Статті в журналах: "Emergency medicine Victoria"

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D'ARCY, ANNE. "MODERN HISTORY OF EMERGENCY MEDICINE IN VICTORIA." Emergency Medicine 3 (August 26, 2009): 204–6. http://dx.doi.org/10.1111/j.1442-2026.1991.tb00742.x.

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Rezaei-Darzi, Ehsan, Janneke Berecki-Gisolf, and Dasamal Tharanga Fernando. "How representative is the Victorian Emergency Minimum Dataset (VEMD) for population-based injury surveillance in Victoria? A retrospective observational study of administrative healthcare data." BMJ Open 12, no. 12 (December 2022): e063115. http://dx.doi.org/10.1136/bmjopen-2022-063115.

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ObjectiveThe Victorian Emergency Minimum Dataset (VEMD) is a key data resource for injury surveillance. The VEMD collects emergency department data from 39 public hospitals across Victoria; however, rural emergency care services are not well captured. The aim of this study is to determine the representativeness of the VEMD for injury surveillance.DesignA retrospective observational study of administrative healthcare data.Setting and participantsInjury admissions in 2014/2015–2018/2019 were extracted from the Victorian Admitted Episodes Dataset (VAED) which captures all Victorian hospital admissions; only cases that arrived through a hospital’s emergency department (ED) were included. Each admission was categorised as taking place in a VEMD-contributing versus a non-VEMD hospital.ResultsThere were 535 477 incident injury admissions in the study period, of which 517 207 (96.6%) were admitted to a VEMD contributing hospital. Male gender (OR 1.13 (95% CI 1.10 to 1.17)) and young age (age 0–14 vs 45–54 years, OR 4.68 (95% CI 3.52 to 6.21)) were associated with VEMD participating (vs non-VEMD-participating) hospitals. Residing in regional/rural areas was negatively associated with VEMD participating (vs non-VEMD participating) hospitals (OR=0.11 (95% CI 0.10 to 0.11)). Intentional injury (assault and self-harm) was also associated with VEMD participation.ConclusionsVEMD representativeness is largely consistent across the whole of Victoria, but varies vastly by region, with substantial under-representation of some areas of Victoria. By comparison, for injury surveillance, regional rates are more reliable when based on the VAED. For local ED-presentation rates, the bias analysis results can be used to create weights, as a temporary solution until rural emergency services injury data is systematically collected and included in state-wide injury surveillance databases.

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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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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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Freed, Gary L., Sarah Gafforini, and Norman Carson. "Age distribution of emergency department presentations in Victoria." Emergency Medicine Australasia 27, no. 2 (February 17, 2015): 102–7. http://dx.doi.org/10.1111/1742-6723.12368.

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WAPOLE, BRYAN. "The first national meeting of emergency medicine doctors JULY 1981 MELBOURNE: VICTORIA." Emergency Medicine 3 (August 26, 2009): 188–89. http://dx.doi.org/10.1111/j.1442-2026.1991.tb00730.x.

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Cleland, Heather, Ieva Sriubaite, and Belinda Gabbe. "Burden and Costs of Severe Burn Injury in Victoria, Australia." European Burn Journal 3, no. 3 (July 13, 2022): 391–400. http://dx.doi.org/10.3390/ebj3030034.

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This study examines the costs of severe burn injury in Victoria, Australia. It quantifies the funding generated through an activity-based case-mix system for hospital treatment of acute injury and presentations in the subsequent two years and costs of the longer-term burden of burn injury due to premature burn-related deaths and disability. Severe adult burns cases in Victoria from 2007–2016 were identified using the Victorian State Trauma Registry (VSTR). Cases were linked with the Victorian Admitted Episodes Dataset (VAED), Victoria Emergency Minimum Dataset (VEMD), and the National Coronial Information System (NCIS). Hospital re-imbursements and costs of Disability-Adjusted Life Years (DALYs) were calculated using disability weights derived from the EQ-5D-3L questionnaire responses at 24 months post injury. There were 331 patients hospitalised with a burn ≥20% total body surface area (TBSA) from 2007–2016. Total mean re-imbursement (SD) for the acute treatment episode per patient in Australian dollars (AUD) was $87,570 ($97,913). There was significant variation in the number of cases by year and re-imbursement per patient, with high outliers common. Excluding 2009, when 173 people died in bushfires, there were 7749 DALYs which cost $991,872,000. Severe burns are uncommon and variable. Economic treatment costs of severe burns are high, and among survivors there is high incidence of long-term disability and overall burden of injury.

