Journal articles on the topic 'Emergency management Victoria'
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McDermott, Francis T., Gregory J. Cooper, Philip L. Hogan, Stephen M. Cordner, and Ann B. Tremayne. "Evaluation of the Prehospital Management of Road Traffic Fatalities in Victoria, Australia." Prehospital and Disaster Medicine 20, no. 4 (August 2005): 219–27. http://dx.doi.org/10.1017/s1049023x00002570.
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AbstractIntroduction:This study was undertaken to identify prehospital system and management deficiencies and preventable deaths between 01 January 1997 and 31 December 1998 in 243 consecutive Victorian road crash victims with fatal outcomes.Methods:The complete prehospital and hospital records, the deposition to the coroner, and autopsy findings were evaluated by computer analysis and peer group review with multidisciplinary discussion.Results:One-hundred eighty-seven (77%) patients had prehospital errors or inadequacies, of which 135 (67%) contributed to death. Three-hundred ninety-four (67%) related to management and 130 (22%) to system deficiencies. Technique errors, diagnosis delays, and errors relatively were infrequent. One of 24 deaths at the crash scene or en route to hospital was considered to be preventable and two potentially preventable.Conclusion:The high prevalence of prehospital deficiencies has been addressed by a Ministerial Task Force on Trauma and Emergency Services and followed by the introduction of a new trauma care system in Victoria.
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Boyle, Malcolm J. "Comparison Overview of Prehospital Errors Involving Road Traffic Fatalities in Victoria, Australia." Prehospital and Disaster Medicine 24, no. 3 (June 2009): 254–61. http://dx.doi.org/10.1017/s1049023x00006890.
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AbstractIntroduction:Until early 2003, the Consultative Committee on Road Traffic Fatalities (CCRTF) in Victoria, Australia was the main body investigating and publishing data about prehospital errors resulting from road traffic fatalities. The objective of this study was to identify and interpret prehospital error rate trends associated with road traffic fatalities during a 10-year period of the CCRTF reports.Methods:This study is a review of the prehospital errors defined in Victorian CCRTF reports of preventable deaths of road traffic fatalities over a 10-year period.Results:Six CCRTF reports contained prehospital data for errors associated with road traffic fatalities. From 1992 to 1998, system errors decreased.However, over the same timeframe, management, technical, and diagnostic errors increased. There was a marked jump in system, technique, and diagnosis errors from 1998 to 2001–2003. However, management errors declined over the same timeframe. The jump in errors in the 1998 to 2001–2003 timeframe coincided with the introduction of advanced life support (ALS) for Victorian paramedics in 2000.The number of preventable deaths decreased from 1992 to 1998, however, there was an increase from 1999 onwards, coinciding with the introduction of the state trauma system and ALS for paramedics.Conclusions:This study demonstrates that there has been an increase in prehospital error rates, especially from 2000, which coincided with the introduction of ALS for paramedics and the state trauma system in Victoria, even though the state trauma system had an overall decrease in error rates.
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Gabriel, Paul. "The Development of Municipal Emergency Management Planning in Victoria, Australia." International Journal of Mass Emergencies & Disasters 20, no. 3 (November 2002): 293–307. http://dx.doi.org/10.1177/028072700202000302.
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In Australia, local government plays an essential role in emergency management, although not a provider of emergency services. The role of supporting emergency services and the community both during and after emergencies has been a traditional role. Added to this is an increasing responsibility as the focal point for the conduct of local mitigation using risk analysis, prioritization, and treatment under the methodology of emergency risk management. This role is part of a shift in the emphasis of emergency management in Australia away from the strong focus on emergencies and the emergency services, towards an emphasis on the sustainability of the community and its life in the context of the risk of loss posed by natural and other hazards. Models of municipal emergency risk management planning are presented to assist municipalities to connect or even integrate their emergency management planning processes with other similar community safety activities such as crime and injury prevention.
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A Gregory, Mark, Kaye Scholfield, Khandakar Ahmed, Dorothy McLaren, James Williams, and Helen Marshall. "Warrnambool Exchange Fire — Resilience and Emergency Management." Journal of Telecommunications and the Digital Economy 2, no. 4 (May 26, 2020): 17. http://dx.doi.org/10.18080/jtde.v2n4.274.
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Effective emergency management of a disaster at a single point of failure is vital if the effects of the disaster are to be mitigated. The immediate impacts of a disaster highlight stakeholder perspectives. There is no one-size-fits-all solution to every disaster. Nevertheless, analysing features, aftermath, impact and interim services made available after a disaster provide lessons that can be utilised to avert or mitigate the effects of similar events in the future. This paper provides lessons learnt from a fire that occurred in 2012 in the Warrnambool telephone exchange located in Victoria, Australia and proposes a strategy that provides increased network resilience and more effective emergency management once the copper-based core switching in exchanges is progressively replaced by fibre service area modules.
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Smith, Gavin, David McD Taylor, Amee Morgans, and Peter Cameron. "Prehospital management of supraventricular tachycardia in Victoria, Australia: Epidemiology and effectiveness of therapies." Emergency Medicine Australasia 26, no. 4 (June 16, 2014): 350–55. http://dx.doi.org/10.1111/1742-6723.12248.
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Goode, Natassia, Paul M. Salmon, Caroline Spencer, Dudley McArdle, and Frank Archer. "Defining disaster resilience: comparisons from key stakeholders involved in emergency management in Victoria, Australia." Disasters 41, no. 1 (March 14, 2016): 171–93. http://dx.doi.org/10.1111/disa.12189.
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Gao, Crystal, Zheng Jie Lim, Sabrina Yeh, Scott Santinon, Scott De Haas, and Kristy Austin. "Assessing the Efficacy of a One-day Structured Induction Program in Orienting Clinical Staff to a Novel Prehospital Medical Deployment Model." Prehospital and Disaster Medicine 34, s1 (May 2019): s102—s103. http://dx.doi.org/10.1017/s1049023x19002127.
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Introduction:St. John Ambulance Victoria provides first aid and medical services at a variety of mass gathering events (MGEs) throughout Victoria. Volunteer healthcare professionals and students (termed “volunteers”) form Medical Assistance Teams (MAT) at these MGEs. MAT deployments manage a variety of patient presentations which include critically ill patients. This reduces high acuity patient transfers to the hospital and, where possible, avoid ambulance and hospital utilization.Aim:To determine the effectiveness of interdisciplinary prehospital simulation workshops in preparing volunteers for MAT deployment at MGEs.Methods:A one-day, simulation-based training session within the MAT environment was implemented to introduce volunteers to the management of various scenarios faced at MGEs. All volunteers were provided an orientation to the equipment and setting up MAT deployments at MGEs. Volunteers then participated in interdisciplinary group-based scenarios such as cardiac arrest management, drug intoxication, spinal injuries, agitated patients, and airway management. To determine the effectiveness of this training session, volunteers were invited to participate in a post-training survey, comprising of Likert scores and open-ended responses.Results:Seventeen volunteers attended the training session with 10 (58.8%) completing the post-training survey. Volunteers were satisfied with environment familiarization in the MAT (Average 4.47/5.00) and found the simulation-based training helpful (Average 3.67/4.00). The induction overall was well-received (4.60/5.00) with volunteers feeling more confident in being deployed at MGEs (4.20/5.00).Discussion:The results of the simulation-based training session were positive with volunteers receptive to the need for a training day prior to MAT deployment at MGEs. The simulation session enables volunteers to be comfortable with working in MAT and managing a diverse range of patients at MGEs. This session is likely to improve interdisciplinary communication and teamwork in the MAT. Future research is aimed at following these volunteers after several MAT deployments to improve the training session for future participants.
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Yao, Yibing, Yuyang Zhang, Taoyu Yao, Kapo Wong, Jin Yeu Tsou, and Yuanzhi Zhang. "A GIS-Based System for Spatial-Temporal Availability Evaluation of the Open Spaces Used as Emergency Shelters: The Case of Victoria, British Columbia, Canada." ISPRS International Journal of Geo-Information 10, no. 2 (February 2, 2021): 63. http://dx.doi.org/10.3390/ijgi10020063.
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Canadian emergency management planners have historically ignored the self-motivated evacuation procedures of people who cannot initially choose the safest evacuation areas. In densely developed urban areas, open spaces can be seen as ideal evacuation areas and should thus be included in shelter planning. In this study, the public open spaces in Great Victoria were selected as the study area and evaluated using GIS technologies. A multi-criteria TOPSIS evaluation model was used to conduct comprehensive quantitative evaluations of the open spaces’ safety, accessibility, and availability. Through hybrid process, service area, and POI aggregation coupling analyses, a model is created that provides an overall evaluation at the district level. In addition to providing a model for evaluating open spaces as emergency shelters, applicable to most Canadian cities, this study emphasizes the importance and disadvantages of open space emergency shelters in Canada, which have heretofore been ignored by decision makers. In Great Victoria, we found that the distribution of open spaces does not match the dynamics of the population distribution, meaning that through inadequate preparation some districts lack a safe evacuation place—this in an area where people are at high risk of earthquake disasters and their subsequent effects.
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Dutch, Martin J., and Kristy B. Austin. "Hospital in the Field: Prehospital Management of GHB Intoxication by Medical Assistance Teams." Prehospital and Disaster Medicine 27, no. 5 (July 19, 2012): 463–67. http://dx.doi.org/10.1017/s1049023x12000994.
