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Emergency clinical nurse specialist practice in Victoria and New South Wales: A cross-sectional study. 维多利亚州和新南威尔士州的急诊临床护士专家实践:一项横断面研究。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-03-20 DOI: 10.1016/j.auec.2025.03.002
Sarah Wiggs, Abra Osborne, Julia Morphet

Background: Emergency Clinical Nurse Specialists (CNS) are experts in treating patients across the lifespan in the dynamic, unpredictable and busy Emergency Department (ED). The aim of this paper was to create a profile of the Emergency CNS role and practice, and assess work satisfaction.

Methods: An online cross-sectional survey based on the College of Emergency Nursing Australasia's Practice Standards for the Specialist Emergency Nurse was conducted in the Australian states of Victoria and New South Wales.

Results: There were 59 survey responses. The domains Lawful Practice, Professional Ethics and Communication were rated as practiced with the greatest frequency, and Lawful Practice and Teamwork were rated very important by respondents. 79 % of CNSs planned to continue working in ED, with all CNSs reporting plans to continue working in healthcare. 77 % of CNSs were satisfied in their current role.

Conclusion: The Practice Standards for the Specialist Emergency Nurse are used regularly and are relevant to CNS practice. CNSs are largely satisfied with their role, which is versatile and multifaceted. However, CNSs face challenges to perform all elements of their role, and reported protected non-clinical time and collaboration with management as enablers to their role.

背景:急诊临床专科护士(CNS)是在动态、不可预测和繁忙的急诊科(ED)治疗患者的专家。本文的目的是创建一个概况的应急中枢神经系统的作用和实践,并评估工作满意度。方法:在澳大利亚维多利亚州和新南威尔士州进行了一项基于澳大利亚急诊护理学院急诊护士执业标准的在线横断面调查。结果:共收到59份问卷。受访者认为“法律实践”、“职业道德”和“沟通”是最常使用的领域,而“法律实践”和“团队合作”被认为非常重要。79% %的CNSs计划继续在急诊科工作,所有CNSs报告计划继续在医疗保健行业工作。77 %的CNSs对目前的角色感到满意。结论:《专科急诊护士执业标准》的使用较为规范,与中枢神经系统执业有一定的相关性。CNSs在很大程度上对他们的角色感到满意,这是一个多功能和多方面的角色。然而,CNSs面临着履行其角色的所有要素的挑战,并报告了保护非临床时间和与管理层合作作为其角色的推动者。
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引用次数: 0
Self-referral trends to a virtual emergency department following initial presentation: A retrospective exploratory analysis. 自我转诊到虚拟急诊科的趋势:回顾性探索性分析。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-04-10 DOI: 10.1016/j.auec.2025.03.008
Belinda L Baines, Joanna Lawrence, Jennie Hutton, Loren Sher, Adam I Semciw, James H Boyd, Rebecca L Jessup, Suzanne M Miller, Jason Talevski

Objective: The Victorian Virtual Emergency Department (VVED) provides emergency care for patients across Victoria, Australia with non-life-threatening concerns. This study aims to explore subsequent self-referral patterns of patients after initial presentation to the VVED.

Methods: A retrospective cohort study was conducted in 42,921 VVED patients between October 2020 and June 2024. Subsequent self-referral rates among VVED patients who were initially referred through a health care provider (HCP) referral pathway were compared to those who self-referred upon their first presentation. Descriptive statistics and multivariable logistic regression modelling were used.

Results: Patients were more likely to self-refer on their second presentation if they self-referred on their first presentation (88 % vs 40 %; p < 0.001). Multivariable logistic regression analyses showed significantly lower odds of subsequent self-referral in all HCP referral pathways compared to the self-referral group. Patients referred through pathways without an HCP present had higher odds of subsequent self-referral than those referred via pathways with a HCP present (OR=1.19, 95 % CI: 1.10-1.28).

Conclusions: Patients who self-refer to the VVED initially are more likely to continue self-referring to the service. Further research is needed to explore factors that may enhance the likelihood of self-referral to virtual emergency care services.

