1,720,973 research outputs found
Pre-hospital triage: The national perspective
No full textTriage in emergency medicine describes the process of categorising patients on the basis of urgency.\ud
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Triage of patients is of importance in three main areas; firstly as a component of primary assessment to guide the treatment of individual patients, secondly as a basis for individual allocation of resources and finally as a case mix description of patient groups.\ud
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In the pre-hospital environment the first and second of these are of most concern. Ambulance officers are faced with deciding how much treatment is offered to the patient in the pre-hospital area, and the effects of treatment in the field on outcome, both good and bad. Vital decisions are often required, in the knowledge that the time required to apply that treatment must be balanced against the delay in accessing advanced care.\ud
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The ambulance officer is also confronted with choices to be made regarding the source of medical care most appropriate to the patient in the circumstances.\ud
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This paper reviews the concepts of triage as it applies to pre-hospital care, the current status of triage models used in the pre-hospital environment both internationally and in Australia and finally presents a plea for consistency based on scientific grounds both within the pre-hospital environment and the hospital system
[Editorial] Paramedics and scope of practice
No full textFree to read on journal website (may need to create free account first)\ud
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<i>Highly-trained paramedics can initiate the pathway of care that will achieve optimal outcomes for patients</i>\ud
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The question, posed to me by the Journal’s editorial staff, “Are paramedics exceeding the evidence?”, is a very global one that implies a dichotomous response. However, nothing in our complex health system can be so simply evaluated, so the question gets an equally global (if vague and unhelpful) answer: “Yes, probably, but no more or less than the rest of health care”..
Analysis of 24 cases of bullrout envenomation
No full textNotesthes robusta (bullrout) is a spined freshwater fish found in the rivers, creeks and estuaries of the east coast of Australia.\ud
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Its sting causes intense pain at the site of envenomation. The symptoms may be successfully treated by immersion of the affected part in hot water and infiltration with local anaesthetic.\ud
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This is a review of 24 cases of presumed bullrout envenomation presenting to the Emergency Department of Ipswich General Hospital. The characteristic and pathognomonic presentation is described and the response to treatment demonstrated
General practice patients in the emergency department
No full textOne of the mysteries of public policy is that at times the public discourse settles on a perspective that is based on flimsy or even contradictory evidence. One such discussion relates to the factors that contribute to the congestion of hospital emergency departments (EDs) in Australia
Determinants of pre-hospital care non-usage for patients with emergency care needs [including commentary by Snooks H.]\ud \ud
No full textObjective-To establish the demographic, health status and insurance determinants of pre-hospital ambulance non-usage for patients with emergency medical needs. \ud
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Methods-Triage category, date of birth, sex, marital status, country of origin, method and time of arrival, ambulance insurance status, diagnosis, and disposal were collected for all patients who presented over a four month period (n=10 229) to the emergency department of a major provincial hospital. Data for patients with urgent (n=678) or critical care needs (n=332) who did not use pre-hospital care were analysed using Poisson regression. \ud
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Results-Only a small percentage (6.6%) of the total sample were triaged as having urgent medical needs or critical care needs (3.2%). Predictors of usage for those with urgent care needs included age greater than 65 years (prevalence ratio (PR)=0.54; 95% confidence interval (CI)= 0.35 to 0.83), being admitted to intensive care or transferred to another hospital (PR=0.62; 95% CI=0.44 to 0.89) or ward (PR=0.72; 95% CI=0.56 to 0.93) and ambulance insurance status (PR=0.67; 95% CI=052 to 0.86). Sex, marital status, time of day and country of origin were not predictive of usage and non-usage. Predictors of usage for those with critical care needs included age 65 years or greater (PR=0.45; 95% CI=0.25 to 0.81) and a diagnosis of trauma (PR=0.49; 95% CI=0.26 to 0.92). A non-English speaking background was predictive of non-usage (PR=1.98; 95% CI=1.06 to 3.70). Sex, marital status, time of day, triage and ambulance insurance status were not predictive of non-usage. \ud
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Conclusions-Socioeconomic and medical factors variously influence ambulance usage depending on the severity or urgency of the medical condition. Ambulance insurance status was less of an influence as severity of condition increased suggesting that, at a critical level of urgency, patients without insurance are willing to pay for a pre-hospital ambulance service.\u
Hospital beds : A primer for counting and comparing
No full textThere is considerable public, political and professional debate about the need for additional hospital beds in Australia. However, there is no clarity in regard to the definition, meaning and significance of hospital bed counts. Relative to population, there has been a total decline in bed availability in Australia over the past 15 years of 14.6% (22.9% for public hospital beds). This decline is partly offset by reductions in length of stay and changes to models of care; however, the net effect is increased bed occupancy which has in turn resulted in system-wide congestion. Future bed capability needs to be better planned to meet growing demands while at the same time continuing trends for more efficient use. Future planning should be based in part on weighted bed capability matched to need.\u
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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