Predictors of Prehospital On-Scene Time in an Australian Emergency Retrieval Service.

Introduction: Prehospital physicians balance the need to stabilize patients prior to transport, minimizing the delay to transport patients to the appropriate level of care. Literature has focused on which interventions should be performed in the prehospital environment, with airway management, specifically prehospital intubation (PHI), being a commonly discussed topic. However, few studies have sought additional factors which influence scene time or quantify the impact of mission characteristics or therapeutic interventions on scene time.

Ketamine reduces the need for intubation in patients with acute severe mental illness and agitation requiring transport to definitive care: An observational study.

Objectives: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline.

Methods: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015.

Results: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013.

Presenting characteristics and processing times for culturally and linguistically diverse (CALD) patients with chest pain in an emergency department: Time, Ethnicity, and Delay (TED) Study II.

Background: To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines.

Methods: This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014.

Fluid bolus therapy in emergency department patients: Indications and physiological changes.

Objective: The aim of the present paper is to study the indications for fluid bolus therapy (FBT) and its associated physiological changes in ED patients.

Methods: Prospective observational study of FBT in a tertiary ED, we recorded indications, number, types and volumes, resuscitation goals and perceived success rates of FBT. Moreover, we studied key physiological variables before, 10 min, 1 h and 2 h after FBT.

Multicentre audit of ACE-inhibitor associated angioedema (MAAAA).

Background: Angiotensin-converting enzyme (ACE) inhibitors are a commonly used class of medications that are generally well tolerated. However, angioedema, a rare but potentially life-threatening adverse effect, may occur.

Methods: A retrospective audit was performed on patients who presented with angioedema to two emergency departments in Adelaide, Australia.

Application of process mining to assess the data quality of routinely collected time-based performance data sourced from electronic health records by validating process conformance.

Effective and accurate use of routinely collected health data to produce Key Performance Indicator reporting is dependent on the underlying data quality. In this research, Process Mining methodology and tools were leveraged to assess the data quality of time-based Emergency Department data sourced from electronic health records. This research was done working closely with the domain experts to validate the process models.

Model to predict inpatient mortality from information gathered at presentation to an emergency department: The Triage Information Mortality Model (TIMM).

Objectives: To derive and validate a mortality prediction model from information available at ED triage.

Methods: Multivariable logistic regression of variables from administrative datasets to predict inpatient mortality of patients admitted through an ED. Accuracy of the model was assessed using the receiver operating characteristic area under the curve (ROC-AUC) and calibration using the Hosmer-Lemeshow goodness of fit test.

Predicting admission of patients by their presentation to the emergency department.

Objective: The present study aims to determine the importance of certain factors in predicting the need of hospital admission for a patient in the ED.

Methods: This is a retrospective observational cohort study between January 2010 and March 2012. The characteristics, including blood test results, of 100,123 patients who presented to the ED of a tertiary referral urban hospital, were incorporated into models using logistic regression in an attempt to predict the likelihood of patients' disposition on leaving the ED.

Analyser position for end-tidal carbon dioxide monitoring in a rebreather circuit.

Introduction: A diving rebreather currently nearing release incorporates an infra-red CO2 analyser at the end of the exhale hose and uses the expired gas CO2 measurement made at this position to detect hypercapnia. This configuration may allow exhaled anatomic and mouthpiece dead space gas to mix with alveolar gas in the exhale hose thus falsely lowering the CO2 measurement, especially at low tidal volumes.

Methods: A test circuit was constructed using a typical rebreather mouthpiece and exhale hose connected into an anaesthetic machine breathing loop.

Calcific uremic arteriolopathy: advances in pathogenesis and treatment.

Calcific uremic arteriolopathy (CUA) is a rare but serious life-threatening complication of CRF that manifests as painful nonhealing eschars in association with panniculitis and dermal necrosis. This condition is being increasingly recognized and reported as a contributing factor to death in dialysis patients. The pathognomic lesion is vascular calcification with intimal arterial hypertrophy and superimposed small vessel thrombosis.

A randomized controlled trial of magnesium sulfate, in addition to usual care, for rate control in atrial fibrillation.

Study Objectives: We examine the safety and efficacy of magnesium sulfate infusion, in addition to usual care, for acute rate reduction in patients with atrial fibrillation and a rapid ventricular response rate.

Methods: This was a prospective, randomized, double-blind, placebo-controlled trial of intravenous magnesium sulfate in adult emergency department patients with rapid atrial fibrillation. Study solutions were given in addition to any therapy the treating physician would normally consider appropriate, including the use of standard rate-reduction agents.