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Mitra, Biswadev, Jubair Al Jubair, Peter A. Cameron, and Belinda J. Gabbe. "Tram-related trauma in Melbourne, Victoria." Emergency Medicine Australasia 22, no. 4 (August 2010): 337–42. http://dx.doi.org/10.1111/j.1742-6723.2010.01309.x.

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Hanumanthaiah, Ramesh Gorghatta, Dheemantha Prasad, Panchakshari Prasanna Bangalore Krishnappa, and Sreelatha R. "Usage of blood products in emergency department at tertiary care centre." International Journal of Advances in Medicine 4, no. 4 (July 20, 2017): 903. http://dx.doi.org/10.18203/2349-3933.ijam20173096.

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Background: Blood usage in the emergency department is a formidable challenge to the treating doctor. Inadvertent use of blood can do more harm to the patient than good. Analyzing blood transfusion data will help in formulating policies for transfusion in Emergency medicine department. The present study is taken to formulate guidelines for transfusion in Emergency department of our hospital. The present study also helps us to analyze the blood requirement, utilization and wastage in Emergency department, Victoria hospital.Methods: The study done was a prospective study over a period of three months from March 2016 to May 2016. A descriptive, prospective study was conducted with a total of three hundred cases collected from the Emergency department (Casualty), Victoria hospital.Results: Commonest indication for packed red cell transfusion was anemia, for FFP was hypoproteinaemia and for platelet concentrate was viral hemorrhagic fever. Transfusion trigger for packed red cells is haemoglobin of less than 7gram/dl with no co-morbid conditions and 7-9 gram/dl when there are co-morbid conditions.Conclusions: A protocol has to be formulated to reduce the wastage and to effectively utilise blood and its products.

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Ranse, J., and S. Lenson. "(A111) Role, Resources, and Clinical and Educational Backgrounds of Nurses Who Participated in the Prehospital Response to the 2009 Bushfires in Victoria, Australia." Prehospital and Disaster Medicine 26, S1 (May 2011): s31. http://dx.doi.org/10.1017/s1049023x11001130.

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The bushfires of February 2009 in Victoria, Australia resulted in the deaths of 173 people and caused injuries to 414. Furthermore, > 2,030 houses and 3,500 structures were destroyed. The role and experience of nurses in this environment are not well understood, and little is known about the clinical and education background of nurses in this setting. This presentation will provide an overview of the bushfires and report on two research projects. The aims of these projects were to explore participant demographics and various aspects of nursing activities in the prehospital environment. These projects used volunteer nursing members of St John Ambulance Australia who responded to the Victorian fires. The first project used a retrospective, descriptive postal survey, and the second was descriptive and exploratory, using semi-structured interviews as a means of data collection. The survey highlighted that nurses had varying clinical and educational backgrounds. Males were overrepresented when compared to the national average of nurses. Most participants had taken disaster-related education, however, this varied in type and duration. Similarly, most had participated in training or mock disasters; however this usually was not related to bushfire emergencies. The qualitative findings identified two main themes having expansive roles and being prepared. These highlighted that nurses maintained a variety of roles, such as clinicians, emotional supporters, coordinators and problem solvers, and they were well prepared for these roles. This research provided insight into the characteristics and level of preparedness of nurses who responded to the 2009 Victorian bushfires in the prehospital environment. Additionally, it highlights the need for more structured education and training for nurse that is aligned with their role and deployment environment.

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Boyle, Malcolm J., M. ClinEpi, Erin C. Smith, and Frank L. Archer. "Trauma Incidents Attended by Emergency Medical Services in Victoria, Australia." Prehospital and Disaster Medicine 23, no. 1 (February 2008): 20–28. http://dx.doi.org/10.1017/s1049023x00005501.

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AbstractIntroduction:International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.Purpose:The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.Methods:A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.Results:There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).Conclusions:This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.

