Rural hospitals face unique challenges in providing emergency care to communities due to their small size and remote locations. On average, rural emergency departments see 46 patients per day, with about 38% being high acuity cases. Medical staff are only rostered from 8am to 10pm, so hospitals rely on over 150 helicopter transfers per year. Rural communities expect access to emergency services 24/7 with adequately skilled doctors and nurses. Very small, remote hospitals like the one in Quilpie, population 600, are staffed by one doctor and a minimal nursing roster, highlighting the need for support of rural medical staff.
Implementing Physician Assistants in the ED to improve patient experience Criterion Conferences
• Supporting doctors to help expedite patient care
• Ensuring high quality and timely care
• Examining effectiveness one year on
Benjamin Close Director Emergency Townsville Hospital, QLD
Dr Derek Thompson: Building a caring futureNuffield Trust
In this slideshow, Dr Derek Thompson, GP and Medical Director at Northumbria Healthcare Foundation Trust, on reducing the length of hospital stay and building a caring future.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Dr Alisha Davies explores evaluation of the 'Better access, better care, better lives' scheme in Barking, Dagenham, Redbridge and Havering as part of the Prime Minister's Challenge Fund.
More care, less pathway: future-proofing end of life care Marie Curie
Dr Peter Nightingale, Marie Curie and RCGP End of life lead, chairs the session with speakers Dr Bill Noble (Medical Director of Marie Curie Cancer Care) and Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care) at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
Associate Professor Ian Scott - Princess Alexandra Hospital; University of Qu...Informa Australia
Associate Professor Ian Scott
Director
Internal Medicine & Clinical Epidemiology; Associate Professor of Medicine
Princess Alexandra Hospital; University of Queensland
Implementing Physician Assistants in the ED to improve patient experience Criterion Conferences
• Supporting doctors to help expedite patient care
• Ensuring high quality and timely care
• Examining effectiveness one year on
Benjamin Close Director Emergency Townsville Hospital, QLD
Dr Derek Thompson: Building a caring futureNuffield Trust
In this slideshow, Dr Derek Thompson, GP and Medical Director at Northumbria Healthcare Foundation Trust, on reducing the length of hospital stay and building a caring future.
Dr Thompson spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Dr Alisha Davies explores evaluation of the 'Better access, better care, better lives' scheme in Barking, Dagenham, Redbridge and Havering as part of the Prime Minister's Challenge Fund.
More care, less pathway: future-proofing end of life care Marie Curie
Dr Peter Nightingale, Marie Curie and RCGP End of life lead, chairs the session with speakers Dr Bill Noble (Medical Director of Marie Curie Cancer Care) and Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care) at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
Associate Professor Ian Scott - Princess Alexandra Hospital; University of Qu...Informa Australia
Associate Professor Ian Scott
Director
Internal Medicine & Clinical Epidemiology; Associate Professor of Medicine
Princess Alexandra Hospital; University of Queensland
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RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. Rural and Remote Hospitals
Data source AIHW Hospital Resources 2015-16
3. Rural Hospital Emergency
• Average 46 patients per day
• Approx 38% Cat 1 – 3
• Medical staff rostered 8am –
10pm
• Over 150 helicopter retrievals per
year
4. Emergency Department Standards
ACEM:
•Level 1 (minimum level of service that can be
defined as an emergency department). Targeted
rural and remote hospital.
ACRRM
•College Standards – recommended minimum
standards for small rural hospital emergency
departments.
•Have been endorsed by Qld Health for CSCF level
1 & 2
6. Very Small Hospital in Remote setting
• Quilpie 980km west
of Brisbane
• 208 km west of
Charleville
• Population approx
600 people
• One doctor
• Nursing roster 2/2/2
plus DON
• 10 bed MPHS
7. Support for staff
Clinical Skills – rural doctors providing services to
rural hospital, spend time in ED.
Importance of standardisation
Personal Support
