Australasian Emergency Care最新文献

{"title":"Emergency ambulance care of families during death, dying, and bereavement: A document analysis of Australian and Aotearoa New Zealand clinical practice guidelines","authors":"Eillish Satchell ,&nbsp;Merryn Gott ,&nbsp;Madeleine Juhrmann ,&nbsp;Bridget Dicker ,&nbsp;Natalie Elizabeth Anderson","doi":"10.1016/j.auec.2025.06.004","DOIUrl":"10.1016/j.auec.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Ambulance personnel play an important role in supporting families during death, dying, and bereavement. Evidence-based clinical practice guidelines are crucial for ensuring high-quality ambulance care. However, it is unknown what guidance currently informs care of bereaved families. This document analysis examines ambulance guidelines pertaining to family care in out-of-hospital death in Australia and Aotearoa New Zealand.</div></div><div><h3>Methods</h3><div>Clinical practice guidelines were sourced from all Australian and Aotearoa New Zealand ambulance services. Using qualitative document analysis, guidance addressing family care during death, dying, and bereavement was examined. Analysis was conducted using a customised coding framework informed by the Australian National Consensus Statement: Essential Elements for safe and high-quality end-of-life care.</div></div><div><h3>Results</h3><div>While most guidelines included essential elements of end-of-life care, there was significant heterogeneity in the scope, detail and nature of guidance. Care instructions varied between services, populations and clinical scenarios. Guidance pertaining to culturally safe care was limited.</div></div><div><h3>Conclusions</h3><div>Ambulance clinical guidance remains focused on technical skills during resuscitation, death, and dying. More guidance is needed to inform important elements of family care such as communication, family partnership, and cultural safety. Incorporating evidenced-based principles of end-of-life care presents an opportunity to improve ambulance support for bereaved families.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 294-299"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512743","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":"Evaluating a paediatric emergency nurse practitioner service in South Australia: A retrospective analysis of 12 months of patient presentations","authors":"Jeffery Faccenda ,&nbsp;Natasha Jennings ,&nbsp;Kathleen Tori","doi":"10.1016/j.auec.2025.06.005","DOIUrl":"10.1016/j.auec.2025.06.005","url":null,"abstract":"<div><div>Quality of patient care in emergency departments is a key indicator of healthcare performance. While the role of Nurse Practitioners (NPs) in adult emergency care is well established, limited research exists on Paediatric Emergency Nurse Practitioners, particularly in the Australian context. This study retrospectively evaluated patient demographics and emergency department service indicators—including waiting time and overall length of stay—for patients in the Paediatric Emergency Department of a tertiary hospital in South Australia. A descriptive exploratory design included all patients managed by Paediatric Nurse Practitioners for a complete episode of care between December 1, 2022, and December 1, 2023. 4849 patients were included, with more males (58.7 %, n = 2845) than females (41.3 %, n = 2004), and a median age of 9 years (IQR 5–13). Median waiting time was 36 min (IQR 18–68), and median length of stay was 129 min (IQR 92–178). Most patients (94.1 %, n = 4561) were discharged home. Common presentations included head wounds (16.1 %, n = 781), distal radius fractures (7.9 %, n = 386), and hand injuries (7.3 %, n = 355). This first evaluation offers insight into patient characteristics and service benchmarks, demonstrating need for further research to support comparisons with other Paediatric Emergency Department services.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 300-306"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546292","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":"Patient acceptability and satisfaction with the rural emergency department nurse practitioner model of care (RED-NP MoC)","authors":"Sophie Dilworth ,&nbsp;Jean Ball ,&nbsp;Michelle Giles ,&nbsp;Lynette Lackay ,&nbsp;Candice Dahlstrom ,&nbsp;Michael Fahy ,&nbsp;Peter Massey ,&nbsp;Gena Lieschke","doi":"10.1016/j.auec.2025.05.002","DOIUrl":"10.1016/j.auec.2025.05.002","url":null,"abstract":"<div><div>In Australia emergency department (ED) workflows have traditionally been reliant on a medical workforce. Ongoing and critical medical workforce shortages in rural areas have resulted in sub-optimal access to emergency department services. Nurse Practitioners (NP) have been proposed as one solution to the crisis. This study aimed to examine patient experiences and satisfaction with a newly implemented rural emergency department nurse practitioner model of care (RED-NP