Gender equity in authorship of emergency medicine publications in Australasia.

Objective: To evaluate gender authorship trends in the official journal of the Australasian College for Emergency Medicine (ACEM), Emergency Medicine Australasia (EMA).

Methods: A bibliometric review of author gender in EMA during the 10-year period 2013-2022. The gender of first/last authors were determined by www.

What effect did the New Zealand COVID-19 lockdown have on computed tomography-head scan utilisation in patients presenting to the emergency department with traumatic head injuries?

Objectives: To explore the unique impact the first COVID-19 national lockdown in New Zealand (NZ) had on the utility of computed tomography (CT)-head scanning in patients presenting to the ED with head injuries.

Methods: Retrospective observational study of CT-head use in head-injured patients presenting to the ED during the 2020 COVID-19 lockdown compared to the corresponding time period in 2019.

Results: During the lockdown period in 2020, the total number of ED presentations reduced by 30.

Is the Sport Concussion Assessment Tool 5th Edition a useful concussion assessment tool in head-injured patients presenting to the emergency department?

Objective: Concussion is a common ED complaint, but diagnosis is challenging as there are no validated objective measures. Use of concussion tools derived from sports medicine is common, but these tools are not well validated in ED settings. The aim of this study was to assess the ability of the Sport Concussion Assessment Tool 5th Edition (SCAT5) to identify concussion in ED patients presenting following head injury.

Exploring the feasibility of smartglass facilitated remote supervision in the emergency department: A simulation study.

Objective: Smartglasses are a wearable computer technology that has potential to facilitate remote supervision to junior doctors working in different clinical settings. The present study aimed to explore the feasibility of smartglass technology to enable remote supervision of junior clinicians by senior clinicians during emergency simulation scenarios.

Methods: This was a feasibility simulation study using high-fidelity mannequins and standardised patients.

Diagnostic performance of S100B as a rule-out test for intracranial pathology in head-injured patients presenting to the emergency department who meet NICE Head Injury Guideline criteria for CT-head scan.

Background: Traumatic brain injury is a common ED presentation. CT-head utilisation is escalating, exacerbating resource pressure in the ED. The biomarker S100B could assist clinicians with CT-head decisions by excluding intracranial pathology.

Cruise ship patient presentation, admission, and intervention rates to the emergency department.

Aims: Patients presenting to emergency departments (EDs) from cruise ships are a unique cohort of patients with several management challenges. Little evidence details the effect this has on EDs in terms of resource use. Therefore, we aimed to review the frequency, characteristics, admission, and intervention rates of cruise ship patient presentations to ED.

Use of the Theoretical Domains Framework to explore factors influencing paediatric fever management practices and antipyretic use in New Zealand emergency departments.

Aim: To explore factors influencing fever management practices and antipyretic use among New Zealand Emergency Department (ED) doctors and nurses using the Theoretical Domains Framework (TDF).

Methods: Cross-sectional survey of doctors and nurses across 11 New Zealand EDs. The questionnaire examined eight of 12 TDF domains, based on a generic questionnaire validated to assess TDF-based determinants of health-care professional behaviour.

Paediatric fever management practices and antipyretic use among doctors and nurses in New Zealand emergency departments.

Objectives: To assess (i) paediatric fever management practices among New Zealand ED doctors and nurses, including adherence to best practice guidelines; and (ii) the acceptability of a randomised controlled trial (RCT) of antipyretics for relief of discomfort in young children.

Methods: A cross-sectional survey of doctors and nurses across 11 New Zealand EDs. The primary outcome of adherence to paediatric fever management best practice guidelines was assessed with clinical vignettes and defined as single antipyretic use for the relief of fever-related discomfort.

Exploring nursing and medical perceptions of sepsis management in a New Zealand emergency department: A qualitative study.

