Emergency Medicine Australasia最新文献

{"title":"Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial)","authors":"Daniel Cudini BEx Sci, BEmergHlth (Paramedic), Grad Dip EmergHlth (ICP), MACPara,&nbsp;Karen Smith BSc(Hons), Grad Cert Exec BA, Grad Dip Epi and Biostats, PhD, OAM,&nbsp;Jeffery Shao BMedSc/MD,&nbsp;Stephen Bernard MBBS, MD, FACEM, FCICM, FCCM, ASM,&nbsp;Daniel Okyere MBBS, MPH,&nbsp;Ziad Nehme BEmergHlth(Paramedic)(Hons), Grad Cert Clin Research Methods, PhD, FACPara, ASM,&nbsp;Emily Nehme BSc(Biomedical), MBiostat, PhD Candidate,&nbsp;David Anderson MStJ, BSc, MBChB, MBioeth, DipPallMed, FCICM, ASM,&nbsp;Nicole Magnuson BSc, MPH,&nbsp;Karin Thursky MBBS, BSc, MD, FRACP,&nbsp;Dhruv Mori MBBS, FACEM,&nbsp;De Witt Oosthuizen M.B.ChB, Dip EM, AMC, FACRRM,&nbsp;Andrew Udy BSc(Hons), Grad Cert Exec BA, Grad Dip Epi and Biostats, PhD","doi":"10.1111/1742-6723.70027","DOIUrl":"https://doi.org/10.1111/1742-6723.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility of pre-hospital blood culture (BC) collection and intravenous (IV) antibiotic administration in patients with suspected sepsis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this open-label trial, BCs were collected in all participants, who were then randomised to ongoing care (control) or ongoing care plus 2 g IV ceftriaxone (intervention). Time to antibiotic administration was the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-five patients were enrolled and randomised (21 control, 14 intervention). BCs were obtained in 89% (<i>n</i> = 31/35) and grew a pathogen in 42% (<i>n</i> = 13/31). Intervention patients received antibiotics a median of 108 (95% CI 34 to 170) minutes earlier (<i>P</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BCs were successfully obtained by paramedics, and pre-hospital IV ceftriaxone resulted in expedited antibiotic administration.</p>\u0000 \u0000 <p>Clinical Trial Registration: ACTRN12618000199213.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638912","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":"Identity in emergency medicine: Who are we and what are we doing?","authors":"Thomas Hitchcock MBBS (UWA), MClinForMed (Monash), FACEM, FFAEM, FACLM, FFCFM","doi":"10.1111/1742-6723.70032","DOIUrl":"https://doi.org/10.1111/1742-6723.70032","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632919","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":"Paediatric resuscitation in regional Queensland: A simulation informed biopsy of current system challenges","authors":"Alexandra St-Onge-St-Hilaire MDCM FRCPC (pediatrics),&nbsp;Jason Acworth MBBS (Hons), FRACP (PEM), GradCertHlthcareSimulatn,&nbsp;Benjamin Lawton MBChB, FRACP (PEM), MPH,&nbsp;Myfanwy Williams BNursing; GradCertED; MNursing (Clinical Education),&nbsp;Louise Dodson BNursing, BHlthSc, GradCertClinSim,&nbsp;Benjamin Symon FRACP (PEM), BAnim","doi":"10.1111/1742-6723.70028","DOIUrl":"https://doi.org/10.1111/1742-6723.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>An outreach education service, Simulation Training Optimising Resuscitation for Kids (STORK) identified opportunities to use their course (Optimus PRIME) to understand and help optimise regional paediatric resuscitation. Our objective was to document challenges faced by healthcare providers in rural, remote, and regional (RRR) health centres in Queensland during a paediatric resuscitation course and ensure information reached stakeholders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using <i>in situ</i> simulation, participants were prompted to identify real-life challenges during paediatric resuscitation. Participants co-generated solutions to these specific challenges and identified local advocates. Summaries for stakeholders included service strengths and improvement opportunities. Site follow-up identified actions taken and supported ongoing challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between March and December 2023, 40 Optimus PRIME courses were delivered. Thirty-nine course summaries were sent. Using the safety software in infusion pumps, 60% and 81% of sites were unable to correctly administer adrenaline or phenytoin, respectively. One or more pieces of paediatric oxygenation or ventilation equipment were lacking at 65% of sites. Participants working at 81% of sites were unfamiliar with the Queensland Health paediatric guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We highlight challenges for healthcare providers across Queensland and demonstrate educational teams can contribute to their resolution. Many problems perceived as local were occurring statewide. Our findings inform further advocacy. Our report informs opportunities for system optimisation and highlights inconsistencies in three key areas: infusion pump safety software, access to paediatric