Australasian Emergency Care最新文献

{"title":"So close, yet so far: Understanding the relationship between ambulance mobilisation times and survival from out-of-hospital cardiac arrest in rural Western Australia","authors":"Ashlea Smith BSc ,&nbsp;David Majewski PhD ,&nbsp;Gavin Pereira PhD ,&nbsp;Jason Belcher MPhil ,&nbsp;Karen Stewart ,&nbsp;Judith Finn PhD ,&nbsp;Stephen Ball PhD","doi":"10.1016/j.auec.2025.06.010","DOIUrl":"10.1016/j.auec.2025.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Internationally, rural areas tend to have prolonged emergency medical service (EMS) response times, associated with a lower survival from out-of-hospital cardiac arrest (OHCA). We examined how the components of EMS response time to OHCA vary according to rurality in Western Australia (WA), and estimated the effect that reducing rural mobilisation times might have on OHCA survival.</div></div><div><h3>Methods</h3><div>Using a retrospective cohort of medical OHCAs in WA with EMS-resuscitation attempted, from 2015 to 2022, we compared the components of response time (Triage, Mobilisation, Travel to the scene and Total Response), stratified by regional remoteness and proximity to nearest town. Using only the rural subgroup, we then used counterfactual simulation methodology to estimate the number of 30-day survivors if response times were reduced in rural areas.</div></div><div><h3>Results</h3><div>Total EMS response time increased with increasing regional remoteness. Mobilisation time also increased with regional remoteness, even among OHCAs occurring within towns; in rural areas, median mobilisation time was 3.32 mins (1.43, 10.00) (mean 6.24, sd 6.61), with metropolitan areas having a median of 0.97 mins (0.63, 1.48) (mean 1.43, sd 2.65). If rural areas had the same mean mobilisation time as metropolitan areas, the relative increase in the estimated number of rural survivors (16.9 %) was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Mobilisation times were significantly longer in rural areas of WA than metropolitan. These results demonstrate that the effects of rurality on OHCA response time are not simply due to rural patients having increased distance from emergency services. Efforts to improve rapid bystander interventions may be particularly beneficial in rural towns for the crucial minutes before EMS personnel arrive.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 4-13"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555923","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":"Barriers to the provision of palliative care nursing in emergency departments in developing countries: A scoping review","authors":"Anna Ivana Mareta ,&nbsp;Evy Dwi Rahmawati ,&nbsp;Dian Rizki Ramadhani ,&nbsp;Raodah Tul Ikhsan ,&nbsp;Decky Nurhadi Sopyan ,&nbsp;Setyawan ,&nbsp;Sri Setiyarini","doi":"10.1016/j.auec.2025.08.004","DOIUrl":"10.1016/j.auec.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>The implementation of palliative care nursing (PCN) in emergency departments (ED) is challenging, particularly in developing countries. There were several barriers faced by ED nurses. However, the specific barriers to the provision of PCN in the ED of developing countries' hospitals remained unclear. This scoping review aimed to explore the barriers to the provision of palliative nursing care in the ED of developing countries’ hospitals.</div></div><div><h3>Methods</h3><div>This scoping review utilized five databases: Scopus, PubMed, ScienceDirect, Medline, and ProQuest, in addition to a Google Scholar search and backward and forward citation tracking. The articles included must have been published between 2014 and 2025, be available as full text, and be written in English. Two authors independently performed the article selection process, adhering to the PRISMA protocol.</div></div><div><h3>Results</h3><div>We included eight articles from six developing countries: China, Brazil, Uganda, Thailand, Indonesia, and Ghana. We identified and classified barriers to the provision of PCN in the ED in developing countries into several themes, including lack of knowledge and skills, lack of health facilities, practical issues, ethical issues, and family boundaries.</div></div><div><h3>Conclusions</h3><div>Understanding the barriers to the provision of PCN is expected to provide a foundation for evaluating and enhancing its implementation in the ED, particularly in developing countries' hospitals.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 65-71"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477204","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":"Preparedness of Tongan emergency nurses to respond to disasters: A mixed-method study","authors":"Mapu-mei-he-ngalu Kauhalaniua ,&nbsp;Karen S. Hammad","doi":"10.1016/j.auec.2025.08.006","DOIUrl":"10.1016/j.auec.