Triggering palliative care referrals through the identification of poor prognosis in older patients presented to emergency departments in rural Australia.

Without objective screening for risk of death, the palliative care needs of older patients near the end of life may be unrecognised and unmet. This study aimed to estimate the usefulness of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool in determining older patients' risk of death within 3-months after initial hospital admission. A prospective cohort study of 235 patients aged 70+ years, who presented to two rural emergency departments in two adjacent Australian states, was utilised.

Preparedness for caregiving: A phenomenological study of the experiences of rural Australian family palliative carers.

The care of people with life-limiting illnesses is increasingly moving away from an acute setting into the community. Thus, the caregiver role is growing in significance and complexity. The importance of preparing and supporting family caregivers is well established; however, less is known about the impact of rurality on preparedness and how preparedness shapes the caregiving continuum including bereavement.

Nebulisers or spacers for the administration of bronchodilators to those with asthma attending emergency departments?

Background: Systematic reviews and national guidelines conclude that the nebulised route of administration of bronchodilators has no advantage over the use of a spacer in moderately severe exacerbations of asthma. Whether this recommendation is implemented and whether it might affect use of staff time is unknown.

Objectives: To determine the current method of administration of bronchodilators to those with non-life-threatening asthma attending emergency departments (ED) in London, UK and to monitor the implementation of a new policy to administer bronchodilators by spacers in one ED with a special reference to the time taken by nurses to administer the therapy by two different routes.

Symptoms and management options in cardiomyopathy.

Cardiomyopathy is the most common cause of sudden cardiac death in young people, including trained athletes (Maron et al, 1996). Often the tragedy of sudden death is the first indication of its presence within a family. This article describes the four types of cardiomyopathy, diagnosis, treatment and management options, and discusses ways in which the new National Service Framework for Coronary Heart Disease (Department of Health, 2005) will help in planning and implementing services.