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Aim: To assess the equity of care of patients with non-traumatic dental presentations (NTDP) to Christchurch Emergency Department (ED) in Aotearoa New Zealand., Methods: This retrospective observational study reviews NTDP to Christchurch ED over a 2-year period (2018-2020). ED and hospital outcomes were compared for Māori, Pacific peoples and NZ Europeans. Results are interpreted utilising Te Ao Māori principles and discussed referencing a Kaupapa Māori framework., Results: There were a total of 2,034 NTDPs, with Māori (27.0%) and Pacific peoples (6.9%) being over-represented compared to local population estimates (9.4% and 3.2% respectively). Māori experienced shorter wait times (45 minutes, 95% CI 22-86) compared to NZ Europeans (56 minutes, 95% CI 24-97) and Pacific peoples (54 minutes, 95% CI 23-97). Māori had the highest age-standardised incidence of admission, but shorter hospital length of stay (0.9 days, IQR 0.4-2.3) compared to Pacific peoples (3.8 days, IQR 1.8-3.9) and NZ Europeans (2.0 days, IQR 1.0-3.7)., Conclusion: This is the first paper to employ a Kaupapa Māori approach examining NTDP patients presenting to the ED. While outcome measures were largely positive, differences in demographic variables indicate upstream failures, specifically barriers to accessing primary oral healthcare and a paucity of Kaupapa Māori initiatives. Further action and accountability are required to provide high-quality, equitable care for Māori., Competing Interests: Nil., (© PMA.)

Aims: Emergency departments (EDs) around the world are increasingly overcrowded, which is associated with significant patient harm. Alcohol use is a known contributor to ED overcrowding. This study aimed to assess trends in the characteristics of alcohol-related ED presentations over time., Methods: A cross-sectional observational study of Christchurch ED attendances during 3-week waves of data collection in November-December 2013, 2017 and 2022 was conducted. Potential participants were those patients attending the Christchurch Hospital ED who had ingested alcohol in the 4 hours prior to arrival, and/or the presentation was thought to be related to alcohol. Those who consented to take part were interviewed to examine amount and source of alcohol., Results: There has been a change in the age profile towards a greater proportion of older patients attending the ED with alcohol-related issues. In 2022, a greater proportion of alcohol was purchased from on-licence venues compared to previous years, although off-licence alcohol purchase and consumption in private locations remained the most common., Conclusion: Alcohol use and harm places a significant, yet preventable, burden on EDs and the wider healthcare system. Implementation of evidence-based alcohol policies is urgently needed to reduce the impact of alcohol in the ED and improve the health of communities., Competing Interests: None to declare., (© PMA.)

Aims: To examine reported levels of violence and aggression within a tertiary level emergency department in New Zealand, and to compare incident reporting within a dedicated yearly audit period to standard organisational reporting procedures., Method: A prospective, longitudinal cohort study involving repeated yearly audits of violence and aggression reported by emergency department staff from 2014-2020., Results: Episodes of violence and aggression were reported at high levels during audit months compared to standard reporting, suggesting current systems do not accurately reflect the presence of violence and aggression. Levels of reported violence and aggression remained relatively static over a seven-year period, despite increasing emergency department attendances. Most events reported involved verbal abuse from patients, and occurred on weekend and night shifts. A number of potentially contributing factors were identified., Conclusions: Persistently higher levels of violence and aggression were reported during the targeted audit months, while reporting via the organisation's formal system during the intervening months remained at low levels. Further research is essential to monitor trends, assess the effectiveness of interventions to improve reporting, modify factors contributing to violence and aggression, and to address the impact on staff and bystanders affected in emergency departments., Competing Interests: Nil.