Emergency Medicine Australasia最新文献

{"title":"Medical Staffing Models of Inpatient Major Trauma Services in Australia and New Zealand.","authors":"Haania Abbasi, Elyssia M Bourke, Mohsin Ejaz, Andrew Buck","doi":"10.1111/1742-6723.70289","DOIUrl":"10.1111/1742-6723.70289","url":null,"abstract":"<p><strong>Objective: </strong>To quantify and describe the different medical specialty staffing models utilised by inpatient trauma services in Major Trauma Centres in Australia and New Zealand.</p><p><strong>Methods: </strong>A standardised telephone survey of all Major Trauma Centres (MTCs) in Australia and New Zealand was conducted between May and August 2024.</p><p><strong>Results: </strong>16/27 (67%) of MTC's in Australia utilise multi-specialty staffing models for their inpatient trauma service. Two of the seven (29%) MTC's in New Zealand utilise a multi-specialty staffing model.</p><p><strong>Conclusions: </strong>This study presents the results of a survey of all adult and paediatric major trauma centres in Australia and New Zealand. It quantifies and describes medical specialist staffing models of inpatient major trauma services. Two-thirds of MTC's in Australia and almost one-third of MTC's in New Zealand utilise multi-specialty medical specialist staffing models for their inpatient trauma services. The range of non-surgical specialties employed in these roles includes Emergency Physicians (FACEM), Anaesthetists (FANZCA) and Intensivists (FCICM). Of those services that utilise a multi-specialty model, there is wide variation in the number and mix of specialties involved, as well as in the structure and function of the admitting services.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70289"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283333","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":"Suspected Pulmonary Embolism Exclusion With D-Dimers in Emergency Departments: Pregnancy (SPEED-ED Pregnancy). A Retrospective Evaluation of the Pregnancy-Adapted YEARS Guideline.","authors":"Colin Banks, Bianca De Florian, Bryony Bennett, James Chia, Vinay Gangathimmaiah","doi":"10.1111/1742-6723.70297","DOIUrl":"10.1111/1742-6723.70297","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and effectiveness of the pregnancy-adapted YEARS guideline at a major referral emergency department.</p><p><strong>Methods: </strong>This was a single-centre, retrospective cohort study of the impact of pregnancy-adapted YEARS guideline at Townsville University Hospital Emergency Department. Pregnant women who presented between July 2018 and June 2025 (2 years before to 5 years after) and were investigated for possible pulmonary embolism (PE) were eligible. Safety was defined as the rate of venous thromboembolism (VTE) at 90 days, and effectiveness as the proportion of women who did not undergo imaging.</p><p><strong>Results: </strong>A total of 532 pregnant women were identified, 76 in the 2 years pre-guideline and 456 in the 5 years post-guideline. Pre-guideline, 24 out of 76 (32%) had D-dimers with no imaging, 36 (47%) had both D-dimers and imaging, 16 (21%) had imaging without D-dimers and there was 1 diagnosed with PE (1.3%). Of the 456 women who presented after guideline introduction, 168 (37%) were evaluated with D-dimers alone, 276 (61%) had D-dimers and imaging, 12 (3%) had imaging without D-dimers and 4 (0.9%) were diagnosed with PE. Of the 168 women post-guideline assessed with D-dimers only, outcome data were available for 150 (89%), none of whom had VTE.</p><p><strong>Conclusions: </strong>The introduction of the pregnancy-adapted YEARS guideline was associated with increased investigation for PE. Over 5 years, there were no known cases of missed PE.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70297"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224063","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":"Developing and Designing an Evidence-Informed Serratus Anterior Plane Block Education Program for Emergency Medicine.","authors":"Christopher Partyka, Timothy Manion, Daniel Gaetani, Anthony Delaney, Kate Curtis","doi":"10.1111/1742-6723.70301","DOIUrl":"10.1111/1742-6723.70301","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this paper is to describe the methods and processes used to develop a theory-informed, dedicated serratus anterior plane block (SAPB) education and training program for Emergency Medicine clinicians.</p><p><strong>Methods: </strong>This program was informed by Kern's six-step approach to curriculum development. Firstly, expert consensus on education and training was developed using a modified Delphi process. Secondly, contemporary medical literature was incorporated with educational pedagogical theoretical frameworks including Bloom's taxonomy of educational objectives, backwards design, and constructive alignment, scaffolded learning, and segmented learning. Finally, these were aligned with existing national policies around regional anaesthesia in the Emergency Department.</p><p><strong>Results: </strong>The resultant SAPB evidence-based education package is supported by the most current evidence for using the SAPB as a regional anaesthesia procedure for patients with rib fracture pain. It serves as an educational tool for clinicians already proficient in the principles of plane blocks with additional guidance on establishing local workshops for practical education as well as ongoing supervision and governance for this procedure.