Emergency Medicine Australasia最新文献

Short-Term Outcomes and Sex-Based Analysis Following Chest Pain Presentations to Emergency Departments in Western Australia—An AUS-MOCHA Substudy 西澳大利亚州急诊科胸痛患者的短期预后和基于性别的分析——一项AUS-MOCHA亚研究

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-19 DOI: 10.1111/1742-6723.70235

Jonathon Stewart, Juan Lu, Adrian Goudie, Frank M. Sanfilippo, Girish Dwivedi

Objective

To describe emergency department (ED) chest pain presentations and outcomes, and sex-based differences in Western Australia.

Methods

We conducted a retrospective cohort study using linked ED, hospital, morbidity, mortality, and pathology data from the Western Australian Data Linkage System as part of the AUS-MOCHA project. We included the index presentation for adults presenting with non-traumatic chest pain between January 2016 and October 2020. Comorbidities were identified via a 10-year lookback of linked morbidity data. The primary outcome was diagnosis of acute coronary syndrome (ACS) or all-cause death within 30 days of ED discharge.

Results

The study included 64,404 patients (mean age 54.8 years, 49.2% female). Most presented ‘out-of-hours’ (62.2%) and received an Australasian Triage Scale (ATS) Category of 2 (85.2%). Females were less likely to receive an ATS 1 and more likely to receive ATS 3 or 4. This difference persisted after propensity matching. However, males were more comorbid and had a higher incidence of 30-day outcomes than females. There was no statistically significant difference in ATS categories between males and females when assessing a propensity matched cohort of only those who experienced 30-day outcome. Among patients discharged home from the ED, 0.4% were diagnosed with ACS and 0.1% died within 30 days.

Conclusion

Patients who were discharged home from EDs had a low risk of subsequent ACS or death within 30 days. Females were triaged less urgently than males, yet had lower 30-day ACS and death rates. Among patients with 30-day outcomes, triage scores did not differ by sex.

目的：描述急诊科（ED）胸痛的表现和结果，以及西澳大利亚州的性别差异。方法：作为AUS-MOCHA项目的一部分，我们使用来自西澳大利亚数据链接系统的ED、医院、发病率、死亡率和病理数据进行了一项回顾性队列研究。我们纳入了2016年1月至2020年10月期间出现非创伤性胸痛的成年人的指数表现。通过对相关发病率数据的10年回顾来确定合并症。主要结局为急诊科出院后30天内诊断为急性冠脉综合征（ACS）或全因死亡。结果：纳入64,404例患者，平均年龄54.8岁，女性49.2%。大多数是“非工作时间”就诊（62.2%），并接受了澳大利亚分流量表（ATS）类别2（85.2%）。女性接受1次ATS的可能性较小，接受3次或4次ATS的可能性较大。这种差异在倾向匹配之后仍然存在。然而，男性的合并症和30天预后的发生率高于女性。当只评估那些经历了30天结果的倾向匹配队列时，男性和女性在ATS类别上没有统计学上的显著差异。在从急诊科出院回家的患者中，0.4%被诊断为ACS， 0.1%在30天内死亡。结论：急诊科患者出院后30天内发生ACS或死亡的风险较低。女性的分诊不像男性那么紧急，但30天ACS和死亡率较低。在30天预后的患者中，分诊评分没有性别差异。

