A5047667619- Emergency and Acute Care Studies
- Central Venous Catheters and Hemodialysis
- Homelessness and Social Issues
- Nausea and vomiting management
- Substance Abuse Treatment and Outcomes
- Patient Safety and Medication Errors
- Pathogenesis and Treatment of Hiccups
- Trauma and Emergency Care Studies
- Anesthesia and Pain Management
- Anesthesia and Sedative Agents
- Pleural and Pulmonary Diseases
- Cardiac Arrest and Resuscitation
- Alcohol Consumption and Health Effects
- Clinical Reasoning and Diagnostic Skills
- Pediatric Pain Management Techniques
- Healthcare cost, quality, practices
- Ultrasound in Clinical Applications
- Health Systems, Economic Evaluations, Quality of Life
- Sepsis Diagnosis and Treatment
- Nursing Roles and Practices
- Infection Control and Ventilation
- Healthcare Policy and Management
- Radiation Dose and Imaging
- Opioid Use Disorder Treatment
- Patient Satisfaction in Healthcare
Monash Health
2016-2025
Monash University
2016-2025
Monash Medical Centre
2014-2025
Australasian College for Emergency Medicine
1999-2024
Southern Health and Social Care Trust
2010
Whether conservative management is an acceptable alternative to interventional for uncomplicated, moderate-to-large primary spontaneous pneumothorax unknown.In this open-label, multicenter, noninferiority trial, we recruited patients 14 50 years of age with a first-known, unilateral, pneumothorax. Patients were randomly assigned immediate the (intervention group) or observational approach (conservative-management and followed 12 months. The outcome was lung reexpansion within 8 weeks.A total...
The aim of the current study was to review drug harms as they occur in Australia using Multi-criteria Decision Analysis (MCDA) methodology adopted earlier studies other jurisdictions.A facilitated workshop with 25 experts from across Australia, held score 22 drugs on 16 criteria: 9 related that a produces individual and 7 others. Participants were guided by facilitators through principles MCDA. In open discussion, each scored criterion. criteria then weighted process swing weighting. Scoring...
ABSTRACT Background Management of primary spontaneous pneumothorax (PSP) has long been contentious. Aims To identify the factors influencing interventional versus conservative management and to assess current practice patterns for moderate‐to‐large PSP in emergency department (ED) patients. Methods Anonymous online survey medicine, respiratory medicine thoracic surgery specialists trainees Australia New Zealand. Data collected included rating decision‐making importance potential drivers PSP,...
There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in ED.The study aims to examine IN a primary agent ED.This is prospective, observational ED presenting with severe pain (≥6 on 11-point scale at triage). dose was 0.7 mg/kg, secondary 0.5 mg/kg 15 min if did not improve. After 6 months, increased 1.0 same optional dose.The outcomes change VAS rating 30 min; percentage reporting clinically significant...
Objective: To determine the proportion of alcohol-related presentations to emergency departments (EDs) in Australia and New Zealand, at a single time point on weekend night shift.Design, setting participants: A prevalence survey ED patients either waiting be seen or currently being conducted 02:00 local 14 December 2013 106 EDs Zealand. Main outcome measures:The number that were alcoholrelated, defined using World Health Organization ICD-10 codes.Results: At hospitals (92 Australia, Zealand)...
Abstract Background and aims Alcohol's harm to others (AHTO) has become a key driver of national international alcohol policy. This study aimed produce contemporary, comprehensive estimate the correlates harms from others' drinking in 2021 Australia. Design, setting, participants measurements Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross‐sectional survey modes: random‐digit dial mobile phone sample 1000 people 1574 Life Australia™ panel survey. In asked...
Abstract Background and aims Emergency department (ED) alcohol‐related presentation data are not routinely collected in Australia New Zealand. It is likely that previous research has underestimated the numbers of patients presenting with conditions. This study aimed to quantify level alcohol harm EDs Zealand [Correction added on 23 Jan 2018, after first online publication: The ‘aims’ section was missing updated this version]. Design Multi‐centre, prospective study. Patients were screened...
Abstract Objectives The objective was to examine cannulation practice and effectiveness of a multimodal intervention reduce peripheral intravenous cannula ( PIVC ) insertion in emergency department ED patients. Methods A prospective before after study cost analysis conducted at single tertiary Australia. Data were collected 24 hours day for 2 weeks pre‐ post implementation intervention. placement utilization within evaluated all eligible Results total 4,173 participants included the...
