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ASEM

The Society was established in 1981 by practitioners who foresaw the emergence of the specialty of emergency medicine and the future implications for the care of acutely ill patients attending hospital “casualty departments”.
From those beginnings emerged the Australasian College for Emergency Medicine, formally incorporated in 1984.
The Society continues to provide a forum for discussion and debate on issues of relevance to emergency medicine.

We are progressively adding to this site, if the information you are after is not on the website, please click here to contact the ASEM office

ASEM ANNOUNCEMENTS


EBOLA Serial 2014

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20th October 2014
During the last week, hospitals across Austrazealand struggled to work out what to do, to prepare for Ebola. What personal protective equipment? Which protocols? Training?

The usual Victory PPE and Victory isolation room won’t cut it if we really get a case. But all this planning, purchasing and training is costly and wasted if we never do get a case.

The experience in Texas has been sobering; one patient presented after flying in from Liberia, two of his nurses are now patients, and the local public health unit is tracing lots of contacts.

It seems obviously terribly important to stop Ebola spreading here, and theoretically possible but actually difficult to do so.

The nation has checked 724 people at Australian airports, tested 11, and all were negative; according to The Australian. Presumably a case will present somewhere in NZ or Australia before this epidemic is over. So at my hospital, the infection control nurse, the ED nurse manager, an interested Hospitalist and I sat at the messy round table in my office to try to work out what to do.

To prevent or limit spread we will need doctors and nurses to agree to help out. And they won’t be lining up unless they are trained to the point of confidence.

We reckon training will involve:
• Use of a supernumerary staff member purely to supervise donning and doffing.
• Ebola standard PPE including gum boots, hood, mask, face shield, thick gown, and double, taped gloves.
• Someone who really knows what works safely to teach us.
• A workshop day with education, practice, and testing with fluorescent paint and UV light.

And that will be expensive. So it might be limited to a team of a few doctors and a dozen or so nurses. All to be able to assess a patient in isolation and transfer to an Ebola treatment centre. (Or not, if the patient turns out to have malaria or something.)



Communicable Disease Network of Australia (CDNA) guidelines were endorsed by CDNA and AHPPC (Australian Health Protection Principal Committee) on 3/10/14.

To be a “person under investigation” you need clinical evidence and limited epidemiological evidence. A temp of >38 C is needed for clinical evidence. (I guess if it is 37.9 or 38.0 you take it a few more times.) And you can “consider” headache, muscle pain, D and V, or bruising.

You put them in isolation, work out the epidemiological risk (level of exposure), clinical features, and contact public health before doing any lab testing. There is an appendix on their website with a tick box form for the assessment.

They need a single room with a private bathroom and an anteroom. Staff need a fluid repellent surgical mask, disposable fluid resistant gown, gloves, and goggles. But then it says, “complete protection from splashes may be achieved by covering all skin…face shields, overalls, disposable shoe coverings and leg coverings. Double gloving might also be considered.” Avoid aerosol generating procedures and add a P2/N95 respirator if you have to.

The NHMRC website has a description of the process for donning and doffing, NHMRC Guidelines. It looks tricky to get perfect without the use of double gloves and ties that can be torn apart at the back.

Routine cleaning is with sodium hypochlorite solution 1000 ppm, or 5000 ppm for spills. Terminal cleaning is the entire room with a neutral detergent, then sodium hypochlorite, and dispose of everything.

Dr Peter Roberts
ASEM NSW Councillor
proberts@asem.org.au

13th October 2014
The country count is: 7 with confirmed cases. On October 10 there were 8033 cases recorded. And Sue Ellen Kovac, the Australian volunteer nurse who thankfully tested negative, points out that 40000 people have family members who have either died or become infected. The Cochrane RCT count is 3.
The CDC points out that the epidemic ends when 70% of patients are in medical care facilities or Ebola Treatment Units (ETUs) or somewhere else with effective isolation.
And the Brisbane Times reports that Cairns and Hinterland Hospital Nad Health Service Chief Julie Hartley-Jones has announced that 2 doctors have been stood down on full pending the results of a review.
What do the Cochrane RCTs say? In 21 people, a DNA vaccine with plasmids coding for 2 strains and nucleoprotein was safe and immunogenic. And another coding for envelope glycoproteins was safe and immunogenic. And ZMab plus interferon seems to work in non-human primates.
Well, what should rich countries like Australia do? Sending professionals to West Africa risks bringing the disease home. Not sending them risks further spread, epidemic…