{"title":"Short-Term Outcomes and Sex-Based Analysis Following Chest Pain Presentations to Emergency Departments in Western Australia—An AUS-MOCHA Substudy","authors":"Jonathon Stewart, Juan Lu, Adrian Goudie, Frank M. Sanfilippo, Girish Dwivedi","doi":"10.1111/1742-6723.70235","DOIUrl":"10.1111/1742-6723.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe emergency department (ED) chest pain presentations and outcomes, and sex-based differences in Western Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using linked ED, hospital, morbidity, mortality, and pathology data from the Western Australian Data Linkage System as part of the AUS-MOCHA project. We included the index presentation for adults presenting with non-traumatic chest pain between January 2016 and October 2020. Comorbidities were identified via a 10-year lookback of linked morbidity data. The primary outcome was diagnosis of acute coronary syndrome (ACS) or all-cause death within 30 days of ED discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 64,404 patients (mean age 54.8 years, 49.2% female). Most presented ‘out-of-hours’ (62.2%) and received an Australasian Triage Scale (ATS) Category of 2 (85.2%). Females were less likely to receive an ATS 1 and more likely to receive ATS 3 or 4. This difference persisted after propensity matching. However, males were more comorbid and had a higher incidence of 30-day outcomes than females. There was no statistically significant difference in ATS categories between males and females when assessing a propensity matched cohort of only those who experienced 30-day outcome. Among patients discharged home from the ED, 0.4% were diagnosed with ACS and 0.1% died within 30 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients who were discharged home from EDs had a low risk of subsequent ACS or death within 30 days. Females were triaged less urgently than males, yet had lower 30-day ACS and death rates. Among patients with 30-day outcomes, triage scores did not differ by sex.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient and Staff Satisfaction With Use of Methoxyflurane in the Emergency Department 急诊科患者和工作人员对甲氧氟醚使用的满意度

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-19 DOI: 10.1111/1742-6723.70229

Nathan Kwong, Carl Luckhoff, Cristina Roman, Biswadev Mitra, Natasha Jennings, Louisa Lam, Peter Cameron

Objective

To assess patient and clinician experience with methoxyflurane in the Emergency Department (ED).

Methods

Patients receiving methoxyflurane as part of their treatment, and respective clinicians, were prospectively enrolled. Outcomes included patient and clinician satisfaction. Satisfaction was assessed using a 5-point Likert scale and summarised using medians (interquartile range; IQR).

Results

Of patients prescribed and administered methoxyflurane, 30 patients and 21 clinicians were enrolled. Median patient satisfaction was 4 out of 5 (IQR 3–5). Median clinician satisfaction was 5 out of 5 (IQR 4–5).

Conclusions

With a specific focus on patient and clinician experience for acute, short-term pain, methoxyflurane is a well-received and effective option for analgesia in the ED.

目的：探讨甲氧基氟醚在急诊科的临床应用经验。方法：前瞻性纳入接受甲氧基氟醚治疗的患者和各自的临床医生。结果包括患者和临床医生的满意度。满意度采用5点李克特量表进行评估，并使用中位数（四分位范围；IQR）进行总结。结果：在处方和使用甲氧基氟醚的患者中，纳入了30名患者和21名临床医生。患者满意度中位数为4 / 5 （IQR 3-5）。临床医生满意度中位数为5分（IQR 4-5）。结论：甲氧基氟醚在急诊科是一种广受好评且有效的镇痛选择，具有治疗急性、短期疼痛的患者和临床经验。

{"title":"Patient and Staff Satisfaction With Use of Methoxyflurane in the Emergency Department","authors":"Nathan Kwong, Carl Luckhoff, Cristina Roman, Biswadev Mitra, Natasha Jennings, Louisa Lam, Peter Cameron","doi":"10.1111/1742-6723.70229","DOIUrl":"10.1111/1742-6723.70229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess patient and clinician experience with methoxyflurane in the Emergency Department (ED).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients receiving methoxyflurane as part of their treatment, and respective clinicians, were prospectively enrolled. Outcomes included patient and clinician satisfaction. Satisfaction was assessed using a 5-point Likert scale and summarised using medians (interquartile range; IQR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of patients prescribed and administered methoxyflurane, 30 patients and 21 clinicians were enrolled. Median patient satisfaction was 4 out of 5 (IQR 3–5). Median clinician satisfaction was 5 out of 5 (IQR 4–5).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>With a specific focus on patient and clinician experience for acute, short-term pain, methoxyflurane is a well-received and effective option for analgesia in the ED.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Symptoms for Acute Coronary Syndrome in Aboriginal and Torres Strait Islander People Assessed in the Emergency Department 急诊科评估原住民及托雷斯海峡岛民急性冠状动脉综合征的预测症状

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-19 DOI: 10.1111/1742-6723.70222

Laura C. Stephensen, Michelle L. Gatton, Ray Mahoney, William Parsonage, Jaimi H. Greenslade, Louise Cullen

Objective

To compare the symptomatology of Aboriginal and Torres Strait Islander and non-Indigenous patients presenting to an emergency department (ED) with suspected acute coronary syndrome (ACS) and to determine whether specific symptoms increased the odds of ACS diagnosis and whether traditional groupings of typical or atypical symptoms are relevant in these populations.