</p><p><strong>Conclusions: </strong>The development of a theory-informed, dedicated SAPB education and training program for Emergency Medicine clinicians required a balanced combination of clinical science and procedural expertise with educational theory. This provides a framework for future works when developing educational resources to introduce new clinical procedures into routine Emergency Medicine practice.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70301"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263891","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":"Droperidol for the Management of the Undifferentiated and Agitated Trauma Patient.","authors":"Frances Williamson, Claire Bertenshaw, Shea Roffey","doi":"10.1111/1742-6723.70293","DOIUrl":"10.1111/1742-6723.70293","url":null,"abstract":"<p><strong>Objective: </strong>Droperidol is increasingly used for agitated behaviour in emergency settings, and whilst Acute Behavioural Disturbance (ABD) guidelines exist for the general population, the use in trauma patients is not defined. This study aimed to explore the frequency of droperidol use in undifferentiated trauma patients, document adverse events and alignment to the general ABD guideline.</p><p><strong>Methods: </strong>A retrospective convenience sample of all adult patients between 1/12/21 and 1/12/23 who met trauma activation criteria and received droperidol either pre-hospital or in the emergency department was analysed. Data including patient characteristics, adverse events and alignment with the state ABD guideline were analysed using descriptive means.</p><p><strong>Results: </strong>Over the three-year study period, 87 patients met inclusion criteria, with most patients being of male sex, middle-aged, and sustaining blunt trauma. Adverse events were common, with 9/87 (10%) having hypoxia (sats < 90%, oxygen applied), hypotension (SBP < 90 mmHg), or extrapyramidal symptoms (dystonia). Adverse events were more common with concurrent alcohol/drug use (78%) or more than one sedative agent (67%). Thirteen patients required multiple sedative agents. Younger patients (< 65 years) were more likely to receive a sedative dose aligned with local and state ABD guidelines (OR 4.5, 95% CI 1.51-13.40).</p><p><strong>Conclusions: </strong>Droperidol is used in undifferentiated trauma patients with ABD. Adverse events were common, and more frequent in patients who report concurrent alcohol or illicit drug use. Wide variation in dose and use of additional medications for sedation of this diverse group was identified in the study and supports the need for further research to define optimal strategies to avoid potentially preventable adverse events.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70293"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210573","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":"Aetiology of Traumatic Shock in an Australian Level 1 Trauma Centre.","authors":"Michael Noonan, Fraser Francis-Pester, Gerard O'Reilly, Joseph Mathew, Chris Groombridge, Dinesh Varma, Mark Fitzgerald","doi":"10.1111/1742-6723.70286","DOIUrl":"10.1111/1742-6723.70286","url":null,"abstract":"<p><strong>Objective: </strong>Resuscitation of traumatic shock (TS) is reflexively oriented towards haemorrhage control, reflecting its contribution to early preventable mortality. While the mechanisms of shock are well established, the relative frequency of haemorrhagic, non-haemorrhagic, indeterminate, and mixed aetiologies in blunt-predominant cohorts is less well characterised. This study aimed to identify and rank the causes of TS among adult major trauma (MT) patients managed at an Australian Level 1 trauma centre.</p><p><strong>Methods: </strong>A retrospective cohort study (Dec 2022-Jan 2025) identified MT patients meeting a pragmatic clinical definition of TS based on early physiological parameters. Structured chart review assigned one or more causes of shock using a predefined hierarchy spanning haemorrhagic, non-haemorrhagic, and indeterminate categories. Causes were ranked by frequency and stratified by injury mechanism.</p><p><strong>Results: </strong>Of 3667 MT patients, 324 (8.8%) met TS criteria. Shocked patients were younger, more severely injured, and had higher in-hospital mortality (22.5% vs. 9.1%). Blunt trauma predominated (86.7%). Pooled haemorrhagic mechanisms accounted for 66.3% of primary aetiologies (64.8% blunt; 76.2% penetrating), leaving approximately one-third of cases attributable to non-haemorrhagic or indeterminate causes. The primary cause was indeterminate in 14.8%, more frequent after blunt than penetrating injury (16.0% vs. 7.1%). Multiple contributory causes were identified in 44.0% of cases.</p><p><strong>Conclusion: </strong>While haemorrhage remained the dominant aetiology of traumatic shock, approximately one-third of cases were attributable to non-haemorrhagic, indeterminate, or mixed mechanisms, with these proportions higher following blunt injury. These findings argue against an exclusively haemorrhage-centred diagnostic approach in blunt-predominant trauma systems and support routine consideration of alternative and coexisting aetiologies during early resuscitation.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70286"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041568","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":"Development of a Binational Clinical Registry for Emergency Care: Data Completeness Across 11 Australian and Aotearoa New Zealand ED Networks.","authors":"G M O'Reilly, P Buntine, J Furyk, L Hannon, A Hermiz, P G Jones, A Rogan, E Tan, D Tham, A Wong, L Hackett, M John-White, N Lowry, M Slaa, J Stella, S Craig","doi":"10.1111/1742-6723.70294","DOIUrl":"10.1111/1742-6723.70294","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this project was to test the feasibility of collating valid and useful ED data to inform the future establishment of a binational (i.e., Australia and Aotearoa New Zealand) clinical registry for emergency care. A secondary aim of this project was to utilise multi-site ED data to assess the crude impact of COVID-19 restrictions on overall ED presentations.