Australasian Emergency Care最新文献_第9页

Gender-based differences in assessment and management of acute abdominal pain in the emergency department: A retrospective audit 急诊科急性腹痛评估和治疗中基于性别的差异：一项回顾性审计。

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-11 DOI: 10.1016/j.auec.2023.03.001

Megan Hayes , Ana Hutchinson , Debra Kerr

{"title":"Gender-based differences in assessment and management of acute abdominal pain in the emergency department: A retrospective audit","authors":"Megan Hayes , Ana Hutchinson , Debra Kerr","doi":"10.1016/j.auec.2023.03.001","DOIUrl":"10.1016/j.auec.2023.03.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Previous research has identified gender-based differences in acute pain management in the </span>emergency department<span> [ED]. The aim of this study was to compare pharmacological management of acute abdominal pain in the ED by gender.</span></p></div><div><h3>Methods</h3><p>A retrospective chart audit<span> was conducted at one private metropolitan ED including adult patients (18–80 years) who presented with acute abdominal pain in 2019. Exclusion criteria included: pregnancy, repeat presentation within the study period, pain-free at initial medical review or documented refusal of analgesia, and oligo-analgesia. Comparisons by gender included: (1) analgesia type and (2) time to analgesia. Bivariate analysis was undertaken using SPSS.</span></p></div><div><h3>Results</h3><p>There were 192 participants: 61 (31.6 %) men and 131 (67.9 %) women. Men were more likely to get combined opioid and non-opioid medication as first line analgesia (men: 26.2 % n = 16; women: 14.5 % n = 19, <em>p</em> = .049). Median time from ED presentation to analgesia was 80 min for men (IQR: 60) versus 94 min for women (IQR: 58), (<em>p</em><span> = .119). Women (25.2 % n = 33) were more likely to receive their first analgesic after 90 min from ED presentation compared to men versus men (11.5 %, n = 7 </span><em>p</em> = .029). In addition, women waited longer before receiving second analgesia (women: 94, men: 30 min, <em>p</em> = .032).</p></div><div><h3>Conclusion</h3><p>Findings confirm there are differences in pharmacological management of acute abdominal pain in the ED. Larger studies are required to further explore differences observed in this study.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9104746","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}

引用次数: 0

Public health messaging during disasters: A qualitative study of emergency department key informants 灾难期间的公共卫生信息：对急诊部门关键信息提供者的定性研究。

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-03 DOI: 10.1016/j.auec.2023.02.005

Nicole M. Coombs, Joanne E. Porter, Michael Barbagallo

{"title":"Public health messaging during disasters: A qualitative study of emergency department key informants","authors":"Nicole M. Coombs, Joanne E. Porter, Michael Barbagallo","doi":"10.1016/j.auec.2023.02.005","DOIUrl":"10.1016/j.auec.2023.02.005","url":null,"abstract":"<div><h3>Background</h3><p>Patient education is a professional obligation for all nurses. Public health messaging in emergency departments during disasters can help prevent further risk or illness for affected communities. In this study, Australian emergency nurse Key Informants share their perceptions and experiences of preventative messaging provided in their departments during disasters and the governance and processes in place to support this practice.</p></div><div><h3>Methods</h3><p>The qualitative phase of a mixed methods study, where semi structured interviews were utilised, and data analysed using a six step Thematic analysis.</p></div><div><h3>Results</h3><p>Three themes were identified: (1) Part of the Job; (2) It’s all in the delivery; and (3) Preparation is the key. These themes include concepts involving the confidence and competence of nurses providing messages, what, when and how messages are being given and how prepared both the department and staff are regarding patient education during disaster events.</p></div><div><h3>Conclusions</h3><p>Nurse confidence is a key factor in the delivery of preventative messages during disasters, potentially resulting from a lack of exposure, a junior workforce and minimal training. Leaders agree that departments are not preparing or supporting messaging practice, with an absence of specific training, formal guidelines, and patient education resources; and that improvement is needed.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10837822","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}

引用次数: 0

Improving care for older patients visiting emergency departments. Are they receiving falls prevention guideline care? 改善对急诊科老年病人的护理。他们是否接受预防跌倒指南护理?

