Central Line MicroSkills (Deliberate Practice)

Central Line MicroSkills (Deliberate Practice)

Emergency Care Videorecordings

EM Crit is a blog put out by Dr Scott Weingart, an ED Intensivist from New York City. In this post he has created a video demonstration of the core micro-skills necessary for expert central line  placement.

Implementing human factors in clinical practice

Implementing human factors in clinical practice

Emergency Care Safety

This open access article in the  Emergency Medicine Journal looks at whether aviation-derived human factors training is acceptable and useful to healthcare professionals. To understand whether and how healthcare professionals have been able to implement human factors approaches to patient safety in their own area of clinical practice.

The method used was a qualitative, longitudinal study using semi-structured interviews and focus groups, of a multi professional group of UK NHS staff (from the emergency department and operating theatres) who have received aviation-derived human factors training.

Timmons, Stephen [et al]. (2015) Implementing human factorsin clinical practice. Emergency Medicine Journal, 32(5), 368-372

Reducing ambulance turnaround time at hospitals

Reducing ambulance turnaround time at hospitals

Ambulance services Emergency Care

This report from the NSW Auditor General's Office concludes that ambulances wait longer in hospital emergency departments today than they have in previous years. This is often because of ambulances being delayed due to beds not being available in the emergency department and paramedics wait with their patient on the ambulance stretcher. The Ministry of Health reports that since 2005-06 emergency department presentations have grown at almost three times the population rate, and ambulance arrivals have grown more, at over four times the population rate.

This audit assessed whether there are effective strategies in place to reduce the time spent by ambulance crews at emergency departments.  The authors found that each day the Ambulance Service loses an average of 18 ambulances on the road due to hospital delays greater than 30 minutes, potentially costing $13.6 million annually to replace. NSW Health has never met its target to offload 90 per cent of ambulance patients in 30 minutes, but results vary between hospitals.  In 2011-12 just over a quarter of NSW hospitals met the off-stretcher target while others who did not have improved their performance. Therefore strategies put in place by some hospitals to reduce delays are working.

Emergency Services and Mental Illness

Emergency Services and Mental Illness

Ambulance services Emergency Care Mental health

What do people affected by a mental illness and carers say about the help they receive from emergency services? What is needed to improve the response of police and ambulance services, mental health crisis teams, and hospital emergency departments when someone has a mental health crisis?
A survey was conducted between November 2012 and January 2013, using a convenience sample of 606 responses to an anonymous questionnaire accessed via www.sane.org (SANE Australia). Most respondents were female (77%) and aged predominantly 25-49 (36%). The diagnoses reported most frequently were depression (27%), bipolar disorder (18%), schizophrenia (15%), anxiety disorders (11%), and personality disorders (7%). The survey was intended to investigate the experience of respondents when they had used emergency services for an urgent mental health concern. Results have been used to identify barriers to effective care, and to make recommendations for improvements. This two-page article summarises the results. (APO 28 June 2013)

Emergency Services and Mental Illness

Emergency Services and Mental Illness

Emergency Care Mental health Suicide prevention

New research by SANE Australia has found that mental health services too often leave police, ambulance staff and families to pick up the pieces when people become unwell, revealing a crisis-driven system.More than 600 people completed the online survey, with almost three-quarters (72%) saying that risk of suicide or self-harm was the main reason for the emergency call.

64% of respondents said emergency services showed little awareness of the impact on family and friends and an even higher proportion (73%) reported that they had not been provided with any referral to services to support them. (Reposted from SANE Mental Health Sector Bulletin for June 2013)

Download SANE Research Bulletin 17: Emergency services and mental illness (June 2013)