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AbstractIntroductionRecreational use of gamma-hydroxybutyrate (GHB) is increasingly common at mass-gathering dance events in Australia. Overdose often occurs in clusters, and places a significant burden on the surrounding health care infrastructure.ObjectiveTo describe the clinical presentation, required interventions and disposition of patrons with GHB intoxication at dance events, when managed by dedicated medical assistance teams.MethodsRetrospective analysis of all patrons attending St. John Ambulance medical assistance teams at dance events in the state of Victoria (Australia), from January 2010 through May 2011.Main outcome measuresClinical presentation, medical interventions and discharge destination.ResultsSixty-one patients with GHB intoxication attended medical teams during the study period. The median age was 22 years, and 64% were male. Altered conscious state was present in 89% of attendances, and a GCS <9 in 44%. Hypotension, bradycardia and hypothermia were commonly encountered. Endotracheal intubation was required in three percent of patrons. Median length of stay onsite was 90 minutes. Ambulance transport to hospital was avoided in 65% of presentations.ConclusionsThe deployment of medical teams at dance events and music festivals successfully managed the majority of GHB intoxications onsite and avoided acute care ambulance transfer and emergency department attendance.DutchMJ,AustinKB.Hospital in the field: prehospital management of GHB intoxication by medical assistance teams.Prehosp Disaster Med.2012;27(4):1-5.
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McMillan, Alison. "Epidemic Thunderstorm Asthma." Prehospital and Disaster Medicine 34, s1 (May 2019): s7. http://dx.doi.org/10.1017/s1049023x19000335.
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Introduction:On November 21 and 22 of 2016, Victoria witnessed an unprecedented epidemic thunderstorm asthma emergency event in size acuity and impact. This scenario was never exercised nor contemplated. The event resulted in a 73% increase in calls to the Emergency Services Telecommunications Authority and 814 ambulance cases in the six hours from 6 pm on November 21, 2016. A 58% increase in people presented to public hospital emergency departments in Melbourne and Geelong on November 21 and 22, 2016 (based on the three-year average). 313 calls were made to the nurse on call from people with breathing, respiratory, and allergy problems (compared to an average of 63 calls for the previous month). Tragically, ten deaths are linked to this event.Methods:A substantial amount of work has been completed, much of which goes towards addressing the Inspector-General for Emergency Management recommendations following a review of the event, including: Release of an epidemic thunderstorm asthma campaign and education programs which were rolled out across Victoria for the community and health professionals from September through November 2017;Development of a new epidemic thunderstorm asthma forecasting system on 1 October 2017 and updated warning protocols during the 2017 grass pollen season;Implementation of a Real-time Health Emergency Monitoring System to alert the department of demands on public hospital emergency departments on the system; andIntroduction of a new State Health Emergency Response Plan in October 2017 to improve coordination and communications before and during a health emergency.Discussion:The presentation will concentrate on the lessons learned more than two years down the track from the event in November 2016.
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Paschen, Jana-Axinja, and Ruth Beilin. "How a risk focus in emergency management can restrict community resilience – a case study from Victoria, Australia." International Journal of Wildland Fire 26, no. 1 (2017): 1. http://dx.doi.org/10.1071/wf16064.
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The research investigated understandings of risk and resilience in emergency management (EM) policy and practice. The core findings illustrate how a complex of institutionalised socio-cultural expectations and standardised processes – that is, evidence-based response models to deal with and communicate uncertainty – influence the operationalisation of resilience in EM. We observe that a focus on disaster risk as a quantifiable product of physical hazards is an attempt to control uncertainty and leads to engineered or technology-centred response solutions. Accordingly, community resilience is principally seen as the product of risk reduction, incident response and recovery interventions. The research shows that resultant command and control management practices produce limited – and limiting – interpretations of community resilience as disaster resilience. This can restrict existing and emergent community responses to risk, and the ability to imagine and enact more systemic types of community resilience. For instance, the short-term disaster focus tends to neglect the social and institutional root causes of community vulnerability and generic risk information is detached from everyday community experience. Using wildfire in Australia as its case study, this paper discusses the social, cultural and practical challenges of operationalising social–ecological resilience in EM.
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Cullinane, Meabh, Stefanie A. Zugna, Helen L. McLachlan, Michelle S. Newton, and Della A. Forster. "Evaluating the impact of a maternity and neonatal emergencies education programme in Australian regional and rural health services on clinician knowledge and confidence: a pre-test post-test study." BMJ Open 12, no. 5 (May 2022): e059921. http://dx.doi.org/10.1136/bmjopen-2021-059921.
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IntroductionAlmost 78 000 women gave birth in the state of Victoria, Australia, in 2019. While most births occurred in metropolitan Melbourne and large regional centres, a significant proportion of women birthed in rural services. In late 2016, to support clinicians to recognise and respond to clinical deterioration, the Victorian government mandated provision of an emergency training programme, called Maternity and Newborn Emergencies (MANE), to rural and regional maternity services across the state. This paper describes the evaluation of MANE.Design and settingA quasi-experimental study design was used; the Kirkpatrick Evaluation Model provided the framework.ParticipantsParticipants came from the 17 rural and regional Victorian maternity services who received MANE in 2018 and/or 2019.Outcome measuresBaseline data were collected from MANE attendees before MANE delivery, and at four time points up to 12 months post-delivery. Clinicians’ knowledge of the MANE learning objectives, and confidence ratings regarding the emergencies covered in MANE were evaluated. The Safety Attitudes Questionnaire (SAQ) assessed safety climate pre-MANE and 6 months post-MANE among all maternity providers at the sites.ResultsImmediately post-MANE, most attendees reported increased confidence to escalate clinical concerns (n=251/259). Knowledge in the non-technical and practical aspects of the programme increased. Management of perinatal emergencies was viewed as equally stressful pre-MANE and post-MANE, but confidence to manage these emergencies increased post-delivery. Pre-MANE SAQ scores showed consistently strong and poor performing services. Six months post-MANE, some services showed improvements in SAQ scores indicative of improved safety climate.ConclusionMANE delivery resulted in both short-term and sustained improvements in knowledge of, and confidence in, maternity emergencies. Further investigation of the SAQ across Victoria may facilitate identification of services with a poor safety climate who could benefit from frequent targeted interventions (such as the MANE programme) at these sites.
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Wong, Michael T. H., Michael T. H. Wong, and Christine Tye. "Low Hospital Inpatient Readmission Rate in Patients with Borderline Personality Disorder: A Naturalistic Study at Southern Health, Victoria, Australia." Australian & New Zealand Journal of Psychiatry 39, no. 7 (July 2005): 607–11. http://dx.doi.org/10.1080/j.1440-1614.2005.01633.x.
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Objective: To study how the standard management protocol and the special management contract relate to the clinical profile of patients with borderline personality disorder and their hospital admission pattern. Method: A retrospective review was undertaken using naturalistic data from the Client Management Interface over a 2-year period. The standard management protocol patient group and the special treatment contract patient group were compared with respect to variables which included basic demographic data, number of admissions, length of stay and comorbidity. Results: Eighty patients received a diagnosis of borderline personality disorder. The majority (81.2%) were managed with the standard management protocol and only 41.5% had more than one admission. For those who received a special treatment contract (18.8%), 93.3% of them had more than one admission. The special treatment contract group had a significantly higher total number of admissions (p<0.001), a higher number of admissions when they received (p<0.001) and did not receive (p=0.001) a diagnosis of borderline personality disorder, a higher number of comorbidities (p=0.004) but not more presentations to the emergency department. Conclusions: Most patients with borderline personality disorder treated with the standard management protocol had a low readmission rate. The small group of patients with comorbidities managed with a special treatment contract had multiple readmissions but not more crisis presentations to the emergency department. Further studies are required to elucidate the therapeutic mechanism of the standard management protocol and special treatment contract and how that impacts on presentations and admissions to a hospital.
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Koritsas, Stella, Malcolm Boyle, and Jan Coles. "Factors Associated with Workplace Violence in Paramedics." Prehospital and Disaster Medicine 24, no. 5 (October 2009): 417–21. http://dx.doi.org/10.1017/s1049023x0000724x.
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AbstractIntroduction:The majority of research that has explored workplace violence has focused on establishing the prevalence of violence in different settings. In general, there is a paucity of research that explores factors that may predict or increase the risk of experiencing violence in the workplace.Objective:The aim of this research was to determine predictors of violence for paramedics.Methods:A questionnaire was developed that focused on paramedics' experi-ences with six forms of violence: verbal abuse, property damage/theft, intimi-dation, physical abuse, sexual harassment, and sexual assault.The questionnaire was distributed randomly to paramedics throughout rural Victoria and metropolitan South Australia, and completed and returned anonymously.Results:Predictors emerged for verbal abuse, intimidation, sexual harassment, and sexual abuse. Specifically, gender was the only predictor of intimidation, sexual harassment, and sexual assault. Paramedic qualifications, how they responded to a call-out, and hours per week in direct patient contact emerged as a predictor of verbal abuse.Conclusions:Certain factors predict or predispose paramedics to workplace violence. The need for workplace violence education and training is impera-tive for the prevention of violence, as well as for its management.
