Ladder-related falls carry a considerable burden to the ED. Recommendations include ladder safety interventions that target ladder users most at risk of falls: men, ≥50 years old and performing domestic tasks. Safety interventions should emphasise task avoidance, education and training, utilisation of safety equipment and appropriate ladder setup.
BACKGROUND: Approximately 5%-8% of emergency department (ED) presentations are due to a dermatological condition. This study aimed to identify and characterise patients with skin conditions presenting to a busy ED.
METHODS:A 5-year retrospective study on patients with dermatological conditions presenting to the Princess Alexandra Hospital ED in Brisbane, Australia was performed. Electronic medical records were used to compare demographics and admission status of the dermatology group and the total ED group presentations. A prospective survey was conducted on low priority triage (triage 4 and 5) patients identifying reasons presenting to the ED. RESULTS: Of a total 281,718 ED presentations, 11,748 dermatology presentations were identified between January 2012 to December 2016. Of the dermatology presentations, 41.5% were female and had an average age of 47. The most common dermatology presentations were cellulitis, abscess, rash unspecified, and ulcer. Of those admitted, 36% were female, average age was 53, mean length of stay of 294 minutes and 83.1% had an infectious aetiology. Of triage 4 and 5 presentations, 66% patients we approached had been seen by a health practitioner prior to coming to the ED.
CONCLUSION:Within the population presenting with a skin related condition to the Princess Alexandra Hospital ED, characteristics associated with admission include male sex, older age, and an infectious etiology. This data may help ED clinicians decide on the discharge disposition of these patients. There may be a role for streamlined admissions for skin related infections, or improved hospital in the home services to support this group.
Objective
Injuries are a major burden on the Australian healthcare system. Power tool usage is a common cause of accidental injury. A better understanding of the trends of power tool injuries will inform prevention strategies and potentially mitigate costs.
Methods
The ED databases from two level 1 hospitals were reviewed for presentations between 2005 and 2015 resulting from accidental injury with power tools. A subgroup of patients presenting to one hospital between 2016 and 2017 were interviewed about the activities and circumstances that led to their injuries, and followed up 3 months later to assess outcomes.
Results
A total of 4057 cases of accidental injury from power tool use were identified. Power saws and grinders contributed to 54% of injuries. Most injuries were located on an upper limb (48%) or the head and neck (30%). Over half (54%) of all head injuries were associated with metal and wood fragments to the eye from grinders, drills and saws. Hospital admission rates were highest for patients aged >60 years. Injuries to females were <5% of all presentations, but 40% of those caused by lawnmowers. Among the 200 patients interviewed, lapses in concentration during use, and modification and inappropriate use of a power tool were the main contributors to injury. Recovery periods >3 months were common.
Conclusions
Accidental injuries from power tool use have a considerable impact on ED resources and can affect the long‐term quality of life of those injured. Effective education about safe usage and protection may prevent many injuries.
Illustrated urine collection instructions were well accepted by female ED patients, improved the rate of proper MSU collection and reduced the rate of urinalysis contamination in the ED.
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