A5046545801- Emergency and Acute Care Studies
- Poisoning and overdose treatments
- Acute Myocardial Infarction Research
- Trauma and Emergency Care Studies
- Healthcare Policy and Management
- Emergency Medicine Education and Research
- Venomous Animal Envenomation and Studies
- Opioid Use Disorder Treatment
- Pharmaceutical Practices and Patient Outcomes
- Cardiac Arrest and Resuscitation
- Forensic Toxicology and Drug Analysis
- Healthcare Decision-Making and Restraints
- Disaster Response and Management
- Rabies epidemiology and control
- Patient Safety and Medication Errors
- Family and Patient Care in Intensive Care Units
- Palliative Care and End-of-Life Issues
- Drug-Induced Hepatotoxicity and Protection
- Healthcare Systems and Technology
- Cardiac Imaging and Diagnostics
- Sepsis Diagnosis and Treatment
- Health and Conflict Studies
- Healthcare and Venom Research
- Clinical Reasoning and Diagnostic Skills
- Acute Ischemic Stroke Management
The University of Melbourne
2015-2024
Austin Health
2003-2024
Austin Hospital
2006-2024
Australasia Paediatric Endocrine Group
2023
The Royal Melbourne Hospital
2014-2022
Ambulance Victoria
2009-2020
Melbourne Health
2014-2020
Integrated Chinese Medicine (China)
2019
Monash University
1999-2016
Monash Health
2011-2016
To compare the severity of paediatric pain as assessed by triage nurse, child and parent.This was an analytical, observational study undertaken in a tertiary referral emergency department between January June (inclusive) 2006. A convenience sample children (aged 3-15 years) with painful conditions enrolled. The parent were asked to assess child's using Wong-Baker FACES rating scale (young children) or linear numerical (nurse, older children, parent). Each participant blinded assessments...
The purpose of the present study was to measure incidence and outcome septic patients presenting at emergency department (ED) with criteria for early goal-directed therapy (EGDT). This hospital-based, retrospective, observational using prospectively collected electronic databases based in a teaching hospital Melbourne, Australia. We conducted outcome-blinded screening infection admitted via ED from 1 January 2000 30 June 2003. obtained data on demographics, laboratory clinical features...
Background— American College of Cardiology/American Heart Association guidelines recommend >75% patients with an ST-elevation myocardial infarction receive primary percutaneous coronary interventions (PPCI) within 90 minutes. Despite these recommendations, this goal has been difficult to achieve. Methods and Results— We conducted a prospective interventional study involving 349 undergoing PPCI at single tertiary referral institution determine the impact prehospital 12-lead ECG triage...
Abstract Objective We aimed to assess the impact of a new model care for patients presenting ED with acute behavioural disturbance. Methods This pre‐/post‐intervention study involved creating dedicated, highly resourced six bed unit, assessment unit (BAU). Co‐located at Royal Melbourne Hospital, was designed fast‐track admission affected by intoxication, mental illness or psychosocial crisis and provide front‐loaded interventions. Results In 12 months from 1 April 2016, 2379 were admitted...
Objective To determine whether sex differences exist in the triage, management and outcomes associated with non-traumatic chest pain presentations emergency department (ED). Methods All adults (≥18 years) to three EDs Melbourne, Australia between 2009 2013 were retrospectively analysed. Data sources included routinely collected hospital databases. Triage scoring of urgency presentation, time medical examination, cardiac troponin testing, admission specialised care units, in-ED in-hospital...
Abstract Objective Artificial intelligence (AI) has gradually found its way into healthcare, and future integration clinical practice is inevitable. In the present study, we evaluate accuracy of a novel AI algorithm designed to predict admission based on triage note after implementation. This first such studies investigate real‐time performance in emergency setting. Methods The that predicts using was translated integrated within St Vincent's Hospital Melbourne's electronic patient...
Women generally wait longer than men prior to seeking treatment for acute myocardial infarction (AMI). They are more likely present with atypical symptoms, and less be admitted coronary or intensive care units (CCU ICU) compared similarly-aged males. die during hospital admission. Sex differences in the associations of delayed arrival, admitting ward, mortality have not been thoroughly investigated. Focusing on presenting symptoms time presentation since symptom onset, we evaluated sex...
We describe six patients diagnosed with serotonin syndrome after exposure to drugs serotonergic activity Drug interactions occurred as a result of combination tricyclic antidepressants, selective reuptake inhibitors, noradrenaline inhibitors or monoamine oxidase inhibitors. Management included supportive care and the use non-specific antagonists (cyproheptadine, benzodiazepines chlorpromazine). All made uneventful recoveries.