MoC). Between November 2023 to June 2024, patients seen by NPs in one of five participating emergency departments were invited to complete an anonymous online or telephone survey. A total 382 participants responded to the survey (22 % response rate). Over 90 % of patients agreed or strongly agreed that the NP listened to them, had time to talk to them, explained in a way that could be understood, was thorough, provided high quality care, was trustworthy and gave good advice. Similarly, over 90 % of patients were satisfied with the care they received from the NP and would be happy to see the NP in the ED again. Most additional comments about the RED-NP MoC supported the quantitative findings, expressing positive experiences. The RED-NP-MoC was highly acceptable to surveyed patients attending five rural hospital EDs.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 268-273"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163775","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":"The rise of consensus methods in paramedicine research: A bibliographic analysis","authors":"Rachael Vella ,&nbsp;Amy Hutchison ,&nbsp;Paul Simpson ,&nbsp;Robin Pap","doi":"10.1016/j.auec.2025.06.008","DOIUrl":"10.1016/j.auec.2025.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Consensus-based studies are increasingly common in paramedicine research. Whilst there are four main consensus methodologies, recent analyses in other disciplines describe great diversity in method characterised by frequent modifications.</div></div><div><h3>Aim</h3><div>To describe the application and characteristics of consensus research methodologies in paramedicine.</div></div><div><h3>Methods</h3><div>A bibliographic analysis was conducted of published research reporting use of a consensus methodology, drawing data from MEDLINE, EMBASE, CINAHL. Two researchers performed abstract screening, full text review, and data extraction. A descriptive analysis was conducted.</div></div><div><h3>Results</h3><div>There were 161 paramedicine consensus studies published between 1997 and 2024. Delphi technique was most frequent (83 %), followed by NGT (12 %). The US accounted for the most studies with 44 (26 %), followed by UK with 33 (20 %), Canada 15 (9 %), Norway 12 (7 %) and Australia 12 (7 %). Modifications were reported by authors in 54 % of studies. Of 141 Delphi studies, 31 % demonstrated the use of published reporting or methodological guidance.</div></div><div><h3>Conclusion</h3><div>The prevalence of consensus research has increased considerably, dominated by Delphi methodology. Significant methodological heterogeneity was observed, and engagement with methodological and reporting guidelines appeared uncommon. There may be a need for stronger methodological guidance within the paramedicine research space to ensure quality in consensus research.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 322-327"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565468","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":"A cross-sectional survey reporting nurses’ perspectives of person-centred care at emergency department triage and waiting room in Australia","authors":"Carrie Janerka ,&nbsp;Gavin D. Leslie ,&nbsp;Fenella J. Gill ,&nbsp;PCC ED Triage Group","doi":"10.1016/j.auec.2025.05.004","DOIUrl":"10.1016/j.auec.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>A person-centred care approach is widely considered a standard for quality healthcare and has been adopted in various acute care settings. However, emergency department (ED) triage presents unique challenges to operationalising person-centred care and provision in this setting is unclear. This study aimed to explore nurses’ perspectives of person-centred care at ED triage and waiting room.</div></div><div><h3>Methods</h3><div>A cross-sectional study of triage nurses across Australia was conducted to understand nurses’ knowledge, attitudes and provision of person-centred care. Quantitative data were analysed using descriptive statistics. Responses to open-ended questions were analysed inductively and deductively using the Picker principles of person-centred care.</div></div><div><h3>Results</h3><div>176 survey responses from nurses across a range of EDs were received. Nurses reported they understood concepts and benefits of person-centred care, yet provision of it varied. Time constraints, high volumes of patients, inadequate staffing and environmental constraints were common barriers. Nurses reported using communication and interpersonal skills, patient involvement and nurse-initiated interventions as strategies for person-centred care.</div></div><div><h3>Conclusions</h3><div>System and organisational-level factors challenge the provision of person-centred care, despite individual efforts by triage nurses. To facilitate person-centred care at ED triage and in the waiting room, consideration of the ED triage context, processes and outcomes is necessary.