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V., Gayathri, Praveen Mali, and Harindranath H. R. "A clinical study of surgical management of acute intestinal obstruction." International Surgery Journal 5, no. 10 (September 25, 2018): 3342. http://dx.doi.org/10.18203/2349-2902.isj20184085.
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Background: Mechanical bowel obstruction remains one of the most common intra-abdominal problems faced by general surgeons in their practice and continues to be a major cause of morbidity and mortality.Methods: This retrospective study was carried out on data obtained from 50 patients who underwent emergency laparotomy for acute intestinal obstruction in Victoria and Bowring and Lady Curzon Hospital from January 2016 to December 2016.Results: Adhesions (26%) were found to be the most common cause followed by obstructed hernia (22%). The common age group was 51-60 years. The commonest symptom was abdominal pain followed by vomiting and constipation. The average duration of presentation was 2 days. Strangulation was found in 20% of cases. Mortality rate in the study was 16%.Conclusions: In conclusion, we have found that adhesions are becoming an ever-increasing underlying cause of bowel obstruction. A trend of elective hernia surgery has reduced the number of patients of hernias presenting with obstruction of bowel.
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Fortington, Lauren V., Sheree Bekker, and Caroline F. Finch. "Integrating and maintaining automated external defibrillators and emergency planning in community sport settings: a qualitative case study." Emergency Medicine Journal 37, no. 10 (June 16, 2020): 617–22. http://dx.doi.org/10.1136/emermed-2019-208781.
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IntroductionA voluntary State Government-led programme in Victoria, Australia ‘Defibrillators for Sporting Clubs and Facilities Program’ ran from 2015 to 2019, broadly aimed at increasing access to automated external defibrillators (AEDs), together with a greater number of community members trained for management of medical emergencies. This study aimed to understand whether participating sport clubs/facilities had successfully integrated an AED and medical planning with other club/facility safety practices, 12 months after delivery of the programme.MethodsThis was a qualitative case study of 14 sport clubs/facilities in Victoria, Australia in 2017, underpinned by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. We conducted observational audits of facilities (to locate AED placement, signage and other relevant location-specific factors) and semi-structured, face-to-face interviews with representatives of the clubs/facilities. Interview questions were designed to determine if and how the related, mandated emergency management programme was adapted for the long term (embedding), whether this aligned to ongoing organisational mission (active engagement), and whether or not it was still ongoing 6 months postinitial implementation (sustainability). Data were evaluated using qualitative descriptive methodology. For reporting, descriptive summaries of the audit were combined with interview data to contextualise and visualise the sport club/facility setting and key results.ResultsKey issues identified were accessibility and visibility of the AED, with inadequate signage and challenges identifying an efficient location for access and storage. Most interviewees reported the AED and training were received with no further actions taken towards safety planning or integration with club/facility practice. Several challenges regarding remaining up to date with training and ensuring required routine checks of the AED take place were also raised.ConclusionsThis study identified several challenges for community sport clubs/facilities in the implementation of an AED and medical planning programme, including where to store the AED, how to make its presence known to the community and how to integrate changes alongside other club/facility practices.
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Parkinson, Debra, Alyssa Duncan, Jaspreet Kaur, Frank Archer, and Caroline Spencer. "Gendered aspects of long-term disaster resilience in Victoria, Australia." January 2022 10.47389/37, no. 37.1 (January 2022): 59–64. http://dx.doi.org/10.47389/37.1.59.
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Research conducted in 2018 documented the disaster experiences of 56 women and men in Australia aged between 18 and 93 years. This paper draws out the gendered factors that affected their resilience, and in so doing, begins to address the dearth of research related to gendered aspects of long-term disaster resilience. It is unique in capturing the voices of survivors who spoke of events 9 years after the 2009 Black Saturday fires and of earlier fires and floods in Victoria more than 50 years ago, including the 1983 Ash Wednesday fires. Over decades, gendered expectations of men and women significantly hindered resilience. Men spoke of the long-term cost to them of demands to ‘be strong’ in the worst of disasters and reasons they were reluctant to seek help afterwards. Women spoke of their contributions holding a lesser value and of discrimination. Discussions of violence against women and children after disaster, and suicide ideation in anticipation of future disasters offered critical insights. Protective factors identified by informants were not wholly intrinsic to their character but were also physical, such as essential resources provided in the immediate aftermath, and psychological and community support offered in the long-term. Factors that helped resilience departed from the ‘masculine’ model of coping post-disaster by moving away from a refusal to admit trauma and suffering, to community-wide resilience bolstered by widespread emotional, social and psychological support. Genuine community planning for disasters before they strike builds trust and offers insights for emergency management planners.
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Maltais, D., M. Gibson, L. Hardy, S. Ruthe, and M. Balazs. "(P1-58) Frailty, Dementia and Disaster: An E-Learning Initiative for Health Care Providers." Prehospital and Disaster Medicine 26, S1 (May 2011): s117. http://dx.doi.org/10.1017/s1049023x11003906.
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Frailty, Dementia and Disaster: an e-learning initiative for Health care providers D. Maltais1, M. Gibson2, L. Hardy3, S. Ruthe4, 1University of Quebec, Chicoutimi 2St. Joseph's Health Care London, London 3Health and Social Services, Yukon Territory Government, Whitehorse 4Emergency Program, Corporation of the District of Oak Bay, Victoria, Canada.This poster describes the development, piloting, evaluation, and dissemination of the e-learning tool: “Frailty, Dementia and Disasters: What Health Care Providers Need to Know”. The purpose of the e-learning tool is to contribute to international efforts to reduce the disproportionate vulnerability of older adults in emergencies and disasters. Key literature on geriatric emergency preparedness and response issues, including the roles and responsibilities of health care providers, was identified and synthesized. Content was piloted in a facilitated workshop in Ontario. A Canada-wide health provider reference group provided feedback on the transition from a traditional powerpoint presentation to an e-learning format. The evaluation process included facilitated review of the tool by health care providers in two in-person workshops in each of Yukon and Quebec and in an independent review by health care providers in British Columbia (virtual). The learning objectives of the e-learning resource are to help health care providers, administrators and policy makers understand the: · disproportionate vulnerability of older adults who are frail and those who have dementia, in emergencies and disasters; · components of the emergency management cycle and how they apply to this target population; · best practice resources that can be used to improve emergency preparedness, response, recovery and mitigation; and · role of health care organizations and providers in emergency management for these older adults. The e-Learning tool is hosted with open access on www.dementiaknowledgebroker.ca (DKB), a platform facilitated by the CDRAKE - the knowledge exchange theme of the Canadian Dementia Knowledge TranslationNetwork (CDKTN).
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Parkinson, Debra, Alyssa Duncan, and Frank Archer. "Barriers and enablers to women in fire and emergency leadership roles." Gender in Management: An International Journal 34, no. 2 (April 8, 2019): 78–93. http://dx.doi.org/10.1108/gm-07-2017-0090.
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Purpose The purpose of this paper is to understand what (if any) actual and perceived barriers exist for women to take on fire and emergency management leadership roles within the Department of Environment, Land, Water and Planning, Victoria, Australia. Design/methodology/approach An anonymous quantitative online survey was used to collect data about opinions and thoughts of staff. This informed the qualitative component of the research – in-depth, semi-structured interviews and a focus group. The combination of these techniques provides deeper insight into the nature of the barriers for women. Findings Respondents identified real barriers for women accessing leadership roles in fire and emergency. Reflecting the wider literature on barriers to women in executive roles, those identified related to sexism, career penalties not faced by men for family responsibilities, and assumptions of women helping other women’s careers. There were more men in senior roles, leaving senior women isolated and often overlooked. Women had fewer role models and sponsors than men and less developed networks, finding it harder to access training and deployments. The context was described by most as “a boys’ club”, where men were seen to dominate meetings and stereotype the abilities of women. Originality/value This paper analyses the barriers to women in fire and emergency leadership roles within a masculine workplace and is rare in including a qualitative aspect to the issue in the Australian context.
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Votova, K., A. Penn, D. R. Harris, M. Bibok, M. Lesperance, L. Lu, S. D. Coutts, and R. Balshaw. "LO011: Identification of mild acute cerebrovascular syndrome (ACVS) in the emergency department: validation of an ACVS clinical classifier to help distinguish mimics." CJEM 18, S1 (May 2016): S33—S34. http://dx.doi.org/10.1017/cem.2016.48.