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.08.003

Melinda Williamson , Annette Barton , Deborah Edwards , Claire Morrisby , Angela Jacques , Kristie J. Harper

{"title":"Improving care for older patients visiting emergency departments. Are they receiving falls prevention guideline care?","authors":"Melinda Williamson , Annette Barton , Deborah Edwards , Claire Morrisby , Angela Jacques , Kristie J. Harper","doi":"10.1016/j.auec.2022.08.003","DOIUrl":"10.1016/j.auec.2022.08.003","url":null,"abstract":"<div><h3>Background</h3><p>The primary objective was to examine whether the Emergency Department<span><span> (ED) treatment of older adults who fall in Australia is concordant with </span>falls prevention and management clinical guideline care recommendations.</span></p></div><div><h3>Methods</h3><p><span>A retrospective medical records </span>audit was completed for patients 65years and older, who attended the ED with a fall and were discharged home. An audit tool was developed from local, national, and international falls clinical guidelines.</p></div><div><h3>Results</h3><p>One thousand and twenty-seven patients presented following a fall throughout 2020. One hundred and seven patient medical records were audited. Assessment of cognition (94%), medication review (76%) and use of a falls risk screen (76%) were commonly completed. Under half of the patients had a documented gait evaluation (40%) and review of vision (18%). Concordance with guideline care was more likely for older patients (p = 0.042), with higher levels of comorbidity (p = 0.013), who required care assistance (p = 0.008) and received treatment from a multidisciplinary team (p < 0.001) in an observation ward (p < 0.001).</p></div><div><h3>Conclusions</h3><p>Older patients with increased comorbidities and higher care needs had more falls guideline care recommendations documented. This was likely to occur when patients were moved to the observation ward where more comprehensive care by a multidisciplinary team could occur.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9344396","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}

引用次数: 2

Hospital presentations with diabetic ketoacidosis: A retrospective review 糖尿病酮症酸中毒的医院表现:回顾性回顾

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.06.001

Steven James , Kylie Annetts , Thuy Frakking , Marc Broadbent , John Waugh , Lin Perry , Julia Lowe , Sean Clark

{"title":"Hospital presentations with diabetic ketoacidosis: A retrospective review","authors":"Steven James , Kylie Annetts , Thuy Frakking , Marc Broadbent , John Waugh , Lin Perry , Julia Lowe , Sean Clark","doi":"10.1016/j.auec.2022.06.001","DOIUrl":"10.1016/j.auec.2022.06.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Diabetic ketoacidosis (DKA) is a significant source of preventable episodes of care and cost. This study aimed to describe the demographic and clinical characteristics of people with </span>type 1 diabetes<span> (T1D) presenting to the Emergency Department (ED) with DKA in an area of socio-economic deprivation in metropolitan Queensland, Australia, and to describe factors associated with hospital admission and re-presentation in this population.</span></p></div><div><h3>Methods</h3><p>This was a retrospective descriptive analysis of routine healthcare record data for January 2015-December 2019. People with T1D were identified through hospital discharge codes.</p></div><div><h3>Results</h3><p>More than half (n = 165) the estimated local T1D population (n = 317) experienced an index ED presentation for DKA; mean±SD age at ED presentation was 31.1 + /− 19.3 years, 126 (76.4%) were aged ≥ 16 years and 20 (12.1%) were newly diagnosed. Index DKA presentation was significantly associated with female sex (p = 0.04) but no other demographic or geographic variables. More than half the presentations (n = 92, 55.8%) occurred outside regular business hours. Twenty-three representations occurred within 90 days, associated with older age (p = 0.045) and lower residential socio-economic score (p = 0.02).</p></div><div><h3>Conclusion</h3><p>Findings highlight the frequent problem of DKA and the importance of socio-economic influences. This flags the need and opportunity to improve support to people with T1D to promote diabetes self-care.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10802601","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}

