Implementing enhanced extracorporeal membrane oxygenation for CPR (ECPR) in the emergency department.

Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge.

Applying Sydney Triage to Admission Risk Tool (START) to improve patient flow in emergency departments: a multicentre randomised, implementation study.

Background: To determine the effectiveness of applying the Sydney Triage to Admission Risk Tool (START) in conjunction with senior early assessment in different Emergency Departments (EDs).

Methods: This multicentre implementation study, conducted in two metropolitan EDs, used a convenience sample of ED patients. Patients who were admitted, after presenting to both EDs, and were assessed using the existing senior ED clinician assessment, were included in the study.

The Emergency nurse Protocols Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial.

Introduction: Emergency department (ED) overcrowding is a global problem and a threat to the quality and safety of emergency care. Providing timely and safe emergency care therein is challenging. To address this in New South Wales (NSW), Australia, the Emergency nurse Protocol Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) was developed.

Clinical characteristics and predictors for hospitalisation during the initial phases of the Delta variant COVID-19 outbreak in Sydney, Australia.

Objectives: The COVID-19 Delta variant of concern continues to pose significant challenges to health systems globally, with increased transmissibility and different patient populations affected. In Sydney, a virtual model of care was implemented in response to the COVID-19 pandemic and Special Health Accommodation (SHA) was made available for community patients with COVID-19 who could not isolate at home or needed health support.

Methods: This retrospective observational cohort study of all patients with COVID-19 Delta variant in SHA during the initial phases of the Delta variant outbreak in Sydney describes the demographic and clinical characteristics of patients with Delta variant COVID-19 and determines predictors of need for in-patient hospital admission.

Does volume or occupancy influence emergency access block? A multivariate time series analysis from a single emergency department in Sydney, Australia during the COVID-19 pandemic.

Objective: The study aims to determine whether ED presentation volume or hospital occupancy had a greater impact on ED performance before and during the COVID-19 health response at a tertiary referral hospital in Sydney, Australia.

Methods: Single centre time series analysis using routinely collected hospital and ED data from January 2019 to September 2020. The primary outcome was ED access block measured by emergency treatment performance (ETP; i.

Evaluating an emergency department-based mental health liaison nurse service: A multi-site translational research project.

Objective: We aimed to translate and evaluate a model of mental health liaison nursing (MHLN) care that was embedded within EDs.

Methods: The 12 month mixed-methods translational research study incorporated descriptive data on ED presentations, waiting times for MHLN intervention, time spent in ED and discharge arrangements across three EDs in New South Wales. The study involved an inner-city ED (where the model was first established) and two rural sites.

Incidence and outcomes of aortic dissection for emergency departments in New South Wales, Australia 2017-2018: A data linkage study.

Objective: The aims of the present study were to describe the age-specific incidence and 30-day mortality of aortic dissection patients presenting to the EDs in New South Wales (NSW).

Methods: This was a data linkage study involving emergency, inpatient and death registry administrative data from NSW.

Results: The present study found 273 instances of aortic dissection in NSW from July 2017 to July 2018.

Predictors and in-hospital mortality associated with prolonged emergency department length of stay in New South Wales tertiary hospitals from 2017 to 2018.

Objective: To determine specific patient, clinical and service factors associated with increased ED length of stay and investigate whether prolonged ED length of stay, as measured by emergency treatment performance (ETP) non-compliance, is an independent predictor of all cause 30-day mortality for patients presenting to, and admitted from ED.

Methods: This was a retrospective analysis of linked state-wide emergency, inpatient and death data from New South Wales. All patients who presented to a tertiary level public hospital (level 5 or 6) ED and admitted to an in-patient unit were included.

The Sydney triage to admission risk tool (START) to improve patient flow in an emergency department: a model of care implementation pilot study.

Background: The Sydney Triage to Admission Risk Tool (START) is a validated clinical analytics tool designed to estimate the probability of in-patient admission based on Emergency Department triage characteristics.

Methods: This was a single centre pilot implementation study using a matched case control sample of patients assessed at ED triage. Patients in the intervention group were identified at triage by the START tool as likely requiring in-patient admission and briefly assessed by an ED Consultant.

Diagnoses, damned diagnoses and statistics: Dealing with disparate diagnostic coding systems within the New South Wales Emergency Department Data Collection.

Objectives: The aims of the present study were to describe the distribution of Systematised Nomenclature of Medicine - Clinical Terms (SNOMED-CT) codes used in the current New South Wales Emergency Department Data Collection (NSW EDDC) and classify duplicate and redundant terms into clinically meaningful sub-groups for future analyses.