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>The emergency department (ED) serves as the access point for people requiring treatment during disasters, meaning emergency nurses are typically the first responders in such situations. Tonga’s location on the Ring of Fire, has led to the Kingdom experiencing numerous disasters, making it imperative that emergency nurses are well-prepared to respond.</div></div><div><h3>Method</h3><div>This study utilized a Convergent Parallel Mixed-Method approach. A survey that collected qualitative and quantitative data was conducted among emergency nurses working on the five main islands of Tonga.</div></div><div><h3>Results</h3><div>A total of 43 emergency nurses responded to the survey with a response rate of 92 %. A key finding of the study is that Tongan emergency nurses are moderately prepared to respond to disasters.</div></div><div><h3>Discussion</h3><div>Five themes emerged from this study, disaster planning, previous disaster response experience, disaster related training, resourcing, external obligations, and readiness to respond.</div></div><div><h3>Conclusion</h3><div>To our knowledge this is the first study to explore the preparedness of Tongan emergency nurses to respond to disasters. While the findings of this study may not be generalizable to other settings, they may be beneficial to other Pacific Island Countries and Territories and small island developing nations.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 80-87"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994659","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":"Letter to the Editor: The clinical frailty scale offers little utility as part of a prediction model for community-dwelling older fallers at risk of re-presenting to the emergency department","authors":"Syed Tawassul Hassan,&nbsp;Ahsan Zaidi,&nbsp;Muhammad Misam Raza,&nbsp;Aayan Salman","doi":"10.1016/j.auec.2025.08.007","DOIUrl":"10.1016/j.auec.2025.08.007","url":null,"abstract":"","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 2-3"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014497","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":"Perspectives of postgraduate emergency health sciences students and clinical educators on prehospital clinical placements: A qualitative study","authors":"Rosario Pilar López-Picazo ,&nbsp;Sofía García-Sanjuán ,&nbsp;Antonio Esteve-Ríos ,&nbsp;Noelia García-Aracil ,&nbsp;María Leopolda Moratalla-Cebrián ,&nbsp;Rocío Juliá-Sanchís","doi":"10.1016/j.auec.2025.08.005","DOIUrl":"10.1016/j.auec.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Postgraduate education in health sciences requires practical and interprofessional training. In prehospital emergency medical services, clinical educators play a key role in integrating theoretical and practical knowledge. However, there is a gap in the literature regarding the perceptions of both clinical educators and postgraduate students on out-of-hospital clinical placements</div></div><div><h3>Methods</h3><div>a descriptive phenomenological approach was used. Semi-structured interviews were conducted with 14 students and 12 clinical educators in the field of prehospital emergency medicine. The interviews were analysed using the Colaizzi method.</div></div><div><h3>Results</h3><div>Four main themes were identified: the challenges faced at the start of prehospital emergency clinical placements; the heterogeneity of teaching methods used by clinical educators; students’ attitudes and levels of preparedness for the prehospital environment; and the development of technical and non-technical skills.</div></div><div><h3>Conclusions</h3><div>This study highlights the importance of a standardised initial orientation to help students integrate into this environment and to align their expectations. It also emphasises the need to standardise teaching practices, provide support for students’ insecurities, and ensure that students have a proactive attitude and a broad knowledge base to help them adapt. Finally, it emphasises the importance of students learning both technical and non-technical skills.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 72-79"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979911","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":"Psychosocial factors associated with mental health presentations of adolescents to the emergency department in Sydney, Australia: A retrospective review","authors":"Saartje Berendsen Russell ,&nbsp;Shanti Pun ,&nbsp;Farina Jeyaraj ,&nbsp;Margaret Murphy ,&nbsp;Nicole Bohlken ,&nbsp;Emma Jenkins ,&nbsp;Kerrie Bubb ,&nbsp;Naomi Derrick ,&nbsp;William Royle ,&nbsp;Radhika Seimon ,&nbsp;Kendall Bein ,&nbsp;Michael M. Dinh","doi":"10.1016/j.auec.2025.07.003","DOIUrl":"10.1016/j.auec.