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Hypertension is a highly prevalent, chronic cardiovascular disease with considerable impacts to population health. Although hypertensive urgencies are common encounters in emergency departments (ED), there is a lack of clear guidance for their clinical management. A poorly managed hypertensive urgency can leave the patient with continuing severe hypertension and at increased risk of end-organ damage. The objective of this study is to determine the current management strategies for hypertensive urgencies in Queensland EDs, and to better understand the reasons for their use. We will survey Queensland ED physicians about their use of and opinions about current management strategies for hypertensive urgencies. We will also conduct a pilot single-site observational study of management strategies for hypertensive urgencies. The findings of this study will inform the design of future research to improve management of hypertensive urgencies in EDs.
READ MOREDelirium in the older adult population is a common hospital complication linked to multiple adverse outcomes including longer lengths of stay, increased morbidity and mortality, greater cognitive and functional decline, and increased risk of re-presentation to the emergency department (ED). Patients with delirium can increase healthcare expenses by up to $30,000 extra per patient. This places a significant burden on the patient and the health system. The Geriatric Emergency Department Initiative (GEDI) has shown benefits in the ED management of older patients including reduction of re-presentations to the ED. However, the effectiveness of GEDI for older patients with delirium remains unclear. The aim of this research project is to compare clinical outcomes of older patients presenting to the ED with positive 4AT scores who received GEDI input versus those who did not, across a six-months period. The outcome measures will include ED length of stay and time to geriatric review.
READ MOREUpper limb injuries including bony fractures/dislocations, are sometimes deformed and require realignment in the emergency department (ED). Numerous techniques are available to allow this procedure to be painless. Bier block (BB) involves placing a band on the upper part of the affected arm to constrict blood flow, with injection of numbing agent into a hand vein on the same side to make the entire arm numb. An alternative technique is ultrasound guided supraclavicular blocks (UGSCB), which involves introducing a needle under ultrasound guidance to nerves situated just above the collar bone and injecting numbing agent around these nerves to make the arm go numb. However, the effectiveness of UGSCB when performed by ED doctors is unknown and patients might recover more quickly. We aim to conduct a randomised trial to compare UGSCB versus BB for re-aligning fractures/dislocations of the upper limb in the ED.
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