Methods: This was an analysis of ED diagnosis codes using a large state-wide administrative ED dataset between 2015 and 2018.

Results: A total of 7.

Feeling the HEAT: Using Hourly Emergency Activity Tracking to demonstrate a novel method of describing activity and patient flow.

Objective: The objective of the present study is to demonstrate a novel method of mapping ED activity to analyse patterns presentations, occupancy and performance trends.

Methods: This was a retrospective, descriptive analysis of de-identified and linked ED presentations across NSW, Australia, over five calendar years, 2010-2014. It was undertaken as part of the Demand for Emergency Services Trend in Years 2010-2014 (DESTINY) study.

The Sydney Triage to Admission Risk Tool (START) to predict Emergency Department Disposition: A derivation and internal validation study using retrospective state-wide data from New South Wales, Australia.

Background: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making.

Methods: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia.

Major trauma mortality in rural and metropolitan NSW, 2009-2014: a retrospective analysis of trauma registry data.

Objective: To determine trends in crude and risk-adjusted mortality for major trauma patients injured in rural or metropolitan New South Wales, 2009-2014.

Design: A retrospective analysis of NSW statewide trauma registry data.

Participants: Adult patients (aged 16 years or more) who presented with major trauma (Injury Severity Scores greater than 15) to a NSW hospital during 2009-2014.

Demand for Emergency Services Trends in New South Wales Years 2010-2014 (DESTINY): Age and Clinical Factors Associated with Ambulance Transportation to Emergency Departments.

Objectives: The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses.

Methods: This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data on presentations to designated EDs across NSW.

Triage, damned triage… and statistics: Sorting out redundancy and duplication within an Emergency Department Presenting Problem Code Set to enhance research capacity.

Background: Having a robust Emergency Department Presenting Problem Code Set (EDPPCS) is important for collecting and analysing data around Emergency Department (ED) activity, funding, bio-surveillance and research. This paper analyses the clinical utilisation of the current EDPPCS using two years worth of ED data collected as part of the larger state-wide Demand for Emergency Services Trends in Years 2010-2014 (DESTINY) project. This project proposes potential improvements in the current EDPPCS including a reduction in duplication and redundant clinical terms.

Age-related trends in injury and injury severity presenting to emergency departments in New South Wales Australia: Implications for major injury surveillance and trauma systems.

Objectives: To describe population based trends and clinical characteristics of injury related presentations to Emergency Departments (EDs).

Design And Setting: A retrospective, descriptive analysis of de-identified linked ED data across New South Wales, Australia over five calendar years, from 2010 to 2014.

Participants: Patients were included in this analysis if they presented to an Emergency Department and had an injury related diagnosis.

Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?

Objective: The present study aims to use a statewide population-based registry to assess the prevalence of low acuity emergency department (ED) presentations, describe the trend in presentation rates and to determine whether they were associated with various presentation characteristics such as the type of hospital as well as clinical and demographic variables.

Design And Setting: This was a retrospective analysis of a population-based registry of ED presentations in New South Wales (NSW). Generalised estimating equations with log links were used to determine factors associated with low acuity presentations to account for repeat presentations and the possibility of clustering of outcomes.

Trends and characteristics of short-term and frequent representations to emergency departments: A population-based study from New South Wales, Australia.

Objective: The objective of this study is to describe the trends and characteristics of short-term and frequent representations to EDs in New South Wales, Australia.

Methods: This was a retrospective analysis of a linked population-based registry of ED representations in New South Wales, conducted as part of the Demand for Emergency Services in Years 2010-2014 project. Trend analysis of unplanned representations to ED within 3 days of discharge from ED, readmission to an in-patient unit within 30 days of index in-patient admission from ED and demographic data and trends for frequent and very frequent ED presenters is discussed.

Understanding drivers of Demand for Emergency Service Trends in Years 2010-2014 in New South Wales: An initial overview of the DESTINY project.

Objective: This study aims to describe the general characteristics and data definitions used in a population-based data set of ED presentations in New South Wales (NSW), used to form the basis of future-trend analyses.

Methods: Retrospective analysis of the Emergency Department Data Collection registry, which provided clinical and demographic information of ED presentations across all EDs in NSW between 2010 and 2014. Presenting problems and ED diagnoses were classified using broad clinical categories including injury/musculoskeletal, respiratory, cardiovascular, ear nose and throat, and mental health.