Dr Peter Roberts
ASEM NSW Councillor
proberts@asem.org.au

8th of October 2014
On 8/10/14 the Sydney Morning Herald published 3 articles on Ebola. The first, sub headed “medical staff trained”, is best read with a world war 2 news real voice. In the tone of saying our boys will be home by Christmas. “The federal health department says the risk of an outbreak in Australia remains very low, and our infection control mechanisms in our hospitals are first rate.”
Unfortunately, I’ve seen the audits which show that we have a spot of bother with hand washing.

Westmead Hospital is the designated hospital for the treatment of Ebola in NSW.
Vicky Sheppeard, director of NSW health communicable disease branch says “While Ebola is a very serious disease, it is not highly contagious. It is not like influenza. It is not caught through coughing or sneezing. It is only caught through contact with bodily fluids of an infected person or animal.”
Curiously then, the next paragraph mentions that 3400 people have died from it, mostly in Guinea, Sierra Leone and Liberia.
Mostly. There are four cases in USA. And another article, from Spain, is headlined “Nurse first to get Ebola out of Africa. The nurse had treated a priest repatriated to Madrid with Ebola.
The third article might actually get the attention of the West. It mentions money. It says “West African crisis hits cocoa prices,” and goes on “Experts say if an outbreak occurs, bean prices will surge beyond the 3.5 year high reached in September and affect retail chocolate prices.”
There seems to me to be a failure to acknowledge a problem here. The international SOS web-site accessed today says that in Liberia and Sierra Leone at September 30, 2014 there were 8000 reported cases. And the real number is likely 2.5 times that. And it is doubling every 3 weeks or so.
A million by February 2015.
Conversely there are 4 experimental treatments and two experimental vaccines. And if 70% of infected people are in appropriate settings by late December 2014, the epidemic in Sierra Leone and Liberia will be nearly over in February 2015.
So......It is possible for the world to bring this under control..... Or not?

Dr Peter Roberts
ASEM NSW Councillor
proberts@asem.org.au

Searching for a Tasmanian and New Zealand Councillor on ASEM Council

Council is looking for interest to fill the positions of Tasmanian and New Zealand ASEM Council representatives. This is an opportunity to become more involved with the Society and an opportunity to have a voice for Council. This involves participation in a teleconference every 6 weeks and an invitation to the Strategic Planning Day, held annually.

Initial enquiries can be made with the current president, Dr Vincent Lambourne
Contact email: $Q$wmbncpvsof@btfn.psh.bv OR $Q$qsftjefou@btfn.psh.bv


Attention All Medical Students!!


Are you a medical student studying in Australia or New Zealand? Are you interested in Emergency Medicine? Then this offer is for you!

ASEM is proud to announce COMPLIMENTARY electronic membership to the Society for any medical student studying in Australia or New Zealand!

To become a Member please click here

Please note: Ensure the box marked ‘Student’ is ticked and then send your form to ASEM, Reply Paid, PO Box 627, Noble Park Vic, 3174 OR email to $Q$jogp@btfn.psh.bv.

After joining, you will receive free access to the Members Only section of the ASEM website as well as an electronic copy of the ASEM Quarterly Newsletter. In future, ASEM aims to offer a host of student-focused resources including information about training, career options, clinical tips and tricks, and competitions.

ASEM now on Facebook!!


The ASEM Facebook page has been created to allow members and the public to become more involved with ASEM and see what is being accomplished and done about Emergency Medicine around Australia and New Zealand.


CONFERENCES

Timely Access to Emergency Departments

A whole of hospital approach to improving the patient journey

26th & 27th November 2014

The conference will be held at L’Aqua, Cockle Bay, Sydney
www.accesstoemergency.com

**Australian Society for Emergency Medicine members quote CC*ASEM when registering to SAVE $100 off the current price!**

Don’t miss your chance to hear from Australia’s top clinical, health & ED representatives!
Time and time again we hear people speak of the need for transformative change across emergency departments– but they rarely offer any answers on how to achieve this.

