James E Andruchow, Timothy Boyne, Isolde Seiden-Long, Dongmei Wang, Shabnam Vatanpour, Grant Innes, Andrew D McRae
OBJECTIVE: Both 1- and 2-hour rapid diagnostic algorithms using high-sensitivity troponin (hs-cTn) have been validated to diagnose acute myocardial infarction (MI), leaving physicians uncertain which algorithm is preferable. The objective of this study was to prospectively evaluate the diagnostic performance of 1- and 2-hour algorithms in clinical practice in a Canadian emergency department (ED). METHODS: ED patients with chest pain had high-sensitivity cardiac troponin-T (hs-cTnT) collected on presentation and 1- and 2-hours later at a single academic centre over a 2-year period...
July 6, 2020: CJEM
Rodrick Lim, Huma Ali, Rachel Gagnier, Michelle Marlborough, Sandra Northcott
No abstract text is available yet for this article.
July 3, 2020: CJEM
Keerat Grewal, Laveena Munshi, Monika K Krzyzanowska
A 64-year-old male with lung cancer presents to the emergency department with one week of cough and increasing shortness of breath. At triage, his temperature is 37.3° Celsius, heart rate 106 beats per minute, blood pressure 136/80, and oxygen saturation 87% on room air, which improves to 94% with 3 L of oxygen via nasal prongs. He has a chest X-ray that demonstrates bilateral patchy infiltrates. He is treated for pneumonia with antibiotics. His respiratory status worsens, with an increasing oxygen requirement...
June 29, 2020: CJEM
Marie-Pier Lanoue, Marie-Josée Sirois, Jeffrey J Perry, Jacques Lee, Raoul Daoust, Andrew Worster, Sandrine Hegg, Pierre-Hugues Carmichael, Audrey-Anne Brousseau-Turcotte, Marcel Émond
OBJECTIVES: 1) To characterize mild, moderate, and severe fear of falling in older emergency department (ED) patients for minor injuries, and 2) to assess whether fear of falling could predict falls and returns to the ED within 6 months of the initial ED visit. METHODS: This study was part of the Canadian Emergency and Trauma Initiative (CETI) prospective cohort (2011-2016). Patients ages ≥ 65, who were independent in their basic daily activities and who were discharged from the ED after consulting for a minor injury, were included...
June 24, 2020: CJEM
Tetyana Maniuk, Garrick Mok, Nicholas Schouela, Lisa Thurgur, Michael Ho, Lisa Fischer, Shahbaz Syed
No abstract text is available yet for this article.
June 24, 2020: CJEM
Francois Lemay, Abel Vanderschuren, Judith Alain
No abstract text is available yet for this article.
June 24, 2020: CJEM
Rodrick Lim, Kristine Van Aarsen, Sara Gray, Louise Rang, Jada Fitzpatrick, Lisa Fischer
No abstract text is available yet for this article.
June 24, 2020: CJEM
Sameer Masood, Lucas B Chartier
No abstract text is available yet for this article.
June 24, 2020: CJEM
Rodrick Lim, Brittany Cameron, Sara Gray, Louise Rang, Kristine Van Aarsen
OBJECTIVES: We sought to conduct a major objective of the Canadian Association of Emergency Physicians (CAEP) Wellness Committee, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools. METHODS: An 89-question questionnaire was distributed to academic heads or wellness leads. The responses were verified by the lead author to ensure that the questions were answered completely and consistently. RESULTS: While formal wellness programs may exist in varying degrees across the 17 universities, most were found to exist only at local, divisional, or departmental levels...
June 23, 2020: CJEM
Brit Long, Elisha Targonsky, Alex Koyfman
A 63-year-old female patient presents with abdominal pain, vomiting, and abdominal distention. She has previously had a cholecystectomy and hysterectomy. She has had no prior similar episodes, and denies fever, hematemesis, or diarrhea. She takes no medications. Vital signs include blood pressure 123/61 mm Hg, heart rate 97, oral temperature 37.2°C, respiratory rate 18, oxygen saturation 97% on room air. Her abdomen is diffusely tender and distended.
June 22, 2020: CJEM
Andrew Healey, Murdoch Leeies, Carmen Hrymak, Alecs Chochinov, Brian Grunau, Bojan Paunovic, Jeanne Teitelbaum, Lindsay C Wilson, Sam D Shemie
The primary purpose of this statement is to improve neuroprognostication after devastating brain injury (DBI), with a secondary benefit of potential organ and tissue donation.