目的:维多利亚虚拟急诊科(VVED)为澳大利亚维多利亚州的非危及生命的病人提供紧急护理。本研究旨在探讨患者首次到VVED就诊后的自我转诊模式。方法:对2020年10月至2024年6月期间42921例VVED患者进行回顾性队列研究。通过卫生保健提供者(HCP)转诊途径转诊的VVED患者随后的自我转诊率与首次就诊时自我转诊的患者进行比较。采用描述性统计和多变量logistic回归模型。结果:如果患者在第一次就诊时自我介绍,他们更有可能在第二次就诊时自我介绍(88 % vs 40 %;p 结论:最初自述VVED的患者更有可能继续自述该服务。需要进一步的研究来探索可能提高自我转诊到虚拟急诊服务的可能性的因素。
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引用次数: 0
Refresher training for emergency department triage nurses - A scoping review. 急诊科分诊护士的进修培训-范围审查。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-04-16 DOI: 10.1016/j.auec.2025.03.006
Amanda Hinds, Susan Kay, Kiah Evans

Background: Triage nurses have under five minutes to assess patients; prioritise urgency and assign wait times. Triage accuracy is vital for patient safety and Emergency Department (ED) efficiency. Guidelines for triage nurse refresher training are unclear. This review aimed to describe the evidence on ED triage nurse refresher training.

Methods: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), searching Medline, Embase and CINAHL databases from 2007 to 2024.

Results: Eighteen studies were included. Problem-based learning, lectures, simulation, and project learning were identified as effective education strategies, with multiple teaching methods frequently used. Cost and delivery mode affected refresher training. Tiredness, patient context, and nurses' forming personal rules over time negatively impacted accuracy, while clear guidelines and flowcharts helped maintain it.

Conclusions: Triage refresher training enhances nurses' accuracy. Clear guidance on minimum standards along with visible resources, guidelines and flowcharts further improve triage accuracy. Further research is needed to understand the long-term effects on patient safety and ED patient flow.

背景:分诊护士有不到五分钟的时间来评估病人;优先考虑紧急情况并分配等待时间。分诊的准确性对患者安全和急诊科(ED)效率至关重要。分诊护士进修培训的指导方针尚不明确。本综述旨在描述急诊分诊护士进修培训的证据。方法:本综述遵循系统评价和meta分析扩展范围评价首选报告项目(PRISMA-ScR),检索Medline、Embase和CINAHL数据库,检索时间为2007年至2024年。结果:纳入18项研究。基于问题的学习、讲座、模拟和项目学习被认为是有效的教育策略,多种教学方法经常被使用。成本和交付方式影响进修培训。随着时间的推移,疲劳、患者环境和护士形成的个人规则会对准确性产生负面影响,而清晰的指导方针和流程图有助于保持准确性。结论:分诊复习培训提高了护士分诊准确性。明确的最低标准指导以及可见的资源、指南和流程图进一步提高了分诊的准确性。需要进一步的研究来了解对患者安全和急诊科患者流量的长期影响。
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引用次数: 0
Mild and moderate traumatic brain injury: Screening, documentation, and referral to concussion services. 轻度和中度创伤性脑损伤:筛查,记录和转介到脑震荡服务。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-04-09 DOI: 10.1016/j.auec.2025.03.007
Mahdi Zangi, John W Pickering, Alice Theadom, Martin Than, Deborah L Snell

Background and aim: Screening of traumatic brain injuries (TBI) using different clinical assessment tools would facilitate diagnosis and effective inpatient follow-up. We aimed to describe rates of diagnosis, classification, documentation, and referral practices for TBI inpatients.

Material and methods: In a retrospective cohort study, we reviewed electronic clinical records of adult patients admitted to a hospital ward with head trauma from an emergency department (ED) in 2021. Data included demographics, injury, TBI diagnoses, and referral to concussion services. Factors predicting ED physician documentation and referral to concussion services were identified.