Tackling the big issues one-by-one, you will hear from institutions that have successfully initiated change and embedded new practices.

Use the lessons they have learnt to shortcut challenges you are currently facing and walk away with a plan for institution-wide change.

Learn from other institutions that have:
• Balance hospital targets with clinical safety & quality
• Strengthen clinician engagement & strategic communication
• Intelligent use of data to measure & improve performance
• Strategies to improve patient flow
> Download the agenda here https://confreg.criterionconferences.com/brochure/?c=186&slp=0#dlBrocAnc

Hear key contributions from
➢ Frank Daly, A/Chief Executive Royal Perth Group, South Metropolitan Health Service & Former State-wide Four Hour Rule Program Clinical Lead, WA
➢ Kate Brockman, Advisor, Whole of Hospital Program NSW Ministry of Health & Former Four Hour Rule Program Lead Royal Perth Hospital, WA
➢ Andrew Stripp, Deputy Chief Executive & Chief Operating Officer, Alfred Health, VIC
➢ Michele Franks, Director of Emergency Medicine Manly Hospital, NSW

Register today and save $400 off the registration fee! Don’t forget you must quote
CC*ASEM when registering to receive your $100 discount. Limited time only!

For more information or to register contact Criterion Conferences on +61 2 9239 5700, visit www.accesstoemergency.com or email $Q$sfhjtusbujpo@dsjufsjpodpogfsfodft.dpn.



>> See all Conferences


EM COURSES

New Non Specialist EM qualifications


Multiple learned Colleges, Universities and Professional Associations now offer certificate or diploma qualifications for non specialists working in Emergency Medicine.

Such qualifications may in the future become minimum standard entry points for senior (non specialist EM physician) appointments in Australian Hospitals.

For further information please see Non Specialist Diplomas and Training Schemes Or click here for an array of medical courses available today!


>> See all Non Specialist Diplomas/Training Schemes


Sydney University Medical School Postgraduate Education

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Sydney Medical School is launching a number of new vocationally orientated postgraduate programs for medical graduates in 2015. These programs have all been developed to help you succeed in today’s competitive environment. They will be taught by leading clinicians and academics, and complement our other vocationally orientated degree programs.

Courses include:
- Master of Medicine (Critical Care)
- Master of Medicine (Psychiatry),
- Graduate Diploma in Medicine (Metabolic Health) and
- Graduate Certificate in Advanced Clinical Skills (Surgical Anatomy).

Sydney Medical School will be running webinars and other information sessions in the months ahead where you will have the opportunity to meet and ask questions of academics teaching in the program.

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For further information please click here

If you would like information about these new courses please register your interest


Comprehensive Trauma Life Support Course (CTLS)

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Held Annually in India

Dr Sashi Kumar (ASEM ACT Council Member) is a CTLS International Faculty Member. Below you will find further information regarding the course and about Dr Sashi Kumar and his speech presented at the 2013 CTLS course in India.

The Comprehensive Trauma Life Support (CTLS) Course is an authentic course on Acute Trauma Management being organised in India by International Trauma Care (Indian Chapter). This is the only comprehensive course catering to Critical Care Specialists, Anesthesiologists, Surgeons, Emergency Physicians, Facio maxillary & Dental Surgeons, Physical Thereapists, Trauma Care Nurses & Rehabilitation Specialists.

Further information regarding the CTLS course please click on the link below:
www.criticare2013kolkata.org

If you would like to view Dr Sashi Kumar's CV and speech on Fluid Resuscitation in Trauma - An Update presented at the recent CTLS course held in March 2013, please click here



>> See all Courses


LINKS

Below are some links that may be of interest. Please click here to view all.

Australian Emergency Medicine Research Review

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This Review features key medical articles from global Emergency Medicine journals with commentary from Professor Anne-Maree Kelly. The Review covers topics such as paediatric emergency medicine, emergency medicine guidelines, wilderness emergency medicine, traumatic injuries, sports injury, head injury, and penetrating trauma.

