6th International Conference for Emergency Nurses
What else is your patient taking?
1,∗ 2 retrospective review of trauma series pelvic X-rays and the
Gail Ross-Adjie , Kerry Deakin
1 assessment and non-invasive pelvic binding to the same
Nursing Clinical Practice, Policy and Research, St John of
God Hospital, Murdoch, WA, Australia
2 a lack of knowledge by nurses and medical staff of binder
Emergency Department, St John of God Hospital, Murdoch,
WA, Australia
Despite the widespread use of complementary and
alternative medicines (CAM) and the well documented inter-
actions between some CAM and prescribed medications
there is no Australian research which examines the rate of
disclosure of CAM to health professionals in the emergency
department (ED).
This study aims to identify what proportion of patients
who present to our ED use at least one non-medically pre-
scribed CAM and their frequency of usage; and to explore
the knowledge of ED nursing staff towards patient use of
complementary and alternative medicines.
The study is being conducted in two parts. Part 1 is a
cross-sectional descriptive study of 371 ED patients at a
private Perth ED using a validated self-administered ques-
tionnaire. Patients are also requested to provide information
about their current CAM usage and attitude towards CAM,
their prescription medication usage and CAM disclosure to
their medical practitioner. Part 2 invites the permanent ED
nursing staff who work at our facility to complete the Nurs-
ing Staff Questionnaire which is largely based on the patient
questionnaire. It aims to collect information about nurses’
knowledge in relation to CAM.
Preliminary results suggest that many patients do cur-
rently take CAM which have the potential to interact with
their prescription medication. Alarmingly many of these
patients do not disclose their CAM usage to either their
prescribing doctor or pharmacist. Not only do triage nurses
need to be aware of this potential for interaction but
both nursing and medical staff require education about the
well-documented interactions between CAM and commonly
prescription drugs.
doi:10.1016/j.aenj.2007.09.062
Identifying and improving staff knowledge of pelvic binder
placement
Nicholas Santeloudi
Emergency Department, The Alfred Hospital, Melbourne,
VIC, Australia
Major pelvic fractures are associated with a high risk of
haemorrhage. However, bleeding can potentially be con-
trolled by appropriate application of a non-invasive pelvic
binder. Importantly, the binder must be properly placed to
be effective and this requires knowledge of the process.
In a retrospective review of trauma series pelvic X-
rays from patients with non-invasive pelvic binders in situ,
a significant number of incorrectly placed pelvic binders
were identified. This meant these patients had not received
adequate pelvic binding. The binders had been applied pre-
hospital, in rural hospitals and in a primary trauma centre.
A two-phase pilot study was commenced to identify and
improve staff knowledge of pelvic binder placement in a
211
major trauma centre. Phase one of the pilot study involved
delivery of education sessions on pelvic pathophysiology,
group of staff. Initial outcomes of the study demonstrated
placement, pelvic fracture pathology and management.
The next phase will involve collection of retrospective
trauma series pelvic X-rays to evaluate improvements in
binder placement post education. It is hoped this study
might be used to generate education on pelvic binder place-
ment cross the state, at all levels of trauma management.
Keywords: Pelvic binder; Trauma centre; Trauma series X-
rays; Non-invasive
doi:10.1016/j.aenj.2007.09.063
The Oxford Chair Technique: A simple, nurse initiated
method to reduce anterior glenohumeral dislocations
Stuart Smith
Emergency Department, Lyell McEwin Hospital, Elizabeth
Vale, SA, Australia
Within the emergency department where I work, nation-
ally and internationally there is no uniform agreement on
the reduction method of choice for patients who have sus-
tained an anterior glenohumeral dislocation. This has led
to a vast array of methods being used, often not evi-
dence based and with little scientific knowledge behind
their use.
The Oxford Chair Technique involves the use of a pur-
pose built chair (though any high backed chair can be used).
Patients sit astride the chair and are talked through the
simple procedure by the practitioner. A poster has been
produced which outlines the technique.
Prior to the introduction of this initiative patients with a
glenohumeral dislocation required conscious sedation and
opiates in order to reduce the dislocation. This carried
potential risks to the patient alongside the logistical issues
of patient care. The procedure was always performed by a
senior doctor in the resuscitation room.
This initiative provided an exciting and rewarding devel-
opment for Emergency Nurse Practitioners to manage a
presentation that has traditionally been out of our scope
of practice. This is a simple, single person technique.
Entonox is given for analgesia. No conscious sedation is
required.
Over an 18-month period a service evaluation project
was undertaken to assess the effectiveness of the Oxford
Chair Technique in comparison to the traditional methods of
glenohumeral reduction. Six research questions were used.
Favourable results to the Oxford Chair Technique com-
pared to traditional methods of glenohumeral reduction
were demonstrated. For instance, the average time from
arrival to discharge for patients managed with the Oxford
Chair Technique was 141 min compared to 254 min for
patients treated with traditional methods of reduction.
The average time from check X-ray to discharge was 51 min
with the Oxford Chair Technique and 119 min for traditional
methods of reduction. Overall there was a 75% success rate