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Introduction: National guidelines (NICE, AHA) for management of Acute Cerebrovascular Syndrome (ACVS) in the Emergency Department (ED) recommend the use of ABCD2 score to risk stratify patients despite its poor specificity and low diagnostic accuracy. The SpecTRA project previously developed a clinical classifier for ACVS vs. Mimic derived from historical clinical data collected during a 5-year period at an outpatient stroke clinic (Victoria, BC). Here we present a prospective evaluation of the performance of our clinical classifier on prospectively collected ED patient data compared to the industry-standard ABCD2. Methods: The prospective cohort consisted of ED patients (N=555, Male=54%, Mean (SD) Age=68.7(15.5), ACVS=70%) enrolled between Jan 2014 and May 2015 at Victoria General Hospital (BC) and Foothills Medical Centre (Calgary, AB). ABCD2 and clinical classifier scores were calculated from clinical data from the ED. We compared the performance of the two classifiers using DeLong’s test of Dependent Receiver Operating Curves (ROC). In keeping with national guidelines, we used a score of 4 or more to assess sensitivity, specificity and accuracy (sens/spec and acc) of the ABCD2; for our clinical classifier, we used the cut point previously determined to maximize agreement between predictions and true class labels in the historical data. Results: Our new clinical classifier significantly outperformed the ABCD2 (z=2.44, p=0.015) with an AUC of 0.72, (95% CI: 0.68, 0.77) vs. 0.66 (0.61, 0.71). In terms of sens/spec and acc, our classifier achieved 0.78/0.55 with acc 71% compared to 0.75/0.46 with acc 66% for the ABCD2 (using the previously specified cut points). Conclusion: Our ACVS clinical classifier showed better performance than the ABCD2 score on a prospective sample of ED patients. The improved specificity of the clinical classifier relative to existing prognostic tools would reduce the number of non-ACVS patients referred for early treatment as well as conserve medical resources. Our ongoing multi-site study will evaluate the utility of the ACVS classifier embedded in a logic-enabled e-fillable form. This form will also provide risk-based thresholds guiding timely ordering of CTA as well as links to clinical treatment guidelines. Longer-term, the e-form and classifiers will be further enhanced to include plasma-based protein biomarker data.
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Parrott, Marissa L., Leanne V. Wicker, Amanda Lamont, Chris Banks, Michelle Lang, Michael Lynch, Bonnie McMeekin, et al. "Emergency Response to Australia’s Black Summer 2019–2020: The Role of a Zoo-Based Conservation Organisation in Wildlife Triage, Rescue, and Resilience for the Future." Animals 11, no. 6 (May 23, 2021): 1515. http://dx.doi.org/10.3390/ani11061515.
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Modern zoos are increasingly taking a leading role in emergency management and wildlife recovery. In the face of climate change and the predicted increase in frequency and magnitude of catastrophic events, zoos provide specialised expertise to assist wildlife welfare and endangered species recovery. In the 2019–2020 Australian bushfire season, now called Australia’s Black Summer, a state government-directed response was developed, assembling specialised individuals and organisations from government, non-government organisations, research institutions, and others. Here, we detail the role of Zoos Victoria staff in wildlife triage and welfare, threatened species evacuation and recovery, media and communications, and fundraising during and after the fires. We share strategies for future resilience, readiness, and the ability to mobilise quickly in catastrophic events. The development of triage protocols, emergency response kits, emergency enclosures, and expanded and new captive breeding programs is underway, as are programs for care of staff mental health and nature-based community healing for people directly affected by the fires. We hope this account of our response to one of the greatest recent threats to Australia’s biodiversity, and steps to prepare for the future will assist other zoos and wildlife organisations around the world in preparations to help wildlife before, during, and after catastrophic events.
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Dufty, Neil. "Understanding and improving community flood preparedness and response: a research framework." April 2021 10.47389/36, No 2 (April 2021): 19–25. http://dx.doi.org/10.47389/36.2.19.
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Many social research projects identify issues with community disaster preparedness and response but struggle to attribute these issues to underlying causes and recommend possible ways to address them. A research framework that considers the underlying causes of preparedness and response and possible interventions was developed for the Wimmera region of Victoria, Australia. The research framework was developed in conjunction with the Wimmera Catchment Management Authority and tested in a social research project across 6 communities in the Wimmera region. This paper provides an outline and rationale for the components of the research framework. It also summarises the regional flood insight afforded by the research framework. The research framework, albeit with some limitations, has universal appeal not only in the examination of community flood preparedness and response, but also for other hazards and other parts of the disaster management cycle.
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Lan, Kaixin, Bohao Duan, Shichao Qiu, Yang Xiao, Meng Liu, and Haocen Dai. "Task Allocation and Traffic Route Optimization in Hybrid Fire-fighting Unmanned Aerial Vehicle Network." Highlights in Science, Engineering and Technology 9 (September 30, 2022): 340–55. http://dx.doi.org/10.54097/hset.v9i.1864.
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With the increase of extreme weather conditions in the world, the probability of forest fires is increasing. How the forest fire management decision-making system can monitor and control the fire quickly and effectively is the key of forest fire fighting work. This paper uses SSA drones carrying high-definition and thermal imaging cameras and telemetry sensors in conjunction, as well as Repeater drones used to greatly expand the frontline low-power radio range, to support fire management decision-making systems. At the same time, explore a drone cooperation plan to deal with different fire terrains and different scales of fire conditions. The aim of this paper is to improve the existing fire management decision system in order to quickly respond to the emergency fire. Research object for the Australian state of Victoria on October 1, 2019 to January 7, 2020 wildfires, explore SSA drones and Repeater drones in the application of the forest fire, ensure that fire management decision-making system to provide the optimal number deployment scheme of fire task quickly and efficiently, and achieve the maximum efficiency and economic optimal compatibility.
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Measday, Danielle, and Rosemary Goodall. "Measuring and Mitigating Mercury Gases in the Museums Victoria Collection." Biodiversity Information Science and Standards 2 (June 13, 2018): e27044. http://dx.doi.org/10.3897/biss.2.27044.
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For the past six years the conservation and collection management departments at Museums Victoria have been conducting a major survey to determine the type and extent of hazardous substances in the collections to better inform safe handling and storage practices. This paper focuses on mercury compounds in the collection, including mercury chloride applied as a pesticide, mercury sulfide pigments, liquid mercury used in scientific equipment, and mineral specimens such as native mercury and cinnabar. All these compounds can release volatile mercury vapour into storage furniture and have the potential to contaminate both the cabinet and other specimens stored nearby. Although previous testing had confirmed that the air in storage rooms and workspaces contained no detectable levels of mercury vapour, recent publications by Hawks et al. 2004, Havermans et al. 2015 and Marcotte et al. 2017 showing high levels of mercury vapour inside storage containers in herbaria raised concern that there could be higher than acceptable levels of mercury vapour building up inside storage cabinets at Museums Victoria. This prompted analysis of the headspace in cabinets using a Jerome J405 portable mercury vapour meter. Testing was informed by the results of previous hazards surveys using X-ray fluorescence spectrography to target cabinets where mercury vapour was likely to be present. Air from cabinets was sampled across the indigenous cultures, history, technology and natural sciences collections. Results showed levels of mercury vapour could be considerably above 25 μg/m3 the Australian time-weighted average (TWA) exposure standard for an 8 hour workday in cabinets of bird skins and indigenous artefacts treated with mercuric chloride pesticides. Results above 150 μg/m3 the temporary emergency exposure level (TEEL) were measured in the mineralogy collection. Mitigation strategies are being implemented to reduce the risks to staff health and contamination of other collection materials, including enclosing mercury-containing species of minerals in gas barrier film, venting high risk cabinets to dissipate vapour before accessing specimens, and engineering controls during the handling of specimens.
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Grundstein, Andrew, Marshall Shepherd, Paul Miller, and Stefanie Ebelt Sarnat. "The Role of Mesoscale-Convective Processes in Explaining the 21 November 2016 Epidemic Thunderstorm Asthma Event in Melbourne, Australia." Journal of Applied Meteorology and Climatology 56, no. 5 (May 2017): 1337–43. http://dx.doi.org/10.1175/jamc-d-17-0027.1.
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AbstractA major thunderstorm asthma epidemic struck Melbourne and surrounding Victoria, Australia, on 21 November 2016, which led to multiple deaths, a flood of residents seeking medical attention for respiratory problems, and an overwhelmed emergency management system. This case day had all the classic ingredients for an epidemic, including high rye grass pollen concentrations, a strong multicellular thunderstorm system moving across the region, and a large population of several million people in the vicinity of Melbourne. A particular characteristic of this event was the strong, gusty winds that likely spread the pollen grains and/or allergenic contents widely across the region to increase population exposure. This exploratory case study is the first to examine the usefulness of low-to-middle-atmospheric thermodynamic information for anticipating epidemic thunderstorm asthma outbreaks by allowing the forecast of strong downdraft winds. The authors investigated the utility of several mesoscale products derived from atmospheric soundings such as downdraft convective available potential energy (DCAPE) and indices for predicting surface wind gusts such as microburst wind speed potential index (MWPI) and a wind gust index (GUSTEX). These results indicate that DCAPE levels reached “high” to “very high” thresholds for strong downdraft winds in the lead-up to the thunderstorm, and the MWPI and GUSTEX indices accurately predicted the high maximum surface wind observations. This information may be useful for diagnostic and prognostic assessment of epidemic thunderstorm asthma and in providing an early warning to health practitioners, emergency management officials, and residents in affected areas.
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Aberdour, S., and A. Henri-Bhargava. "P.100 A competency-based stroke curriculum for non-neurologists." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 44, S2 (June 2017): S39. http://dx.doi.org/10.1017/cjn.2017.184.
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Background: Previously-identified deficiencies in stroke training for emergency and internal medicine trainees led us to develop a competency-based curriculum for a stroke rotation, based upon entrusbable professional activities (EPAs). EPAs are observable and measurable activities that are routine care within a given medical specialty. Methods: We surveyed stroke- and non-stroke neurologists using a modified Delphi process with two iterations. The survey sought input on the number and nature of EPAs considered most important and achievable during a one month stroke rotation. Results: Surveyed neurologists considered 5-10 EPAs as adequate and reasonable to achieve during a one month elective. A list of the most essential EPAs was obtained and will be used as the basis of a curriculum for rotating residents in Internal and Emergency medicine at the Island Medical Program in Victoria, BC. Conclusions: Our work highlights an approach to meeting an identified gap in resident training in an important area of neurology (stroke). A competency based approach to medical education, focusing on EPAs, offers an innovative way of approaching resident education that seeks to ensure residents develop skills that experts in the field have identified as most essential for the work at hand (in this case, the proper management of stroke patients).
