Kerrianne Watt

Objective: Ambulance services are increasingly relied upon to provide a vital emergency point‐of‐care health service to adults who fall while living in Residential Aged Care Facilities (RACFs). This study examined patterns of ambulance attendance to falls‐related cases among people aged 65 years and over living in RACFs. Methods: We conducted an exploratory, descriptive, retrospective case series study of Queensland Ambulance Service ( QAS ) response data within a regional area of Queensland, Australia between 1 January 2021 and 31 December 2023. We analysed demographic data, triage category and patterns of QAS attendance. Results: There were 6663 QAS falls‐related attendances during the study period for 3545 unique patients. Attendances increased significantly for the 3 years from 2021 ( n = 1916) to 2023 ( n = 2528), χ ² (df = 2) = 84.35, p < 0.001. Forty‐three per cent of residents experienced two or more fall‐related events, and 88% of attendances resulted in transport to hospital. Attendance numbers were similar across the days of the week. There were significant differences in when calls were received during the 24 h for all years combined ( χ ² (df = 23) = 489.62, p < 0.001) and for 2021 ( χ ² (df = 23) = 182.15, p < 0.001), 2022 ( χ ² (df = 23) = 154.04, p < 0.001) and 2023 ( χ ² (df = 23) = 195.22, p < 0.001). Conclusions: The findings of this study identified an urgent need to address health system optimisation and resource allocation to provide timely and appropriate services to people living in RACFs . Future studies could provide further evidence about the increasing demands on ambulance resources and strategies to improve high‐quality, person‐centred care.

Background: Queensland, Australia, is a popular tourist destination known for its beaches and exotic flora and fauna; however, travel also carries injury risk. This study aimed to describe the epidemiology of ambulance-attended adult tourist injuries among domestic and international visitors to inform travel safety strategies. Methods: Data were extracted from Queensland Ambulance Service (QAS) records for injury-related cases involving non-Queensland residents aged ≥15 years attended between 1 January 2009 and 31 December 2018. Ambulance pick-up location coordinates were used as a proxy for injury location. Geospatial analysis was conducted, and χ ² tests examined differences between visitor groups by age, sex and injury characteristics. Age-standardised rates were calculated annually using population data from Tourism Research Australia’s national and international visitor surveys. Results: There were 27 687 visitor injuries aged ≥15 years attended by QAS, with males accounting for 52.5% of cases. Injury-related ambulance attendance rates were similar for domestic (IR=32.3 per 100 000 per annum; n=21 685) and international visitors (IR=29.5 per 100 000 per annum; n=6002). The highest injury rates occurred among young males aged 15–24 years and older females aged ≥65 years. Falls and transport incidents were the leading injury mechanisms among both visitor groups. Discussion: Findings suggest differences according to age, sex and visitor type, with young males and older females representing higher risk groups. These results highlight the need for targeted prevention strategies and further investigation into the circumstances surrounding tourist injuries. Conclusion: Understanding the burden and characteristics of tourist injuries is crucial to informing health service provision, targeted travel health advice and injury prevention strategies.

BACKGROUND: Burn injury is responsible for both acute and ongoing inflammation, resulting in systematic changes impacting the cardiovascular, hepatobiliary, endocrine, and metabolic systems, but there is minimal investigation into long-term clinical outcomes. This study aimed to investigate mortality due to cardiovascular related long-term postburn injury. METHODS: This was a retrospective cohort study linking a burns unit database with mortality outcomes from a Registry of Births, Deaths and Marriages. Data were extracted from the Australian Institute of Health and Welfare and stratified into three age groups: 15 to 44 years, 45 to 64 years, and 65+ years. Mortality rate ratios (MRRs) and 95% confidence interval (CI) were calculated to compare the burns cohort mortality incidence rates with the national mortality incidence rates for each of the three age groups. Logistic regression was used to identify demographic and clinical factors associated with cardiovascular mortality. RESULTS: A total of 4,134 individuals in the database were analyzed according to demographic and clinical variables. The 20-year age-standardized cardiovascular mortality rate for the burns cohort was significantly higher compared with the Australian population (250.6 per 100,000 person-years vs. 207.9 per 100,000 person-years) (MRR, 1.21; 95% CI, 1.001–1.45). Cardiovascular mortality was significantly higher in males aged 15–44 and 45–64 years had a cardiovascular mortality rate significantly higher than the Australian population (MRR = 10.06, 95% CI 3.49–16.63), and (MRR = 2.40, 95% CI 1.42–3.38) respectively. Those who died of cardiovascular disease were more frequently intubated postburn injury (p = 0.01), admitted to intensive care (p < 0.0001), and had preexisting comorbid physical conditions (60.9% vs. 15.0%, p < 0.0001). CONCLUSION: Survivors from burn injury, especially young males, are at increased long-term risk of death from cardiovascular disease. Increased screening and counseling pertaining to lifestyle factors should be standard management postburn injury. Longitudinal observation of physiological changes, investigation of mechanistic factors, and investigation of interventional strategies should be instituted. LEVEL OF EVIDENCE: Prognostic and Epidemiologic; Level IV.