Objectives: To survey emergency department (ED) clinical staff about their perceptions of alcohol-related presentations. Design, setting and participants: A mixed methods online ED clinicians in Australia New Zealand, conducted from 30 May to 7 July 2014. Main outcome measures: The frequency aggression alcohol-affected patients or carers experienced by staff; the perceived impact presentations on function, waiting times, other staff. Results: In total, 2002 completed survey, including 904...
Current management of primary spontaneous pneumothorax (PSP) is variable, with little evidence from randomised controlled trials to guide treatment. Guidelines emphasise intervention in many patients, which involves chest drain insertion, hospital admission and occasionally surgery. However, there that conservative may be effective safe, it also reduce the risk recurrence. Significant questions remain regarding optimal initial approach PSP.
Abstract Objective Compare pain relief from non‐opioid, codeine and oxycodone analgesic regimens in adults with moderate limb injury. Method Double‐blind, randomised, controlled, non‐inferiority trial. Three of six tablets, each included 2 × 500 mg paracetamol 200 ibuprofen 100 thiamine (non‐opioid), 30 (codeine) or 5 tablets (oxycodone). Primary outcome: difference mean visual analogue scale (VAS) change between groups at min, a limit inferiority 13. Secondary outcomes VAS rating baseline...
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...
Abstract It can be difficult to avoid unnecessary investigations and treatments, which are a form of low‐value care. Yet every intervention in medicine has potential harms, may outweigh the benefits. Deliberate clinical inertia is art doing nothing as positive response. This paper provides suggestions on how incorporate deliberate into our daily practice, gives an overview current initiatives such ‘Choosing Wisely’ ‘Right Care Alliance’. The decision ‘do nothing’ complex due competing...
The Cardiff Model for Violence Prevention is a data sharing approach aiming to reduce violence-related presentations emergency departments (EDs). This model has not previously been tested with patients attending EDs in major Australian urban setting, nor the use of media reporting results and letters venues without local violence prevention board tested. To determine this approach's effect on alcohol-associated presentation rates during high-alcohol hours (HAHs) ED servicing nightlife...
To determine the extent of alcohol-related violence in EDs throughout Australia and New Zealand impact this has had on ED staff. A mixed methods, cross-sectional, online survey staff working conducted between 1 August 11 September 2022 measuring frequency physical or verbal aggression from patients their relatives/carers; changes to occupational over preceding 5 years; COVID-19 these presentations; perceived function well-being. total 1284 responded, with almost all (97.9%) reporting having...
Abstract Objectives Evaluate patient satisfaction with paramedic and residential aged care facility (RACF) staff‐initiated tele‐emergency through the Southeast Melbourne Virtual ED. Methods Patient surveys were conducted across two of constituent virtual EDs (VEDs). Results Of 452 responses, 427 (94.5%) had no negative comments, 341 (75.4%) rating service 8 out 10 or higher, 83.4% would recommend to family friends. Conclusions Emergency telehealth services favoured by patients, ratings...
Abstract Objective To compare actual ED length of stay (LOS) using laboratory‐based high‐sensitivity cardiac troponin I (hs‐cTnI) testing with the potential LOS that could result from point‐of‐care (POC) hs‐cTnI tests. Methods Baseline tests were performed on same blood sample in laboratory (Access hsTnI assay) and (Atellica VTLi POC assay). Actual compared for patients who discharged after having a baseline test only. Total incorporated time arrival to collection, sampling availability...
ABSTRACT Decompensated (aka tension) primary spontaneous pneumothorax (PSP) is extremely rare. There no published evidence that conservative treatment of stable patients with radiological features so‐called ‘tension’ (e.g., tracheal deviation and mediastinal shift) results in adverse outcomes. also preliminary these do not correlate significant clinical instability. However, anecdotally, clinicians report being uncomfortable providing interventional for PSP tension, part fear litigation....
ABSTRACT Objective To measure the contribution of clinical assistants (CAs) to departmental flow and length stay. Methods An observational study comparing key performance indicators (KPIs) between shifts with without assistants. Results A total 122 were included from 1 November 31 December 2021. There was no difference in proportion patients who seen by a doctor within h, ambulance offload times, or 4‐h departure metrics (regardless non‐admitted, admitted, short stay status). Conclusion CAs...
To describe the treatment and assessment of emergency department nausea vomiting (EDNV) in Australasia by Fellows Australasian College for Emergency Medicine (FACEM). determine influence various factors on FACEM anti-emetic choice. compare drug effectiveness, side effects, cost pharmacy directives adult EDNV choice between choosing two most common first-line agents.A cross-sectional survey all practising ED was conducted mail-out February 2009.Of surveyed 48.7% (532/1092) responded. The...