Research Review publications are free to receive for all Australian health professionals.

If you would like further information, or subscribe to receive publications via email please click here


Patient Blood Management Guidelines 2013

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Please click on the link below to view the progress update for 2013's Patient Blood Management Guidlines.

National Blood Authority

The National Blood Authority (NBA) is pleased to announce that the Patient Blood Management Guidelines: Module 4 - Critical Care and accompanying Quick Reference Guide are now available and can be downloaded or ordered free of charge from the NBA website.

www.nba.gov.au


Emergency ID Spots Australia

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Emergency ID is an Australian owned and operated provider of medical jewellery and emergency ID products.
The business was founded by former Police Officer, Nicole Graham, who had seen firsthand the need for vital patient information to be immediately accessible in emergency situations.
At just 34 Nicole experienced a serious heart condition which required open heart surgery and sparked her search for affordable, attractive and potentially lifesaving medical jewellery. After recognising the options were very limited, Nicole established Emergency ID Australia to provide greater product choice, and ultimately peace of mind, for Australians and their families.
People who benefit from medical jewellery and emergency ID include those with an existing medical condition, diabetes, epilepsy, allergies, dementia, children with special needs, those at risk of heart attack or stroke, athletes, those with mental illness or disabilities, and travellers.
Emergency ID has Australia’s largest range of medical ID bracelets, necklaces, key rings, lanyards, wallet cards, stickers and wrist bands. The business has launched an Emergency ID App for Apple and Android smartphones, which displays critical medical and contact details on a phone’s locked screen.
The business has a fast growing fan base with more than 33,000 likers on Facebook, testament to the popularity of its products for people of all ages with a wide range of health and medical needs.
Emergency ID Australia is Ausbuy accredited and Nicole Graham is a Board Member of Ausbuy.

www.emergencyid.com.au


Federal Government Grants for Rural Emergency Medicine Doctors

The Federal Government has recently announced an increase in funding for procedural GPs in rural areas (RRMA 3-7) to access ongoing training and skills maintenance in emergency medicine under the "Strengthening Medicare" Program. This can include travel costs, locum relief and associated expenses. The maximum amount is $2000 per day for 3 days. To be eligible, GPs must provide evidence they providing emergency medicine services to a 24 hour emergency department or similar facility.

Funding is also available for skills maintenance in obstetrics, anaesthetics and surgery.

Further information is available from:
ACRRM or RACGP

BMJ Learning


Free access to BMJ Learning for all NSW Health Professionals

BMJ Learning is a CPD website which contains hundreds of learning modules covering over 70 specialties and both clinical and non-clinical topics. The online modules are in a range of different formats including audio, video and animations, and are all written by experts. Modules can be paused and restarted at any time, making them a convenient and flexible way for healthcare professionals to keep up-to-date and test their knowledge.

For further information please visit: BMJ Learning

Childhood Fracture Management Project

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The Childhood Fracture Management Project is a collaboration between the Victorian specialist paediatric orthopaedic hospitals: The Royal Children’s Hospital, Monash Children’s, Western Health and Barwon Health.

Led by the Victorian Paediatric Orthopaedic Network (VPON) and Developed by Emergency Physicians and Orthopaedic Surgeons, the Childhood Fracture Management Project provides all Victorian hospitals with best-practice guidelines and education for identifying and managing paediatric fractures.

To access the Childhood Fracture guidelines resources go to: ww2.rch.org.au

Life in the Fast Lane

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This Medical Blog was born out of passionate (and usually unresolved) debate pertaining to the elements of eLearning; clinical cases; ECG interpretation; medical education; toxicology; medical history and information sharing strategies in the open source era.

www.lifeinthefastlane.com/


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ASEM
PO Box 627
Noble Park
VIC
3174

Tel: (03) 9701 5675
Fax: (03) 9701 5811
Email: $Q$jogp@btfn.psh.bv

ABN: 64 231 328 255

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Epworth Healthcare Group
"Australia's largest private hospital is a proud sponsor of ASEM"
www.epworth.org.au


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