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 280-286"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086932","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":"Reducing pathology testing in emergency departments: A scoping review","authors":"Luise Kazda ,&nbsp;Kristen Pickles ,&nbsp;Philomena Colagiuri ,&nbsp;Katy Bell ,&nbsp;Brian O’Connell ,&nbsp;Erin Mathieu ,&nbsp;on behalf of the NSW Health Net Zero Clinical Leads Program","doi":"10.1016/j.auec.2025.05.006","DOIUrl":"10.1016/j.auec.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Pathology testing in emergency departments (EDs) is often unnecessary, leading to avoidable financial and environmental costs without improving clinical care. This overview summarises interventions to reduce pathology testing in EDs, their effectiveness, and any resulting financial, environmental, patient, or staff impacts.</div></div><div><h3>Methods</h3><div>We searched multiple databases up to February 2025 and conducted citation searches. Eligible studies included intervention and aetiological observational studies of pathology tests in EDs. Secondary studies and conference abstracts were excluded.</div></div><div><h3>Results</h3><div>Of 1,755 records, 34 studies met inclusion criteria: 32 quality improvement studies, one cohort study, and one randomised controlled trial. Interventions included ordering system changes, education, audit &amp; feedback, guideline development, penalties, and alternative care models. Significant reductions ranging from 1.5% to 99% (median: 29%) in targeted pathology tests were reported in 33 of 34 studies. All 25 studies reporting financial impacts found cost reductions, with potential savings up to AUS$1 million in one Australian ED over 18 months (median:US$247,000 per year for nine studies reporting annual savings in US$). No adverse patient or staff impacts were found. No studies reported on environmental impacts.</div></div><div><h3>Conclusion</h3><div>Nearly all interventions reduced test frequency with beneficial or no impacts on patient care and staff efficiency, along with notable cost savings. Future studies should include environmental impacts and assess clinical care co-benefits of reducing unnecessary pathology testing.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 250-263"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163777","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":"PISTACHIO (Primary Trauma Care Course Impact & Outcome): A prospective before and after intervention study of the Primary Trauma Care course effect on road trauma morbidity and mortality in two Vietnamese hospitals","authors":"Ba Tuan Nguyen ,&nbsp;C. Leigh Blizzard ,&nbsp;Andrew Palmer ,&nbsp;Huu Tu Nguyen ,&nbsp;Quyet Thang Cong ,&nbsp;Viet Tran ,&nbsp;Toi Lam Phung ,&nbsp;Marcus Skinner ,&nbsp;Haydn Perndt ,&nbsp;Mark R. Nelson","doi":"10.1016/j.auec.2025.05.003","DOIUrl":"10.1016/j.auec.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Road trauma<span><span> is a major public health problem in Vietnam. The Vietnamese </span>medical education system is deficient in providing education to address this. The Primary Trauma Care (PTC) course has been used but not yet been evaluated for its impact on patient outcomes'. We conducted this study to assess the impact of the PTC course on patient outcomes in 2 local hospitals in Vietnam.</span></div></div><div><h3>Methods</h3><div><span>The research was a prospective before and after intervention study. The intervention (PTC course) was run over 2 days in 2021. The outcomes reported here are mortality at 24 hours, 30 days, and length of hospital stay. Univariate analyses were conducted using χ</span>²<span> to investigate the effectiveness of the course. Multivariate analysis<span> was also taken to control for confounding factors. Fisher’s exact test was used to discern statistical significance.</span></span></div></div><div><h3>Result</h3><div>The PTC course halved 24-hour and 30-day mortality from 2.9 % and 4.6 % in the pre-course to 1.0 % and 2.4 % in the post-course period respectively (p &lt; 0.01). However, it failed to shorten the length of hospital stay from 9.0 ± 7.8–8.2 ± 7.1 days (p = 0.458).</div></div><div><h3>Conclusion</h3><div>The PTC course was effective in two Vietnamese hospitals in improving road trauma survival without reducing the length of hospital stay.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 274-279"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040913","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":"Mild and moderate traumatic brain injury: Screening, documentation and referral to concussion services","authors":"Syed Aaraiz Ul Hassan,&nbsp;Noor Ul Huda,&nbsp;Maryam Maheen","doi":"10.1016/j.auec.2025.05.005","DOIUrl":"10.1016/j.auec.2025.05.005","url":null,"abstract":"","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 247-248"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144541","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":"Clinical presentation of tension pneumothorax among patients undergoing prehospital thoracostomy: A retrospective cohort study","authors":"Angela Park ,&nbsp;Richard Armour ,&nbsp;Kate Cantwell","doi":"10.1016/j.auec.2025.06.006","DOIUrl":"10.1016/j.auec.