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Oteir, Alaa O., Karen Smith, Johannes Stoelwinder, James W. Middleton, Shelley Cox, Lisa N. Sharwood, and Paul A. Jennings. "Prehospital Predictors of Traumatic Spinal Cord Injury in Victoria, Australia." Prehospital Emergency Care 21, no. 5 (April 17, 2017): 583–90. http://dx.doi.org/10.1080/10903127.2017.1308608.

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Rahman, Asheq, Catherine Martin, Andis Graudins, and Rose Chapman. "Deliberate Self-Poisoning Presenting to an Emergency Medicine Network in South-East Melbourne: A Descriptive Study." Emergency Medicine International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/461841.

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Background. Deliberate self-poisoning (DSP) comprises a small but significant proportion of presentations to the emergency department (ED). However, the prevalence and patient characteristics of self-poisoning attendances to EDs in Victoria have not been recently characterised.Aim. To identify and compare the characteristics of adult patients presenting to the three EDs of Monash Health following DSP.Methods. Retrospective clinical audit of adult DSP attendances between 1st July 2009 and 30th June 2012.Results. A total of 3558 cases over three years were identified fulfilling the search criteria. The mean age of patients was 36.3 years with the largest numbers aged between 18 and 30 (38%). About 30% of patients were born overseas. Forty-eight percent were discharged home, 15% were admitted to ED short stay units, and 5% required ICU admission. The median ED length of stay was 359 minutes (IQR 231–607). The most frequently reported substances in DSP were benzodiazepines (36.6%), paracetamol (22.2%), and antipsychotics (12.1%). Exposure to more than one substance for the episode of DSP was common (47%).Conclusion. This information may help identify the trends in poisoning substances used for DSP in Victoria, which in turn may provide clinicians with information to provide more focused and targeted interventions.

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Waack, Jacinta, Matthew Shepherd, Emily Andrew, Stephen Bernard, and Karen Smith. "Delayed Sequence Intubation by Intensive Care Flight Paramedics in Victoria, Australia." Prehospital Emergency Care 22, no. 5 (February 6, 2018): 588–94. http://dx.doi.org/10.1080/10903127.2018.1426665.

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Bystrzycki, Adam, and John Coleridge. "Drug- and poison-related deaths in Victoria during 1997." Emergency Medicine Australasia 12, no. 4 (December 2000): 303–9. http://dx.doi.org/10.1046/j.1442-2026.2000.00152.x.

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Cameron, Peter A., Marcus P. Kennedy, and John J. McNeil. "The effects of bonus payments on emergency service performance in Victoria." Medical Journal of Australia 171, no. 5 (September 1999): 243–46. http://dx.doi.org/10.5694/j.1326-5377.1999.tb123630.x.

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Glaser, William F., Peter A. Cameron, Marcus P. Kennedy, and John J. McNeil. "The effects of bonus payments on emergency service performance in Victoria." Medical Journal of Australia 172, no. 2 (January 2000): 92–93. http://dx.doi.org/10.5694/j.1326-5377.2000.tb139213.x.

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Law, Samuel, Imogen Ackerly, Brittany Scott-Rimmington, and Keith Nallaratnam. "Two cases of lead poisoning from inhaled opium in Victoria." Emergency Medicine Australasia 31, no. 1 (January 12, 2019): 144–45. http://dx.doi.org/10.1111/1742-6723.13224.

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Smith, Karen L., Peter A. Cameron, Alastair Meyer, and John J. McNeil. "Knowledge of heart attack symptoms in a community survey of Victoria." Emergency Medicine Australasia 14, no. 3 (September 2002): 255–60. http://dx.doi.org/10.1046/j.1442-2026.2002.00340.x.

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Muller, Andrew, Kylie Dyson, Stephen Bernard, and Karen Smith. "Seasonal Variation in Out-of-Hospital Cardiac Arrest in Victoria 2008–2017: Winter Peak." Prehospital Emergency Care 24, no. 6 (January 23, 2020): 769–77. http://dx.doi.org/10.1080/10903127.2019.1708518.