引用次数: 0

The prehospital management of ambulance-attended adults who fell: A scoping review 在救护车救护下跌倒的成年人的院前管理:一项范围审查

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.07.006

Paige Marie Watkins , Stacey Masters , Anne-Marie Hill , Hideo Tohira , Deon Brink , Judith Finn , Peter Buzzacott

{"title":"The prehospital management of ambulance-attended adults who fell: A scoping review","authors":"Paige Marie Watkins , Stacey Masters , Anne-Marie Hill , Hideo Tohira , Deon Brink , Judith Finn , Peter Buzzacott","doi":"10.1016/j.auec.2022.07.006","DOIUrl":"10.1016/j.auec.2022.07.006","url":null,"abstract":"<div><h3>Background</h3><p>The ageing population is requiring more ambulance attendances for falls. This scoping review aimed to map and synthesise the evidence for the prehospital management of Emergency Medical Services (EMS) attended adult patients who fall.</p></div><div><h3>Methods</h3><p><span><span>The Joanna Briggs Institute methods for scoping reviews were used. Six databases were searched (Medline, Scopus, </span>CINAHL, Cochrane, EMBASE, ProQuest), 1st August 2021. Included sources reported: ambulance attended (</span><em>context</em>), adults who fell (<em>population</em>), injuries, interventions or disposition data (<em>concept</em>). Data were narratively synthesised.</p></div><div><h3>Results</h3><p>One-hundred and fifteen research sources met the inclusion criteria. Detailed information describing prehospital delivered EMS interventions, transport decisions and alternative care pathways was limited. Overall, adults< 65 years were less likely than older adults to be attended repeatedly and/or not transported. Being male, falling from height and sustaining severe injuries were associated with transport to major trauma centres. Older females, falling from standing/low height with minor injuries were less likely to be transported to major trauma centres.</p></div><div><h3>Conclusion</h3><p>The relationship between patient characteristics, falls and resulting injuries were well described in the literature. Other evidence about EMS management in prehospital settings was limited. Further research regarding prehospital interventions, transport decisions and alternative care pathways in the prehospital setting is recommended.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792799","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}

引用次数: 3

A novel study of situational awareness among out-of-hospital providers during an online clinical simulation 在在线临床模拟过程中，院外提供者的情境意识的一项新研究

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.08.005

Justin Hunter , Michael Porter , Brett Williams

{"title":"A novel study of situational awareness among out-of-hospital providers during an online clinical simulation","authors":"Justin Hunter , Michael Porter , Brett Williams","doi":"10.1016/j.auec.2022.08.005","DOIUrl":"10.1016/j.auec.2022.08.005","url":null,"abstract":"<div><h3>Background</h3><p>Out-of-hospital providers must be situationally aware in order to maintain safety for themselves, their patients, the public, and their crew. They must be able to recognize situations, interpret them, and predict how those situations may unfold in the future.</p></div><div><h3>Method</h3><p>A mixed-methods explanatory sequential design where out-of-hospital providers in Oklahoma, USA, participated in an 18-minute online simulation and then had their situational awareness (SA) measured. Upon completion, participants provided feedback during scheduled interviews.</p></div><div><h3>Results</h3><p>A total of 156 out-of-hospital providers participated. Participants were not situationally aware. While not statistically significant, those with higher education had higher SA scores. Participants perceived that the simulation processes were beneficial to their ongoing care in the field, and were satisfied with the online simulation environment.</p></div><div><h3>Conclusions</h3><p>Out-of-hospital providers are not situationally aware during an online clinical simulation. While they are focused intently on the surroundings of the scene, they do not put that same focus on the patient. With the appropriate technology and setup, the use of the Situational Awareness Global Assessment Technique (SAGAT) during online simulation is feasible and could enhance clinical performance. Further studies are needed to determine if overall education or years of clinical experience play a role in out-of-hospital SA.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9344831","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}