Methods

Prospectively collected symptom data from 1643 adult patients presenting at two Queensland emergency departments between 2011–2014 and 2016–2019 who were assessed for suspected ACS were analysed according to self-reported Indigenous status. ACS diagnosis was the primary outcome.

Results

In 1643 patients investigated for suspected ACS, chest pain (92.1%), diaphoresis (47.8%), and shortness of breath (52.2%) were the most reported symptoms. For the 194 patients diagnosed with ACS, chest pain was reported less frequently in Aboriginal and Torres Strait Islander patients compared with non-Indigenous patients (81.5% vs. 94.2%, p = 0.009). For Aboriginal and Torres Strait Islander patients, vomiting and indigestion were associated with increased odds of ACS; left-sided chest pain or sharp pain was associated with decreased odds. Aboriginal and Torres Strait Islander patients with ACS were more likely to present atypically than non-Indigenous patients, but typicality was not associated with ACS.

Conclusion

Clinicians must have a high index of suspicion for ACS in Aboriginal and Torres Strait Islander people with chest pain who present with symptoms of gastrointestinal upset such as indigestion or vomiting. Typical or atypical groupings of ACS symptoms are of limited value or relevance in Australian populations, and these terms should be phased out.

Trial Registration

ANZCRN12617000756325

目的：比较急诊科（ED）疑似急性冠脉综合征（ACS）的原住民和托雷斯海峡岛民与非原住民患者的症状，并确定特定症状是否增加ACS的诊断几率，以及这些人群中典型或非典型症状的传统分组是否相关。方法：前瞻性收集2011-2014年至2016-2019年期间在昆士兰州两个急诊科就诊的1643名成年患者的症状数据，并根据自我报告的土著身份进行分析。ACS诊断是主要结局。结果：1643例疑似ACS患者中，胸痛（92.1%）、出汗（47.8%）和呼吸短促（52.2%）是报告最多的症状。在被诊断为ACS的194例患者中，土著和托雷斯海峡岛民患者的胸痛发生率低于非土著患者（81.5%比94.2%,p = 0.009）。对于原住民和托雷斯海峡岛民患者，呕吐和消化不良与ACS的几率增加有关；左侧胸痛或剧烈疼痛与患病几率降低有关。原住民和托雷斯海峡岛民ACS患者比非原住民患者更有可能表现出非典型性，但典型性与ACS无关。结论：临床医生必须高度怀疑原住民和托雷斯海峡岛民胸痛的ACS，并表现出胃肠道不适的症状，如消化不良或呕吐。ACS症状的典型或非典型分组在澳大利亚人群中价值或相关性有限，这些术语应逐步淘汰。试验注册号：ANZCRN12617000756325。

