Attitudes and regard for specific medical conditions among Australian emergency medicine clinicians.

OBJECTIVE: To quantify the attitude ED clinicians hold towards patients presenting with different medical conditions, including a novel pandemic condition. METHODS: A cross-sectional study of emergency doctors and nurses utilising the Medical Condition Regard Scale (MCRS); a validated tool used to capture the bias and emotions of clinicians towards individual medical conditions. The five conditions presented to participants each represent a classical medical, complex medical, psychiatric/substance use, somatoform and a novel medical condition. RESULTS: One hundred and ninety-six clinicians were included in the study including 116 nurses and 80 doctors. Concerning each condition, both medical and nursing staff demonstrated the highest regard for a classical medical condition (58 ± 5 and 57 ± 6, respectively). Significantly different from the classical medical condition, the lowest MCRS scores were for the somatoform condition (36 ± 10) for emergency doctors and the substance use condition (39 ± 11) for emergency nurses. Regard for a novel condition (i.e., COVID-19 infection) was comparably high among both cohorts. CONCLUSION: Emergency doctors and nurses generally hold lower regard for complex medical conditions with behavioural components, including substance use disorders and somatoform conditions.

Epidemiology, clinical presentations and outcome of patients presenting to the emergency department after a COVID-19 vaccination: An observational study.

OBJECTIVE: The World Health Organization declared the COVID-19 pandemic on 11 March 2020. In 2021, several vaccines were provisionally approved to reduce the risk of transmission and hospitalisation of COVID-19 infection. A surge in COVID-19 vaccination was seen between August and October 2021 in Victoria, Australia. We hypothesised this led to an increase in ED presentations. METHODS: Patients in the present study were adults who presented to the ED within 21 days of receiving a dose of a COVID-19 vaccine between 11 August 2021 and 14 November 2021. All cases underwent chart reviews to extract epidemiological features, clinical presentations, ED assessments, investigations and disposition. RESULTS: Notably, 968 patients were included in the study, comprising 6.1% of all ED presentations during the study period. The median age was 31 years. 82.9% of patients were younger than 45 years. 20.1% of patients arrived by ambulance. Chest pain was the most common presenting complaint (43.6%), followed by headache (10.3%) and palpitations (8.2%). The most common investigations were a full blood examination (73.5%), an ECG (63.8%) and serum troponin (49.1%). 64.8% of patients were directly discharged home and 22.1% were sent home after a short stay admission. Only 2.2% of patients were admitted to the hospital. CONCLUSION: A majority of patients who presented to the ED after their COVID vaccinations were young and discharged home after the initial assessment. These presentations have significantly increased the workload in prehospital settings and EDs, contributing to increased investigation usage, ED treatment space occupancy, and increased costs to the health system.