引用次数: 2

New Zealand emergency nurses’ perspectives and experiences of professional joy in clinical practice: An exploratory qualitative study 新西兰急诊护士在临床实践中对专业快乐的看法与体会:一项探索性质的研究

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.07.008

Caroline M. Leaf, Jacqui M. Murray

{"title":"New Zealand emergency nurses’ perspectives and experiences of professional joy in clinical practice: An exploratory qualitative study","authors":"Caroline M. Leaf, Jacqui M. Murray","doi":"10.1016/j.auec.2022.07.008","DOIUrl":"10.1016/j.auec.2022.07.008","url":null,"abstract":"<div><h3>Background</h3><p>Nursing is becoming an increasingly stressful occupation, identified by high rates of burnout, compounded by a worldwide nursing shortage. Differing solutions to combat burnout have not provided long-term positive outcomes. This research explored emergency nurses’ perspectives and experiences of one potential solution, known as <em>joy in work</em>, or <em>professional joy.</em></p></div><div><h3>Methods</h3><p>A qualitative, descriptive design was used to conduct semi-structured interviews with six registered nurses<span> from two New Zealand emergency departments. Thematic analysis techniques were used.</span></p></div><div><h3>Findings</h3><p>Professional joy was frequently experienced, despite the difficulties faced in the emergency environment. Joy was identified as being like a spark which provided an <em>uplift</em>. The experience of joy positively impacted the nurse, and beyond, and potentially provided a buffer that assisted with mitigating the daily challenges. Recalling or sharing experiences of joy evoked a sense of wellbeing in the nurse, which in turn provided motivation to keep on nursing. This research identified a link between nurse wellbeing, joy and the importance of a healthy work environment.</p></div><div><h3>Conclusion</h3><p>While this study was relatively small, the findings highlight the significant positive impact the experience of joy had on these nurses. Further research is recommended to gain greater understanding of this important topic.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10796652","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}

引用次数: 0

Effect of real-time feedback device compared to use or non-use of a checklist performance aid on post-training performance and retention of infant cardiopulmonary resuscitation: A randomized simulation-based trial 实时反馈装置与使用或不使用检查表对训练后婴儿心肺复苏表现和保留的影响:一项随机模拟试验

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.07.005

Daniel Aiham Ghazali , Raphaëlle Rousseau , Cyril Breque , Denis Oriot

{"title":"Effect of real-time feedback device compared to use or non-use of a checklist performance aid on post-training performance and retention of infant cardiopulmonary resuscitation: A randomized simulation-based trial","authors":"Daniel Aiham Ghazali , Raphaëlle Rousseau , Cyril Breque , Denis Oriot","doi":"10.1016/j.auec.2022.07.005","DOIUrl":"10.1016/j.auec.2022.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aims to determine the best method for achieving optimal performance of pediatric cardiopulmonary resuscitation (CPR) during simulation-based training, whether with or without a performance aid.</p></div><div><h3>Methods</h3><p>In this randomized controlled study, 46 participants performed simulated CPR in pairs on a Resusci Baby QCPR™ mannequin, repeated after four weeks. All participants performed the first simulation without performance aids. For the second simulation, they were randomly assigned to one of three groups with stratification based on status: throughout CPR, Group A (n = 16) was the control group and did not use a performance aid; Group B (n = 16) used the CPR checklist; Group C (n = 14) used real-time visualization of their CPR activity on a feedback device. Overall performance was assessed using the QCPR™.</p></div><div><h3>Results</h3><p>All groups demonstrated improved performance on the second simulation (p < 0.01). Use of the feedback device resulted in better CPR performance than use of the CPR checklist (p = 0.02) or no performance aid (p = 0.04). Additionally, participants thought that the QCPR™ could effectively improve their technical competences.</p></div><div><h3>Conclusions</h3><p>Performance aid based on continuous feedback is helpful in the learning process. The use of the QCPR™, a real-time feedback device, improved the quality of resuscitation during infant CPR simulation-based training.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10785438","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}

