The Impact of Critical Care Quarantine on the Residual Risk of Unexpected Organ Donor Blood-borne Virus Infection.

Background: The transmission of undetected infections from organ donors to recipients is a persistent concern in transplantation medicine. Despite nucleic acid testing, some infections, especially those acquired recently, may evade detection. This study aimed to model the effects of critical care interval before screening on the residual risk of undetected infections in organ donors.

Revised nucleic acid test window periods: Applications and limitations in organ donation practice.

Background: Nucleic acid test window periods for HIV, HCV, and HBV facilitate estimation of the residual risk of unexpected disease transmission and assist clinicians in determining the timeframe in which a recently acquired infection is at risk of nondetection.

Objectives: Firstly, to provide revised estimates of the NAT window periods based on a currently used triplex NAT assay. Secondly, to examine their validity in organ donation and transplantation practice.

Recently Acquired Blood-borne Virus Infections in Australian Deceased Organ Donors: Estimation of the Residual Risk of Unexpected Transmission.

Unlabelled: Unexpected donor-derived infections of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV are rare but important potential complications of deceased organ transplantation. The prevalence of recently acquired (yield) infections has not been previously described in a national cohort of Australian deceased organ donors. Donor yield infections are of particularly significance, as they can be used to gain insights in the incidence of disease in the donor pool and in turn, estimate the risk of unexpected disease transmission to recipients.

Prevalence of Blood-Borne Viruses and Predictors of Risk in Potential Organ Donors in Australia.

Internationally, the designation of a patient as an increased viral risk organ donor has been associated with lower utilisation rates. The actual prevalence of blood borne viruses in Australian potential organ donors, and the predictive performance of questionnaires administered to stratify this risk, remains unknown. We conducted a retrospective review of all patients who commenced workup for donation on the national database between 2014-2020.

Remote COVID-19 patient monitoring system: a qualitative evaluation.

Background: Many COVID-19 patients are discharged home from hospital with instructions to self-isolate. This reduces the burden on potentially overwhelmed hospitals. The Royal Melbourne Hospital (RMH) Home Monitoring Programme (HMP) is a model of care for COVID-19 patients which chiefly tracks pulse oximetry and body temperature readings.

The Rapid Development of Virtual Care Tools in Response to COVID-19: Case Studies in Three Australian Health Services.

Background: News of the impact of COVID-19 around the world delivered a brief opportunity for Australian health services to plan new ways of delivering care to large numbers of people while maintaining staff safety through greater physical separation. The rapid pivot to telemedicine and virtual care provided immediate and longer term benefits; however, such rapid-cycle development also created risks.

Objective: The aim of this study was to understand the sociotechnical aspects of the rapid-cycle development of seven different COVID-19 virtual care tools, and to identify enablers, barriers, and risks at three health services in Victoria, Australia.

Threat of COVID-19 impacting on a quaternary healthcare service: a retrospective cohort study of administrative data.

Objectives: The threat of a pandemic, over and above the disease itself, may have significant and broad effects on a healthcare system. We aimed to describe the impact of the SARS-CoV-2 pandemic (during a relatively low transmission period) and associated societal restrictions on presentations, admissions and outpatient visits.

Design: We compared hospital activity in 2020 with the preceding 5 years, 2015-2019, using a retrospective cohort study design.

Characteristics, presentation and outcomes of music festival patrons with stimulant drug-induced serotonin toxicity.

Objective: A large number of stimulant drug-associated deaths at music festivals in Australia were reported during the southern hemisphere summer of 2018-2019. This led to the prehospital deployment of healthcare professional-led critical care response teams. We aimed to describe the characteristics, clinical presentation, management and outcomes of music festival patrons with stimulant drug-induced serotonin toxicity managed using this model during the study period.

Patients presenting for hospital-based screening for the coronavirus disease 2019: Risk of disease, and healthcare access preferences.

Objective: Early during the coronavirus disease 2019 (COVID-19) pandemic, Australian EDs experienced an unprecedented surge in patients seeking screening. Understanding what proportion of these patients require testing and who can be safely screened in community-based models of care is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns.

Methods: In this cross-sectional survey, we screened patients presenting to a COVID-19 screening clinic in a tertiary ED.

Distribution of potential eye and tissue donors within an Australian teaching hospital.

Eye and Tissue donation has the capacity to transform lives, yet the vast majority of potential in-hospital donors are not recognised. Studies which describe the relative importance of specific units or wards in determining the size of the donor pool are limited. The aim of this study was to map the distribution of potential Eye and Tissue donors within the study hospital.

Estimation of the potential eye and tissue donor pool in an Australian emergency department.

Objective: EDs have long been considered a potential source of eye and tissue donors, but no specific evidence to support this was identified in the Australian setting. The present study aims to bridge that knowledge gap, by analysing medical and social histories of those who have died over a 5 year period so as to determine donation eligibility in this population.

Methods: A retrospective audit was undertaken of all patients who died within the Royal Melbourne Hospital ED between 2010 and 2014.

Extreme sports: extreme physiology. Exercise-induced pulmonary oedema.

We report five patients who presented to an on-site medical team with concurrent haemoptysis and shortness of breath at a recent triathlon event. After initial management in the field, three of the five patients were transported to hospital via ambulance for further management, resulting in patients with haemoptysis and dyspnoea being 17 times more likely to require hospital transport. It is important to consider the differential diagnoses for this presentation, particularly exercise-induced pulmonary oedema.

Hospital in the field: prehospital management of GHB intoxication by medical assistance teams.

Introduction: Recreational use of gamma-hydroxybutyrate (GHB) is increasingly common at mass-gathering dance events in Australia. Overdose often occurs in clusters, and places a significant burden on the surrounding health care infrastructure.

Objective: To describe the clinical presentation, required interventions and disposition of patrons with GHB intoxication at dance events, when managed by dedicated medical assistance teams.

Triage presenting complaint descriptions bias emergency department waiting times.

Objectives: The authors aimed to determine whether certain emergency department (ED) triage "presenting complaint" descriptions are associated with shorter or longer waiting times, when compared with matched controls.

Methods: This was a retrospective, analytical study in three tertiary referral EDs. Data relating to adult patients with Australasian National Triage Scale (NTS) Category 3-5 complaints, who presented over 1 year, were accessed.

Mass gathering medicine: the Melbourne 2006 Commonwealth Games experience.

Objective: To investigate the nature and acuity of medical presentations of patrons and staff attending the Melbourne 2006 Commonwealth Games (M2006) venues and festival live sites.

Design And Setting: Retrospective case series chart audit of patients who were managed by St John Ambulance during the M2006.

Participants: Patients who presented requiring first-aid review or treatment at any of the 21 designated event venues or 16 live sites during their prescribed operating hours between 15 March 2006 and 26 March 2006.

Nurofen Plus misuse: an emerging cause of perforated gastric ulcer.

Over a 6-month period, two patients presented to a community hospital emergency department with perforated gastric ulcers as the result of recreational misuse of over-the-counter ibuprofen-codeine preparations. Misuse of these medications appears to be an emerging cause of significant morbidity in patients with codeine addiction.