Sodium Bicarbonate for Metabolic Acidosis in the ICU: Results of a Pilot Randomized Double-Blind Clinical Trial.

Objectives: To identify the best population, design of the intervention, and to assess between-group biochemical separation, in preparation for a future phase III trial.

Design: Investigator-initiated, parallel-group, pilot randomized double-blind trial.

Setting: Eight ICUs in Australia, New Zealand, and Japan, with participants recruited from April 2021 to August 2022.

Pre-medical emergency team activations - Patient characteristics, outcomes and predictors of deterioration.

Background: Pre-medical emergency team (MET) calls are an increasingly common tier of Rapid Response Systems, but the epidemiology of patients who trigger a Pre-MET is not well understoof.

Objectives: This study aims to examine the epidemiology and outcomes of patients who trigger a pre-MET activation and identify risk factors for further deterioration.

Methods: This is a retrospective cohort study of pre-MET activations in a university-affiliated metropolitan hospital in Australia, between 13 April 2021 and 4 October 2021.

Virtual visiting in the intensive care unit: implementation, utilisation and provider acceptance in an Australian metropolitan health service.

We describe the design and implementation of an intensive care unit (ICU) virtual visiting program in a metropolitan ICU in Melbourne, Victoria, Australia, to examine patterns of use, and describe clinician acceptance of this technology. This was a mixed-methods study, comprising a retrospective analysis of virtual visits from 18 August to 30 September 2020. Patterns of utilisation included duration and time of visits, as well as bandwidth used.

Non-beneficial resuscitation during inhospital cardiac arrests in a metropolitan teaching hospital.

Background: There is increasing recognition that a proportion of hospitalised patients receive non-beneficial resuscitation, with the potential to cause harm.

Aim: To describe the prevalence of non-beneficial resuscitation attempts in hospitalised patients and identify interventions that could be used to reduce these events.

Methods: A retrospective analysis was conducted of all adult inhospital cardiac arrests (IHCA) receiving cardiopulmonary resuscitation (CPR) in a teaching hospital over 9 years.

Impact of lockdowns on critical care service demand in a metropolitan hospital in Melbourne, Australia.

Objective: There is a growing recognition of the impact of lockdowns on non-COVID-19 demand for critical care services. While a reduction in demand has been postulated, there remains a paucity of quantitative data on the extent and nature of this reduction. The present study aims to quantify the impact of lockdown on critical care services, namely ED, intensive care unit (ICU), medical emergency team (MET) and emergency theatre (ET) demand, during the lockdown in Victoria, Australia.

Intensive care implications of epidemic thunderstorm asthma.

Objective: To investigate the environmental precipitants, treatment and outcome of critically ill patients affected by the largest and most lethal reported epidemic of thunderstorm asthma.

Design, Setting And Participants: Retrospective multicentre observational study. Meteorological, airborne particulate and pollen data, and a case series of 35 patients admitted to 15 intensive care units (ICUs) due to the thunderstorm asthma event of 21-22 November 2016, in Victoria, Australia, were analysed and compared with 1062 total ICU-admitted Australian patients with asthma in 2016.

The Melbourne epidemic thunderstorm asthma event 2016: an investigation of environmental triggers, effect on health services, and patient risk factors.

Background: A multidisciplinary collaboration investigated the world's largest, most catastrophic epidemic thunderstorm asthma event that took place in Melbourne, Australia, on Nov 21, 2016, to inform mechanisms and preventive strategies.

Methods: Meteorological and airborne pollen data, satellite-derived vegetation index, ambulance callouts, emergency department presentations, and data on hospital admissions for Nov 21, 2016, as well as leading up to and following the event were collected between Nov 21, 2016, and March 31, 2017, and analysed. We contacted patients who presented during the epidemic thunderstorm asthma event at eight metropolitan health services (each including up to three hospitals) via telephone questionnaire to determine patient characteristics, and investigated outcomes of intensive care unit (ICU) admissions.

Influences on emergency department length of stay for older people.

Objective: The aim of this study was to examine the influences on emergency department (ED) length of stay (LOS) for older people and develop a predictive model for an ED LOS more than 4 h.

Methods: This retrospective cohort study used organizational data linkage at the patient level from a major Australian health service. The study population was aged 65 years or older, attending an ED during the 2013/2014 financial year.

Can DCP and LCP plates generate more compression? The effect of multiple eccentrically placed screws and their drill positioning guides.

Aims: The purpose of this biomechanical study was to assess the capacity of dynamic and locking compression plates (DCP and LCP) in improving fracture compression through the use of multiple compression screws, and the effect of alternating their placement between the two sides of the fracture compared with placing them all on one side. The study also compared fracture compression between DCP and LCP, and between the loading and universal drill guides in DCP.

Materials And Methods: Fracture compression was measured using a customised load cell placed in a transverse osteotomy in synthetic bone models.

Variability in management of early severe sepsis.

Objective: A study was undertaken to characterise how doctors in emergency medicine (EM), acute medicine (AM) and critical care (ICU) in the UK, USA and Australia and New Zealand (ANZ) approach the initial resuscitative care of patients with severe sepsis.

Methods: In 2007, members on the mailing lists of UK, US and ANZ EM, ICU and AM specialist organisations were invited to answer an anonymous scenario-based online survey. Respondents described their management of a patient with pneumonia and signs of sepsis.

Australasian resuscitation of sepsis evaluation (ARISE): A multi-centre, prospective, inception cohort study.

Aim: Determine current resuscitation practices and outcomes in patients presenting to the emergency department (ED) with sepsis and hypoperfusion or septic shock in Australia and New Zealand (ANZ).

Methods: Three-month prospective, multi-centre, observational study of all adult patients with sepsis and hypoperfusion or septic shock in the ED of 32 ANZ tertiary-referral, metropolitan and rural hospitals.

Results: 324 patients were enrolled (mean [SD] age 63.