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1.
Emerg Med Australas ; 35(3): 442-449, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36410371

RESUMO

OBJECTIVES: To describe the demographics, presentation characteristics, clinical features and cardiac outcomes for Aboriginal and Torres Strait Islander patients who present to a regional cardiac referral centre ED with suspected acute coronary syndrome (ACS). METHODS: This was a single-centre observational study conducted at a regional referral hospital in Far North Queensland, Australia from November 2017 to September 2018 and January 2019 to December 2019. Study participants were 278 Aboriginal and Torres Strait Islander people presenting to an ED and investigated for suspected ACS. The main outcome measure was the proportion of patients with ACS at index presentation and differences in characteristics between those with and without ACS. RESULTS: ACS at presentation was diagnosed in 38.1% of patients (n = 106). The mean age of patients with ACS was 53.5 years (SD 9.5) compared with 48.7 years (SD 12.1) in those without ACS (P = 0.001). Patients with ACS were more likely to be male (63.2% vs 39.0%, P < 0.001), smokers (70.6% vs 52.3%, P = 0.002), have diabetes (56.6% vs 38.4%, P = 0.003) and have renal impairment (24.5% vs 10.5%, P = 0.002). CONCLUSIONS: Aboriginal and Torres Strait Islander patients with suspected ACS have a high burden of traditional cardiac risk factors, regardless of whether they are eventually diagnosed with ACS. These patients may benefit from assessment for coronary artery disease regardless of age at presentation.


Assuntos
Síndrome Coronariana Aguda , Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Síndrome Coronariana Aguda/diagnóstico , Austrália , Queensland/epidemiologia , Encaminhamento e Consulta
3.
Heart Lung Circ ; 31(7): 1029-1036, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35337734

RESUMO

OBJECTIVES: The Improved Assessment of Chest pain Trial (IMPACT) pathway is an accelerated strategy for the assessment of emergency patients presenting with suspected acute coronary syndrome (ACS). The objective of this study was to report outcomes for Aboriginal and Torres Strait Islander patients deemed low-, intermediate-, or high-risk according to this pathway. DESIGN: This was a prospective observational trial conducted between November 2017 and December 2019. SETTING: Regional hospital in Far North Queensland. PARTICIPANTS: Aboriginal and Torres Strait Islander people presenting to the Emergency Department with suspected ACS were asked to participate. Participants were stratified as low-, intermediate- or high-risk of ACS according to the IMPACT pathway. High-and intermediate risk patients were managed according to the IMPACT pathway. Management of low-risk patients included additional inpatient cardiac testing, which was not part of the original IMPACT pathway. MAIN OUTCOME MEASURES: The primary outcome was acute coronary syndrome within 30-days. Secondary outcomes included length of stay and prevalence of objective testing. RESULTS: A total of 155 participants were classified as either at low-risk (n=18 11.6%), intermediate-risk (n=87 56.1%), or high-risk (n=50 32.3%) of ACS. Thirty-day (30-day) ACS occurred in 29 (18.6%) patients, which included 26 (52.0%) high-risk patients and three (3.4%) intermediate-risk patients. No patients in the low-risk group were diagnosed with ACS during their index presentation or by 30-days. Median hospital length-of-stay was 11.9 hours (interquartile range [IQR] 5.3-20.2 hrs) for low- and 15.5 hours (IQR 5.9-29.2 hrs) for intermediate-risk patients. CONCLUSION: The IMPACT pathway, which has been associated with reduced LOS in other settings, could be safely implemented for patients of Aboriginal and Torres Strait Islander origin, classifying two-thirds as low- or intermediate risk. However, a clinically significant proportion of Aboriginal and Torres Strait Islander patients experience cardiac events, which supports the need to provide early objective testing for coronary artery disease.


Assuntos
Síndrome Coronariana Aguda , Havaiano Nativo ou Outro Ilhéu do Pacífico , Síndrome Coronariana Aguda/diagnóstico , Serviço Hospitalar de Emergência , Humanos , Prevalência , Queensland/epidemiologia
4.
Emerg Med Australas ; 30(6): 743-748, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29145705

RESUMO

The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production. Although specifically developed with early ACEM trainees in mind, it is envisaged the resources will be useful for all emergency clinicians. The project was funded by the Australian Commonwealth Department of Health.