</p><p><strong>Methods: </strong>This was a retrospective observational study using data routinely collected by EDs. The inclusion criteria were all patients presenting to participating EDs between 2017 and 2020. The primary outcome was data completeness. The secondary outcome was the number of ED presentations. Variables for which there was at least 80% data completeness across all participating sites were eligible for simple demonstrations of multi-jurisdictional analyses.</p><p><strong>Results: </strong>There were data for 11 ED networks and 4,405,762 ED presentations. There were just nine variables which met the 80% completeness cutoff: network and site identification, birthdate, gender, First Nations self-identification, ED arrival date and time, ED arrival mode, triage category, ED triage date and time. Compared to the expected number of overall annual ED presentations, there was a reduction of 16% (95% CI 14% to 17%) in the actual number of overall ED presentations in 2020.</p><p><strong>Conclusions: </strong>Data completeness for routinely collected data collated from multiple sites was satisfactory for just a small number of variables. These findings inform the opportunities and challenges to establishing a binational clinical registry for emergency care.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70294"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239109","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":"The Use of Cognitive Aids to Assist With the Resuscitation of Emergency Department Patients: A Scoping Review.","authors":"John Paul Smiles, Colleen Cheek, Elizabeth Austin, Catherine A McIntosh, Courtney Greenwood, Robyn Clay-Williams","doi":"10.1111/1742-6723.70270","DOIUrl":"10.1111/1742-6723.70270","url":null,"abstract":"<p><p>Cognitive aids are used to reduce practitioners' mental load during clinical emergencies. Emerging evidence suggests the utility of cognitive aids in clinical settings such as anaesthesia, but little is known about their use within emergency medicine. This scoping review describes the extent and type of evidence on how cognitive aids assist in the resuscitation of patients in the Emergency Department (ED). The search strategy aimed to locate English language studies in the peer-reviewed literature on resuscitation or resuscitative procedures performed on patients of any age in the ED. Searches were performed using Medline, Embase, Scopus and Web of Science, from 1 January 2015 to 9 January 2025. Simulation and non-simulation studies and both electronic and non-electronic aids were included. Studies for non-ED settings were excluded. We included all study designs and data were analysed descriptively. The search yielded 4873 citations which were imported into Covidence. Following abstract/title review, 3275 citations were excluded; 74 full texts were reviewed, resulting in inclusion of 45 studies. The included studies demonstrated considerable heterogeneity in design, population, and context, with low evidence quality overall. This scoping review describes the broad array of cognitive aids available to assist ED resuscitation and highlights that although supporting evidence is generally weak there appears to be little harm from cognitive aid use. The findings indicate a need for multicentre trials of cognitive aids assessing real-world effectiveness and patient-centred outcomes. Future studies should also ensure transparent detailing of cognitive aid design and implementation to facilitate reproducibility and practical uptake.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70270"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927604","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":"Evaluation of an AI Scribe Tool in the Emergency Department: A Single-Arm Observational Study.","authors":"Hamed Akhlaghi, Sam Freeman, Kevin Sun, Neo Nie, John Ding, Leo Chen, Eden Pham, Brendan Morrissey, Jonathan Karro","doi":"10.1111/1742-6723.70272","DOIUrl":"10.1111/1742-6723.70272","url":null,"abstract":"<p><strong>Background: </strong>Generative artificial intelligence (AI) is reshaping the way clinicians record their clinical notes. AI-scribe systems leverage generative AI capabilities to transcribe clinical encounters into draft clinical notes. In this study, we assessed clinician uptake and estimated modelled documentation time savings for an AI-scribe system in an emergency department (ED).</p><p><strong>Method: </strong>ED physicians and trainees were provided access to an AI-scribe for 5 weeks. Data from the first week were excluded. The transcript of each presentation, the initial AI-generated clinical note and the final EMR clinical notes were used to calculate time to finalise AI-assisted notes.</p><p><strong>Results: </strong>Forty ED consultants and 23 trainees accessed the AI-scribe. Over the study period, nine consultants (22.5%) and 11 registrars (48%) used the system. The AI-scribe was used for 248 ED presentations, including 185 (74.6%) by trainees and 63 (25.4%) by consultants. The system generated 44,489 words. Following clinician review, 18,140 words were added and 2274 were deleted prior to submitting the final clinical notes. For a clinician with an average typing speed, use of the AI-scribe resulted in a time saving of 7.1 h of documentation. This was reduced to 4.9 h for rapid typer clinicians. Overall, the initial AI-generated notes were modified on 1143 occasions. The most frequently revised section was the history of presenting illness (23.3%) followed by the management plan (22.9%).