Reopening after lockdown

Australia is rapidly moving towards “living with COVID-19”, with relaxation of some public health measures. The number of severe cases of COVID-19 may be mitigated by vaccination, but ‘living with COVID-19’ will be associated with higher number of patients seeking emergency care. Four senior clinicians from Monash in Melbourne offer their thoughts about what this means for the emergency care system as well as some solutions that will help us respond adequately and safely.

COVID-19 and ED nursing

Since the pandemic began last year, this journal has fast-tracked to publication many papers about it, specifically in the context of emergency care. Consistent with this philosophy, we publish a paper from Victoria reporting that approximately one year after the onset of the pandemic in Australia, a high proportion of ED nurses intend to leave ED nursing within 5 years, which will exacerbate pre-existing shortages. Although the authors acknowledge weaknesses in their study, we invited the Chief Nursing and Midwifery Officer of Australia, Alison McMillan, to comment.

CPAP and NIV in a retrieval service

A study from Queensland reports the use of respiratory support via continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) in a medical retrieval service. A 13-month unblinded retrospective case series suggests that CPAP and NIV have a low risk profile in adult aeromedical retrieval, even for prolonged periods of time.

Asthma in Queensland

Six years of routinely collected data from 28 public hospitals in Queensland suggest that asthma hospital admissions are increasing, largely driven by use of Short Stay Unit admissions for asthma, with large variation in both incidence and proportion admitted across different regions. Routinely collected data can in part be used to understand risk factors for asthma related hospital admission following an ED presentation and further inform public health policy development.

Major haemorrhage protocol in paediatric trauma

Fixed ratio blood product administration may improve outcomes in trauma patients with massive blood loss. A study from Melbourne describes the impact of a major haemorrhage protocol (MHP) on the ratio of blood products administered for paediatric major trauma. The authors conclude that a MHP did not change the ratio of blood product administration in their cohort of patients due to the infrequency of massive blood loss. Future studies may focus on the impact of treating coagulopathy and hypo-fibrinogenaemia on patient-centred outcomes.

End of life care

The Palliative and Support Services Department at Flinders University in South Australia report the evaluation of an end-of-life education module “Emergency Department End-of-Life Care”. They conclude that the module had a significant positive impact on learners in relation to perceived knowledge, skill, attitude, and confidence. The authors suggest that the EOLE ED module could be a useful online learning resource for health professionals.

Remote videoconferencing

In a follow-up to a previous submission about tele-ophthalmic supervision of emergency orbital decompression, we report a successful outcome for a patient with acute retrobulbar haemorrhage following remote, videoconference supervision of a lateral canthotomy and cantholysis.

Journal format changes

Over the coming months you will see some changes to article sections (or banners) appearing in the journal. This is to improve consistency across the Wiley library of journals and will enhance cataloguing and search functions. We will still publish the same content and the changes will make things clearer for the reader - e.g. ‘Case Letter’ will become the more traditional ‘Case Report’, ‘Trainee Focus’ will now show what sort of article it is – e.g. ‘Trainee Focus – Perspective’, ‘Paediatrics’ can be ‘Original Research – Paediatrics’ etc. The changes will be made in the submission system before the end of the year, and will filter through as articles are published. As always, please refer to the Author Guidelines on Wiley Online Library for details on each article type and how to format for submission.

Geoff HUGHES

Editor-in-Chief

Emergency Medicine Australasia