Assuntos
Manuseio das Vias Aéreas/métodos , Educação Médica Continuada/métodos , Medicina de Emergência/educação , Ensino/normas , Manuseio das Vias Aéreas/tendências , Austrália , Educação Médica Continuada/normas , Medicina de Emergência/métodos , Humanos , Internet , Desenvolvimento de Programas , Interface Usuário-Computador
5.
Emerg Med Australas ; 28(1): 113-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26608232

RESUMO

In recent years, the Australasian College for Emergency Medicine (ACEM) has increasingly focused on the need for high-quality research in emergency medicine (EM). One important initiative was the establishment of the ACEM Foundation, which among other responsibilities, is required to support clinical research through the provision of research funding and other measures. In February 2015, the Foundation held a Research Forum that was attended by the leading EM researchers from Australasia. The Forum aimed to determine how a productive research culture could be developed within the ACEM. Nine key objectives were determined including that research should be a core business of the ACEM and a core activity of the EM workforce, and that EM research should be sustainable and adequately supported. This report describes the background and conduct of the Forum, its recommendations and the way in which they could be implemented.


Assuntos
Pesquisa Biomédica/organização & administração , Medicina de Emergência , Australásia , Pesquisa Biomédica/educação , Congressos como Assunto , Medicina de Emergência/educação , Medicina de Emergência/organização & administração , Fundações/organização & administração , Humanos , Cultura Organizacional , Apoio à Pesquisa como Assunto
6.
Aust Health Rev ; 27(2): 61-7, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15525238

RESUMO

This study investigates demographic patterns of emergency presentations to Northern Territory (NT) public hospitals over the past five years with respect to population changes, Aboriginality and age of patients. Retrospective analysis was undertaken on the 1996-2001 data extracted from the NT Module of Caresys and the Hospital Morbidity Data System. There was a 4.6% decrease in total presentations to the five public hospitals but a 9.4% growth in the population during the study period. Substantial differences in emergency presentation patterns were found between Aboriginal and non-Aboriginal patients. There were more Aboriginal presentations than non-Aboriginal presentations for all age groups except for 5 to 19 years and 70 to 74 years. Analysis based on the national triage scale showed the higher needs of older adults with the 60 or over age group accounting for the majority of presentations, and Aboriginal presentation rates exceeded the non-Aboriginal presentation rates in most triage categories. Re-attendance within seven days at the emergency departments occurred predominantly among Aboriginal patients regardless of age group. The analysis has highlighted several emerging demographic patterns. The issue of non-urgent visits by Aboriginal patients occupying a large portion of the emergency department utilisation also needs to be addressed.


Assuntos
Hospitais Públicos , Havaiano Nativo ou Outro Ilhéu do Pacífico , Demografia , Serviço Hospitalar de Emergência , Humanos , Northern Territory , Estudos Retrospectivos
7.
Aust Health Rev ; 26(2): 43-8, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-15368835

RESUMO

This study aims to quantify trends in emergency presentations to Northern Territory (NT) public hospitals over the past five years with respect to demand and access. Retrospective analysis was undertaken on data extracted from the NT Module of Caresys and the Hospital Morbidity Data System. There has been a 4.6% decrease in presentations to the five public hospitals between 1996 and 2001 compared to a 9.4% growth in the population. Despite the apparent decline in total presentations, the acuity of patients has increased dramatically over the same period. Access analysis of presentations seen within the recommended triage time revealed considerable variability, especially for triage categories 2, 3 and 4. The access block problem, discrepancies in recorded waiting time and irregularities among the regional hospitals within the triage system have also been identified. Recommendations including improved access to inpatient beds and admission to wards were developed in response to the changing role of the emergency department.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Agendamento de Consultas , Bases de Dados Factuais , Pesquisas sobre Atenção à Saúde , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Northern Territory/epidemiologia , Crescimento Demográfico , Fatores de Tempo , Triagem
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