The Toowoomba adult trauma triage tool

Since the introduction of the Australasian Triage Scale (ATS) there has been considerable variation in its application. Improved uniformity in the application of the ATS by triage nurses is required. A reproducible, reliable and valid method to classify the illness acuity of Emergency Department patients so that a triage category 3 by one nurse means the same as a triage category 3 by another, not only in the same ED but also in another institution would be of considerable value to emergency nurses. This has been the driving motivation behind developing the Toowoomba Adult Trauma Triage Tool (TATTT). It is hoped the TATTT will support emergency nurses working in this challenging area by promoting standardisation and decreasing subjectivity in the triage decision process

Planetary Candidates Observed by Kepler VI: Planet Sample from Q1-Q16 (47 Months)

\We present the sixth catalog of Kepler candidate planets based on nearly 4 years of high precision photometry. This catalog builds on the legacy of previous catalogs released by the Kepler project and includes 1493 new Kepler Objects of Interest (KOIs) of which 554 are planet candidates, and 131 of these candidates have best fit radii <1.5 R_earth. This brings the total number of KOIs and planet candidates to 7305 and 4173 respectively. We suspect that many of these new candidates at the low signal-to-noise limit may be false alarms created by instrumental noise, and discuss our efforts to identify such objects. We re-evaluate all previously published KOIs with orbital periods of >50 days to provide a consistently vetted sample that can be used to improve planet occurrence rate calculations. We discuss the performance of our planet detection algorithms, and the consistency of our vetting products. The full catalog is publicly available at the NASA Exoplanet Archive.Comment: 18 pages, to be published in the Astrophysical Journal Supplement Serie

Patients' attitudes to analgesics and expectations of emergency care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand

Alleviating pain and suffering has long been a goal of health professionals. Pain has been shown to be one of the leading reasons that patients present to emergency departments (ED) throughout the world and the use of analgesics in ED's has been extensively explored. What has been less extensively researched is why some patients in pain choose not to use analgesics and what it is that they expect from emergency health care. The present work is an exploratory study looking at the attitudes of patients in pain, presenting to an urban ED and declining analgesics. It asks why patients decline analgesics and what they expect from emergency care. Seven participants were recruited over a two month period and volunteered to participate in semi-structured interviews while waiting to see a health professional. Four women and three men participated. Thematic analysis led to several themes being reported. People did not like taking analgesics because their injury was "not that painful"; they used "pain as a reference point"; and they had an "aversion to taking medications". Reasons for accessing emergency services included a "need to know what's wrong" and a belief that "diagnostic tests" were required. A surprising theme to emerge was the use of dental pain as a reference point for pain tolerance and pain behaviours. It was concluded that health professionals should accept that some patients in pain do not desire analgesics. Patients have non-pharmacological means of coping with pain. They access emergency care for diagnosis, active treatment, and have an underlying need to understand the cause of their pain. It is suggested that future study might include interviews with health professionals to compare and contrast their subjective perceptions with objective observations and to investigate the use of dental pain as a reference point

Sample representation in a psychological treatment study after single event paediatric trauma

Children and their families who attended an emergency department following a single traumatic incident and who agreed to participate in a psychological treatment study (N = 211) were compared with nonparticipants (N = 2333) on several measures of trauma and injury severity: duration of admission and heart rate in the emergency department, emergency transport and admission to hospital, injury severity score, and triage code. Within the nonparticipant population, those who requested further information about the study (N = 573) were exposed to more severe trauma or injury than other nonparticipants (N = 1760). In addition, participants were exposed to more severe trauma or injury than either group of nonparticipants. These observations indicate that those exposed to more severe trauma or injury do not avoid participation in psychological treatment studies. Findings can therefore be generalized to those with more severe exposure, but not to the population as a whole

Data modelling for emergency response

Emergency response is one of the most demanding phases in disaster management. The fire brigade, paramedics, police and municipality are the organisations involved in the first response to the incident. They coordinate their work based on welldefined policies and procedures, but they also need the most complete and up-todate information about the incident, which would allow a reliable decision-making.\ud There is a variety of systems answering the needs of different emergency responders, but they have many drawbacks: the systems are developed for a specific sector; it is difficult to exchange information between systems; the systems offer too much or little information, etc. Several systems have been developed to share information during emergencies but usually they maintain the nformation that is coming from field operations in an unstructured way.\ud This report presents a data model for organisation of dynamic data (operational and situational data) for emergency response. The model is developed within the RGI-239 project ‘Geographical Data Infrastructure for Disaster Management’ (GDI4DM)

Australian hospital statistics 2012-13: emergency department care

Emergency department presentations increased by 4.0% on average each year between 2008-09 and 2012-13, this report finds.ow many emergency department presentations were there? More than 6.7 million emergency department presentations were reported by public hospital emergency departments in 2012-13, corresponding to just over 18,000 presentations each day. Emergency department presentations increased by 4.0% on average each year between 2008-09 and 2012-13. After adjusting for changes in the coverage of the collection, the increase was about 2.9% on average each year. Between 2011-12 and 2012-13, emergency department presentations increased by 2.5% nationally, with the largest increases in Tasmania (3.8%) and Queensland (3.7%). A greater proportion of patients presented to emergency departments over the weekends and on Mondays compared with the other days of the week, and 69% of patients arrived between the hours of 8am and 8pm.How long did patients wait? In 2012-13, 50% of patients received treatment by a medical officer or nurse within 19 minutes of presenting to the emergency department and 90% received treatment within 101 minutes of presentation. From 2008-09 to 2012-13, the overall proportion of patients \u27seen on time\u27 increased from 70% to 73%. In 2012-13, the proportion \u27seen on time\u27 varied across the states and territories, from 51% in the Australian Capital Territory, to 78% in New South Wales. Almost 100% of resuscitation patients (those requiring treatment immediately) and 82% of emergency patients (requiring treatment within 10 minutes) were seen on time. About 5% of emergency presentations were for Aboriginal and Torres Strait Islander people. In the largest hospitals, about 70% of Indigenous Australians were seen on time, compared with 72% for other Australians.How long did patients stay? Generally, the length of treatment time (the amount of time between the start and end of clinical care) was longer for patients who were subsequently admitted to the hospital and for patients who required more urgent treatment. For patients who were subsequently admitted, 8% had a treatment time of less than an hour; for other patients, 32% had a treatment time of less than an hour. The aim of the National Emergency Access Target is that, by 31 December 2015, 90% of emergency department visits will be completed in 4 hours or less. In 2012-13, just over two-thirds (67%) of emergency department visits were completed in 4 hours or less-an increase from 64% in 2011-12. Western Australia had the highest proportion (77%) of emergency department visits completed in 4 hours or less and the Australian Capital Territory had the lowest (57%). About 27% of emergency department patients were admitted to hospital after their emergency department care. For these patients, 36% had completed their emergency department visit in 4 hours or less, and 90% were admitted within 13 hours and 41 minutes. Western Australia had the highest proportion (46%) of emergency department patients admitted in 4 hours or less and the Northern Territory had the lowest (24%)