Benefits of emergency department routine blood test performance on patients whose allocated triage category is not time critical: a retrospective study.

Introduction: Emergency department clinicians, and particularly nurses in triage, frequently perform routine blood tests on patients whose allocated triage category is not time critical (triage categories 3, 4 and 5 of the Australasian Triage Scale). Some observers have questioned the utility of routine blood testing in these acute healthcare settings given the cost and workload implications.

Methods: A quantitative method using retrospective observational design was utilised guided by STROBE checklist.

Acknowledgement and use of advance care directives and goals of care by emergency department staff: a mixed method post intervention study.

Introduction: Advance Care Planning (ACP) refers to a process that includes Advance Care Directives (ACD) and Goals of Care (GOC), a practice widely used for over three decades. Following the findings of an audit and a cross-sectional study in 2019 and 2021 respectively, we implemented several educational and other interventional strategies aimed at enhancing staff awareness and emphasizing the importance of recognizing and documenting of ACD/GOC. The aim of this study was to evaluate the acknowledgement and use of ACD and GOC by Emergency Department (ED) staff following these interventions.

Improving the safety of anticoagulation initiation in patients discharged from the emergency department.

Objective: To improve the safety of anticoagulation initiation by increasing the proportion of patients reviewed by a pharmacist.

Methods: An electronic intervention was developed to ensure all patients prescribed anticoagulation on discharge were reviewed by an ED pharmacist. Safe anticoagulation initiation was compared for patients seen and not seen.

Evaluation of a calcium, magnesium and phosphate clinical ordering tool in the emergency department.

Objective: We developed a clinical tool comprising patient risk factors for having an abnormal calcium (Ca), magnesium (Mg) or phosphate (PO) level. We hypothesized that patients without a risk factor do not require testing. This study examined the tool's potential utility for rationalizing Ca, Mg and PO ordering in the emergency department (ED).

Cardiopulmonary resuscitation and endotracheal intubation decisions for adults with advance care directive and resuscitation plans in the emergency department.

Background: Emergency departments routinely offer cardiopulmonary resuscitation and endotracheal intubation to patients in resuscitative states. With increasing longevity and prevalence of chronic conditions in Australia, there has been growing need to uptake and implement advance care directives and resuscitation plans. This study investigates the frequency of the presence of advance care directives and resuscitation plans and its utilisation in cardiopulmonary and endotracheal intubation decision making.

Risk variables associated with abnormal calcium, magnesium and phosphate levels among emergency department patients.

Objective: The utility of calcium, magnesium and phosphate measurement in the ED is limited. We aimed to determine clinical risk variables for abnormal levels of these electrolytes in order to inform the development of an ordering guideline.

Methods: We performed a retrospective, observational study of patients who presented to a tertiary referral ED between January and June 2017.

Utility of calcium, magnesium and phosphate testing in the emergency department.

Objective: To determine how frequently calcium (Ca), magnesium (Mg) and phosphate (PO ) tests change ED patient management.

Methods: We undertook a retrospective observational study in an Australian tertiary referral ED. We enrolled adult patients (aged ≥18 years) who presented between 1 January and 30 June 2017 and who had a serum Ca, Mg or PO test ordered and completed during their ED stay.

Comparison of emergency department time performance between a Canadian and an Australian academic tertiary hospital.

Objective: To compare performance and factors predicting failure to reach Ontario and Australian government time targets between a Canadian (Sunnybrook Hospital) and an Australian (Austin Health) academic tertiary-level hospitals in 2012, and to assess for change of factors and performance in 2016 between the same hospitals.

Methods: This was a retrospective, observational study of patient administrative data in two calendar years. The main outcome measure was reaching Ontario and Australian ED time targets for admissions, high and low urgency discharges.

Emergency presentations of acute biliary pain: changing patterns of management in a tertiary institute.

Background: Acute biliary pain is the most common presentation of gallstone disease. Untreated patients risk recurrent pain, cholecystitis, obstructive jaundice, pancreatitis and multiple hospital presentations. We examine the outcome of implementing a policy to offer laparoscopic cholecystectomy on index presentation to patients with biliary colic in a tertiary hospital in Australia.

Aortic dissection detection risk score has high sensitivity with moderate inter-rater reliability.

Objective: To retrospectively assess the accuracy and inter-rater reliability of the aortic dissection detection risk score (ADD-RS).

Methods: Single-centre, observational, diagnostic accuracy study undertaken in a university-affiliated, tertiary hospital ED.

Results: Two hundred patients were enrolled.

Taming the zebra: Unravelling the barriers to diagnosing aortic dissection.

Aortic dissection is a lethal cardiovascular emergency that continues to pose a diagnostic dilemma to the emergency physician. The condition is rare, can present atypically and is associated with a cumulative mortality for every hour that passes. While it is a recognised differential of acute chest pain, its prevalence in comparison to other causes often leads to the diagnosis being overlooked.

Case-control study to investigate variables associated with incidents and adverse events in the emergency department.

Objective: To detect and analyse incidents (Is) and adverse events (AEs) in the ED. We hypothesised that I/AE are associated with patient load.

Methods: We undertook a case-control study in a tertiary level hospital ED (from 1 April 2012 to 31 March 2013).

Variables associated with administration of analgesia, nurse-initiated analgesia and early analgesia in the emergency department.

Objective: To determine the patient and clinical variables associated with administration of any analgesia, nurse-initiated analgesia (NIA, prescribed and administered by a nurse) and early analgesia (within 30 min of presentation).

Methods: We undertook a retrospective cohort study of patients who presented to a metropolitan ED in Melbourne, Australia, during July and August, 2013. The ED has an established NIA programme.

Factors associated with high levels of patient satisfaction with pain management.

Objectives: The objective was to determine, among emergency department (ED) patients, the factors associated with a high level of satisfaction with pain management.

Methods: This was a prospective cohort study in a single ED. Consecutive adult patients, with triage pain scores of ≥4 (numerical rating scale=0 to 10), were enrolled.

Factors that impact on emergency department patient compliance with antibiotic regimens.

Aim: To investigate factors that impact upon compliance with antibiotic regimens among patients in the emergency department (ED).

Methods: This was a prospective cohort study of patients prescribed antibiotics in a single ED. Patients were identified by witnessing the consultation, medical records and 'after hours' prescriptions.

Carbon monoxide and cyanide poisoning in fire related deaths in Victoria, Australia.

Objective: This study was undertaken to examine the association of hydrogen cyanide and carboxyhaemoglobin in victims of fire related deaths in Australia. The secondary aim was to document demographic data about Australian fire related deaths.

Methods: An observational retrospective study was undertaken of autopsy reports from the Victorian Institute of Forensic Medicine.

Multidisciplinary assessment at triage: a new way forward.

Objective: To evaluate a dual doctor and nurse triage system at a tertiary referral hospital.

Methods: Data were compared between periods of multidisciplinary triage and periods of standard triage. Data comparison was also made between rostered multidisciplinary triage shifts and non-multidisciplinary triage shifts.