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Kumar, Arunaz, Sam Sturrock, Euan M. Wallace, Debra Nestel, Donna Lucey, Sally Stoyles, Jenny Morgan, Peter Neil, Michelle Schlipalius, and Philip Dekoninck. "Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick’s framework: a mixed methods study." BMJ Open 8, no. 2 (February 2018): e017451. http://dx.doi.org/10.1136/bmjopen-2017-017451.
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ObjectivesThe aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick’s framework. We explored participants’ acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants’ perception of usefulness of PROMPT in their clinical practice.Study designMixed methods approach with a pre-test/post-test design.SettingHealthcare network providing obstetric care in Victoria, Australia.ParticipantsMedical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011–2012 (n=15 361 births) and 2014–2015 (n=12 388 births).InterventionAttendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills.Main outcome measureClinical outcomes compared before and after embedding PROMPT in educational practice.Secondary outcome measureAssessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice.ResultsThere was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies.ConclusionParticipants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.
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Jan Forbes, Rouve, and Julie Williams. "The role of acknowledgment in the psychosocial recovery of young adults in disaster events." April 2021 10.47389/36, No 2 (April 2021): 42–47. http://dx.doi.org/10.47389/36.2.42.
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In 2009, 4 major bushfires destroyed vast areas of Gippsland in eastern Victoria including the areas around Delburn, Bunyip, Churchill and Wilsons Promontory. These are collectively known as the 2009 Gippsland bushfires. Research was conducted to investigate the psychosocial recovery of young adults in these areas. Twenty young adults participated in the study and, while these young adults are not an homogenous group, commonalities were identified across their stories. Asked what would have helped their recovery, the participants all said that acknowledgment of their personal and age-specific needs was the single most important factor that enabled or impeded recovery. This paper describes some of their stories. The paper looks at how participants viewed acknowledgment and the effects of its absence on their psychosocial recovery and how they felt unacknowledged in local recovery supports. The paper reports on the findings of this research and suggests an approach for management and longer-term recovery support that is inclusive of the specific needs of young adults.
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., Fatima, Fatima Rauf, Sobia Nawaz, and Muhammad Adeem Busharat. "Efficacy of Reamed Intelocking Nail in the Management of Closed Tibal Shaft Fractures." Pakistan Journal of Medical and Health Sciences 16, no. 4 (April 29, 2022): 1186–88. http://dx.doi.org/10.53350/pjmhs221641186.
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Objective: The purpose of this study is to evaluate the efficiency of reamed interlocking nails in the treatment of closed tibal shaft fractures. Study Design: The Observational and Descriptive study Place and Duration: Allied Hospital Faisalabad / Bahawal Victoria Hospital Bahawalpur.Jun 2018-Dec 2018. Material and Methods: A total of 130 patients, both sexes, were included in this analysis. Enrollees were between the ages of 18 and 60. After obtaining written agreement, the demographic information of registered patients was gathered and stored in a database. A reamed interlocking nail was used to repair tibial shaft fractures in patients brought to the emergency room. Postoperatively, the length of time it took to achieve union and the frequency of problems were also evaluated. During the course of 14 months, all of the patients' follow-ups were completed. SPSS 24.0 was used to analyze the data. Results: Included patients had mean age 30.4±5.41 years and had mean BMI 23.13±8.51 kg/m2. Majority were males in this study. Most common cause of fracture was road traffic accident. In our study mean time of union among simple fractures were 11.53±14.61 weeks and mean union time of segmental fractures were 19.3±9.20 weeks. Among 130 cases, frequency of non-union fractures were 10 (7.7%), union fractures were 90 (69.2%) and delayed union were 30 (23.1%). Conclusion: A reamed interlocking nail was the most successful and safest treatment for closed tibal shaft fractures, according to this study. A total of 92.3% of the participants in this study were able to successfully consummate their unions. Keywords: Union, Tibial shaft fractures, Interlocking nail
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Wiegers, Eveline J. A., Tony Trapani, Belinda J. Gabbe, Dashiell Gantner, Fiona Lecky, Andrew I. R. Maas, David K. Menon, et al. "Characteristics, management and outcomes of patients with severe traumatic brain injury in Victoria, Australia compared to United Kingdom and Europe: A comparison between two harmonised prospective cohort studies." Injury 52, no. 9 (September 2021): 2576–87. http://dx.doi.org/10.1016/j.injury.2021.04.033.
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Fortington, Lauren V., Liam West, Damian Morgan, and Caroline F. Finch. "Implementing automated external defibrillators into community sports clubs/facilities: a cross-sectional survey of community club member preparedness for medical emergencies." BMJ Open Sport & Exercise Medicine 5, no. 1 (June 2019): e000536. http://dx.doi.org/10.1136/bmjsem-2019-000536.
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ObjectiveThere is a growing focus on ensuring the availability of automated external defibrillators (AED) in sport settings to assist in preventing sudden cardiac death. For the AED to be most effective, understanding how best to integrate it with wider risk management and emergency action plans (EAP) is needed. The aim of this survey was to identify sports club/facility member knowledge of AED use and club EAPs, 6 months following participation in a government-funded AED provision and cardiopulmonary resuscitation training programme.MethodsCross-sectional survey of community sports clubs and facilities in Victoria, Australia. Included participants were members of sports club/facilities that had been provided with an AED and basic first aid training as part of a government programme to increase access to, and awareness of, AEDs. A descriptive analysis of availability of EAPs and AEDs, together with practical scenarios on AED use and maintenance, is presented.ResultsFrom 191 respondents, more than half (56%) had no previous training in AED use. Knowledge on availability of an EAP at the club/facility was varied: 53% said yes and knew where it was located, while 41% did not have, or did not know if they had, an EAP. Responses to clinical scenarios for use of AED were mostly accurate, with the exception of being unsure how to respond when ‘a participant falls to the ground and is making shaking movements.’ConclusionsWhile there were positive outcomes from this programme, such as half of the respondents being newly trained in emergency first aid response, further improvements are required to assist members with embedding their AED into their club/facility EAP and practices.
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Roberts, Fiona, Frank Archer, and Caroline Spencer. "“We Just Want to Help” - Nonprofits Contributions to Community Resilience in the Disaster Space." Prehospital and Disaster Medicine 34, s1 (May 2019): s22. http://dx.doi.org/10.1017/s1049023x19000645.
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Introduction:The National Strategy for Disaster Resilience (NSDR) characterizes resilient communities as having strong disaster and financial mitigation strategies, strong social capacity, networks, and self-reliance. Nonprofit organizations (NPOs) embrace many characteristics of a disaster resilient community. NPOs do not operate for the profit of individual members. Community groups like Lions and Rotary Club have long histories, and while not established to respond to disasters, they frequently have heavy involvement in preparing for or recovering from, disasters.Aim:The study aims to address the question, “What is the potential role of nonprofit organizations in building community resilience to disasters?”Methods:An applied research project was carried out, using theories of resilience, social capital, and the Sendai framework to conceptualize the frameworks and guide the process. Qualitative research methods, thematic analysis, and case studies helped identify Lions, Rotary, and Neighbourhood Houses Victoria strengths, barriers, and enablers.Results:Research demonstrated how NPOs made significant contributions to building communities’ resilience to disasters. NPOs facilitate three Sendai guiding principles of engaging, empowering, and enabling the community to build disaster resilience. Actions included raising awareness to disaster risk, reducing disaster risk, helping prepare for disasters, and contributing to long term disaster recovery. NPO strengths included local knowledge, community trust, and connections, which matched characteristics listed in the NSDR for a disaster resilient community. However, barriers to participation included traditional emergency services ignoring NPOs, lack of role definition, and lack of perceived legitimacy.Discussion:As the first Australia research to scientifically analyze the contributions of these NPOs to build community resilience, before, during and after disaster, this study enhances understanding and recognition of NPOs and assists in identifying means to facilitate their disaster resilience activities and place them more effectively within Emergency Management strategic processes. Greater utilization of such assets could lead to better community outcomes.
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Ayton, Darshini, Renée O'Donnell, Dave Vicary, Catherine Bateman, Chris Moran, Velandai K. Srikanth, Julie Lustig, et al. "Psychosocial volunteer support for older adults with cognitive impairment: development of MyCare Ageing using a codesign approach via action research." BMJ Open 10, no. 9 (September 2020): e036449. http://dx.doi.org/10.1136/bmjopen-2019-036449.
