Ann-Maree Lynch

University of Western Australia, Perth City, Western Australia, Australia

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Publications (4)7.69 Total impact

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    ABSTRACT: To characterise the phenomena of paediatric frequent attenders (FAs) to emergency departments (EDs) in Perth. A linked data population study of all children (<15 years) attending Perth hospital EDs between 1 July 2000 and 31 December 2006. FAs attending five or more times annually were assessed for demographic characteristics, mode of arrival, urgency, clinical conditions and disposition by frequency of attendance. Over 6.5 years, 229, 883 children contributed to 378, 068 annualised chains of events (mean 1.5). Most children (98.2%) attended EDs less than five times a year. The more frequently children attended, the more likely they were to be male, younger, self-referred, have respiratory or infectious disorders, and to arrive by ambulance. Characteristics of those attending 0-4 (n= 371 171) and 5-9 (n= 6405) times per year were broadly similar, while those attending 10-19 times per year (n= 461) were more urgent, had a higher frequency of respiratory disease and higher admission rates (all P < 0.001). Those attending more than 20 times a year (n= 31) had serious chronic illness. Frequent attenders of 5-9 times a year may be no sicker or more in need of hospital services than those who attend less frequently. The preponderance of respiratory and infectious disorders across all FA groups suggests these could be the focus of further research. We advocate a holistic approach to take into account parental expectations, and a systems approach to change ED attendance behaviour.
    Journal of Paediatrics and Child Health 12/2010; 46(12):723-8. · 1.25 Impact Factor
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    ABSTRACT: To evaluate cases of suspected drink spiking presenting to the ED by the prospective collection of standardized relevant historical, clinical and laboratory data. A prospective observational study of 101 patients presenting to metropolitan hospital ED with suspected drink spiking within the previous 12 h. Clinical history, including details surrounding the alleged drink spiking incident, and examination. Blood ethanol concentration measurement, together with the analysis of urine and blood samples for illicit and sedative drugs. Of the 97 alleged drink spiking cases included, there were only 9 plausible cases. We did not identify a single case where a sedative drug was likely to have been illegally placed in a drink in a pub or nightclub. Illicit drugs were detected in 28% of the study group. Ethanol was commonly detected, with the mean number of standard drinks consumed being 7.7 +/- 3.9 SD, and the median blood ethanol concentration at the time of presentation was 0.096% (96 mg/dL). At follow-up there were no major sequelae and no police prosecutions. Thirty five per cent of patients still believed that they had been a victim of drink spiking irrespective of the results. Our study did not reflect the current public perception of drink spiking. Drink spiking with sedative or illicit drugs appears to be rare. If drink spiking does occur, ethanol appears to be the most common agent used. Of greater concern was the frequency of illicit drug use and excessive ethanol consumption within the study population, making it difficult to determine whether a person had truly had a drink spiked.
    Emergency medicine Australasia: EMA 07/2009; 21(3):222-8. · 0.99 Impact Factor
  • Ann-Maree Lynch, Bridgett McKay, Lindsay Murray
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    ABSTRACT: Cases of unintentional pediatric ingestions of oral contraceptive pills are commonly reported to Poison Information Centers (PICs). No study had examined clinical outcomes in the past 30 years, although the hormone content of these preparations has been substantially reduced. We assessed short-term outcomes to determine the relevance of advice provided, particularly that vaginal bleeding can occur. Prospective observational study of cases reported to a state PIC were followed up over a 5-month period. There were 63 cases with complete follow-up, average age was 2 years and 10 months; 65% of the patients were female. Median number of pills ingested was 5.0 [Interquartile Range (IQR) 3-16.5]. Minor symptoms including vomiting and irritability were reported in 44% of cases. No case of vaginal bleeding was reported. No major clinical effects and no instances of vaginal bleeding were reported.
    Clinical Toxicology 12/2008; 47(2):174-7. · 2.59 Impact Factor
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    ABSTRACT: To examine the characteristics of adult patient attendances to emergency departments (EDs) in Perth hospitals by patients' frequency of attendance. A linked-data population study of adults (aged > or = 15 years) attending all nine Perth hospital EDs between 1 July 2000 and 31 December 2006. Proportion of frequent attenders (FAs; those attending five or more times annually); and demographic characteristics, mode of arrival at the ED, disposition (admission, transfer, discharge or death), urgency and clinical conditions by frequency of attendance. There was a mean of 1.5 attendances per individual per year, resulting in 1 583 924 attendances by 663 309 individuals over the 6.5 years of the study. Most patients (97.6%) attended Perth EDs fewer than five times a year. The more frequently patients attended, the more likely they were to be male, middle-aged and late-middle-aged, have self-referred, have mental and behavioural disorders and alcohol intoxication, to not wait to be assessed, and to arrive by ambulance. The groups of patients attending between 5-9 and 10-19 times per year (97.4% of FAs) had more urgent conditions, more circulatory system disease and higher admission rates than all other patients. Most FAs at Perth EDs present fewer than 20 times a year and have more serious and urgent illness than other patients, more often requiring inpatient services. A very small minority of patients (around 100 patients/year) attends 20 or more times a year, many with mental and behavioural disorders and alcohol intoxication not requiring hospital admission.
    The Medical journal of Australia 11/2008; 189(10):552-6. · 2.85 Impact Factor