June 19, 2020: CJEM
Matthew E M Yeung, Colin G Weaver, Kevin Janz, Rebecca Haines-Saah, Eddy Lang
OBJECTIVES: Non-medical cannabis recently became legal for adults in Canada. Legalization provides opportunity to investigate the public health effects of national cannabis legalization on presentations to emergency departments (EDs). Our study aimed to explore association between cannabis-related ED presentations, poison control and telemedicine calls, and cannabis legalization. METHODS: Data were collected from the National Ambulatory Care Reporting System from October 1, 2013, to July 31, 2019, for 14 urban Alberta EDs, from Alberta poison control, and from HealthLink, a public telehealth service covering all of Alberta...
June 19, 2020: CJEM
Alecs Chochinov
No abstract text is available yet for this article.
June 15, 2020: CJEM
Nadine Reid, Lucas B Chartier, Aaron Orkin, Michelle Klaiman, Kendra Naidoo, Vicky Stergiopoulos
No abstract text is available yet for this article.
June 15, 2020: CJEM
Gerhard Dashi
"So, how is your trip?" they ask excitedly over the phone. "Very interesting. We went to the mountains," I reply, changing the topic from what I know they want to hear. They humour me, ask me about the monkeys, before my sister rephrases my mother's initial question, "What about the hospital? How is the work?"
June 15, 2020: CJEM
William T Davis, Michael D April, Sumeru Mehta, Brit Long, Gregory Boys, Steven Shroyer
OBJECTIVES: The aim of this study was to describe the sensitivity of various C-reactive protein (CRP) cut-off values to identify patients requiring magnetic resonance imaging evaluation for pyogenic spinal infection among emergency department (ED) adults presenting with neck or back pain. METHODS: We prospectively enrolled a convenience series of adults presenting to a community ED with neck or back pain in whom ED providers had concern for pyogenic spinal infection in a derivation cohort from 2004 to 2010 and a validation cohort from 2010 to 2018...
June 15, 2020: CJEM
Nicholas Prudhomme, Michael O'Brien, Meghan M McConnell, Nancy Dudek, Warren J Cheung
OBJECTIVES: The Emergency Medicine (EM) Specialty Committee of the Royal College of Physicians and Surgeons of Canada (RCPSC) specifies that resuscitation entrustable professional activities (EPAs) can be assessed in the workplace and simulated environments. However, limited validity evidence for these assessments in either setting exists. We sought to determine if EPA ratings improve over time and whether an association exists between ratings in the workplace v. simulation environment...
June 15, 2020: CJEM
Zoe Polsky, Margriet Greidanus, Anjali Pandya, W Bradley Jacobs
A 43-year-old male, with a history of chronic back pain, presents to the emergency department (ED) with acute onset chronic pain. He states he "tweaked something" and has been debilitated by back pain, radiating down both his legs, for 24 hours. He has not had a bowel movement but denies noticing any "saddle anesthesia." His clinical exam is limited by pain, and it is difficult to determine if he has objective weakness. His perineal sensation is intact, as is his sensation upon digital rectal examination...
June 10, 2020: CJEM
Jessica A Harper, Terry P Klassen, Robert Balshaw, Justin Dyck, Martin H Osmond
OBJECTIVES: Vomiting is common in children after minor head injury. In previous research, isolated vomiting was not a significant predictor of intracranial injury after minor head injury; however, the significance of recurrent vomiting is unclear. This study aimed to determine the value of recurrent vomiting in predicting intracranial injury after pediatric minor head injury. METHODS: This secondary analysis of the CATCH2 prospective multicenter cohort study included participants (0-16 years) who presented to a pediatric emergency department (ED) within 24 hours of a minor head injury...
June 9, 2020: CJEM
Daniel J Lee, Joel Lockwood, Paul Das, Ri Wang, Eitan Grinspun, John M Lee
OBJECTIVES: To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and dysgeusia/ageusia have been identified as highly prevalent symptoms, there are wide geographic variations, necessitating the regional evaluation of the prevalence of the symptoms. METHODS: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (over 18 years old) who underwent COVID-19 tests at an ambulatory assessment centre...
June 8, 2020: CJEM
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