Results: Of approximately 34,000 adults admitted from the ED, 1059 presented with head trauma, and 609 (57.5 %) were diagnosed with TBI. There were 553 mild/moderate TBI cases with an incidence rate of 103.4 per 100,000 adult population in Canterbury. 14 % (n = 77) were referred to a concussion service. Predictors of ED-documented TBI included non-isolated head injury (OR:0.60), head CT request (OR:9.12), injured in street/public areas (OR:2.03). Older age and non-isolated head injury decreased odds of concussion service referral (0.96 and 0.46, respectively), while female and ED-documented TBI increased odds of referral (5.8 and 28, respectively).

Conclusion: Better documentation of mild/moderate TBI might facilitate health care access, with efficient clinical decision making.

背景与目的:使用不同的临床评估工具筛查创伤性脑损伤(TBI)有助于诊断和有效的住院随访。我们的目的是描述TBI住院患者的诊疗率、分类、记录和转诊实践。材料和方法:在一项回顾性队列研究中,我们回顾了2021年从急诊科(ED)入住医院病房的头部创伤成年患者的电子临床记录。数据包括人口统计、损伤、TBI诊断和转介到脑震荡服务。确定了预测急诊科医师记录和转介到脑震荡服务的因素。结果:在大约34,000名从急诊科入院的成年人中,1059人表现为头部创伤,609人(57.5 %)被诊断为TBI。在坎特伯雷有553例轻中度TBI病例,发病率为103.4 / 10万成年人。14 % (n = 77)被转介到脑震荡服务部门。ed记录的TBI预测因素包括非孤立性头部损伤(OR:0.60)、头部CT要求(OR:9.12)、在街道/公共区域受伤(OR:2.03)。年龄较大和非孤立性头部损伤降低了脑震荡转诊的几率(分别为0.96和0.46),而女性和ed记录的TBI增加了转诊的几率(分别为5.8和28)。结论:更好地记录轻/中度创伤性脑损伤可能有助于获得医疗保健,有效地进行临床决策。
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引用次数: 0
Emergency department staff perceptions of representation through an observational documentary series. 通过观察纪录片系列急诊科员工的代表性的看法。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-04-30 DOI: 10.1016/j.auec.2025.04.001
Felicity Moon, Angela Dean, Mark J Putland

Background: The representation of healthcare professionals in television has been subject to critique due to the depictions of stereotypical tropes between professional disciplines. Production of factual television programs requires healthcare professionals to perform their roles for a diverse audience, and ideally presents an accurate portrayal of patient care.

Methods: We used an anonymous mixed-method survey framed by symbolic interactionism and Goffman's theory of presentation of self to explore how staff negotiate representation during the filming of an observational documentary in an Emergency Department. Quantitative data were analysed using descriptive statistics and qualitative data using thematic analysis.

Results: In total 105 staff completed the survey, predominantly nurses and physicians. They reported mixed responses to the impact of filming on professional performance and clinical care. Two themes from the qualitative data revealed that staff sought ideal representation through television production, while also being required to engage in additional work to adjust to the filming team, manage team dynamics, and provide appropriate patient care.

Conclusion: Filming of documentaries provides the opportunity for healthcare professionals to engage in representation. However, there is a need to challenge dominant depictions of medical-nursing hierarchies, and present a broader variety of clinical presentations.

背景:由于对专业学科之间的刻板印象的描述,电视中医疗保健专业人员的表现一直受到批评。事实电视节目的制作需要医疗保健专业人员为不同的观众扮演他们的角色,并理想地呈现病人护理的准确写照。方法:采用符号互动主义和戈夫曼自我呈现理论框架下的匿名混合方法调查,探讨急诊科工作人员在拍摄一部观察性纪录片时如何协商呈现。定量数据采用描述性统计分析,定性数据采用专题分析。结果:共105名工作人员完成调查,以护士和医生为主。他们报告了对拍摄对专业表现和临床护理的影响的不同反应。定性数据的两个主题表明,工作人员通过电视制作寻求理想的表现,同时也需要从事额外的工作,以适应拍摄团队,管理团队动态,并提供适当的病人护理。结论:纪录片的拍摄为医疗保健专业人员提供了参与代理的机会。然而,有必要挑战医疗护理等级的主导描述,并提出更广泛的临床表现。
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引用次数: 0
Effects of cold needle and ShotBlocker applied in the emergency department on pain and satisfaction in intramuscular injection pain: A randomized controlled trial. 急诊科应用冷针和注射阻断剂对肌内注射疼痛的疼痛和满意度的影响:一项随机对照试验。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-02-08 DOI: 10.1016/j.auec.2025.02.001
Yadigar Ordu, Hilal Türkben Polat, Kadir Küçükceran