{"title":"Predictive Symptoms for Acute Coronary Syndrome in Aboriginal and Torres Strait Islander People Assessed in the Emergency Department","authors":"Laura C. Stephensen, Michelle L. Gatton, Ray Mahoney, William Parsonage, Jaimi H. Greenslade, Louise Cullen","doi":"10.1111/1742-6723.70222","DOIUrl":"10.1111/1742-6723.70222","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the symptomatology of Aboriginal and Torres Strait Islander and non-Indigenous patients presenting to an emergency department (ED) with suspected acute coronary syndrome (ACS) and to determine whether specific symptoms increased the odds of ACS diagnosis and whether traditional groupings of typical or atypical symptoms are relevant in these populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospectively collected symptom data from 1643 adult patients presenting at two Queensland emergency departments between 2011–2014 and 2016–2019 who were assessed for suspected ACS were analysed according to self-reported Indigenous status. ACS diagnosis was the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 1643 patients investigated for suspected ACS, chest pain (92.1%), diaphoresis (47.8%), and shortness of breath (52.2%) were the most reported symptoms. For the 194 patients diagnosed with ACS, chest pain was reported less frequently in Aboriginal and Torres Strait Islander patients compared with non-Indigenous patients (81.5% vs. 94.2%, <i>p</i> = 0.009). For Aboriginal and Torres Strait Islander patients, vomiting and indigestion were associated with increased odds of ACS; left-sided chest pain or sharp pain was associated with decreased odds. Aboriginal and Torres Strait Islander patients with ACS were more likely to present atypically than non-Indigenous patients, but typicality was not associated with ACS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinicians must have a high index of suspicion for ACS in Aboriginal and Torres Strait Islander people with chest pain who present with symptoms of gastrointestinal upset such as indigestion or vomiting. Typical or atypical groupings of ACS symptoms are of limited value or relevance in Australian populations, and these terms should be phased out.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ANZCRN12617000756325</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225981","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

What Is the Distribution of Aortic Dissection Detection Risk Score in an ED Population Undergoing CT Aortography for Potential Aortic Dissection? 在接受CT主动脉造影的ED人群中，主动脉夹层检测风险评分的分布是什么？

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-19 DOI: 10.1111/1742-6723.70236

Emma Duffett, Matthew Birdsey, Thomas Webster, Julian Mathai, Anne-Maree Kelly

引用次数: 0

A Retrospective Evaluation of Emergency Department Electric Scooter Impact Before and After the Introduction of a Hire Electric Scooter Service 急诊部电动滑板车引入租赁服务前后影响的回顾性评价

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-19 DOI: 10.1111/1742-6723.70227

Amanda McConnell, Heather McNeil, Jasraaj Singh, William Kitchen, Mark Johnson, Lucy Atkinson

Objective

To assess the impact of hire e-scooters on injury presentations at Cairns emergency department (ED).

Methods

A retrospective cohort study comparing e-scooter injuries before and after the introduction of hire e-scooters.

Results

A total of 323 patients presented with e-scooter injuries. There were 133 ‘before’ and 190 ‘after’ cases. The majority were males aged 10–20. Hospital admissions and length of stay increased in the ‘after’ group (32% vs. 9%, 27 vs. 9 staying > 24 h).

Conclusions

Hire e-scooters are associated with a higher trauma burden. These findings support targeted safety interventions and collaborative injury prevention strategies.

目的：评估租用电动滑板车对凯恩斯急诊科（ED）损伤报告的影响。方法：采用回顾性队列研究，比较电动滑板车引入前后的伤害情况。结果：共有323例患者出现电动滑板车损伤。其中133例为“事前”，190例为“事后”。大多数是10-20岁的男性。“术后”组住院次数和住院时间增加（32%比9%，27比9住院24小时）。结论：租用电动滑板车与较高的创伤负担相关。这些发现支持有针对性的安全干预和协同伤害预防策略。

{"title":"A Retrospective Evaluation of Emergency Department Electric Scooter Impact Before and After the Introduction of a Hire Electric Scooter Service","authors":"Amanda McConnell, Heather McNeil, Jasraaj Singh, William Kitchen, Mark Johnson, Lucy Atkinson","doi":"10.1111/1742-6723.70227","DOIUrl":"10.1111/1742-6723.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of hire e-scooters on injury presentations at Cairns emergency department (ED).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study comparing e-scooter injuries before and after the introduction of hire e-scooters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 323 patients presented with e-scooter injuries. There were 133 ‘before’ and 190 ‘after’ cases. The majority were males aged 10–20. Hospital admissions and length of stay increased in the ‘after’ group (32% vs. 9%, 27 vs. 9 staying > 24 h).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hire e-scooters are associated with a higher trauma burden. These findings support targeted safety interventions and collaborative injury prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225956","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 Impact of Aboriginal Health Liaison Officers and Culturally Safe Strategies on Emergency Department Leave Events: A Scoping Review 原住民健康联络官和文化安全策略对急诊科休假事件的影响：范围审查。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-19 DOI: 10.1111/1742-6723.70230