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Eastwood, David, Kylie Dyson, Emily Andrew, Stephen Bernard, and Karen Smith. "Exercise-related out of hospital cardiac arrest in Victoria, Australia." Resuscitation 130 (September 2018): e20. http://dx.doi.org/10.1016/j.resuscitation.2018.07.347.

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Hiscock, Harriet, Rachel J. Neely, Shaoke Lei, and Gary Freed. "Paediatric mental and physical health presentations to emergency departments, Victoria, 2008–15." Medical Journal of Australia 208, no. 8 (April 23, 2018): 343–48. http://dx.doi.org/10.5694/mja17.00434.

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Thompson, J., C. Batey, S. Borrell, L. Houston, G. Land, P. Bass, A. Lickliter, K. Watson, C. Stansfield, and G. Harrington. "The Alfred Hospitals Emergency Department response as H1N1 (Swine flu) griped Victoria." Australasian Emergency Nursing Journal 12, no. 4 (November 2009): 166. http://dx.doi.org/10.1016/j.aenj.2009.08.051.

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Ryan, Matt, Julian Stella, Herman Chiu, and Michael Ragg. "Injury patterns and preventability in prehospital motor vehicle crash fatalities in Victoria." Emergency Medicine Australasia 16, no. 4 (August 2004): 274–79. http://dx.doi.org/10.1111/j.1742-6723.2004.00622.x.

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Magnuson, Nicole, Ziad Nehme, Steve Bernard, and Karen Smith. "Paramedic-witnessed paediatric out-of-hospital cardiac arrests in Victoria, Australia." Resuscitation 130 (September 2018): e144. http://dx.doi.org/10.1016/j.resuscitation.2018.07.310.

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Smith, K. L., A. Currell, T. Walker, H. Neely, and S. Byers. "A pre-ambulance basic life support (PABLS) strategy in Victoria, Australia." Resuscitation 81, no. 2 (December 2010): S86. http://dx.doi.org/10.1016/j.resuscitation.2010.09.354.

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Curtis, Kate, Margaret Fry, Sarah Kourouche, Belinda Kennedy, Julie Considine, Hatem Alkhouri, Mary Lam, et al. "Implementation evaluation of an evidence-based emergency nursing framework (HIRAID): study protocol for a step-wedge randomised control trial." BMJ Open 13, no. 1 (January 2023): e067022. http://dx.doi.org/10.1136/bmjopen-2022-067022.

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IntroductionPoor patient assessment results in undetected clinical deterioration. Yet, there is no standardised assessment framework for >29 000 Australian emergency nurses. To reduce clinical variation and increase safety and quality of initial emergency nursing care, the evidence-based emergency nursing framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) was developed and piloted. This paper presents the rationale and protocol for a multicentre clinical trial of HIRAID.Methods and analysisUsing an effectiveness-implementation hybrid design, the study incorporates a stepped-wedge cluster randomised controlled trial of HIRAID at 31 emergency departments (EDs) in New South Wales, Victoria and Queensland. The primary outcomes are incidence of inpatient deterioration related to ED care, time to analgesia, patient satisfaction and medical satisfaction with nursing clinical handover (effectiveness). Strategies that optimise HIRAID uptake (implementation) and implementation fidelity will be determined to assess if HIRAID was implemented as intended at all sites.Ethics and disseminationEthics has been approved for NSW sites through Greater Western Human Research Ethics Committee (2020/ETH02164), and for Victoria and Queensland sites through Royal Brisbane & Woman’s Hospital Human Research Ethics Committee (2021/QRBW/80026). The final phase of the study will integrate the findings in a toolkit for national rollout. A dissemination, communications (variety of platforms) and upscaling strategy will be designed and actioned with the organisations that influence state and national level health policy and emergency nurse education, including the Australian Commission for Quality and Safety in Health Care. Scaling up of findings could be achieved by embedding HIRAID into national transition to nursing programmes, ‘business as usual’ ED training schedules and university curricula.Trial registration numberACTRN12621001456842.

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Gao, Crystal, Zheng Jie Lim, Brendan Freestone, Kristy Austin, and Rob McManus. "Use of a Novel Electronic Patient Care Record System at Mass Gathering Events by St. John Ambulance Victoria." Prehospital and Disaster Medicine 34, s1 (May 2019): s88. http://dx.doi.org/10.1017/s1049023x19001845.