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Tension pneumothorax (TPTX) is a life-threatening condition requiring rapid diagnosis and management. However, accurate diagnosis is challenging in the prehospital environment. We sought to investigate the clinical presentation of TPTX in the prehospital environment. Secondary objectives were to investigate if any vital signs are independently associated with TPTX, and if any differences in vital signs of TPTX exist between patients based on ventilatory status.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients &gt; 18 years of age, not in cardiac arrest, who received thoracostomy from paramedics in Ambulance Victoria between January 2020 and July 2023. Descriptive characteristics, vital signs and management data were collected. Patients were defined as having had a TPTX if they met a published definition criterion of TPTX. A secondary sub-group sample was created by dividing patients in the TPTX group based on their ventilatory status at the time of thoracostomy (positive pressure ventilated [PPV] or spontaneously ventilating [SV]). Descriptive statistics, univariate analysis and multivariate analysis via logistic regression were performed.</div></div><div><h3>Results</h3><div>A total of 361 patients were included, with 179 (49.6 %) of these patients meeting the definition criteria of TPTX. Out of these, 67 were receiving PPV and 112 were SV. The median age of patients with TPTX was 44 years, most (79 %) were male, most occurred secondary to trauma (91.6 %). Out of patients with TPTX, 98 (87.5 %) had an altered conscious state, 128 (71.5 %) were tachycardic, 75 (41.9 %) were hypotensive, 33 (18.4 %) had an unrecordable blood pressure, 97 (54.2 %) had hypoxemia, and 82 (73.2 %) were tachypneic. Hypotension (aOR 2.04; 95 % CI 1.09–3.79; p = 0.025) and hypoxemia (aOR 2.12; 95 % CI 1.18–3.81; p = 0.011) were independently associated with the presence of TPTX in multivariate analysis. When comparing vital signs between SV and PPV patients with TPTX, no vital signs reached a statistically significant difference in multivariate analysis.</div></div><div><h3>Conclusion</h3><div>The presence of hypoxemia and hypotension were independently associated with the presence of TPTX. Vital signs associated with the presence of TPTX did not differ by ventilatory status of the patient. Future research should report on conscious state assessment and respiratory rate when investigating the clinical presentation of TPTX.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 307-313"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509579","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":"Prehospital nurse adherence to abdominal pain guidelines in Sweden and possible association with educational level","authors":"Camilla Dannvall ,&nbsp;Hilda Öhman ,&nbsp;Johan Herlitz ,&nbsp;Magnus Andersson Hagiwara ,&nbsp;Carl Magnusson","doi":"10.1016/j.auec.2025.06.007","DOIUrl":"10.1016/j.auec.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal pain is a common symptom encountered by emergency medical services (EMS) in Sweden. EMS nurses follow a structured process involving clinical history, physical examination, and final assessment, as guided by regional protocols. However, little is known about EMS nurses' adherence to these guidelines.</div></div><div><h3>Objective</h3><div>This study aims to evaluate adherence to regional guidelines for managing abdominal pain in EMS and explore whether EMS nurses' educational level is associated with adherence.</div></div><div><h3>Methods</h3><div>A retrospective, descriptive review of EMS case records for patients with ESS Code 6 (abdominal pain) was conducted. Data were analyzed to compare adherence to guidelines between EMS nurses with and without specialized education.</div></div><div><h3>Results</h3><div>A total of 600 cases were reviewed. Guideline adherence was suboptimal in several areas, such as pain intensity documented in only 36 % of cases, and abdominal palpation performed in 70 %. EMS nurses with specialized education were more likely to administer pain relief, perform abdominal palpation, and measure blood glucose.</div></div><div><h3>Conclusion</h3><div>Adherence to guidelines for managing abdominal pain in EMS was limited, particularly in documenting pain intensity. The findings suggest that a higher level of education among EMS nurses may improve compliance with assessment and treatment protocols.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 314-321"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565467","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}