M. Budda-Deen (Gomeroi), I. Reidy, L. Rose, R. Rossiter

In Australia, First Nations Peoples are reported as 1.5 times more likely to leave the Emergency Department before treatment completion. Reasons are multifactorial and complex, including length of wait times, lack of cultural safety and persistent institutional racism. This scoping review aimed to determine the impact of Aboriginal Health Liaison Officers on First Nations Peoples' rates of Take Own Leave in Emergency Departments. The Joanna Briggs Institute methodology for scoping reviews, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews, the associated checklist, and the CONSIDER criteria enabled the synthesis of the best available evidence. The search included CINAHL Plus with Full Text (EBSCOhost), Medline (Ovid), PsycINFO (Ovid), Scopus, citation searching and Grey Literature. A total of 533 articles were screened, with seven relevant studies included in this scoping review. Robust research evidence of the impact of Aboriginal Health Liaison Officers on leave events was largely absent in the literature. Strategies designed to improve cultural safety were found to improve rates of healthcare attendance. The Aboriginal and Torres Strait Islander Quality Appraisal Tool was used to appraise the quality of the included studies, finding limited consultation with First Nations Peoples in research design. Findings highlight that improved cultural safety improves First Nations Peoples' Emergency Department attendance. All studies are specific to the Emergency Department setting with projects implemented to reduce leave events and/or implementation of Aboriginal Health Liaison Officer roles. The review provides some evidence that Aboriginal Health Liaison Officers would improve Emergency Department attendance.

在澳大利亚，据报道，原住民在治疗结束前离开急诊科的可能性是其他人的1.5倍。原因是多方面和复杂的，包括等待时间过长、缺乏文化安全感和持续存在的体制性种族主义。这一范围审查的目的是确定土著保健联络官对第一民族在急诊科自行请假率的影响。乔安娜布里格斯研究所的范围审查方法，系统审查的首选报告项目和范围审查的元分析扩展，相关的清单和考虑标准能够综合最佳可用证据。检索包括CINAHL Plus with Full Text （EBSCOhost）、Medline （Ovid）、PsycINFO （Ovid）、Scopus、引文检索和灰色文献。共筛选了533篇文章，其中7篇相关研究纳入本范围综述。文献中基本上没有关于土著卫生联络官对休假事件影响的有力研究证据。研究发现，旨在改善文化安全的战略可以提高保健出勤率。使用土著和托雷斯海峡岛民质量评估工具来评估纳入研究的质量，发现在研究设计中与第一民族进行了有限的咨询。调查结果强调，文化安全的改善提高了第一民族急诊科的出勤率。所有研究都是针对急诊科设置的，并实施了减少休假事件和/或执行土著卫生联络官角色的项目。审查提供了一些证据，表明土著卫生联络官将提高急诊室的出勤率。

{"title":"The Impact of Aboriginal Health Liaison Officers and Culturally Safe Strategies on Emergency Department Leave Events: A Scoping Review","authors":"M. Budda-Deen (Gomeroi), I. Reidy, L. Rose, R. Rossiter","doi":"10.1111/1742-6723.70230","DOIUrl":"10.1111/1742-6723.70230","url":null,"abstract":"<p>In Australia, First Nations Peoples are reported as 1.5 times more likely to leave the Emergency Department before treatment completion. Reasons are multifactorial and complex, including length of wait times, lack of cultural safety and persistent institutional racism. This scoping review aimed to determine the impact of Aboriginal Health Liaison Officers on First Nations Peoples' rates of Take Own Leave in Emergency Departments. The Joanna Briggs Institute methodology for scoping reviews, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews, the associated checklist, and the CONSIDER criteria enabled the synthesis of the best available evidence. The search included CINAHL Plus with Full Text (EBSCOhost), Medline (Ovid), PsycINFO (Ovid), Scopus, citation searching and Grey Literature. A total of 533 articles were screened, with seven relevant studies included in this scoping review. Robust research evidence of the impact of Aboriginal Health Liaison Officers on leave events was largely absent in the literature. Strategies designed to improve cultural safety were found to improve rates of healthcare attendance. The Aboriginal and Torres Strait Islander Quality Appraisal Tool was used to appraise the quality of the included studies, finding limited consultation with First Nations Peoples in research design. Findings highlight that improved cultural safety improves First Nations Peoples' Emergency Department attendance. All studies are specific to the Emergency Department setting with projects implemented to reduce leave events and/or implementation of Aboriginal Health Liaison Officer roles. The review provides some evidence that Aboriginal Health Liaison Officers would improve Emergency Department attendance.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiologist Approval for CTPA in the ED: A Single-Centre Pilot Study Did Not Demonstrate a Statistically Significant Difference in Diagnostic Yield 放射科医师在ED中批准CTPA：一项单中心试点研究没有证明在诊断率上有统计学意义的差异。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-18 DOI: 10.1111/1742-6723.70237