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Background and objectivesOlder adults with cognitive impairment are vulnerable to frequent hospital admissions and emergency department presentations. The aim of this study was to use a codesign approach to develop MyCare Ageing, a programme that will train volunteers to provide psychosocial support to older people with dementia and/or delirium in hospital and at home when discharged from hospital.SettingMelbourne, Victoria, Australia.Research designThis study adopts an action research methodology. We report on two co-design workshops with keystakeholders: Workshop 1: identification of components from three existing programmes to inform the development of the MyCare Ageing program logic and, Workshop 2: identification of implementation strategies.ParticipantsThe key stakeholders and workshop participants included clinicians (geriatricians, nurses and allied health), hospital staff (volunteer coordinators and hospital executives), Baptcare staff, a consumer, researchers and implementation experts and project staff.ResultsWorkshop 1 identified the components from three existing programmes—the Volunteer Dementia and Delirium Care programme, Home-Start and MyCare for inclusion in MyCare Ageing. In workshop 2, the p implementation plan was developed taking into consideration hospital-specific processes, training and support needs of volunteers and safety and risk management processes.Discussion and conclusionThe codesign process was successfully applied to develop the MyCare Ageing programme to provide volunteer support to patients with dementia and/or delirium in hospital and their transition home. MyCare Ageing is an innovative programme that meets an identified need from hospitals and consumers to support patients with dementia and/or delirium to improve psychosocial outcomes on discharge from hospital.
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Peiris, Sujanie, Stuart Newstead, Janneke Berecki-Gisolf, Bernard Chen, and Brian Fildes. "Quantifying the Lost Safety Benefits of ADAS Technologies Due to Inadequate Supporting Road Infrastructure." Sustainability 14, no. 4 (February 16, 2022): 2234. http://dx.doi.org/10.3390/su14042234.
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Advanced driver assistance systems (ADAS) provide warnings to drivers and, if applicable, intervene to mitigate a collision if one is imminent. Autonomous emergency brakes (AEB) and lane keep assistance (LKA) systems are mandated in several new vehicles, given their predicted injury and fatality reduction benefits. These predicted benefits are based on the assumption that roads are always entirely supportive of ADAS technologies. Little research, however, has been conducted regarding the preparedness of the road network to support these technologies in Australia, given its vastly expansive terrain and varying road quality. The objective of this study was to estimate what proportion of crashes that are sensitive to AEB and LKA, would not be mitigated due to unsupportive road infrastructure, and therefore, the lost benefits of the technologies due to inadequate road infrastructure. To do this, previously identified technology effectiveness estimates and a published methodology for identifying ADAS-supportive infrastructure availability was applied to an estimated AEB and LKA-sensitive crash subset (using crash data from Victoria, South Australia and Queensland, 2013–2018 inclusive). Findings demonstrate that while the road networks across the three states appeared largely supportive of AEB technology, the lack of delineation across arterial and sub-arterial (or equivalent) roads is likely to have serious implications on road safety, given 13–23% of all fatal and serious injury (FSI) crashes that occurred on these road classes were LKA-sensitive. Based on historical crash data, over 37 fatalities and 357 serious injuries may not be avoided annually across the three Australian states based on the lack of satisfactory road delineation on arterial and sub-arterial (or equivalent) roads alone. Further, almost 24% of fatalities in Victoria, 24% of fatalities in Queensland and 21% of fatalities in South Australia (that are AEB- or LKA-sensitive) are unlikely to be prevented, given existing road infrastructure. These figures are conservative estimates of the lost benefits of the technologies as they only consider fatal and serious injury crashes and do not include minor injury or property damage crashes, the benefits of pedestrian-sensitive AEB crashes in high-speed zones or AEB fitted to heavy vehicles. It is timely for road investments to be considered, prioritised and allocated, given the anticipated penetration of the new technologies into the fleet, to ensure that the road infrastructure is capable of supporting the upcoming fleet safety improvements.
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Knott, Jonathan C., Alex Pleban, David Taylor, and David Castle. "Management of Mental Health Patients Attending Victorian Emergency Departments." Australian & New Zealand Journal of Psychiatry 41, no. 9 (September 2007): 759–67. http://dx.doi.org/10.1080/00048670701517934.
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Objective: To evaluate the management of mental health presentations to Victorian emergency departments. Method: An observational study in five Victorian emergency departments (four metropolitan and one regional). All patients with an ICD-10 discharge diagnosis for a predetermined mental health disorder were included. Data were collected on patient demographics, presentation, clinical management (emergency and mental health) and disposition. Results: There were 3702 patients enrolled (96.0% of all mental health presentations). At presentation 39.1% were intoxicated and 39.9% arrived by ambulance, 17.6% with the police. There was a significant variation (p <0.001) between sites for: the median time to be seen by a clinician (14 vs 43 min), the time between referral to and review by mental health services (15 vs 50 min), the median time in the emergency department (208 min vs 380 min), the proportion who spent >24 h in the emergency department (0.0% vs 11.6%) and disposition (proportion discharged home from ED 49.8% vs 63.5%). Conclusion: Important variations were identified in the management of patients with mental health presentations to Victorian emergency departments. This variation is most likely due to differing access to resources. All levels of administration must work with carers and patients to ensure that optimal patient care is provided at every site.
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Leivesley, Robert. "From Emergency Management at Coode Island to Crisis Management in the Victorian Chemical Industry." Journal of Contingencies and Crisis Management 1, no. 2 (June 1993): 111–20. http://dx.doi.org/10.1111/j.1468-5973.1993.tb00013.x.
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Costa, Nadia, Mary Sullivan, Rae Walker, and Kerin M. Robinson. "Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People." Health Information Management Journal 37, no. 3 (October 2008): 15–25. http://dx.doi.org/10.1177/183335830803700303.
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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.
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Rezania, Fatemeh, Christopher J. A. Neil, and Tissa Wijeratne. "Disparities in Care and Outcome of Stroke Patients from Culturally and Linguistically Diverse Communities in Metropolitan Australia." Journal of Clinical Medicine 10, no. 24 (December 14, 2021): 5870. http://dx.doi.org/10.3390/jcm10245870.
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Background: Acute stroke is a time-critical emergency where diagnosis and acute management are highly dependent upon the accuracy of the patient’s history. We hypothesised that the language barrier is associated with delayed onset time to thrombolysis and poor clinical outcomes. This study aims to evaluate the effect of language barriers on time to thrombolysis and clinical outcomes in acute ischemic stroke. Concerning the method, this is a retrospective study of all patients admitted to a metropolitan stroke unit (Melbourne, Victoria, Australia) with an acute ischemic stroke treated with tissue plasminogen activator between 1/2013 and 9/2017. Baseline characteristics, thrombolysis time intervals, length of stay, discharge destination, and in-hospital mortality were compared among patients with and without a language barrier using multivariate analysis after adjustment for age, sex, stroke severity, premorbid modified Rankin Scale (mRS), and Charlson Comorbidity Index (CCI). Language barriers were defined as a primary language other than English. A total of 374 patients were included. Our findings show that 76 patients (20.3%) had a language barrier. Mean age was five years older for patients with language barriers (76.7 vs. 71.8 years, p = 0.004). Less non-English speaking patients had premorbid mRS score of zero (p = 0.002), and more had premorbid mRS score of one or two (p = 0.04). There was no statistically significant difference between the two groups in terms of stroke severity on presentation (p = 0.06). The onset to needle time was significantly longer in patients with a language barrier (188 min vs. 173 min, p = 0.04). Onset to arrival and door to imaging times were reassuringly similar between the two groups. However, imaging to needle time was 9 min delayed in non-English speaking patients with a marginal p value (65 vs. 56 min, p = 0.06). Patients with language barriers stayed longer in the stroke unit (six vs. four days, p = 0.02) and had higher discharge rates than residential aged care facilities in those admitted from home (9.2% vs. 2.3%, p = 0.02). In-hospital mortality was not different between the two groups (p = 0.8). In conclusion, language barriers were associated with almost 14 min delay in thrombolysis. The delay was primarily attributable to imaging to needle time. Language barriers were also associated with poorer clinical outcomes.
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Comino, E., B. P. Miller, and N. J. Enright. "Soil seedbanks in natural and restored boxironbark forests at Stawell Gold Mine, Victoria." Pacific Conservation Biology 10, no. 1 (2004): 9. http://dx.doi.org/10.1071/pc040009.
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Natural communities have the capacity to regenerate themselves, and this functional ecosystem attribute must be regarded as a key indicator of success for revegetation programmes. The accumulation of species (and individuals) as dormant propagules in a soil seedbank, representing potential future states for the vegetation, is one possible index of revegetation success. Here, we investigate the soil seedbanks for five natural vegetation (Box-Ironbark forest) remnants, a topsoil stockpile and three revegetated mine-site areas associated with gold mining at Stawell (Victoria, Australia). The revegetation efforts largely date from 1987 and, in terms of their composition and structure, are relatively similar to natural vegetation remnants. Soil samples were treated with heat or smoke (plus control) and were monitored for seedling emergence, species composition and density in the glasshouse for 150 days. Seedling densities in treated seedbank samples were high (2 200 to 17 500 seedlings m-2) while species richness was low, ranging from 10 to 20 species per sample. Exotic species made up 22?61 % of emergents and 33?50% of species observed. Correlation of seedbank composition and density with chemical attributes of soils, and with above ground (extant) vegetation at sites showed few significant relationships. Total species richness and the proportion of exotic species varied significantly between natural bushland remnants and revegetation areas. Richness was highest, and the proportion of exotic species was lowest in natural bushland samples. Total emergent numbers and the density of exotic emergents did not vary significantly between remnant bushland and revegetation areas. Declining vigour of some woody species in revegetation sites that are well represented in the seedbank, including Acacia pycnantha and A. genistifolia, indicates that the reintroduction of fire might be an appropriate management practice to facilitate long-term recovery of a functional community on these revegetated surfaces, but the potential for the establishment of weed species from the seed-bank following fire may pose a challenge to management.