引用次数: 0

Triage and length of stay in emergency department visits due to alcohol intoxication: A retrospective chart review 酒精中毒患者急诊分诊和住院时间:回顾性图表回顾

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.08.004

Sunmi Lee , Hyunjin Oh

{"title":"Triage and length of stay in emergency department visits due to alcohol intoxication: A retrospective chart review","authors":"Sunmi Lee , Hyunjin Oh","doi":"10.1016/j.auec.2022.08.004","DOIUrl":"10.1016/j.auec.2022.08.004","url":null,"abstract":"<div><h3>Background</h3><p><span>Patients with alcohol intoxication are screened and treated at emergency departments (EDs), at the cost of alcohol-related ED visit resource consumption. The purposes of this study were to identify characteristics of patients with alcohol intoxication, in terms of triage, </span>blood alcohol concentration (BAC), and ED length of stay (LOS) and to compare these characteristics by homelessness status.</p></div><div><h3>Methods</h3><p>We conducted a retrospective chart review of all visits and referrals to one drunken center in an ED between January and December 2019. Adults aged over 18 years admitted to the drunken center with a blood alcohol concentration (BAC) of 100 mg/dl or higher were included.</p></div><div><h3>Results</h3><p>Approximately 89 % were male, around 30.4 % of the patients with acute alcohol intoxication were homeless. Approximately 46 % of patients were Medicaid or non-insured. Approximately 74.2 % of the patients were classified as KTAS 4 (less urgent) and 5 (nonurgency) upon initial KTAS evaluation. Both BAC and ED LOS were significantly higher in the homeless group.</p></div><div><h3>Conclusions</h3><p>About half of alcohol intoxicated patients who visited ED were vulnerable, and they visited the ED due to the problem of less urgent or non-urgent status of triage. Sobering places, not ED, and connecting patients with social work programs is important.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10785464","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}

引用次数: 0

A descriptive study on the use of restrictive interventions for potentially or actually violent patients in the emergency department 对急诊科潜在或实际暴力患者使用限制性干预措施的描述性研究

IF 1.8 4区医学

Australasian Emergency Care Pub Date : 2023-03-01 DOI: 10.1016/j.auec.2022.07.001

Hayden Tosswill , C.J. Cabilan , Ben Learmont , Karen Taurima

{"title":"A descriptive study on the use of restrictive interventions for potentially or actually violent patients in the emergency department","authors":"Hayden Tosswill , C.J. Cabilan , Ben Learmont , Karen Taurima","doi":"10.1016/j.auec.2022.07.001","DOIUrl":"10.1016/j.auec.2022.07.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Restrictive interventions (chemical, physical, or mechanical restraints) to manage patients who are potentially or actually violent in the emergency department (ED) can be harmful and costly. Non-restrictive interventions are advocated; but this must be preceded with an understanding of </span>patient characteristics that influence their use. A study was conducted to describe the use of restrictive interventions and ascribe it with patient characteristics in the ED.</p></div><div><h3>Methods</h3><p>Records from October 2020 to March 2021 in the occupational violence database were used to analyse patient characteristics and restrictive interventions. Logistic regression was used to establish influencing factors of restrictive interventions adjusting for clinically relevant confounders.</p></div><div><h3>Results</h3><p><span>Of the N = 1276 potentially or actually violent patients, 70 % received restrictive interventions. Chemical restraint was common, with 1 in 2 patients receiving either oral medication or intramuscular injection. Probability of restrictive interventions were higher </span>in patients who were intoxicated [(adjusted odds ratio (aOR) 3.48, 95 % confidence interval (CI) 1.675–7.21)], had high triage score (aOR 2.084, 95 % CI 1.094–3.96), and were in the ED involuntarily (aOR 1.494, 95 % CI 1.105–2.020).</p></div><div><h3>Conclusion</h3><p>The results reveal the need for multifaceted approaches that limit the presentations of, and minimise restrictive interventions among, potentially or actually violent patients.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360162","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}

引用次数: 1