Hwang Tan, Pramod Chandru

Objective

Overuse of CT Pulmonary Angiography (CTPA) remains a challenge in emergency medicine. Some institutions resort to radiologist vetting to reduce unnecessary imaging. This is a pilot study that aims to investigate the effect of radiology vetting on the CTPA yield.

Methods and Results

This is a retrospective study comparing CTPA yields with and without radiology vetting. The results showed that there was no statistically significant difference in CTPA diagnostic yield, 11.4% (CI 9.2–14.0) versus 10.2% (CI 6.8–14.6), p = 0.60.

Conclusion

This study showed that removing radiologist approval for CTPA did not appear to reduce diagnostic yield.

目的：CT肺血管造影（CTPA）的过度使用仍然是急诊医学的一个挑战。一些机构求助于放射科医生的审查，以减少不必要的成像。这是一项试点研究，旨在调查放射学审查对CTPA产量的影响。方法和结果：这是一项回顾性研究，比较有和没有放射学审查的CTPA产量。结果显示CTPA诊断率为11.4% (CI 9.2 ~ 14.0) vs 10.2% (CI 6.8 ~ 14.6), p = 0.60，无统计学差异。结论：本研究表明，取消放射科医师对CTPA的批准并不会降低诊断率。

{"title":"Radiologist Approval for CTPA in the ED: A Single-Centre Pilot Study Did Not Demonstrate a Statistically Significant Difference in Diagnostic Yield","authors":"Hwang Tan, Pramod Chandru","doi":"10.1111/1742-6723.70237","DOIUrl":"10.1111/1742-6723.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Overuse of CT Pulmonary Angiography (CTPA) remains a challenge in emergency medicine. Some institutions resort to radiologist vetting to reduce unnecessary imaging. This is a pilot study that aims to investigate the effect of radiology vetting on the CTPA yield.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This is a retrospective study comparing CTPA yields with and without radiology vetting. The results showed that there was no statistically significant difference in CTPA diagnostic yield, 11.4% (CI 9.2–14.0) versus 10.2% (CI 6.8–14.6), <i>p</i> = 0.60.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study showed that removing radiologist approval for CTPA did not appear to reduce diagnostic yield.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212427","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

Risk Stratification for Acute Aortic Syndrome: Premise, Promise and Performance 急性主动脉综合征的风险分层：前提、前景和表现。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-18 DOI: 10.1111/1742-6723.70233

Steve W. F. R. Waqanivavalagi, Sameer Bhat, Peter G. Jones

引用次数: 0

The Effect of Increasing Age on Outcomes in Major Trauma: A Retrospective Cohort Study 年龄增加对重大创伤预后的影响：一项回顾性队列研究。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-08 DOI: 10.1111/1742-6723.70226

Maria Nonis, Andrew McCombie, Christopher Wakeman, John Geddes, Laura R. Joyce

Objective

To investigate the impact of increasing age on clinical outcomes in major trauma patients. Primary outcomes assessed included time to diagnostic imaging, length of hospital stay, and mortality rates both in-hospital and at 30 days post-injury.