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Оshovskyy, V. I. "Analysis of the results of a retrospective cohort study of the course of pregnancy, childbirth and the postpartum period in high-risk patients to identify factors of unfavorable outcomes and build a predictive model of fetal loss." Reproductive health of woman 2 (April 1, 2021): 47–52. http://dx.doi.org/10.30841/2708-8731.2.2021.232552.
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Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches.The objective: to identify antenatal factors that correlate with perinatal losses, by conducting a retrospective cohort study of women at high perinatal risk, to build a multifactorial prognostic model of adverse pregnancy outcomes.Materials and methods. A retrospective cohort study was conducted from 2014 to 2016 on the basis of the medical center LLC «Uniclinic», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 2154 medical cards of pregnant women from the group of high perinatal risk were selected and analyzed. Of these, 782 pregnant women were included in the final protocol after verification of compliance with the criteria.Results. Cesarean delivery occurred in 115 cases (14.7%). In 50 cases (6.4%) the caesarean section was performed in a planned manner, in 65 (8.3%) – in an emergency. In 39 (5%) cases, the indication for surgical delivery was acute fetal distress. Antenatal fetal death occurred in 11 (1.4%) cases: one case in terms of <34 weeks and <37 weeks of gestation, the remaining 9 cases – in terms of> 37 weeks. Intranatal death of two fetuses (0.3%) was due to acute asphyxia on the background of placental insufficiency. In the early neonatal period, 14 (1.8%) newborns died. Hospitalization of the newborn to the intensive care unit for the first 7 days was registered in 64 (8.2%) cases.The need for mechanical ventilation was stated in 3.96% (31/782) of newborns. The method of construction and analysis of multifactor models of logistic regression was used in the analysis of the relationship between the risk of perinatal losses (antenatal death, intranatal death, early neonatal death) and factor characteristics.Conclusion. Signs associated with the risk of perinatal loss: the presence of chronic hypertension, preeclampsia in previous pregnancies, type of fertilization (natural or artificial), the concentration of PAPP-A (MoM), the concentration of free β-HCG (MoM) in the second trimester, average PI in the uterine arteries in 28–30 weeks of pregnancy, PI in the middle cerebral arteries in 28–30 weeks of pregnancy, episodes of low fetal heart rate variability in the third trimester of pregnancy, episodes of high fetal heart rate variability in the third trimester of pregnancy. The model, built on selected features, allows with a sensitivity of 73.1% (95% CI: 52.2% – 88.4%) and a specificity of 72.7% (95% CI: 69.3% – 75.9%) to predict risk perinatal loss.
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Alarcon Manchego, Peter, Jonathan Knott, Andis Graudins, Bruce Bartley, and Biswadev Mitra. "Management of mental health patients in Victorian emergency departments: A 10 year follow-up study." Emergency Medicine Australasia 27, no. 6 (November 24, 2015): 529–36. http://dx.doi.org/10.1111/1742-6723.12500.
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Brown, Ashlee Maree, Dara M. Twomey, and Anna Wong Shee. "Evaluating mild traumatic brain injury management at a regional emergency department." Injury Prevention 24, no. 5 (June 4, 2018): 390–94. http://dx.doi.org/10.1136/injuryprev-2018-042865.
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BackgroundEmergency departments (EDs) are usually the first point of contact, and often the only medical service available, for patients with mild traumatic brain injury (mTBI) in rural and regional areas. Clinical practice guidelines (CPGs) have been created to ensure best practice management of mTBI in EDs. Adherence to mTBI CPGs has rarely been evaluated in rural and regional areas.AimThe aim of this paper was to assess a regional health service’s adherence to their mTBI CPG.MethodsThis was a 12-month retrospective audit of 1280 ED records of patients ≥16 years presenting with mTBI to a regional Australian ED. Case selection used the Victorian Admitted Episodes Dataset codes for suspected head injury: principal diagnosis codes (S00-T98), concussive injury recorded in diagnosis codes (S06.00-S06.05) and unintentional external cause code (V00-X59). The data were collected to determine 4-hour observation rates, CT scan rates, safe discharge and appropriate referral documentation.ResultsFewer people received a CT scan than qualified (n=245, 65.3%), only 45% had 4-hour observations recorded, safe discharge was documented in 74.1% of cases and 33% received educational resources.Discussion/conclusionSeveral key elements for the management of mTBI were under-recorded, particularly 4-hour observations, safe discharge and education. Acquired brain injury clinic referrals were received in overwhelmingly fewer cases than had a CT scan (n=19, 6.3%). Overall, this study suggests that the regional health service does not currently fully adhere to the CPG and that the referral services are potentially underutilised.
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Smith, Gavin, David McD Taylor, Amee Morgans, and Peter Cameron. "Prehospital Synchronized Electrical Cardioversion of a Poorly Perfused SVT Patient by Paramedics." Prehospital and Disaster Medicine 28, no. 3 (March 14, 2013): 301–4. http://dx.doi.org/10.1017/s1049023x13000174.
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AbstractSynchronized Direct Current Cardioversion (SDC) is an established therapy for the termination of supraventricular tachycardia (SVT – either atrio-ventricular nodal reentry tachycardia (AVNRT) or atrio-ventricular reentrant tachycardia (AVRT)) with poor perfusion. The evidence is extremely limited with regard to the safety and effectiveness of this therapy. In Australia, half of the eight ambulance services include SDC within their clinical practice guidelines for the management of poorly perfused SVT; however the degree of variation in the application of SDC across these guidelines suggests a need to quantify the practice. This case provides a previously unreported example of the safety and effectiveness of prehospital SDC for SVT (with poor perfusion precipitated by a Valsalva Maneuver) by Victorian paramedics, and discusses the available literature regarding the effectiveness and safety of this practice.SmithG, TaylorD, MorgansA, CameronP. Prehospital synchronized electrical cardioversion of a poorly perfused SVT patient by paramedics. Prehosp Disaster Med. 2013;28(3):1-4.
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Bud-Frierman, Lisa, Andrew Godley, and Judith Wale. "Weetman Pearson in Mexico and the Emergence of a British Oil Major, 1901–1919." Business History Review 84, no. 2 (2010): 275–300. http://dx.doi.org/10.1017/s0007680500002610.
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British overseas investment was a powerful force behind rapid global integration before World War I. Close to half of the total was in the form of foreign direct investment. Weetman Pearson was among the most successful of Britain's overseas-based entrepreneurs of the period. By 1919, the Pearson group of companies had become one of Britain's most valuable industrial enterprises, having diversified from international contracting into the Mexican oil industry. The Pearson group highlights the technical competence of British entrepreneurs in managing large, complex infrastructure projects, capable of navigating their way through various political systems, and adept at turning to whichever organizational form best suited their business interests. These characteristics were far removed from the now outdated stereotype of the incompetent late Victorian entrepreneur.
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Jones, P., K. Leder, A. Cheng, I. Woolley, P. Cameron, R. Gruen, S. Lyon, and D. Spelman. "Victorian Spleen Registry's role in the management of trauma patients undergoing splenectomy and splenic artery embolisation." Injury 41 (July 2010): S40—S41. http://dx.doi.org/10.1016/j.injury.2010.01.049.
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Skerratt, Lee F., Lee Berger, Nick Clemann, Dave A. Hunter, Gerry Marantelli, David A. Newell, Annie Philips, et al. "Priorities for management of chytridiomycosis in Australia: saving frogs from extinction." Wildlife Research 43, no. 2 (2016): 105. http://dx.doi.org/10.1071/wr15071.
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To protect Australian amphibian biodiversity, we have identified and prioritised frog species at an imminent risk of extinction from chytridiomycosis, and devised national management and research priorities for disease mitigation. Six Australian frogs have not been observed in the wild since the initial emergence of chytridiomycosis and may be extinct. Seven extant frog species were assessed as needing urgent conservation interventions because of (1) their small populations and/or ongoing declines throughout their ranges (southern corroboree frog (Pseudophryne corroboree, New South Wales), northern corroboree frog (Pseudophryne pengilleyi, Australian Capital Territory, New South Wales), Baw Baw frog (Philoria frosti, Victoria), Litoria spenceri (spotted tree frog, Victoria, New South Wales), Kroombit tinkerfrog (Taudactylus pleione, Queensland), armoured mist frog (Litoria lorica, Queensland)) or (2) predicted severe decline associated with the spread of chytridiomycosis in the case of Tasmanian tree frog (Litoria burrowsae, Tasmania). For these species, the risk of extinction is high, but can be mitigated. They require increased survey effort to define their distributional limits and to monitor and detect further population changes, as well as well-resourced management strategies that include captive assurance populations. A further 22 frog species were considered at a moderate to lower risk of extinction from chytridiomycosis. Management actions that identify and create or maintain habitat refugia from chytridiomycosis and target other threatening processes such as habitat loss and degradation may be effective in promoting their recovery. Our assessments for some of these species remain uncertain and further taxonomical clarification is needed to determine their conservation importance. Management actions are currently being developed and trialled to mitigate the threat posed by chytridiomycosis. However, proven solutions to facilitate population recovery in the wild are lacking; hence, we prioritise research topics to achieve this aim. Importantly, the effectiveness of novel management solutions will likely differ among species due to variation in disease ecology, highlighting the need for species-specific research. We call for an independent management and research fund of AU$15 million over 5 years to be allocated to recovery actions as determined by a National Chytridiomycosis Working Group of amphibian managers and scientists. Procrastination on this issue will likely result in additional extinction of Australia’s amphibians in the near future.
