Thoracic aortic dissection and aneurysm remain difficult diagnoses to make in the ED. Point-of-care ultrasound can identify the intimal flap of thoracic aortic dissection directly as well as the indirect signs of dissection: pericardial effusion, aortic valve regurgitation and aortic dilation. This systematic review included 9 relevant studies. Sensitivity and specificity ranges for studies of thoracic aorta dissection are 41-91% and 94-100% respectively when an intimal flap is seen. Sensitivity and specificity ranges for studies of thoracic aorta dilation >40mm were 50-100% and 93-100% respectively; for >45mm ranges were 64-65% and 95-99%. Literature review identifies that point-of-care ultrasound is specific for dissection or aneurysm and can reduce time to diagnosis.

State-authorised involuntary detention of persons experiencing mental health emergencies is controversial but little studied. Queensland is the only Australian jurisdiction where a person is detained for an examination in an ED under public health law, specifically, an ‘emergency examination authority’. Although information is incomplete, most emergency examination authority patients are discharged following examination, yet many have experienced self-harm and more than half have serious substance abuse problems.

Emergency nurse practitioners have near-perfect agreement on patient disposition with plastic surgery trainees, with Cohen's kappa of 0.7–0.85 overall and when grouped into operative management versus non-operative management.

When comparing clinician documentation for infective presentations in ED against a formal sepsis pathway, a significantly lower proportion screened as potential sepsis and septic shock. Nearly one-third of the initial parenteral antibiotic prescriptions in ED were assessed as inappropriate indicating that there is a role for antibiotic prescribing guidance in ED.

Paediatric Intubations performed by Intensive care paramedics.

Self-reported practices regarding routine insertion of idle catheters, using antecubital fossa as the first insertion site, insertion without confidence and lack of routine reviewing the ongoing needs of peripheral intravenous catheter were not aligned with the Standard.

An emergency short stay area was introduced to a rural ED and improved Emergency Treatment Performance targets for admitted patients.

The present study aimed to complete a retrospective synthesis of mental health emergency presentations across the Barwon South West (1 February 2017–31 December 2019), using data from the Victorian Emergency Minimum Dataset and Rural Acute Hospital Database Register. We identified 11 613 mental health emergency presentations. Neurotic, stress-related and somatoform disorders and mental and behavioural disorders because of psychoactive substance use were the most frequent types of presentations recorded.

The initial pain score of the paracetamol-only group was significantly lower than those of the other two groups (P <0.001). The pain scores were similarly reduced in the methoxyflurane group and the ketamine wafer group.

A contemporary Australian, single-centre, retrospective review of all major trauma patients over a 10-year period was performed, comparing injury characteristics, severity and outcomes among intoxicated and non-intoxicated patients. Among 9700 patients, we found escalating rates of drug intoxication and declining rates of alcohol intoxication. Intoxicated patients presented more frequently following violent and non-accidental injury and had greater odds of requiring intensive care despite no differences in Injury Severity Scores.

The objective is to determine the impact of the COVID-19 state-wide lockdown on ED presentations for older adults in Queensland, Australia. It is a retrospective cohort study pertaining to adults aged 70+ years. There was a significant decrease in presentation rates to EDs during the COVID-19 state-wide lockdown for the older population, followed by an increase in presentation rates, longer ED LOS, and an increased ED mortality rate, in the post-state-wide lockdown period.

A retrospective audit of the alignment of COVID-19 swabs taken in Wellington ED with the March 15th and April 8th case definitions during New Zealand's Level 4 lockdown in 2020. There was poor alignment of testing with the March case definition at just 11.6% compared to the wider April case definition at 88.2%, and testing outside of criteria was associated with specific variables. Poor alignment of testing with case definitions may have negative impacts on resource management and improved communication from policymakers may improve case definition implementation.

This single-centre retrospective cohort study was performed to identify the individual clinical features and risk factors most strongly associated with the diagnosis of transient neurological symptoms with a cerebrovascular cause, as compared to common transient ischaemic attack (TIA) mimics. Specific clinical features and risk factors were associated with the final diagnosis at TIA clinic. Further research is needed with the aim of developing new diagnostic tools based on risk factors and clinical features and implementing them into practice.

Seizures account for approximately 1% of all ED presentations. This study shows that in atraumatic recurrent seizure presentations to the ED pathology testing is frequently requested yet rarely results in meaningful changes in patient management. We recommend that clinicians rely on patient history and examination findings in conjunction with clinical gestalt when deciding on which investigations to request for this population.

The diagnosis of traumatic diaphragmatic injury is challenging, without frank signs of herniation of abdominal contents on CXR or CT, the diagnosis is often not made on initial imaging. In patients with the evidence of blunt traumatic injury in the lower-chest/upper-abdomen, a high degree of clinical suspicion should be held and follow-up CXR's/CT's arranged.

A small number of patients with major trauma associated with near-hanging are transferred to an MTS.

This retrospective study describes the timing of antibiotics in children meeting local sepsis criteria. It explores the barriers to timely antibiotic administration in febrile children presenting to a tertiary ED.

This is a retrospective review of pregabalin-related poisoning presentations to a tertiary Australian Emergency Department in the four years prior to, and one year following the introduction of QScript Real Time Prescription Monitoring System. Pregabalin-related poisoning presentations fell by 28% from an average of 98 presentations annually over the four years prior to QScript implementation to 71 in 2022. The severity of poisonings was similar over the periods. The introduction of QScript was associated with a reduction in pregabalin-related poisoning presentations.