Determination of emergency nurse practitioner and plastic surgery trainee disposition decision agreement for plastic surgery emergency department presentations: A prospective study.

Objective: To examine if there was a high degree of agreement for disposition decisions of emergency nurse practitioners (ENP) compared to plastic surgery trainees (PST) for plastic surgery presentations.

Methods: A prospective study of disposition decision agreement from February 2020 to January 2021 for patients who required plastic surgery consultation and managed exclusively by an ENP. Absolute percentages were used to determine the exact disposition decision accuracy of ENP and the PST, while Cohen's kappa compared disposition decision agreement.

Documentation of paediatric head injuries in a mixed metropolitan emergency department.

Objective: Head injuries are a common presentation of children to Australian EDs. Healthcare documentation is an important tool for enhancing patient care. In our study, we aimed to assess the adequacy of paediatric head injury documentation in a mixed ED.

Defying Occam's Razor: A Case of Pulmonary Embolism Masked By Cardiac Tamponade.

Background: Occam's razor instructs physicians to assume one single cause for multiple symptoms, whereas Hickam's dictum encourages them to suspect multiple concurrent pathologies. Although the general practice is to follow Occam's razor, occasionally Hickam's dictum reigns supreme. Here we present one such case, where the concurrent presence of two life-threatening pathologies posed clinical challenges in diagnosis and management.

Preparedness of Australasian emergency departments for point-of-care ultrasound in the COVID-19 pandemic.

Introduction: Point-of-care ultrasound (POCUS) has been brought to the limelight again, with a surge in lung ultrasound in suspected COVID-19 patients. This is due to POCUS superiority over chest X-ray, equivalent efficacy to computerised tomography chest for COVID-19 diagnosis and potential minimisation of cross-infection. However, inadequate disinfection practices could make ultrasound machines a vector for disease transmission.

Australasian emergency ultrasound: A survey on the current status.

Objective: Emergency ultrasound (EUS) has become an integral part of emergency medicine, and the core pillars of governance, infrastructure, administration, education and quality assurance (QA) are vital for its quality and continued growth. We aimed to assess the status of these vital pillars among Australasian EDs.

Methods: A survey among the clinical leads in ultrasound (CLUS) in Australasian EDs from November 2020 to April 2021.

Echocardiography does not prolong peri-shock pause in cardiopulmonary resuscitation using the COACH-RED protocol with non-expert sonographers in simulated cardiac arrest.

Objective: Focused echocardiography during peri-shock pause (PSP) can prognosticate and detect reversible causes in cardiac arrest but minimising interruptions to chest compressions improves outcome. The COACH-RED protocol was adapted from the COACHED protocol to systematically incorporate echocardiography into rhythm check without prolonging PSP beyond the recommended 10 s. The primary objective of this study was to test the feasibility of emergency nurses learning to perform all roles in the COACH-RED protocol.

CLUE: COVID-19 lung ultrasound in emergency department.

Lung ultrasound (LUS) plays a critical role in the SARS-CoV-2 pandemic. Evidence is mounting on its utility to diagnose, assess the severity and as a triage tool in the ED. Sonographic features correlate well to computed tomography (CT) chest findings and a bedside LUS performed by a trained clinician along with clinical examination, could be an alternative to chest X-ray and CT chest in these highly infectious patients.

Ultrasound-Guided Manual Testicular Detorsion in the Emergency Department.

Background: Scrotal ultrasound helps in the rapid diagnosis of complete testicular torsion and assessment of alternative causes of acute scrotal pain. Early detection of torsion of the testis and reperfusion, either manually or surgically, is paramount to preserving testicular viability. Manual detorsion also offers immediate symptom relief by alleviating ischemia.

COACHRED: A protocol for the safe and timely incorporation of focused echocardiography into the rhythm check during cardiopulmonary resuscitation.

Focused echocardiography may be a useful tool in cardiopulmonary resuscitation for prognostication, to identify certain reversible causes of cardiac arrest, and to guide further management and procedures. Nonetheless, many clinicians have reservations regarding its widespread adoption due to evidence that it leads to prolonged interruption of cardiac compressions. Furthermore, the lack of a clear protocol for the inclusion of focused echocardiography into the rhythm check can lead to confusion in teams not familiar with incorporating the modality, as well as safety concerns for the echosonographer during delivery of a shock.