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Emergency medicine conference highlights - Wed November 27


Adelaide, 26 November 2013

Embargoed until 12.01 am Wednesday November 27

Emergency medicine conference highlights Wednesday November 27

The annual scientific meeting of the Australasian College for Emergency Medicine is being held at the Adelaide Convention Centre, North Terrace, Adelaide, November 25-28.

Outlined below is one conference topic for Wednesday, as well as two on the Thursday program. Both of the Thursday speakers are available for interview (immediate release of the interview reports) on Wednesday November 27 as well as on Thursday.

15.45-16.00 Wednesday Chronic kidney disease rate high, but diagnosis rate low

A study of chronic kidney disease (CKD) in a general practice population has found the prevalence of CKD to be high, although the diagnosis rate was low.

Dr Brian O’Connell, from St Vincent’s Hospital in Sydney, will tell the conference that the burden of chronic kidney disease (CKD) is growing worldwide.

“Despite an estimated prevalence of CKD of 15.1% in our primary care sample, the rate of diagnosis in the medical records was low and many of these patients were not receiving recommended treatments to minimise cardiovascular complications.

He said the use of eGFR rather than simple creatinine measurement increases the diagnostic rate for chronic kidney disease, particularly amongst older women, with an additional 5.4% of the population in this study diagnosed with CKD(as defined by eGFR <60.

Dr O’Connell’s study, although conducted in Ireland, is relevant to GP patients in Australia.

Thursday November 28

Why are ambulances ramped?

Ambulance ramping (delayed off-stretcher time) is a significant problem for hospitals in the Western world.

It occurs when ambulances are unable to unload their patient in the emergency department and remain queued outside hospital.

This leads to delays in patient assessment and management as well as reducing the number of ambulances able to respond to the community.

The ED is full because it is occupied by patients who are awaiting a hospital bed; however, because there are no beds in the hospital, they must wait in the ED causing overcrowding. This is called access block.

To determine the main reasons ambulances were ramped, Professor Yusuf Nagree from Fremantle Hospital and Sally Burrows from the Western Australia Institute for Medical Research conducted a study from 1 January 2008 to 30 June 2013 using data from the Emergency Department Information System of three major tertiary hospitals in Western Australia.

They found a high correlation between ramping time and access block and between ramping time and the total time admitted patients were in the ED.

There was very little correlation between ramping time and total attendances, and even less correlation between ramping and GP-type attendances.

“Ambulance ramping is primarily caused by admitted patients in the emergency department and is not well correlated with total number of patients attending or total number of GP-type patients attending,” Professor Nagree said.

CAM use common in kids coming to emergency departments (Professor Taylor not available for interview until Wednesday)

The use of complementary and alternative medicine (CAM) is common among paediatric emergency department patients, a new study has found.

Professor David Taylor, Director of Emergency and General Medicine Research at Austin Health, and colleagues studied patients attending three emergency departments between January and June 2013.

The parents of over 400 patients participated in the study.

Of these patients, 180 (44.0%) and 17 (4.2%) had taken a CAM within the previous 12 months and on the day of presentation, respectively.

There were no gender or ethnic differences in CAM use; however, CAM use was significantly more common among older patients and tended to be more common among those with chronic disease.

Fish oil, acidophilus, garlic, chamomile and cranberry were the most commonly used CAMs.

Reported adverse events were rare.

Parents who had administered CAMs tended to believe that CAMs were safe, drug free, could prevent illness, were more effective than prescription medicines and were safe when taken with prescription medicines.

The study is ongoing.

Professor Taylor will tell the conference that there is the potential for interactions between CAMs taken on the day of presentation and drugs administered in the ED. Also, parents who administer CAM tend to have differing perceptions of CAM safety.


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