Methods

A retrospective observational study was conducted involving major trauma patients presenting to a tertiary referral centre over a 6-year period, 2017–2023. The effect of increasing age on triage, investigation and management, and clinical outcomes, including length of stay and mortality, was examined.

Results

Analysis demonstrated that the likelihood of trauma team activation decreased with increasing age, independent of injury severity score. Increasing age was a significant predictor of in-hospital mortality (odds ratio: 1.06, 95% confidence interval: 1.05–1.07). Rates of computed tomography (CT) utilisation were comparable between older and younger cohorts (≥ 65 vs. < 65 years, 94.8% vs. 94.9%); yet, older patients experienced significantly longer median wait times for imaging (130 min [≥ 65] vs. 79 min [< 65]).

Conclusions

Increasing age is associated with decreased trauma team activation rates irrespective of injury severity. Furthermore, older trauma patients exhibit substantially higher mortality rates, with a marked increase observed beyond initial hospital discharge. Age-specific trauma team activation criteria may reduce under-triage and potentially improve outcomes in older patients.

目的：探讨年龄增长对重大创伤患者临床预后的影响。评估的主要结局包括到诊断成像的时间、住院时间以及住院和受伤后30天的死亡率。方法：对2017-2023年期间在三级转诊中心就诊的重大创伤患者进行回顾性观察研究。研究了年龄增加对分诊、调查和管理以及临床结果（包括住院时间和死亡率）的影响。结果：分析表明，创伤组激活的可能性随着年龄的增加而降低，与损伤严重程度评分无关。年龄增加是住院死亡率的显著预测因子（优势比：1.06,95%可信区间：1.05-1.07）。计算机断层扫描（CT）使用率在老年和年轻队列之间具有可比性（≥65 vs.）。结论：无论损伤严重程度如何，年龄的增加与创伤组激活率的降低有关。此外，老年创伤患者的死亡率高得多，出院后死亡率明显增加。特定年龄的创伤小组激活标准可能会减少分类不足，并可能改善老年患者的预后。

{"title":"The Effect of Increasing Age on Outcomes in Major Trauma: A Retrospective Cohort Study","authors":"Maria Nonis, Andrew McCombie, Christopher Wakeman, John Geddes, Laura R. Joyce","doi":"10.1111/1742-6723.70226","DOIUrl":"10.1111/1742-6723.70226","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the impact of increasing age on clinical outcomes in major trauma patients. Primary outcomes assessed included time to diagnostic imaging, length of hospital stay, and mortality rates both in-hospital and at 30 days post-injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study was conducted involving major trauma patients presenting to a tertiary referral centre over a 6-year period, 2017–2023. The effect of increasing age on triage, investigation and management, and clinical outcomes, including length of stay and mortality, was examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis demonstrated that the likelihood of trauma team activation decreased with increasing age, independent of injury severity score. Increasing age was a significant predictor of in-hospital mortality (odds ratio: 1.06, 95% confidence interval: 1.05–1.07). Rates of computed tomography (CT) utilisation were comparable between older and younger cohorts (≥ 65 vs. < 65 years, 94.8% vs. 94.9%); yet, older patients experienced significantly longer median wait times for imaging (130 min [≥ 65] vs. 79 min [< 65]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increasing age is associated with decreased trauma team activation rates irrespective of injury severity. Furthermore, older trauma patients exhibit substantially higher mortality rates, with a marked increase observed beyond initial hospital discharge. Age-specific trauma team activation criteria may reduce under-triage and potentially improve outcomes in older patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Self-Rostering for Emergency Career Medical Officers (CMOs) and Registrars Within a Small Metropolitan Emergency Department: A Mixed Methods Study on Employee Satisfaction and Implementation Processes 小型城市急诊科紧急职业医务人员（cmo）和登记员的自我登记：员工满意度和实施过程的混合方法研究。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-02-05 DOI: 10.1111/1742-6723.70221

Khanh Nguyen, Pramod Chandru

Objective

To review a newly implemented medical staff self-rostering process in a small metropolitan emergency department to ensure sustainability without compromising emergency department safe staffing guidelines.