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Dipnall, Joanna F., Richard Page, Lan Du, Matthew Costa, Ronan A. Lyons, Peter Cameron, Richard de Steiger, et al. "Predicting fracture outcomes from clinical registry data using artificial intelligence supplemented models for evidence-informed treatment (PRAISE) study protocol." PLOS ONE 16, no. 9 (September 23, 2021): e0257361. http://dx.doi.org/10.1371/journal.pone.0257361.
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Background Distal radius (wrist) fractures are the second most common fracture admitted to hospital. The anatomical pattern of these types of injuries is diverse, with variation in clinical management, guidelines for management remain inconclusive, and the uptake of findings from clinical trials into routine practice limited. Robust predictive modelling, which considers both the characteristics of the fracture and patient, provides the best opportunity to reduce variation in care and improve patient outcomes. This type of data is housed in unstructured data sources with no particular format or schema. The “Predicting fracture outcomes from clinical Registry data using Artificial Intelligence (AI) Supplemented models for Evidence-informed treatment (PRAISE)” study aims to use AI methods on unstructured data to describe the fracture characteristics and test if using this information improves identification of key fracture characteristics and prediction of patient-reported outcome measures and clinical outcomes following wrist fractures compared to prediction models based on standard registry data. Methods and design Adult (16+ years) patients presenting to the emergency department, treated in a short stay unit, or admitted to hospital for >24h for management of a wrist fracture in four Victorian hospitals will be included in this study. The study will use routine registry data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), and electronic medical record (EMR) information (e.g. X-rays, surgical reports, radiology reports, images). A multimodal deep learning fracture reasoning system (DLFRS) will be developed that reasons on EMR information. Machine learning prediction models will test the performance with/without output from the DLFRS. Discussion The PRAISE study will establish the use of AI techniques to provide enhanced information about fracture characteristics in people with wrist fractures. Prediction models using AI derived characteristics are expected to provide better prediction of clinical and patient-reported outcomes following distal radius fracture.
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Singh, Aseemjot, Gulshan Mahajan, and Bhagirath Singh Chauhan. "Germination ecology of wild mustard (Sinapis arvensis) and its implications for weed management." Weed Science 70, no. 1 (October 1, 2021): 103–11. http://dx.doi.org/10.1017/wsc.2021.66.
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AbstractWild mustard (Sinapis arvensis L.) is a widespread weed of the southeastern cropping region of Australia. Seed germination ecology of S. arvensis populations selected from different climatic regions may differ due to adaptative traits. Experiments were conducted to evaluate the effects of temperature, light, radiant heat, soil moisture, salt concentration, and burial depth on seed germination and seedling emergence of two populations (Queensland [Qld] population: tropical region; and Victoria [Vic] population: temperate region) of S. arvensis. Both populations germinated over a wide range of day/night (12-h/12-h) temperatures (15/5 to 35/25 C), and had the highest germination at 30/20 C. Under complete darkness, the Qld population (61%) had higher germination than the Vic population (21%); however, under the light/dark regime, both populations had similar germination (78% to 86%). At 100 C pretreatment for 5 min, the Qld population (44%) had higher germination than the Vic population (13%). Germination of both populations was nil when given pretreatment at 150 and 200 C. The Vic population was found tolerant to high osmotic and salt stress compared with the Qld population. At an osmotic potential of −0.4 MPa, germination of Qld and Vic populations was reduced by 85% and 42%, respectively, compared with their respective controls. At 40, 80, and 160 mM sodium chloride, germination was lower for the Qld population than the Vic population. Averaged over the populations, seedling emergence was highest (52%) from a burial depth of 1 cm and was nil from 8-cm depth. Differential germination behaviors of both populations to temperature, light, radiant heat, water stress, and salt stress suggest that populations of S. arvensis may have undergone differential adaptation. Knowledge gained from this study will assist in developing suitable control measures for this weed species to reduce the soil seedbank.
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Vesk, Peter A., William K. Morris, Warwick McCallum, Rhiannon Apted, and Carla Miles. "Processes of woodland eucalypt regeneration: lessons from the bush returns trial." Proceedings of the Royal Society of Victoria 128, no. 1 (2016): 54. http://dx.doi.org/10.1071/rs16005.
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Natural regeneration may contribute significantly to eucalypt woodland management, but has uncertain outcomes. As part of a monitoring program, we sought to investigate the processes of eucalypt regeneration within the Bush Returns trial, a native vegetation management incentive scheme in the Goulburn Broken catchment of Victoria. By year 4 of the 10-year program, eucalypt seedlings were found at about 24% of sampled quadrats. This varied substantially across sites, with only half the participating properties having any seedlings. Individual trees varied widely in their seed production, but seed rain was not related to the spatial context of the trees. Seedling emergence was infrequent and seed sowing trials had very patchy, and overall low, success. Seed removal experiments indicated that seeds were removed faster and more completely in sites with more bare ground (less grass and litter) and during warmer weather. The probability of a seedling surviving summer was approximately 0.3‒0.5, with some site-to-site uncertainty attributable to soil moisture availability. The processes of eucalypt recruitment are infrequent, patchy and difficult to predict. Long timeframes with appropriate incentives are needed to manage natural regeneration. Research to investigate this would require replicated experiments, with multiple treatments across multiple sites.
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Shortt, Jake, Neil Waters, Mary Comande, Mark N. Polizzotto, Martine Moran, Marija Borosak, Damien J. Jolley, and Erica M. Wood. "Red Cell Transfusion Support for Hematology and Oncology Patients Is Both Substantial and Often Required Urgently. Results from the Bloodhound Study: A Comprehensive, Prospective Australian Study of Red Cell Use." Blood 112, no. 11 (November 16, 2008): 3047. http://dx.doi.org/10.1182/blood.v112.11.3047.3047.
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Abstract Although red cell (RC) transfusion is often essential for the management of malignant and benign hematology, few prospective data are available on RC use in this patient group. In order to inform national emergency blood supply planning, we performed a longitudinal, prospective audit of RC use within the Australian state of Victoria (population 5.5 million) over a 9-month period (Jun ‘07–Feb ‘08). Our primary aims were to identify major clinical areas of RC utilisation and determine the urgency of RC use therein. Hemato-oncology (HO) patients were the largest overall user of RC in the state, prompting the detailed subgroup analysis reported in this abstract. 5132 RC units were randomly selected at point of production and distributed at a constant rate along with state-wide inventory (thus sampling 3.7% of the total population of RCs distributed during the study period). Details regarding the fate of each selected unit were actively followed by collation of associated case-report forms (CRFs). 5052 (98.4%) CRFs were returned; 4829 (95.6% CI±0.5%) of RCs were transfused. 1623 (33.6±1.3%) of these were administered to HO patients (median HO recipient age 68, range 1–100; 44% female). Clinical areas of use within the HO cohort included: malignant hematology/stem cell transplant, 34.8±2.3% of RCs; non-hematological oncology, 29.0±2.2%; benign hematology, 27.8±2.2% and hematinic deficiency, 8.4±1.4%. Although few (1.5±0.1%) transfusions were required acutely (<1 hr), the majority (53.6±2.4%) of HO recipients required RCs within 24hrs; only 3.1±0.9% of transfusions were considered deferrable for more than 1 week. Within individual clinical categories, urgency of RC supply was highest for the malignant disorders, with 59.7±4.1% of RCs for malignant hematology/SCT and 61.9±4.4% of RCs for non-hematological oncology required within 24hrs. The corresponding figures for benign hematology and hematinic deficiency were 36.4±4.4% and 24.4±9.5% respectively. The ABO group of recipients did not differ from the background Australian population estimates, but there was a significant excess of Rh positivity in the benign hematology cohort, possibly due to segregation of Rh phenotype with transfusion-requiring hemoglobinopathies (89.4±2.9% Rh +ve in benign hematology vs 82.5±2.2% in Australian population; p<0.001). Product modifications (including extended RC phenotyping, CMV screening, leucodepletion, irradiation) were more heavily utilised by HO patients than the wider transfused patient population. These results demonstrate the continuing importance of RC support in HO patients, and underscore the predominantly high acuity of RC transfusion in this group. We suggest that using increasingly restrictive transfusion thresholds in the context of a major blood shortage would be unlikely to have a significant impact on RC demands by HO patients with established anemia. However, delaying the administration (or reducing the intensity) of myelosuppressive chemotherapy as part of a RC triaging strategy may result in major short-to-intermediate term gains in inventory for transfusion services. The identification of ongoing, largely avoidable, low acuity RC transfusion for hematinic deficiency within the cohort also provides an opportunity to improve clinical practice while conserving finite RC resources. Consideration of alternatives to transfusion, optimisation of hematinics and judicious use of erythropoietic stimulating agents remain an important and potentially under-utilised facet to HO patient care.