Abstract Objective: To evaluate a dual doctor and nurse triage system at tertiary referral hospital. Methods: Data were compared between periods of multidisciplinary standard triage. comparison was also made rostered shifts non‐multidisciplinary shifts. Staff satisfaction with the process assessed. Results: The percentage patients seen within Australasian Triage Scale performance indicator thresholds increased from 75% to 81% in Category 2 ( P = 0.12) 56% 78% 3 < 0.0001). There reduction...
This study was undertaken to examine the association of hydrogen cyanide and carboxyhaemoglobin in victims fire related deaths Australia. The secondary aim document demographic data about Australian deaths.An observational retrospective autopsy reports from Victorian Institute Forensic Medicine. Reports were electronically searched using terms burns, "smoke" or "fire" as a cause death calender years 1992 1998. Data on circumstances results toxicological screening obtained 178 persons....
Abstract Objectives The objective was to investigate the correlation of visual analog scale ( VAS ) and numeric rating NRS for nausea severity measurement explore options improved reporting antiemetic efficacy trial results. Methods This a multicenter observational study adult emergency department ED patients with nausea. Participants rated at enrollment 30 minutes posttreatment using an adjectival scale, , . Posttreatment, described symptom change satisfaction. Results Ratings were...
For pandemic influenza planning, realistic estimates of personal protective equipment (PPE) and antiviral medication required for hospital healthcare workers (HCWs) are vital. In this simulation study, a patient with suspected avian or (API) sought treatment at 9 Australian emergency departments where patient-staff interactions during the first 6 hours hospitalization were observed. Based on World Health Organization definitions guidelines, mean number "close contacts" API was 12.3 (range...
Methylene blue inhibits the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway, decreasing vasodilation and increasing responsiveness to vasopressors. It is reported improve haemodynamics in distributive shock from various causes including septicaemia post-cardiac surgery. Reports of use overdose are limited. We describe methylene treat a case refractory following mixed drug poisoning.A 41-year-old male presented ingestion 18 g extended-release quetiapine, 10 controlled-release...
This study aimed to determine the epidemiology of therapeutic errors among children in community setting.This was a prospective, observational 491 consecutive cases reported Victorian Poisons Information Centre, between January 2006 and March 2007. A total 450 (91.7%) parents/carers were followed up by telephone approximately 48 h after initial call. The main outcome measures nature, causes outcomes actions taken or recommendations given avoid future errors.The majority (334, 68.0%, 95%...
Abstract Objective To determine the frequency of finger thoracostomy performed by intensive care flight paramedics after introduction a training programme in this procedure and complications that were diagnosed hospital arrival. Methods This was retrospective cohort study adult paediatric trauma patients undergoing on helicopter emergency medical service between June 2015 May 2018. Hospital data obtained through manual search records at each three receiving major services. Additional sourced...
The early prediction of hospital admission is important to ED patient management. Using available electronic data, we aimed develop a predictive model for admission.We analysed all presentations the tertiary referral centre over 7 years. To our knowledge, data set nearly 600 000 largest reported. demographic, clinical, socioeconomic, triage, vital signs, pathology and keywords in notes, trained machine learning (ML) with from 2015 2020 evaluated it on held-out 2021 mid-2022. We assessed...
Abstract Introduction: The use of chemical, biological, radiation, and nuclear (CBRN) weapons is not new, though rare, it an issue concern around the world due to their ability cause large-scale mass-casualty events potential threat global stability. purpose this study explore CBRN by non-state actors through analysis Violent Non-State Actor (VNSA) Event database, aims better inform health care systems risks consequences such events. Methods: Data collection was performed using a...
Abstract Objective: The study was performed to determine the nature of adverse events in an ED. Methods: methodology has been described accompanying paper. Two by two tables were analysed using two‐tailed Fisher’s exact test. A P ‐value ≤0.05 considered significant. Statistical analysis MINITAB. Results: One hundred and ninety‐four detected, from a sample 3222 patients. Except where specified, with management causation ≤3 excluded. This excluded 24 (12.4%) leaving 170 for analysis. Errors...
To assess the impact on length of stay and rate major adverse cardiovascular events a cardiac computed tomographic (CT) angiography-guided algorithm to examine patients who present emergency department (ED) with low- intermediate-risk chest pain.The study was approved by institutional review board, all gave written informed consent. Two hundred three consecutive (mean age, 55 years ± 11 [standard deviation]; 123 men) ischemic-type pain were prospectively enrolled. Patients underwent initial...