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Introduction:The growing number of mass gathering events (MGEs) in Victoria has seen an increase in demand for event health services and the need for real-time reporting of medical incidents at these events.Aim:Since 2016, St. John Ambulance Victoria has introduced an electronic patient care record (ePCR) system with the aim of improving patient care and satisfaction. It appears that this ePCR system is the first of its kind to be trialed at MGEs by a volunteer organization.Methods:A qualitative study was conducted to determine strengths and limitations of the ePCR system by compiling results of surveys and interviews and through anonymous feedback from volunteers and patrons (event organizers, patients). This study is ongoing.Results:It was found that the use of ePCR: 1.Allowed for collection of relevant data to assist in future planning of MGEs2.Aids the overall coordination of first aid delivery at MGEs -faster relaying of patient information to event commanders-reduction of paperwork-improved ability to locate first aid crews using GPS tracking3.Received positive feedback from first aiders, event organizers, and patrons4.Was deemed easy-to-use (4/5), acceptable (4.3/5), and helpful (4.1/5) by our membersDiscussion:These experiences demonstrate that ePCR is well-received, easy to use, and leads to improved patient satisfaction and treatment outcomes at MGEs. Furthermore, the ability to collect and analyze real-time data such as GPS location tracking, incidence heat maps, and patient demographics facilitate future event planning and resource allocation at MGEs. It is acknowledged that this study is preliminary, and the trialed use of an ePCR system has been limited to metropolitan areas and MGEs with <1 million patrons. The intent is to continue this study and explore the use of ePCRs at larger MGEs and events in rural or regional areas.

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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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Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.

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BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

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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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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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Newman, D. "Maritime Pre-Hospital Emergency Care Primary Retrieval Team – Operational Considerations." Journal of The Royal Naval Medical Service 98, no. 1 (March 2012): 16–18. http://dx.doi.org/10.1136/jrnms-98-16.

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AbstractThis article examines the non clinical skills and training required for effective maritime pre-hospital emergency care provision within a Role Two Afloat facility, allowing for a Primary Retrieval Team to be deployed in support of boarding operations. The provision of pre-hospital emergency care and sending a retrieval team forward has been trialled in various forms. In 2010 and 2011 a R2A team was deployed aboard RFA FORT VICTORIA. This included a Primary Retrieval Team consisting of an Emergency Nurse Specialist, a Medical Assistant which can be enhanced when required by an Emergency Care or Anaesthetic Consultant. This differs from the land operations support provided by the airborne Medical Emergency Response Team (MERT) as the maritime environment requires a bespoke solution for casualty retrieval as the method of deployment and the type of casualties and their locations may be more varied, requiring greater flexibility of approach.

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Mikocka-Walus, A., R. Hiller, and P. A. Cameron. "Aortic transection: Demographics, treatment and outcomes in Victoria." Injury 41 (July 2010): S56. http://dx.doi.org/10.1016/j.injury.2010.01.086.

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Cox, Shelley, Renee Roggenkamp, Stephen Bernard, and Karen Smith. "The epidemiology of elderly falls attended by emergency medical services in Victoria, Australia." Injury 49, no. 9 (September 2018): 1712–19. http://dx.doi.org/10.1016/j.injury.2018.06.038.

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Keating, Simon, and John Thompson. "Ten years on: An overview of the nurse practitioner in Victoria." Australasian Emergency Nursing Journal 11, no. 4 (November 2008): 205. http://dx.doi.org/10.1016/j.aenj.2008.09.031.

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Kelly, Anne-Maree. "Are there lessons from the cluster of neonatal deaths in Victoria for emergency physicians?" Emergency Medicine Australasia 28, no. 3 (March 8, 2016): 353–54. http://dx.doi.org/10.1111/1742-6723.12561.

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Ang, Jia Ying, Belinda Gabbe, Peter Cameron, and Ben Beck. "Animal–vehicle collisions in Victoria, Australia: An under‐recognised cause of road traffic crashes." Emergency Medicine Australasia 31, no. 5 (July 30, 2019): 851–55. http://dx.doi.org/10.1111/1742-6723.13361.

