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Australian Emergency Departments (australian + emergency_department)
Selected AbstractsFailed Validation of the Argall Weight Formula for Estimating Children's Weight in an Australian Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 5 2007Kevin Nguyen BackgroundAn estimate of a child's weight is required for critical interventions, particularly pharmacotherapy. Weight measurement is not always practical, so weight estimation methods are used. Recently, a new weight estimation formula was suggested. The Argall formula estimates weight in kilograms as follows: (age in years + 2) × 3. ObjectivesTo validate the Argall weight formula. MethodsThis was a prospective, observational, cohort study conducted in the pediatric emergency department (ED) of Sunshine Hospital. Children aged up to 11 years who presented to the ED during August 18, 2005, to February 25, 2006, were included. Actual weight, height, age, and ethnicity were obtained. Data were analyzed by descriptive statistics (proportion, mean, median, and SD). Agreement between estimated weight using the Argall formula and measured weight is reported by using mean bias, SD, and root mean square error (RMSE) analysis. ResultsFour hundred ten cases were included, 46% were female, and the median age was 4 years. The Argall formula had a mean bias of ,1.66 kg and RMSE of 5.65. Only 37% of Argall estimates were within 10% of the child's actual weight. The formula performed less well in children weighing more than 35 kg but performed better in Asian children than white children. ConclusionsThe Argall weight estimation formula has poor accuracy for weight estimation in Australian children, in particular those weighing more than 35 kg. [source] Nurse discharge planning in the emergency department: a Toowoomba, Australia, studyJOURNAL OF CLINICAL NURSING, Issue 8 2006Desley Hegney BA Aim., This study aimed to ascertain whether a model of risk screening carried out by an experienced community nurse was effective in decreasing re-presentations and readmissions and the length of stay of older people presenting to an Australian emergency department. Objectives., The objectives of the study were to (i) identify all older people who presented to the emergency department of an Australian regional hospital; (ii) identify the proportion of re-presentations and readmissions within this cohort of patients; and (iii) risk-screen all older patients and provide referrals when necessary to community services. Design., The study involved the application of a risk screening tool to 2139 men and women over 70 years of age from October 2002 to June 2003. Of these, 1102 (51·5%) were admitted and 246 (11·5%) were re-presentations with the same illness. Patients presenting from Monday to Friday from 08:00 to 16:00 hours were risk-screened face to face in the emergency department. Outside of these hours, but within 72 hours of presentation, risk screening was carried out by telephone if the patient was discharged or within the ward if the patient had been admitted. Results., There was a 16% decrease in the re-presentation rate of people over 70 years of age to the emergency department. Additionally during this time there was a 5·5% decrease in the readmission rate (this decrease did not reach significance). There was a decrease in the average length of stay in hospital from 6·17 days per patient in October 2002 to 5·37 days per patient in June 2003. An unexpected finding was the decrease in re-presentations in people who represented to the emergency department three or more times per month (known as ,frequent flyers'). Conclusions., Risk screening of older people in the emergency department by a specialist community nurse resulted in a decrease of re-presentations to the emergency department. There was some evidence of a decreased length of stay. It is suggested that the decrease in re-presentations was the result of increased referral and use of community services. It appears that the use of a specialist community nurse to undertake risk screening rather than the triage nurse may impact on service utilization. Relevance to clinical practice., It is apparent that older people presenting to the emergency department have complex care needs. Undertaking risk screening using an experienced community nurse to ascertain the correct level of community assistance required and ensuring speedy referral to appropriate community services has positive outcomes for both the hospital and the patient. [source] Optimizing triage consistency in Australian emergency departments: The Emergency Triage Education KitEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2008Marie Frances Gerdtz Abstract Objective: The Emergency Triage Education Kit was designed to optimize consistency of triage using the Australasian Triage Scale. The present study was conducted to determine the interrater reliability of a set of scenarios for inclusion in the programme. Methods: A postal survey of 237 paper-based triage scenarios was utilized. A quota sample of triage nurses (n = 42) rated each scenario using the Australasian Triage Scale. The scenarios were analysed for concordance and agreement. The criterion for inclusion of the scenarios in the programme was , , 0.6. Results: Data were collected during 2 April to 14 May 2007. Agreement for the set was , = 0.412 (95% CI 0.410,0.415). Of the initial set: 92/237 (38.8%, 95% CI 32.6,45.3) showed concordance ,70% to the modal triage category (, = 0.632, 95% CI 0.629,0.636) and 155/237 (65.4%, 95% CI 59.3,71.5) showed concordance ,60% to the modal triage category (, = 0.507, 95% CI 0.504,0.510). Scenarios involving mental health and pregnancy presentations showed lower levels of agreement (, = 0.243, 95% CI 0.237,0.249; , = 0.319, 95% CI 0.310,0.328). Conclusion: All scenarios that showed good levels of agreement have been included in the Emergency Triage Education Kit and are recommended for testing purposes; those that showed moderate agreement have been incorporated for teaching purposes. Both scenario sets are accompanied by explanatory notes that link the decision outcome to the Australasian College for Emergency Medicine Guidelines on the Implementation of the Australasian Triage Scale. Future analysis of the scenarios is required to identify how task-related factors influence consistency of triage. [source] Sustained-release bupropion overdose: A new entity for Australian emergency departmentsEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2002Richard Paoloni Abstract Bupropion hydrochloride (Zyban, Glaxo Wellcome Australia, Melbourne, Vic., Australia) was released in Australia in November 2000 as adjunctive therapy to assist with smoking cessation, having previously been used as an antidepressant in the US since 1989. The toxicity profile of bupropion hydrochloride in overdose differs considerably from other antidepressants, with prominent neurological manifestations and little cardiovascular toxicity. A case of bupropion overdose demonstrating the typical toxic syndrome is presented, together with a review of the literature and a discussion of the magnitude of the demand for bupropion and of the potential differences in presentation of overdoses in Australia. [source] | ||||||||||