Flow chart for type of guidance – horizontal flow.

Children with a head injury are frequently evaluated in acute care settings. By adopting or adapting existing international paediatric clinical practice guidelines for head injuries or devising de novo recommendations, a multidisciplinary multistate working group led by the PREDICT network developed 71 recommendations (evidence-informed = 35, consensus-based = 17, practice points = 19). The resulting PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children provides high-level evidence and practical guidance for front line clinicians.

We assessed patient satisfaction with laceration management, post-ED care, cosmesis, and complication rates in 89 emergency department patients. Between one half and two thirds of patients were very satisfied with these outcomes. However, there is scope for improvement, especially for follow-up and wound care advice.

Occupational violence and aggression in the ED is an issue of global concern. Historically, the full moon has been steeped in myths and superstitions of madness and violence. We found that the first quarter and third quarter moons, but not the full moon, were associated with occupational violence and aggression in the ED.

Our objective was to identify pre-burn centre factors associated with inhalation injury confirmed on bronchoscopy, and to develop a prognostic model for inhalation injury. Increasing percentage of total body surface area burned, flame, enclosed space, face burns, hoarse voice, soot in mouth and shortness of breath were predictive of inhalation injury.

Kids assessment and liaison for mental health (MH) pathway at ED. Internationally, concern about meeting the need of an increasing number of children and adolescents presenting to ED with MH difficulties in an effective and timely manner is well documented. This paper describes one approach to increase capacity of ED while enhancing collaboration between ED and MH clinicians.

The role of paramedics in ED streaming models has not been adequately explored. We prospective surveyed paramedics in 500 cases and found the overall concordance between paramedics' and nurse streaming decision was high (86.4%). There was no significant clinical risk in most cases (64/68) where nurses and paramedics disagreed.

Relatively few children and adolescents with mental health presentations receive psychotropic medications in ED. Those who did were likely to be male, have a more acute triage category (Australasian Triage Scale category 1 or 2), have an ED length of stay greater than 12 h and present after hours.

We conducted a prospective cross-sectional study investigating non-mydriatic fundus photography as a new diagnostic test for adult ED patients presenting with headache, focal neurological deficit, visual disturbance or diastolic blood pressure>120mmHg. Amongst 345 consecutive patients 16% (95%CI:13 - 21%) had urgent fundus pathology, and ED doctors had 40% sensitivity (95% CI 27% - 54%) and 82% specificity (95% CI 76% - 86%) to detect this pathology on fundus photographs. Fundus photography with telehealth specialist image review detects a clinically significant proportion of fundus pathology and offers an alternative to direct ophthalmoscopy to detect some time-critical illnesses that can be missed in routine care.

National lockdown was associated with a significant reduction in average daily ED visits across traumatic and non-traumatic patients. Although we could not conclude the cause of these changes, communication from healthcare professionals and public health officers is warranted to reinforce the importance of timely ED visits for acute health conditions.

In this prospective multi-site study during Australia's ‘second wave’, a substantial proportion of ED presentations required SARS-CoV-2 testing and isolation. The presence of SARS-CoV-2 on nasopharyngeal swab was associated with an increase in the odds of death and mechanical ventilation in hospital.

Evidence exists supporting the observation that ED overcrowding and access block result in poorer patient outcomes. Our results showed that the main determinants of the reduction of ED overcrowding and access block during the COVID-19 pandemic were associated with reductions in hospital occupancy and elective surgery levels.

Non-urgent consultations in ED are attributed to multiple factors encompassing socio-demographic, socio-economic and psychosocial dimensions. These factors must be considered in improving the current healthcare management system for the appropriate utilisation of ED in the Philippines.