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Williams, Eric W. "116. Developing an Effective Medical Coordination and Control Organization For Disasters and Major Emergencies: State of Victoria, Australia." Prehospital and Disaster Medicine 10, S2 (September 1995): S20—S21. http://dx.doi.org/10.1017/s1049023x00500430.

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Lam, Tina, Jane Hayman, Janneke Berecki-Gisolf, Paul Sanfilippo, Dan I. Lubman, and Suzanne Nielsen. "Comparing rates and characteristics of emergency department presentations related to pharmaceutical opioid poisoning in Australia: a study protocol for a retrospective observational study." BMJ Open 10, no. 9 (September 2020): e038979. http://dx.doi.org/10.1136/bmjopen-2020-038979.

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Introduction and aimsPharmaceutical opioids are an important contributor to the global ‘opioid crisis’, and are implicated in 70% of Australia’s opioid-related mortality. However, there have been few studies which consider the relative contribution of different pharmaceutical opioids to harm.We aim to compare commonly used pharmaceutical opioids in terms of (1) rates of harm, and (2) demographic and clinical characteristics associated with that harm.Method and analysisObservational study of emergency department presentations for non-fatal poisoning related to pharmaceutical opioid use. Data from 2009 to 2019 will be extracted from the Victorian Emergency Minimum Dataset which contains data from public hospitals with dedicated emergency departments in Victoria, Australia’s second most populous state. A combination of free-text and International Classification of Diseases 10th Revision codes will be used to identify relevant cases, with manual screening of each case to confirm relevance. We will calculate supply-adjusted rates of presentations using Poisson regression for all pharmaceutical opioid cases identified, separately for nine commonly prescribed pharmaceutical opioids (buprenorphine, codeine, fentanyl, methadone, morphine, oxycodone, oxycodone-naloxone, tapentadol, tramadol), and for a multiple opioid category. We will use multinomial logistic regression to compare demographic and clinical characteristics, such as triage category, across opioid types.Ethics and disseminationThis work is conducted under approval 21427 from the Monash University Human Research Ethics Committee for ongoing injury surveillance. As per conditions of approval, cells of <5 will not be reported, though zeroes will be preserved. We will present project findings in a peer-reviewed journal article as well as at relevant scientific conferences.

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Bevan, C., C. Palmer, V. Gorman, and C. Officer. "Child restraint system use in vehicles in Victoria, Australia." Injury Extra 40, no. 8 (August 2009): 141. http://dx.doi.org/10.1016/j.injury.2009.03.026.

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Eastwood, Kathryn, Stuart Howell, Ziad Nehme, Judith Finn, Karen Smith, Peter Cameron, Dion Stub, and Janet E. Bray. "Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome." Open Heart 8, no. 2 (October 2021): e001792. http://dx.doi.org/10.1136/openhrt-2021-001792.

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ObjectiveBetween 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian’s awareness of acute coronary syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia.MethodsThe Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP). We modelled changes in the incidence of ED presentations, and the association between the campaign period and (1) EMS arrival and (2) referred to ED by a general practitioner (GP). Models were adjusted for increasing population size, ACS subtype and demographics.ResultsBetween 2003 and 2015, there were 124 632 eligible ED presentations with ACS and 536 148 with U-CP. In patients with ACS, the campaign period was associated with an increase in ED presentations (incidence rate ratio: 1.11; 95% CI 1.07 to 1.15), a decrease in presentations via a GP (adjusted OR (AOR): 0.77; 95% CI 0.70 to 0.86) and an increase in EMS use (AOR: 1.10; 95% CI 1.05 to 1.17). Similar, but smaller associations were seen in U-CP.ConclusionsThe Warning Signs Campaign was associated with improvements in treatment seeking in patients with ACS—including increased EMS use. The increase in ACS ED presentations corresponds with a decrease in out-of-hospital cardiac arrest over this time. Future education needs to focus on improving EMS use in ACS patient groups where use remains low.

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Quinn, Nuala, Cameron S. Palmer, Stephen Bernard, Michael Noonan, and Warwick J. Teague. "Thoracostomy in children with severe trauma: An overview of the paediatric experience in Victoria, Australia." Emergency Medicine Australasia 32, no. 1 (September 18, 2019): 117–26. http://dx.doi.org/10.1111/1742-6723.13392.