Methods

We performed a multi-methods study on the implementation and user experience of a novel rostering process for registrars and CMOs in a small emergency department. Quantitative analysis was performed using a Likert scale to assess operational and implementation success as well as data on hours spent on roster generation, number of sick calls and number of shift swaps. Qualitative structured interviews were also analysed using an inductive process resulting in a thematic analysis.

Results

Our implementation outcome scoring showed a median score of 5 for all three domains of the implementation questionnaire including acceptability (IQR 4–5), appropriateness (IQR 4–5) and feasibility (IQR 4–5). Our thematic analysis demonstrated strong themes around flexibility and choice, usability and interface, responsibility for a complete roster, as well as wellbeing and balance. Our analysis of roster metrics showed a large reduction in required shift swaps (29 vs. 163) and time spent on roster development and publication (4 h vs. 20 h) over a 13-week rostering period. While consultant time spent on roster development and publication was reduced, this was accompanied by a redistribution of workload to participating staff, who spent a median of 1.4 h per rostering cycle.

Conclusions

We conclude that in a small metropolitan hospital, self-rostering is a feasible and implementable operational intervention with improvements in employee wellbeing.

目的：回顾在小型城市急诊科新实施的医务人员自我名册流程，以确保可持续性，而不影响急诊科安全人员配备指南。方法：我们对一家小型急诊科的注册员和cmo的新名册流程的实施和用户体验进行了多方法研究。使用李克特量表进行定量分析，以评估操作和实施的成功，以及在花名册生成上花费的小时数、请病假次数和换班次数的数据。定性结构化访谈也使用归纳过程进行分析，从而得出主题分析。结果：我们的实施结果评分显示，在实施问卷的所有三个领域，包括可接受性（IQR 4-5）、适当性（IQR 4-5）和可行性（IQR 4-5），中位数得分为5分。我们的主题分析展示了围绕灵活性和选择，可用性和界面，完整花名册的责任，以及福利和平衡的强大主题。我们对花名册指标的分析显示，在13周的花名册期间，所需的轮班交换（29对163）和花在花名册开发和发布上的时间（4小时对20小时）大大减少。虽然顾问在编制和出版名册上花费的时间减少了，但同时也将工作量重新分配给参与的工作人员，他们每个名册周期平均花费1.4小时。结论：我们得出结论，在一个小的都市医院，自我名册是一个可行的和可实施的操作干预与改善员工的幸福感。

{"title":"Self-Rostering for Emergency Career Medical Officers (CMOs) and Registrars Within a Small Metropolitan Emergency Department: A Mixed Methods Study on Employee Satisfaction and Implementation Processes","authors":"Khanh Nguyen, Pramod Chandru","doi":"10.1111/1742-6723.70221","DOIUrl":"10.1111/1742-6723.70221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To review a newly implemented medical staff self-rostering process in a small metropolitan emergency department to ensure sustainability without compromising emergency department safe staffing guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a multi-methods study on the implementation and user experience of a novel rostering process for registrars and CMOs in a small emergency department. Quantitative analysis was performed using a Likert scale to assess operational and implementation success as well as data on hours spent on roster generation, number of sick calls and number of shift swaps. Qualitative structured interviews were also analysed using an inductive process resulting in a thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our implementation outcome scoring showed a median score of 5 for all three domains of the implementation questionnaire including acceptability (IQR 4–5), appropriateness (IQR 4–5) and feasibility (IQR 4–5). Our thematic analysis demonstrated strong themes around flexibility and choice, usability and interface, responsibility for a complete roster, as well as wellbeing and balance. Our analysis of roster metrics showed a large reduction in required shift swaps (29 vs. 163) and time spent on roster development and publication (4 h vs. 20 h) over a 13-week rostering period. While consultant time spent on roster development and publication was reduced, this was accompanied by a redistribution of workload to participating staff, who spent a median of 1.4 h per rostering cycle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We conclude that in a small metropolitan hospital, self-rostering is a feasible and implementable operational intervention with improvements in employee wellbeing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124229","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