</p><p><strong>Conclusion: </strong>Uptake of AI-scribe was higher among trainees than consultants, and the platform achieved substantial time savings. Future studies are required to quantify real-time productivity gains over longer periods.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70272"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835225","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":"Reducing Post-Fall Emergency Department Transfer From Residential Aged Care Homes: The Falls Outreach and Residential Mobile Assessment Team (FORMAT) Before-and-After Study.","authors":"Patrick J Owen, Andrea Bee, Donna Pattison, Joseph Miller, Liam Hackett, Paul Buntine","doi":"10.1111/1742-6723.70276","DOIUrl":"10.1111/1742-6723.70276","url":null,"abstract":"<p><strong>Objective: </strong>We examined whether the 116 emergency department transfers from residential aged care homes prevented by an intervention that provided on-site assessment and management following a fall led to a detectable shift in system-level emergency department utilisation.</p><p><strong>Methods: </strong>This 17-month before-and-after study was conducted at three metropolitan hospital emergency departments of a single health service in Melbourne, Australia. Monthly post-fall emergency department transfers from 108 residential aged care homes were compared before (1 May 2021 to 30 April 2022) and after (1 May 2022 to 30 September 2022) the intervention using two routinely collected administrative datasets. The primary analysis included patients eligible for the intervention. Sensitivity analyses examined patients ineligible for the intervention and a season-matched before period (1 May 2021 to 30 September 2021).</p><p><strong>Results: </strong>Mean (SD) monthly post-fall emergency department transfers from residential aged care homes among patients eligible for the intervention were 92.2 (14.9) before and 74.2 (7.2) after implementation (mean difference [95% CI]: 18.0 [2.9, 33.1], p = 0.023; season-matched: 28.2 [10.3, 46.1], p = 0.007). Monthly post-fall emergency department transfers from residential aged care homes among patients ineligible for the intervention did not significantly differ before and after the intervention (mean difference [95% CI]: 1.8 [-3.0, 6.7], p = 0.434; season-matched: 1.8 [-5.1, 8.7], p = 0.566). We detected 78% (n ≈ 90) of the verified 116 emergency department transfers prevented.</p><p><strong>Conclusion: </strong>On-site assessment and management following a fall at residential aged care homes may reduce system-level emergency department utilisation. Examining sustainability and cost-effectiveness appears warranted.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70276"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13183477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971394","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":"Screening for Asymptomatic Sexually Transmitted Infections in Emergency Departments: An Integrative Review of Public Health Outcomes.","authors":"Joshua Wilcox, Faye Jordan","doi":"10.1111/1742-6723.70298","DOIUrl":"10.1111/1742-6723.70298","url":null,"abstract":"<p><strong>Objective: </strong>To synthesise evidence on opportunistic screening for asymptomatic sexually transmitted infections and bloodborne viruses (STI/BBV) in emergency departments (EDs), focusing on detection, public health outcomes and feasibility.</p><p><strong>Methods: </strong>An integrative review was conducted using Whittemore and Knafl's framework. PubMed, EBSCO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, and Embase were searched (2012-2024). Eligible sources included quantitative, qualitative, mixed-methods and policy papers. Studies were appraised with the Mixed Methods Appraisal Tool (MMAT) and synthesised thematically.</p><p><strong>Results: </strong>A total of 20 studies were included. Thematic synthesis identified four key domains: routine or opt-out ED screening increased case detection and was cost-effective; barriers included privacy concerns, workflow constraints and low risk perception; behaviour-based eligibility better aligned screening with actual risk factors, whereas population-based approaches often misclassified exposure; and implementation was facilitated by confidentiality safeguards, streamlined workflows, self-collection and electronic prompts.</p><p><strong>Conclusion: </strong>Routine, opportunistic asymptomatic STI/BBV screening embedded within emergency department workflows reliably increases case detection of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, and HIV and is cost-effective. Behaviour-based eligibility better aligns screening with actual transmission risk than identity- or population-based stratification, and implementation strategies that safeguard confidentiality, support self-collection, deliver results discreetly, and integrate electronic prompts into routine workflows consistently improve acceptance and feasibility. For Australian emergency departments, the evidence supports adopting routine, opportunistic, behaviour-based screening as a feasible, high-yield public health intervention. Conclusions are bounded by the predominance of United States studies, limited longitudinal follow-up, and the use of a single reviewer.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 3","pages":"e70298"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293996","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}