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Ting, D. K., B. Bailey, F. Scheuermeyer, T. M. Chan, and D. R. Harris. "P150: Emergency medicine resident perspectives on journal club as a community of practice and its impact on clinical medicine." CJEM 20, S1 (May 2018): S110. http://dx.doi.org/10.1017/cem.2018.348.

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Introduction: Despite revolutionary changes in the medical education landscape, journal club (JC) continues to be a ubiquitous pedagogical tool and is a primary way that residency programs review new evidence and teach evidence-based medicine. JC is a community of practice among physicians, which may help translate research findings into practice. Program representatives state that JC should have a goal of translating novel research into changes in clinical care, but there has been minimal evaluation of the success of JC in achieving this goal. Specifically, emergency medicine resident perspectives on the utility of JC remain unknown. Methods: We designed a multi-centre qualitative study for three distinct academic environments at the University of British Columbia (Vancouver, Victoria and Kelowna). Pilot testing was performed to generate preliminary themes and to finalize the interview script. An exploratory, semi-structured focus group was performed, followed by multiple one-on-one interviews using snowball sampling. Iterative thematic analysis directed data collection until thematic sufficiency was achieved. Analysis was conducted using a constructivist Grounded Theory method with communities of practice as a theoretical lens. Themes were compared to the existing literature to corroborate or challenge existing educational theory. Results: Pilot testing has revealed the following primary themes: (1) Only select residents are able to increase their participation in JC over the course of residency and navigate the transition from peripheral participant to core member; (2) These residents use their increased clinical experience to perceive relevance in JC topics, and; (3) Residents who remain peripheral participants identify a lack time to prepare for journal club and a lack of staff physician attendance as barriers to resident engagement. We will further develop these themes during the focus group and interview phases of our study. Conclusion: JC is a potentially valuable educational resource for residents. JC works as a community of practice only for a select group of residents, and many remain peripheral participants for the duration of their residency. Incorporation of Free Open-Access Medical Education resources may also decrease preparation time for residents and staff physicians and increase buy-in. To augment clinical impact, the JC community of practice may need to expand beyond emergency medicine and include other specialties.

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Taylor, David McD, Karen Ashby, and Ken D. Winkel. "An Analysis of Marine Animal Injuries Presenting to Emergency Departments in Victoria, Australia." Wilderness & Environmental Medicine 13, no. 2 (June 2002): 106–12. http://dx.doi.org/10.1580/1080-6032(2002)013[0106:aaomai]2.0.co;2.

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Cheung, N., C. H. Cheng, C. A. Graham, B. J. Gabbe, J. H. Yeung, T. Kossmann, R. T. Judson, T. H. Rainer, and P. A. Cameron. "246: Trauma Care Systems: A Comparison of Trauma Care in Victoria, Australia and Hong Kong, China." Annals of Emergency Medicine 51, no. 4 (April 2008): 546. http://dx.doi.org/10.1016/j.annemergmed.2008.01.216.

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Pauly, Bernadette, Bruce Wallace, Flora Pagan, Jack Phillips, Mark Wilson, Heather Hobbs, and Joann Connolly. "Impact of overdose prevention sites during a public health emergency in Victoria, Canada." PLOS ONE 15, no. 5 (May 21, 2020): e0229208. http://dx.doi.org/10.1371/journal.pone.0229208.

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Bloom, Jason E., Emily Andrew, Luke P. Dawson, Ziad Nehme, Michael Stephenson, David Anderson, Himawan Fernando, et al. "Incidence and Outcomes of Nontraumatic Shock in Adults Using Emergency Medical Services in Victoria, Australia." JAMA Network Open 5, no. 1 (January 26, 2022): e2145179. http://dx.doi.org/10.1001/jamanetworkopen.2021.45179.

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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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Atkin, Chris, Ilan Freedman, Jeffrey V. Rosenfeld, Mark Fitzgerald, and Thomas Kossmann. "The evolution of an integrated State Trauma System in Victoria, Australia." Injury 36, no. 11 (November 2005): 1277–87. http://dx.doi.org/10.1016/j.injury.2005.05.011.

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