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Emergency Medicine Australasia (2015) 27, 273–278
LETTERS TO THE EDITOR
Get the DRIFT for great discharge summaries Dear Editor, We appreciated the excellent systematic review by Wimsett et al. regarding the components of a good quality discharge summary1 and the related blog post2 providing guidance on the quality of discharge summaries. We are involved in the training of undergraduate medical students and have some specific responsibilities for general practice (NY) and emergency medicine (VB) rotations and aim to guide students’ referral documentation skills within these practice contexts. During the general practice rotation students undertake an exercise in which they watch a 14 min video of an ED consultation, then have 6 min to write a discharge letter back to the GP. Results in previous years have been poor in terms of the information being included. Using the systematic review results, we developed an acronym to guide their documentation – ‘DRIFT’ (Fig. 1). In February 2015 the student
Discharge diagnosis Rx received
students in both general practice and ED rotations to write referral letters and discharge summaries to each other, hence reinforcing these important skills.
Ix done (and results if relevant) Competing interests Follow up required Team involved Figure 1. DRIFT. Ix, investigations; Rx, treatment.
exercise was undertaken again but with the inclusion of the acronym. One hundred per cent of the cohort included all the elements of DRIFT (and most included more). Although not claiming any scientific rigour in our methodology, we offer this as a practical application of the published systematic review. Our next steps are to use this template for formative assessment and to design an exercise that requires
None declared.
References 1. Wimsett J, Harper A, Jones P. Review article: Components of a good quality discharge summary: a systematic review. Emerg. Med. Australas. 2014; 26: 430–8. 2. Cadogan M. Life in the fast lane. 2014. [Cited 11 Feb 2015.] Available from URL: http://cdn.lifeinthefastlane .com/wp-content/uploads/2015/01/ emm12285-sup-0002-si.pdf
Natasha YATES and Victoria BRAZIL Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia doi: 10.1111/1742-6723.12395
Underutilisation of synchronised cardioversion Dear Editor, It is with interest that I read the paper by Smith et al., a study that describes the out-of-hospital epidemiology of supraventricular tachycardia (SVT) in Victoria, Australia.1 In this paper, only four out of 882 study patients with SVT received synchronised cardioversion, with a 100% success rate. The use of electrical cardioversion in this study was lower than anticipated, with only 0.3% of patients receiving this electrical therapy. One would expect the use of
cardioversion to be higher than 0.3%, because a large fraction of the study sample had chest pain and/or hypotension, and patients with hypotension and chest pain related to their SVT are classified as unstable.2,3 The International Liaison Committee on Resuscitation (ILCOR) and other international guidelines recommend synchronised cardioversion as the firstline emergency treatment for persons with unstable SVTs.2–4 Specifically, more than a quarter (253/882; 28.7%) of patients were hypotensive and there-
fore unstable and were candidates for synchronised cardioversion as per the recommendations of ILCOR, the Australian Resuscitation Council and the American Heart Association. 1–3 Furthermore, 410/882 (46.5%) patients complained of pain that was associated with their SVT, and because chest pain is a sign of instability, cardioversion was indicated for most of these chest pain patients, too. As so many patients with chest pain and/or hypotension were noted in
© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Emergency Medicine Australasia (2015) 27, 273–278
LETTERS TO THE EDITOR
Get the DRIFT for great discharge summaries Dear Editor, We appreciated the excellent systematic review by Wimsett et al. regarding the components of a good quality discharge summary1 and the related blog post2 providing guidance on the quality of discharge summaries. We are involved in the training of undergraduate medical students and have some specific responsibilities for general practice (NY) and emergency medicine (VB) rotations and aim to guide students’ referral documentation skills within these practice contexts. During the general practice rotation students undertake an exercise in which they watch a 14 min video of an ED consultation, then have 6 min to write a discharge letter back to the GP. Results in previous years have been poor in terms of the information being included. Using the systematic review results, we developed an acronym to guide their documentation – ‘DRIFT’ (Fig. 1). In February 2015 the student
Discharge diagnosis Rx received
students in both general practice and ED rotations to write referral letters and discharge summaries to each other, hence reinforcing these important skills.
Ix done (and results if relevant) Competing interests Follow up required Team involved Figure 1. DRIFT. Ix, investigations; Rx, treatment.
exercise was undertaken again but with the inclusion of the acronym. One hundred per cent of the cohort included all the elements of DRIFT (and most included more). Although not claiming any scientific rigour in our methodology, we offer this as a practical application of the published systematic review. Our next steps are to use this template for formative assessment and to design an exercise that requires
None declared.
References 1. Wimsett J, Harper A, Jones P. Review article: Components of a good quality discharge summary: a systematic review. Emerg. Med. Australas. 2014; 26: 430–8. 2. Cadogan M. Life in the fast lane. 2014. [Cited 11 Feb 2015.] Available from URL: http://cdn.lifeinthefastlane .com/wp-content/uploads/2015/01/ emm12285-sup-0002-si.pdf
Natasha YATES and Victoria BRAZIL Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia doi: 10.1111/1742-6723.12395
Underutilisation of synchronised cardioversion Dear Editor, It is with interest that I read the paper by Smith et al., a study that describes the out-of-hospital epidemiology of supraventricular tachycardia (SVT) in Victoria, Australia.1 In this paper, only four out of 882 study patients with SVT received synchronised cardioversion, with a 100% success rate. The use of electrical cardioversion in this study was lower than anticipated, with only 0.3% of patients receiving this electrical therapy. One would expect the use of
cardioversion to be higher than 0.3%, because a large fraction of the study sample had chest pain and/or hypotension, and patients with hypotension and chest pain related to their SVT are classified as unstable.2,3 The International Liaison Committee on Resuscitation (ILCOR) and other international guidelines recommend synchronised cardioversion as the firstline emergency treatment for persons with unstable SVTs.2–4 Specifically, more than a quarter (253/882; 28.7%) of patients were hypotensive and there-
fore unstable and were candidates for synchronised cardioversion as per the recommendations of ILCOR, the Australian Resuscitation Council and the American Heart Association. 1–3 Furthermore, 410/882 (46.5%) patients complained of pain that was associated with their SVT, and because chest pain is a sign of instability, cardioversion was indicated for most of these chest pain patients, too. As so many patients with chest pain and/or hypotension were noted in
© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