Background: The most commonly reported side effect of intramuscular injection is pain. Cold needles and ShotBlocker can be used as non-pharmacological methods for pain relief. This study aims to determine the effect of cold needle and ShotBlocker on pain and satisfaction in intramuscular injection pain.

Methods: This is a triple-blind, randomized controlled study. The study was conducted on 120 patients (40: control, 40: cold needle, 40: ShotBlocker) who presented to the emergency department of a university hospital in Turkey for cyanocobalamin injection in July-August 2024. Data were collected using a patient identification form, visual pain scale (VPS), and injection satisfaction scale. SPSS statistical package (version 22.0; SPSS, Inc., USA) was used to analyze the data.

Results: In the study, the groups were found to be similar except for age and continuous drug use. The pain scores of the control group were significantly higher than those of the cold needle and ShotBlocker groups. Injection satisfaction was significantly higher in the cold needle and ShotBlocker groups than in the control group.

Conclusion: Both the Cold Needle and the ShotBlocker can be used as effective methods to reduce pain associated with intramuscular injections and improve injection satisfaction. Both methods are non-pharmacological, inexpensive, and easy to use, and they can be used safely and effectively in all clinical settings.

背景:肌内注射最常见的副作用是疼痛。冷针和注射阻断剂可以作为非药物缓解疼痛的方法。本研究旨在确定冷针和注射阻断剂对肌内注射疼痛的疼痛和满意度的影响。方法:这是一项三盲、随机对照研究。本研究对2024年7 - 8月在土耳其一所大学医院急诊科接受氰钴胺素注射的120例患者(对照组40例,冷针40例,注射阻断剂40例)进行了研究。数据收集采用患者识别表,视觉疼痛量表(VPS)和注射满意度量表。SPSS统计软件包(22.0版);采用SPSS, Inc., USA)对数据进行分析。结果:两组患者除年龄和持续用药情况外无明显差异。对照组疼痛评分明显高于冷针组和注射阻断剂组。注射满意度在冷针组和注射阻断剂组明显高于对照组。结论:Cold Needle和ShotBlocker均可作为减轻肌内注射疼痛和提高注射满意度的有效方法。这两种方法都是非药物、廉价和易于使用的,它们可以在所有临床环境中安全有效地使用。
{"title":"Effects of cold needle and ShotBlocker applied in the emergency department on pain and satisfaction in intramuscular injection pain: A randomized controlled trial.","authors":"Yadigar Ordu, Hilal Türkben Polat, Kadir Küçükceran","doi":"10.1016/j.auec.2025.02.001","DOIUrl":"10.1016/j.auec.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>The most commonly reported side effect of intramuscular injection is pain. Cold needles and ShotBlocker can be used as non-pharmacological methods for pain relief. This study aims to determine the effect of cold needle and ShotBlocker on pain and satisfaction in intramuscular injection pain.</p><p><strong>Methods: </strong>This is a triple-blind, randomized controlled study. The study was conducted on 120 patients (40: control, 40: cold needle, 40: ShotBlocker) who presented to the emergency department of a university hospital in Turkey for cyanocobalamin injection in July-August 2024. Data were collected using a patient identification form, visual pain scale (VPS), and injection satisfaction scale. SPSS statistical package (version 22.0; SPSS, Inc., USA) was used to analyze the data.</p><p><strong>Results: </strong>In the study, the groups were found to be similar except for age and continuous drug use. The pain scores of the control group were significantly higher than those of the cold needle and ShotBlocker groups. Injection satisfaction was significantly higher in the cold needle and ShotBlocker groups than in the control group.</p><p><strong>Conclusion: </strong>Both the Cold Needle and the ShotBlocker can be used as effective methods to reduce pain associated with intramuscular injections and improve injection satisfaction. Both methods are non-pharmacological, inexpensive, and easy to use, and they can be used safely and effectively in all clinical settings.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":"157-162"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383693","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
Adherence to ambulance performance indicators and patient outcomes after stroke: An Australian data linkage study. 坚持救护车性能指标和中风后患者的结果:澳大利亚的数据链接研究。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-07-04 DOI: 10.1016/j.auec.2025.04.002
Amminadab L Eliakundu, Joosup Kim, Karen Smith, Monique F Kilkenny, Mulugeta M Birhanu, Kathleen L Bagot, Emily Nehme, Shelley Cox, Bruce C V Campbell, Ben Clissold, Helen M Dewey, Jodie Rabaut, Henry Ma, Christopher F Bladin, Dominique A Cadilhac