Objective: Early sepsis recognition and treatment are essential in order to reduce the burden of disease. Initial assessment of patients with infection is often undertaken by ED nurses and resident doctors. This descriptive qualitative study aimed to explore their perceptions and perspectives regarding the factors that impede the identification and management of patients with sepsis.

Can serum biomarkers be used to rule out significant intracranial pathology in emergency department patients with mild traumatic brain injury? A Systemic Review & Meta-Analysis.

Background: Interest has mounted into the use of objective clinical biomarkers for traumatic brain injury (TBI). This systematic review and meta-analysis aimed to synthesise the existing evidence investigating the use of serum & plasma biomarkers to exclude significant intracranial injuries seen on CT head scans in patients that present to ED with TBI.

Methods: The primary outcome was to review the diagnostic accuracy (sensitivity & specificity) of S100B, GFAP and UCH-L1 to exclude significant intracranial pathology on CT head scan in adults presenting with TBI.

Workplace wellbeing in emergency departments in Aotearoa New Zealand 2020.

Aim: To quantify staff burnout and wellbeing in emergency departments (EDs) throughout New Zealand (NZ).

Methods: A national cross sectional electronic survey of New Zealand clinical and non-clinical ED staff was conducted between 9 March and 3 April 2020. Burnout and wellbeing were assessed using the Copenhagen Burnout Inventory (CBI) and a variety of quantitative measures.

Facilitators, barriers and opportunities in workplace wellbeing: A national survey of emergency department staff.

Introduction: Emergency department (ED) staff face daily exposure to the illness, injury, intoxication, violence and distress of others. Rates of clinician burnout are high and associated with poor patient outcomes. This study sought to measure the prevalence of burnout in ED personnel as well as determine the important facilitators of and barriers to workplace wellbeing.

Alcohol and acute traumatic brain injury in the emergency department.

Objective: There is limited research from Australasian EDs describing the demographic make-up, injury severity and impact of alcohol in patients requiring computed tomography (CT) for suspected traumatic brain injury (TBI). The present study aims to review the frequency and presenting patterns of patients who consume alcohol prior to presenting with suspected TBI.

Methods: Retrospective observational study of patients referred for head CT to exclude TBI from a major referral centre and regional ED in New Zealand, between 1 September 2018 and 31 August 2019.

Effect of simulation training on nurse leadership in a shared leadership model for cardiopulmonary resuscitation in the emergency department.

Objective: Empowering a senior nurse in a shared leadership role has been proposed as a more efficient set up for the cardiac arrest team in ED. In this model, a senior nurse leads the cardiac arrest algorithm which allows cognitive off-loading of the lead emergency physician. The emergency physician is then more available to perform tasks such as echocardiography and exclude reversible causes.

The effect of prior walking on coronary heart disease risk markers in South Asian and European men.

Purpose: Heart disease risk is elevated in South Asians possibly due to impaired postprandial metabolism. Running has been shown to induce greater reductions in postprandial lipaemia in South Asian than European men, but the effect of walking in South Asians is unknown.

Methods: Fifteen South Asian and 14 white European men aged 19-30 years completed two, 2-day trials in a randomised crossover design.

Exaggerated blood pressure response to dynamic exercise despite chronic refractory hypotension: results of a human case study.

Background: Chronic refractory hypotension is a rare but significant mortality risk in renal failure patients. Such aberrant physiology usually deems patient unfit for renal transplant surgery. Exercise stimulates the mechano-chemoreceptors in the skeletal muscle thereby modulating the sympathetic effects on blood pressure regulation.

When mentalizing fails.

The author presents a long-term psychotherapy process that illustrates the challenges of helping a patient with a severe personality disorder to engage in the process of mentalizing. Illustrative therapist-patient dialogue from several sessions over the course of the psychotherapy supports the author's conclusion that, despite the therapist's perseverance, the patient remained stuck in her determination to use the therapist as a means toward self-sabotaging practical ends rather than establishing a relationship that would support reflection and growth.