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":"“In from the Beginning” – Evaluation of a framework to improve the experience of nurses commencing in the emergency department","authors":"Anna O’Hare ,&nbsp;Geoffrey Melville ,&nbsp;Brenton Ritchie ,&nbsp;Ryan Kloger ,&nbsp;Barb Crawford ,&nbsp;Kate Curtis","doi":"10.1016/j.auec.2025.07.001","DOIUrl":"10.1016/j.auec.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Australia has a nursing shortage. Emergency Departments (EDs) are particularly affected, necessitating interventions to support and retain new emergency nurses. This study evaluates \"In from the Beginning,\" a framework designed to improve the experience of new emergency nurses.</div></div><div><h3>Methods</h3><div>A 12-month longitudinal study was conducted in 2023–2024 at three Australian EDs with 72 nurses. Surveys administered at baseline, six and 12 months were used to assess ascent to competence and belonging. Differences between groups were assessed using nonparametric tests, changes over time with linear mixed-effects models and content analysis for free text.</div></div><div><h3>Results</h3><div>All 72 nurses participated, 15 received the intervention, 50 (70 %) completed 12 m follow-up. Participants reported high levels of feeling welcomed (median 26.5/30). The intervention group reported lower baseline self-confidence, but greater rate of improvement compared to control group (β=8.95, SE=3.75, p = 0.019). There were no differences in belonging, learning and competency. Qualitative data emphasised importance of mentorship. Retention at 12 months was 87 % in the intervention group and 65 % in control group (Χ²₍₁₎ = 1.72. p = 0.19).</div></div><div><h3>Conclusion</h3><div>The \"In from the Beginning\" framework provided support to new emergency nurses and resulted in improved self-confidence. Future research will explore long-term impacts on retention.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 14-21"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746124","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":"Who has incomplete emergency department care among mental health patients in Australia? Does it impact short and longer-term representations?","authors":"Shanley Chong ,&nbsp;Helen M. Achat ,&nbsp;Joanne M. Stubbs ,&nbsp;Mark McLean","doi":"10.1016/j.auec.2025.06.001","DOIUrl":"10.1016/j.auec.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Patients with mental health (MH) problems are at higher-than-average risk of leaving emergency departments (EDs) against medical advice and of re-presentations. For patients with a MH diagnosis in ED, we aimed to identify factors associated with patients who leave at own risk (LAOR) and the association between LAOR and 7- and 28-day re-presentations.</div></div><div><h3>Methods</h3><div>A retrospective analysis of all MH presentations to public hospital EDs in a Local Health District in Sydney, Australia between 2022 and 2023. GLIMMIX logistic regression models explored associations between patient and healthcare characteristics and risk of LAOR, and between LAOR and re-presentations.</div></div><div><h3>Results</h3><div>Patients more likely to LAOR were younger than 60, born in Australia, arrived at the ED between 4 pm and 8 am by private transport, were not triaged as resuscitation/emergency, had treatment initiated outside the triage benchmark time, and had an “Unspecified mental disorder” diagnosis. LAOR was inversely associated with time spent in the ED. LAOR was independently positively associated with a multi-fold risk of 7- and 28-day re-presentation.</div></div><div><h3>Conclusion</h3><div>Aspects of individual circumstances, healthcare, and patient’s MH contribute to LAOR incidence. Future research should examine the potential long-term consequences of LAOR for MH patients and disentangle factors affecting the ED’s care of MH presentations. (195 words)</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 287-293"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337218","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":"Frailty assessment in prehospital care: Bridging the gap in Malaysia’s emergency services","authors":"Mohd Idzwan Zakaria","doi":"10.1016/j.auec.2025.06.002","DOIUrl":"10.1016/j.auec.2025.06.002","url":null,"abstract":"<div><div>This letter highlights the lack of standardised frailty assessment in Malaysia’s prehospital emergency care and contrasts it with emerging practices in Australia. It advocates for system-wide improvements including training, integration, and policy reform to support frailty screening, aiming to enhance outcomes for older adults in resource-limited settings</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Page 249"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499482","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}