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with mental health concerns are increasingly presenting to emergency departments (EDs). Understanding psychosocial triggers that contribute to presentation may improve patient management. This study aimed to identify these psychosocial factors using the HEEADSSS assessment framework for adolescents. HEEADSSS is an acronym for the topics it incorporates; Home; Education/Employment; Eating/Exercise (Sleep); Activities/Peer Relationships (Hobbies); Drug use; Sexuality (Sexual orientation/Gender); Suicide (Self-harm/Depression/ Mood); Safety and Spirituality.</div></div><div><h3>Methods</h3><div>This was a retrospective chart review of electronic medical records (eMR) of mental health presentations in 10–24-year-olds to three metropolitan EDs during 2021. Trained nurses collected data from the ED clinical notes. De-identified data were categorically indexed to the topics of the HEEADSSS framework and analysed qualitatively to identify psychosocial factors and themes relating to MH presentation.</div></div><div><h3>Results</h3><div>1748 presentations were analysed. The categories of Home, Mood, Sleep, Suicide and Peer Relationships identified high rates of issues amongst the study population. Common issues included difficult family dynamics (30.0 %), trauma (26.4 %), low mood (30.3 %), poor sleep (30.8 %) as well as themes of loneliness (7.6 %) and feeling socially isolated (18.2 %).</div></div><div><h3>Conclusion</h3><div>Using the HEEADSSS assessment framework allowed capture of unique psychosocial factors that contributed to mental health concerns for adolescents presenting to ED. Further research is needed to determine the importance of each factor as a precipitating reason for ED presentation.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 30-35"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777005","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":"Reframing paediatric mental health screening and assessment in emergency care through a biopsychosocial lens: A call for system-level integration","authors":"Kristina Maximous ,&nbsp;Sonja Maria ,&nbsp;Andreia Schineanu","doi":"10.1016/j.auec.2025.09.001","DOIUrl":"10.1016/j.auec.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric mental health crises are an escalating burden in global emergency care, with suicide the second leading cause of death among 10–19-year-olds. Emergency settings often represent the first point of contact for children in psychological distress. However, fragmented implementation, limited use of holistic approaches, and an absence of validated screening tools in paramedicine, contribute to missed opportunities for early intervention.</div></div><div><h3>Methods</h3><div>This scoping review followed the Joanna Briggs Institute (JBI) methodological framework and PRISMA-ScR guidelines and sourced literature from key databases from 2004 to 2024. Included studies involved validated screening or assessment tools for children aged 0–19 used in emergency care contexts. Data were extracted, charted, and thematically analysed using a biopsychosocial (BPS) lens to evaluate tool design, clinical feasibility, and relevance.</div></div><div><h3>Results</h3><div>Thirty studies met inclusion criteria, identifying 21 screening and 10 assessment tools, mainly used in hospital-based emergency departments. None were applied in paramedicine. Only five tools aligned with the BPS model. Key barriers included time constraints, training deficits, care discontinuity, and limited inclusivity for culturally and linguistically diverse or neurodivergent populations.</div></div><div><h3>Conclusion</h3><div>There is an urgent need for BPS-informed, developmentally appropriate tools tailored for paramedic use to improve equitable, child-centred emergency mental health care.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 88-96"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042257","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":"Play amid pressure: Multidisciplinary perspectives on the role of child life therapy in an Australian tertiary hospital emergency department.","authors":"Samar Al-Shamaa, Amber Jones, Jennifer Brodie, Maria Pyle, Natasha Marano, Faye Jordan, Meenu Wadhwa, Kate McLaughlin, Hannah L Gullo","doi":"10.1016/j.auec.2026.02.002","DOIUrl":"https://doi.org/10.1016/j.auec.2026.02.002","url":null,"abstract":"<p><strong>Background: </strong>Child life therapists (CLT) use play and education to empower children and reduce their stress and anxiety in hospital. There is growing research on their effect on patient care; however, experiences of the multidisciplinary team (MDT) who work alongside them have not been explored.</p><p><strong>Objectives: </strong>To explore the MDT's perceptions on the role and impact of CLT in a children's emergency department (CED), during routine procedures such as cannulation, sedation and laceration repair.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted using in person semi-structured interviews with 12 participants recruited through convenience sampling. Interviews were audio-recorded and manually transcribed verbatim, then subjected to inductive coding, primarily descriptive, and grouped into themes to identify patterns.