Background: The impact of Emergency Medical Service (EMS) stroke performance indicators on patient outcomes is unclear. We aimed to evaluate adherence to EMS indicators (15 minutes response, 60 minutes transport to a stroke centre or both) and associations with treatment access and patient outcomes.

Method: Retrospective cohort study using data from the Australian Stroke Clinical Registry and ambulance records from Victoria (2015-2017) for patients (≥18 years) with stroke transported by ambulance. Multivariable regression models were used to evaluate EMS adherence to performance indicators and outcomes of interest.

Results: Among 4206 patients (72 years; 42 % female), EMS indicators were less frequently met for patients in regional areas (aOR: 0.27; 95 % CI: 0.17, 0.43). Socio-economic disparities were observed, with patients in advantaged areas less likely to receive an ambulance response within 15 minutes. Adherence to EMS performance indicators was associated with shorter off-stretcher time and increased thrombolytic therapy use (aOR: 1.62; 95 % CI: 1.24, 2.11). EMS adherence to performance indicators did not significantly impact functional independence, or health-related quality of life.

Conclusions: EMS adherence to performance indicators improved off-stretcher time and thrombolytic therapy use but was influenced by geographic and socio-economic status. Refining EMS performance targets and tailoring public and EMS education on stroke is needed.

背景:急诊医疗服务(EMS)卒中表现指标对患者预后的影响尚不清楚。我们的目的是评估EMS指标的依从性(15分钟反应,60分钟转移到卒中中心或两者兼有)以及与治疗可及性和患者预后的关系。方法:回顾性队列研究,使用澳大利亚卒中临床登记处和维多利亚州救护车记录(2015-2017)的数据,对救护车运送的卒中患者(≥18岁)进行研究。使用多变量回归模型来评估EMS对绩效指标和相关结果的依从性。结果:4206例患者(72岁;42 %女性),区域患者的EMS指标达到的频率较低(aOR: 0.27;95 % ci: 0.17, 0.43)。观察到社会经济差异,优势地区的患者不太可能在15分钟内收到救护车响应。遵守EMS绩效指标与较短的下担架时间和增加的溶栓治疗使用相关(aOR: 1.62;95 % ci: 1.24, 2.11)。EMS对绩效指标的依从性没有显著影响功能独立性或与健康相关的生活质量。结论:EMS对绩效指标的依从性提高了下担架时间和溶栓治疗的使用,但受地理和社会经济地位的影响。需要完善医疗服务的绩效目标,并针对中风进行针对性的公共和医疗服务教育。
{"title":"Adherence to ambulance performance indicators and patient outcomes after stroke: An Australian data linkage study.","authors":"Amminadab L Eliakundu, Joosup Kim, Karen Smith, Monique F Kilkenny, Mulugeta M Birhanu, Kathleen L Bagot, Emily Nehme, Shelley Cox, Bruce C V Campbell, Ben Clissold, Helen M Dewey, Jodie Rabaut, Henry Ma, Christopher F Bladin, Dominique A Cadilhac","doi":"10.1016/j.auec.2025.04.002","DOIUrl":"10.1016/j.auec.2025.04.002","url":null,"abstract":"<p><strong>Background: </strong>The impact of Emergency Medical Service (EMS) stroke performance indicators on patient outcomes is unclear. We aimed to evaluate adherence to EMS indicators (15 minutes response, 60 minutes transport to a stroke centre or both) and associations with treatment access and patient outcomes.</p><p><strong>Method: </strong>Retrospective cohort study using data from the Australian Stroke Clinical Registry and ambulance records from Victoria (2015-2017) for patients (≥18 years) with stroke transported by ambulance. Multivariable regression models were used to evaluate EMS adherence to performance indicators and outcomes of interest.</p><p><strong>Results: </strong>Among 4206 patients (72 years; 42 % female), EMS indicators were less frequently met for patients in regional areas (aOR: 0.27; 95 % CI: 0.17, 0.43). Socio-economic disparities were observed, with patients in advantaged areas less likely to receive an ambulance response within 15 minutes. Adherence to EMS performance indicators was associated with shorter off-stretcher time and increased thrombolytic therapy use (aOR: 1.62; 95 % CI: 1.24, 2.11). EMS adherence to performance indicators did not significantly impact functional independence, or health-related quality of life.