Enhancing Aotearoa, New Zealand's Free Healthline Service through Image Upload Technology.

Background: Healthline is one of the 39 free telehealth services that Whakarongorau Aotearoa/New Zealand Telehealth Services provides to New Zealanders. In early 2021, an image upload system for viewing service user-uploaded images was implemented into the Healthline service.

Aims: The aim of this research was to understand the utilisation of Healthline's image upload system by clinicians and service users in New Zealand.

Naloxone use by Aotearoa New Zealand emergency medical services, 2017-2021.

Objective: Emergency medical services (EMS) use of naloxone in the prehospital setting is indicated in patients who have significantly impaired breathing or level of consciousness when opioid intoxication is suspected. The present study characterised naloxone use in a nationwide sample of Aotearoa New Zealand road EMS patients to establish a baseline for surveillance of any changes in the future.

Methods: A retrospective analysis of rates of patients with naloxone administrations was conducted using Hato Hone St John (2017-2021) and Wellington Free Ambulance (2018-2021) electronic patient report form datasets.

Out-of-Hospital emergency airway management practices: A nationwide observational study from Aotearoa New Zealand.

Background And Objectives: Airway management is crucial for emergency care in critically ill patients outside the hospital setting. An Airway Registry is useful in providing essential information for quality improvement purposes. Therefore, this study aimed to develop an out-of-hospital airway registry and describe airway management practices in Aotearoa New Zealand (AoNZ).

Predictive value of the New Zealand Early Warning Score for early mortality in low-acuity patients discharged at scene by paramedics: an observational study.

Objectives: The utility of New Zealand Early Warning Score (NZEWS) for prediction of adversity in low-acuity patients discharged at scene by paramedics has not been investigated. The objective of this study was to evaluate the association between the NZEWS risk-assessment tool and adverse outcomes of early mortality or ambulance reattendance within 48 hours in low-acuity, prehospital patients not transported by ambulance.

Design: A retrospective cohort study.

Prehospital identification of ST-segment elevation myocardial infarction and mortality (ANZACS-QI 61).

Background: Early recognition of ST-segment elevation myocardial infarction (STEMI) is needed for timely cardiac monitoring and reperfusion therapy.

Methods: Three anonymously linked New Zealand national datasets (July 2016-November 2018) were used to assess the utilisation of ambulance transport in STEMI cases, the concordance between ambulance initial clinical impressions and hospital STEMI diagnoses, and the association between initial paramedic clinical impressions and 30-day mortality. The St John Ambulance electronic record captures community call-outs and paramedic initial clinical impressions.

Positive association between ambulance double-crewing and OHCA outcomes: A New Zealand observational study.

Background And Objectives: New Zealand emergency medical service (EMS) crewing configurations generally place one (single) or two (double) crew on each responding ambulance unit. Recent studies demonstrated that double-crewing was associated with improved survival from out-of-hospital cardiac arrest (OHCA), therefore single-crewed ambulances have been phased out. We aimed to determine the association between this crewing policy change and OHCA outcomes in New Zealand.

The impact of a national COVID-19 lockdown on acute coronary syndrome hospitalisations in New Zealand (ANZACS-QI 55).

Background: Countries with a high incidence of coronavirus 2019 (COVID-19) reported reduced hospitalisations for acute coronary syndromes (ACS) during the pandemic. This study describes the impact of a nationwide lockdown on ACS hospitalisations in New Zealand (NZ), a country with a low incidence of COVID-19.

Methods: All patients admitted to a NZ Hospital with ACS who underwent coronary angiography in the All NZ ACS Quality Improvement registry during the lockdown (23 March - 26 April 2020) were compared with equivalent weeks in 2015-2019.

Changes in demand for emergency ambulances during a nationwide lockdown that resulted in elimination of COVID-19: an observational study from New Zealand.

Objective: To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand.

Design: A descriptive cross-sectional, observational study.

Setting: High-quality data from ambulance electronic clinical records, New Zealand.

Factors Associated with Emergency Medical Service Reattendance in Low Acuity Patients Not Transported by Ambulance.

The decision for emergency medical services (EMS) personnel not to transport a patient is challenging: there is a risk of subsequent deterioration but transportation of all patients to hospital would overburden emergency departments. The aim of this large-scale EMS study was to identify factors associated with an increased likelihood of ambulance reattendance within 48 hours in low acuity patients who were not transported by ambulance. We conducted a 2-year retrospective cohort study using data from the St John New Zealand EMS between 1 July 2016 and 30 June 2018 to investigate demographic and clinical associations with ambulance reattendance.

Ethnic disparities in the incidence and outcome from out-of-hospital cardiac arrest: A New Zealand observational study.

Background: New Zealand (NZ) has an ethnically diverse population. International studies have demonstrated significant differences in health equity by ethnicity; however, there is limited evidence in the context of out-of-hospital cardiac arrest in NZ. We investigated whether heath disparities in incidence and outcome of out-of-hospital cardiac arrest exist between NZ ethnic groups.

Direct transport to PCI-capable hospitals after out-of-hospital cardiac arrest in New Zealand: Inequities and outcomes.

Background: It is widely accepted that survival from OHCA may be improved through direct transfer of patients to hospitals with percutaneous coronary intervention (PCI) capability. However, within the New Zealand healthcare system there is limited evidence available to support this. We aimed to compare patient characteristics and outcomes following an out-of-hospital cardiac arrest between those patients transported to hospitals with or without PCI-capability within New Zealand.