</p><p><strong>Results: </strong>Four key themes arose: (1) positive impact on family and wellbeing; (2) operational excellence and workflow enhancement; (3) professional impact and practice evolution; and (4) service demand and implementation challenges. Code frequency indicated that anxiety reduction, positive impact, resource availability, and improved workflow were the most prominent aspects identified.</p><p><strong>Conclusion: </strong>Introduction of CLT had a positive perceived impact on the MDT, contributing to enhanced patient-centred care. Findings reflected strong support for CLT integration within teams and recognised practical implementation considerations to inform future adoption in other departments.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312644","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 a clinical guideline supporting nurse practitioner requesting computerized tomography scans via consensus methodology.","authors":"Alison Craswell, Jacqueline Peet, Aletta Cowen, Dimple Charters, Stacey Watts","doi":"10.1016/j.auec.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.auec.2026.02.001","url":null,"abstract":"<p><strong>Background: </strong>Predicted nurse shortages internationally call for nurses to work at their full scope of practice. Nurse practitioners recommending computerised tomography imaging require medical signoff impacting emergency department flow. We aimed to develop a clinical guideline to support nurse practitioner-led requesting of computerised tomography scans for adults presenting to emergency department ambulatory care at a regional hospital.</p><p><strong>Methods: </strong>We used a RAND/UCLA appropriateness method over two phases. Literature from a detailed review using a systematic process was extracted and synthesized into categories and shared via an online survey platform for phase one. Aggregated votes and comments were re-shared in summary before phase two, a face-to-face meeting of expert stakeholders.</p><p><strong>Results: </strong>Five experts anonymously participated in phase one, and six contributed to the phase two meeting. Phase one agreement on appropriateness on the three literature generated topics ranged between 60 % and 80 %. Concerns about the need for emergency departments to be strategic with resources and fears of risk of increase in radiation exposure to patients were raised. In phase two, seven of the proposed eight items reached consensus (83 %-100 %).</p><p><strong>Conclusion: </strong>The agreed guideline supporting nurse practitioner ordering of computerised tomography scans provides a pathway to improve ambulatory care flow for patients with specific conditions.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167890","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":"Implementing an emergency nursing framework improves the quality of clinical handover: A stepped-wedge cluster randomised control trial.","authors":"Kate Curtis, Julie Considine, Belinda Kennedy, Margaret Murphy, Mary K Lam, Darcy Morris, Christina Aggar, Margaret Fry, Steven M McPhail, James Hughes, Michael Dinh, Ramon Z Shaban","doi":"10.1016/j.auec.2026.01.003","DOIUrl":"https://doi.org/10.1016/j.auec.2026.01.003","url":null,"abstract":"<p><strong>Aim: </strong>To examine the effect of the HIRAID® emergency nursing framework on clinical handover.</p><p><strong>Background: </strong>Clinical handover is very frequent in emergency departments and critical for patient safety. Inadequate handovers are associated with up to 80 % of adverse events.</p><p><strong>Methods: </strong>This modified stepped-wedge cluster randomised control trial was conducted across 29 Australian rural, regional and metropolitan emergency departments between 2020 and 2024. HIRAID® was implemented using a behaviour change theory-informed strategy. Surveys were distributed to eligible staff. Quantitative data were analysed using a multiple regression approach; qualitative data using inductive content analysis.</p><p><strong>Results: </strong>Surveys were completed by 1205 nurses (671 control, 534 intervention) and 328 medical staff (176 control, 152 intervention). Significant improvements were observed in satisfaction with nurse-to-nurse communication of patient history (t = 5.57, p < 0.001, 95 % C.I. = 0.33-0.69), physical assessment (t = 4.72, p < 0.001, 95 % C.I. = 0.28-0.68), recognition of clinical deterioration (t = 2.58, p = 0.01, 95 % C.I. = 0.06-0.43), information relevance (t = 3.29, p = 0.001, 95 % C.I. = 0.13-0.51) and completeness (t = 3.60, p < 0.001, 95 % C.I. = 0.17-0.56). Qualitative findings supported these results.</p><p><strong>Conclusions: </strong>Implementing a structured emergency nursing framework improved nurse-to-nurse clinical handover, supporting safer patient care.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042185","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}