</p><p><strong>Conclusions: </strong>EMS adherence to performance indicators improved off-stretcher time and thrombolytic therapy use but was influenced by geographic and socio-economic status. Refining EMS performance targets and tailoring public and EMS education on stroke is needed.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":"233-239"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568137","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
Screening and assessment of falls risk in the emergency department. 急诊科跌倒风险的筛选和评估。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-09-01 Epub Date: 2025-03-16 DOI: 10.1016/j.auec.2025.03.003
Paul Fulbrook, Sandra J Miles, Faye Jordan, Sarah Hazelwood, Hwee Yong Debbie Lee

Background: Falls are a source of harm, repeat emergency department visits and hospital admission for older adults. Undertaking a comprehensive geriatric screening including falls-risk is recommended in guidelines for optimal older adult emergency department care.

Methods: A pragmatic prospective cohort study was undertaken to evaluate use of further falls-risk screening in older adults in a large tertiary Australian hospital emergency department. Primary outcome measures of interest were length of stay; discharge destination; 30-day and 90-day re-presentations.

Results: Of 651 eligible cases, 320 were randomly recruited for further screening following consent. The implementation cohort spent an average 45 m longer in the emergency department with a greater proportion admitted to the short stay unit, staying there longer than a comparison cohort. There were significantly fewer 30-day fall-related representations (2.9 %) in the implementation cohort.

Conclusions: Despite a small reduction in emergency department re-presentation within 30 days in the implementation cohort, hospital admission was not reduced. Further research is needed to examine any cost-benefit ratio of additional falls-risk screening and intervention in emergency departments.

背景:跌倒是伤害的一个来源,重复急诊就诊和住院的老年人。开展全面的老年筛查,包括跌倒风险,建议在指导方针的最佳老年人急诊科护理。方法:在澳大利亚一家大型三级医院急诊科进行了一项实用的前瞻性队列研究,以评估老年人进一步跌倒风险筛查的使用情况。主要观察指标为住院时间;放电目的地;30天和90天的重新陈述。结果:在651例符合条件的病例中,随机招募320例在同意后进行进一步筛查。实施队列在急诊科平均多花了45 m,其中更大比例的患者住进了短期住院单元,在那里呆的时间比比较队列长。在实施队列中,与30天跌倒相关的表征显著减少(2.9 %)。结论:尽管在实施队列中,30天内急诊科再次就诊的人数略有减少,但住院率并未减少。需要进一步的研究来检验急诊部门额外的跌倒风险筛查和干预的成本效益比。
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引用次数: 0
Drowning in research? A scoping review of the emergency response to medical emergencies occurring in water-based environments 沉迷于研究?对水基环境中发生的医疗紧急情况应急反应的范围审查。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-08-22 DOI: 10.1016/j.auec.2025.08.003
Derek Collings-Hughes , Ashlea Smith , Stephen Ball

Background

The water-based environment presents challenges to emergency services responding to medical emergencies. These include logistical difficulties, interagency response requirements, and knowledge of unique clinical conditions. Understanding which water-based incidents need emergency response, their locations, and resource needs is essential for preparing paramedics and other emergency service personnel.

