerton-Warbuton, Lisa Kuhn","doi":"10.1111/1742-6723.70273","DOIUrl":"10.1111/1742-6723.70273","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a common cardiac dysrhythmia encountered in the Emergency Department (ED) setting. The term, 'recent-onset AF', whilst inconsistently defined across protocols and guidelines, generally refers to the 48-h window for cardioversion when used in the ED setting. A clear terminology and taxonomy of AF is needed to guide ED clinicians, researchers and patients with respect to AF and its acute presentation to the ED. In this article, we discuss the current inconsistencies with terminology pertaining to acute AF and present evidence to support the use of the term 'acute recent-onset AF'. In addition, a three-part taxonomy is suggested to better delineate the various presentations of AF to the ED.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70273"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834107","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":"Distribution and Accessibility of Hospital-Based Emergency Departments for Paediatric Patients in Rural and Remote Western Australia: A Geographic Analysis.","authors":"Hanin Bakhaider, Somayyeh Azimi, Marc Tennant, Estie Kruger","doi":"10.1111/1742-6723.70302","DOIUrl":"10.1111/1742-6723.70302","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the distribution of emergency departments relative to remoteness and socioeconomic disadvantage and explored service availability for children in non-metropolitan Western Australia.</p><p><strong>Methods: </strong>We conducted a spatial analysis using the Australian Government datasets. Child population counts and emergency facility locations were integrated into Quantum Geographic Information System and classified by remoteness using the Modified Monash Model (MMM) and by area-level socioeconomic disadvantage using the Index of Relative Socioeconomic Disadvantage (IRSD). Buffer zones were generated around each facility to quantify the proportion of children residing within specified distance thresholds. Service availability was assessed using facility-to-child and bed-to-child ratios.</p><p><strong>Results: </strong>Emergency department availability declined with increasing remoteness: MMM5 contained the largest share of facilities (42.6%), followed by MMM6 (31.2%) and MMM7 (26.2%). However, ratios appeared more favourable in very remote areas, with facility-to-child ratios improving from 1:848 (MMM5) to 1:741 (MMM7). Bed availability showed a similar pattern, ranging from 1:83 in MMM5 to 1:60 in MMM7. Socioeconomic analyses revealed a concentration of facilities and bed capacity in the most disadvantaged areas, with IRSD 1 hosting 57.4% of all facilities and 35.8% of total bed capacity.</p><p><strong>Conclusion: </strong>Geographic and socioeconomic inequities in emergency care provision persist across rural and remote Western Australia. Apparent improvements in ratios in very remote areas are driven by low population density rather than greater service investment. These findings support a shift to needs-based paediatric emergency service planning, using remoteness and IRSD-stratified proximity and capacity measures to prioritise communities with the greatest access shortfalls.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70302"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148250022","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 \"Acute Suspected Stroke Clinical Pathway Use in Tasmanian Emergency Departments: A Retrospective Study\".","authors":"","doi":"10.1111/1742-6723.70267","DOIUrl":"10.1111/1742-6723.70267","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70267"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765824","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":"Words and Language Matter: Improving Older Person's Healthcare Outcomes Through Use of Age-Positive Language.","authors":"Nemat Alsaba, Carolyn Hullick, Rebecca Heath, Denise Hobson, Bridie Mulholland, Ellen Burkett","doi":"10.1111/1742-6723.70295","DOIUrl":"10.1111/1742-6723.70295","url":null,"abstract":"<p><p>Ageism is a public health emergency affecting both the health outcomes of older people and the global economy. Emergency Departments are environments where emergency clinicians often face increased cognitive load and are more susceptible to cognitive bias, which can influence patient outcomes. With an ageing population, sustainable healthcare requires a multifaceted approach that includes awareness of the extensive harms of ageism. The language and words used by healthcare providers both directly and indirectly impact patient experience and health outcomes. Consciously transitioning to age-positive language is one strategy emergency clinicians can use to combat ageism and improve healthcare experiences and outcomes for older persons presenting for emergency care.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70295"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223995","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}