332 results for “emergency patient transfer”
63y · Male·Hypoxic ischaemic brain injury and pneumonia complicating cardiac arrest in a ma…
…ombination of polypharmacy with QT-prolonging agents, airway obstruction, and respiratory depression in a patient with known sensitivity to sedation likely precipitated fatal arrhythmia or asphyxiation. Key lessons: psy…
73y · Male·Gregory Frank Burkhalter: carbon monoxide toxicity due to inhalation of carbon m…
…ms in the residence despite legal requirements. Clinical lessons include recognition that severely burned patients require immediate transfer to specialist burn centres, anticipation of cardiac complications in massive …
65y · Male·Ischaemic heart disease on a background of hypertension
…firmation. Meanwhile, Barker crew's paramedic phoned requesting reassignment to a lower-priority hospital transfer, which the dispatcher granted. Stirling crew (14+ minutes away) were then dispatched instead. Kennedy arr…
48y · Female·Hypoxic ischaemic encephalopathy due to pulmonary thromboembolism due to deep ve…
… risk assessment was performed despite multiple clear risk factors: immobility, obesity, and smoking. The patient had five missed opportunities for VTE risk evaluation at admission and transfer points. Systemic factors …
8y · Female·Multiple injuries sustained in collision between semi-trailer and train at level…
…reas: (1) the driver and vehicle factors, (2) level crossing infrastructure and warning systems, and (3) emergency medical response. Key clinical findings include: Mr Scholl, an experienced driver familiar with the cros…
72y · Male·acute cerebral infarction complicating acute myocardial infarction
…pert concluded that testing on either date would have identified acute coronary syndrome, enabling timely transfer for intervention with good survival prospects (70-80%). When Bromage presented again on 1 March with feve…
60y · Male·Hypertensive heart disease with chronic fatty liver as other significant conditi…
…agement of severe acute back pain caused by a suspected L3/4 disc herniation while awaiting neurosurgical transfer to Royal Brisbane Hospital. During his 9-day admission, his pain was managed with escalating doses of oxy…
88y · Female·Acute on chronic renal failure due to dehydration on a background of Lewy body d…
…ed to consider dehydration, missed-diagnosed stroke based on asymmetric tone, and mistakenly believed the patient was not for active treatment, delaying hospital transfer by 18 hours. The coroner found dehydration preve…
44y · Male·cardiogenic shock, on a background of severe tricuspid valve regurgitation, seve…
…ach institution. The coroner accepted that Mr Blundell received high-standard care identical to community patients. Key clinical lessons include recognising the inoperability of certain severe valvular diseases with pul…
35y · Female·Hypoxic-ischaemic encephalopathy due to cardiorespiratory arrest due to vertebro…
… to mental health issues. While early diagnosis may not have changed the outcome given rural location and transfer times, the discharge was inappropriate and represented a diagnostic failure due to anchoring bias and att…
25y · Female·Airway obstruction complicating laryngeal dilation for the treatment of subglott…
…ing laryngeal dilation. She was admitted to ICU with asthma exacerbation from respiratory infection, then transferred to a general ward on 20 May 2015. Critical failures included: inadequate ICU-to-ward handover lacking …
16y · Female·Adrenal insufficiency (Addison's Disease)
…e through earlier specialist referral and proper supervision of trainee doctors managing seriously unwell patients with prolonged undiagnosed illness.
61y · Male·Undetermined
…ng; and multi-drug sedation with QT-prolonging agents without adequate cardio-respiratory monitoring in a patient with pre-existing QT prolongation and sleep apnoea represented substandard care. Adherence to existing gu…
43y · Male·Multi-organ failure with coagulopathy secondary to acute exacerbation of chronic…
…signs of increased intracranial pressure. The neurosurgeon rescheduled surgery for Sunday morning but the patient suffered cardiac arrest at 4am Sunday before surgery could proceed. Clinical lessons: (1) patients with s…
64y · Female·fatal cardiac arrhythmia in a lady with obstructed sleep apnoea, obesity and suf…
…m. Despite recording hypoxia (oxygen saturation 93%) and requiring supplemental oxygen overnight, she was transferred to an aged-care psychiatric ward (Banksia Ward) the following afternoon. At 3.10 pm she received an in…
20y · Male·Ligature compression of the neck (hanging)
…Nurse Bone failed to ensure the deceased was properly sighted and documented observations at 8pm when the patient was likely already dead outside the ward. The ward was unsecured with multiple unmonitored exits. Critica…
82y · Female·traumatic closed head injury (subdural haematoma) resulting from a fall from sta…
…proving at the time of the fall. Key clinical lessons: ensure direct communication between hospitals when patients are readmitted shortly after discharge; verify discharge medication lists carefully; conduct complete ph…
75y · Male·Acute cardiac failure due to mitral valve disease (surgically treated)
…ere mitral valve regurgitation (4/4) was confirmed with progressive deterioration. After 12 hours, he was transferred to TPCH for emergency mitral valve replacement. Cardiopulmonary bypass could not be weaned; he died fr…
73y · Male·ruptured abdominal aortic aneurysm
George Hutton, a 73-year-old man with hypertension, presented to rural emergency department with sudden onset severe abdominal pain while turning his head. Clinical findings were atypic…
81y · Female·aspiration pneumonia, exacerbation of chronic obstructive airways disease (emphy…
…pus, died from aspiration pneumonia, COPD exacerbation and congestive heart failure. A critical ambulance transfer delay occurred when her initial request (5:45 am) was cancelled due to lack of staff to accompany her as …
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