resuscitation equipment, and access to information technology. Statewide consistency synergising with local expertise is needed to ensure every child in Queensland has access to optimal resuscitation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612534","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":"Doing it all well: Resuscitation, observation and the need for deliberate practice","authors":"Clare A. Skinner","doi":"10.1111/1742-6723.70030","DOIUrl":"https://doi.org/10.1111/1742-6723.70030","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602836","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":"Music in the emergency department and its association with delirium and other clinical outcomes","authors":"Hinpetch Daungsupawong,&nbsp;Viroj Wiwanitkit","doi":"10.1111/1742-6723.70025","DOIUrl":"https://doi.org/10.1111/1742-6723.70025","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602834","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 letter regarding “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,&nbsp;Sandra Wang,&nbsp;Alison Short","doi":"10.1111/1742-6723.70029","DOIUrl":"https://doi.org/10.1111/1742-6723.70029","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602835","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":"Enough is enough: Alcohol-related occupational violence and aggression in emergency departments in Australia and New Zealand","authors":"Diana Egerton-Warburton MBBS, FACEM, MClinEpi, MPH, CPPU, OAM,&nbsp;Jolene Lim BPharm, PhD,&nbsp;Dinesh Seiji Seneviratne MBBS,&nbsp;Sue Bumpstead RN MBA,&nbsp;Laura R Joyce FACEM, MBChB, BMedSc (Hons), MMedEd,&nbsp;Lisa Kuhn RN, PhD, FCENA,&nbsp;Katie Moore MPH,&nbsp;Drew B Richardson BMedSc, MBBS (Hons), FACEM, GradCertME, MD,&nbsp;Robert Lee BAppSci (Hons), PhD,&nbsp;Daniel M Fatovich MBBS, FACEM, PhD","doi":"10.1111/1742-6723.70021","DOIUrl":"https://doi.org/10.1111/1742-6723.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the extent of alcohol-related violence in EDs throughout Australia and New Zealand and the impact this has had on ED staff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed methods, cross-sectional, online survey of ED staff working in Australia and New Zealand conducted between 1 August and 11 September 2022 measuring the frequency of physical or verbal alcohol-related aggression from patients and their relatives/carers; changes to the frequency of alcohol-related occupational violence over the preceding 5 years; the impact of COVID-19 on these presentations; and the perceived impact on ED function and staff well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1284 ED staff responded, with almost all (97.9%) reporting having experienced verbal aggression and 92.7% experienced physical aggression from alcohol-affected patients at some point over the preceding 12 months. Alcohol-related presentations were significantly associated with negatively impacting patient wait times (86.1%), the care of other patients (87.5%) and other patients in the waiting room (94.6%). A large majority of ED staff also noted that these presentations negatively impacted staff wellness (82.4%), workload (93.1%) and job satisfaction (78.9%). Most (68.2%) believed that the issue of alcohol-related violence had worsened over the preceding 5 years and 46.7% believed that COVID-19 specifically has worsened the incidence of alcohol-related violence in the ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Alcohol-related occupational violence and aggression is experienced by almost all ED staff and the prevalence is perceived to be increasing. It results in negative impacts on both staff well-being, the care of other patients and ED function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143564641","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 in perspective: How emergency department culture drives over-investigation","authors":"Simon Judkins MBBS, FACEM","doi":"10.1111/1742-6723.70015","DOIUrl":"https://doi.org/10.1111/1742-6723.70015","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554359","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":"Identification and de-implementation of low-value emergency care","authors":"Vinay Gangathimmaiah MBBS, MPH, FACEM","doi":"10.1111/1742-6723.70014","DOIUrl":"https://doi.org/10.1111/1742-6723.70014","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554353","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":"Deliberate clinical inertia: A paradoxical strategy to improve patient flow?","authors":"Gerben Keijzers MSc (Biomed Hlth Sci), MBBS, FACEM, PhD, Emergency Physician","doi":"10.1111/1742-6723.70016","DOIUrl":"https://doi.org/10.1111/1742-6723.70016","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554352","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}