Objective

To describe the existing literature examining the prehospital response and management of patients who experience an emergency in a water-based environment.

Review methods

This review used a scoping review methodology following JBI guidance. Five databases were searched: Ovid Medline, EMCARE, CINAHL, SPORTDiscus, and Web of Science. Two independent reviewers screened articles against predefined inclusion criteria. Data were extracted using a structured form, in accordance with JBI guidance.

Results

The search identified 6122 articles, of which 101 were included in the review. Eight emergency service types were described. A broad range of medical emergencies were reported, although most studies focused on fatal drowning. Research on non-fatal drowning and interagency coordination was limited, and reported outcome varied considerably across studies.

Conclusions

Much of the prehospital research on water-based emergencies reports only on fatal drowning, with limited attention to other incident types or agency interoperability. Further research is needed to improve understanding of emergency response, patient outcomes, and interoperability of emergency services in the context of water-based emergencies.
背景:基于水的环境对应对医疗紧急情况的应急服务提出了挑战。其中包括后勤困难、机构间反应要求以及对独特临床条件的了解。了解哪些水基事件需要紧急响应、发生地点和资源需求,对于医护人员和其他紧急服务人员做好准备至关重要。目的:描述现有的文献研究在水基环境中经历紧急情况的患者院前反应和管理。评审方法:本次评审采用了遵循JBI指导的范围评审方法。检索了5个数据库:Ovid Medline、EMCARE、CINAHL、SPORTDiscus和Web of Science。两名独立审稿人根据预先确定的纳入标准筛选文章。按照JBI指南,使用结构化表格提取数据。结果:检索到6122篇文章,其中101篇被纳入综述。描述了八种紧急服务类型。报告了各种各样的医疗紧急情况,尽管大多数研究的重点是致命的溺水。关于非致命性溺水和机构间协调的研究有限,各研究报告的结果差异很大。结论:许多关于水上紧急情况的院前研究报告仅针对致命溺水,而对其他事件类型或机构互操作性的关注有限。需要进一步研究,以提高对水基紧急情况下应急反应、患者结果和应急服务互操作性的理解。
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引用次数: 0
Perspectives of postgraduate emergency health sciences students and clinical educators on prehospital clinical placements: A qualitative study 急诊卫生科学研究生和临床教育工作者院前临床实习的观点:一项定性研究。
IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2025-08-21 DOI: 10.1016/j.auec.2025.08.005
Rosario Pilar López-Picazo , Sofía García-Sanjuán , Antonio Esteve-Ríos , Noelia García-Aracil , María Leopolda Moratalla-Cebrián , Rocío Juliá-Sanchís

Background

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

Methods

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.

Results

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.

Conclusions

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.
背景:卫生科学研究生教育需要实践和跨专业培训。在院前急救服务中,临床教育工作者在整合理论和实践知识方面发挥着关键作用。然而,关于临床教育工作者和研究生对院外临床实习的看法,文献中存在差距。方法:采用描述性现象学方法。对院前急诊医学领域的14名学生和12名临床教育工作者进行了半结构化访谈。使用Colaizzi方法对访谈进行分析。结果:确定了四个主要主题:院前急诊临床实习开始时面临的挑战;临床教育工作者教学方法的异质性学生对院前环境的态度和准备水平;以及技术和非技术技能的发展。结论:这项研究强调了标准化的初始导向的重要性,以帮助学生融入这种环境并调整他们的期望。它还强调需要规范教学实践,为学生的不安全感提供支持,并确保学生有积极的态度和广泛的知识基础来帮助他们适应。最后,它强调了学生学习技术和非技术技能的重要性。
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引用次数: 0
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Australasian Emergency Care
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