Objectives The aim of this work is to describe routine integration of prehospital emergency health records into a health master linkage file, delivering ongoing access to integrated patient treatment and outcome information for ambulance-attended patients in Queensland. Methods The Queensland Ambulance Service (QAS) data are integrated monthly into the Queensland Health master linkage file (MLF) using a linkage algorithm that relies on probabilistic matches in combination with deterministic rules based on patient demographic details, date, time, and facility identifiers. Each ambulance record is assigned an enduring linkage key (unique patient identifier) and further processing determines whether each record matches with a corresponding hospital emergency department, admission, or death registry record. In this study, all QAS electronic ambulance report form (eARF) records from October 2016 to December 2018 where at least one key linkage variable was present (n = 1,771,734) were integrated into the MLF. Results The majority of records (n = 1,456,502; 82.2%) were for transported patients, and 90.1% (n = 1,312,176) of these transports were to public hospital facilities. Of these transport records, 93.9% (n = 1,231,951) matched to ED records and 59.3% (n = 864,394) also linked to admitted patient records. Of ambulance non-transport records integrated into the MLF, 23.6% (n = 74,311) matched with ED records. Conclusion This study demonstrates robust linkage methods, quality assurance processes, and high linkage rates of data across the continuum of care (prehospital/emergency department/admitted patient/death) in Queensland. The resulting infrastructure provides a high-quality linked dataset that facilitates complex research and analysis to inform critical functions such as quality improvement, system evaluation, and design.

Objective To describe annual incidence and temporal trends (2002–2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES). Methods This is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes: (1) survival to less than 30 days (SurvResults Over the 13 years there were 4393 cases for analyses. The incidence of total admitted events (9.72–10.13; pConclusion Evidence suggests that implemented strategies to improve outcomes from OHCA have been successful and penetrated groups living in more remote locations and the lower socioeconomic groups. These populations still require focus. Ongoing reporting of long-term outcomes from OHCA should be undertaken using population-based incidence.

Objective: To describe incidence in pre‐hospital outcomes of adult out‐of‐hospital cardiac arrest (OHCA) of presumed cardiac aetiology, attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014, by age, gender, geographical remoteness and socio‐economic status.Methods: The QAS OHCA Registry was used to identify cases, which was then linked with Queensland Hospital Admitted Patient Data Collection and Queensland Death Registry. Population data were obtained for each calendar year by age and gender from the Australian Bureau of Statistics in order to calculate incidence rates. Four mutually exclusive pre‐hospital outcomes were analysed: (i) no resuscitation (No‐Resus); (ii) resuscitation, no pre‐hospital return of spontaneous circulation (No‐ROSC); (iii) resuscitation, pre‐hospital return of spontaneous circulation not sustained to hospital (Unsustained‐ROSC); and (iv) resuscitation, pre‐hospital return of spontaneous circulation sustained to hospital (Sustained‐ROSC).Results: Over the 13 years, there were 30 560 OHCA cases for analyses. Incidence was significantly greater in males than females and incrementally increased with age, for each outcome. Incidence of total OHCA events generally increased as remoteness increased (major cities: 72.39 per 100 000 [95% CI 71.35–73.45]; very remote: 87.01 per 100 000 [95% CI 78.03–95.98]). There was an inverse association between incidence of OHCA events and socio‐economic status (SEIFA 1 and 2: 81.34 per 100 000 [95% CI 79.28–83.40]; SEIFA 9 and 10: 61.57 per 100 000 [95% CI 59.67–63.46]).Conclusion: Rural‐specific strategies should be continued. Prevention and management strategies for OHCA targeting lower socio‐economic groups require focus.