John M Tallon, Lu Zheng, Julie Wei, William Dick, George Papadopoulos, Ognjenka Djurdjev
BACKGROUND: Resource allocation planning for emergency medical services (EMS) systems determines appropriate resources including what paramedic qualification and how rapidly to respond to patients for optimal outcomes. The British Columbia Emergency Health Services implemented a revised response plan in 2013. METHODS: A pre- and post-methodology was used to evaluate the effect of the resource allocation plan revision on 24-hour mortality. All adult cases with evaluable outcome data (obtained through linked provincial health administrative data) were analyzed...
October 29, 2019: CJEM
Hugo Langlois, Monique Cormier, Eric Villeneuve, Robert S Hoffman, Cristina Longo, Sophie Gosselin
OBJECTIVES: Although alcohol withdrawal is common, the recognition of benzodiazepine-resistant alcohol withdrawal is a relatively new concept. To provide a framework for both literature review and future research, we assessed clinicians' personal definition of resistant alcohol withdrawal. METHOD: We developed a cross-sectional web-based survey. Administrators from collaborating toxicology and emergency medicine associations deployed the survey directly to their respective memberships...
October 24, 2019: CJEM
Jonathon Nataraj, James Stempien, Stuart Netherton, Mark Yosri Wahba, Taofiq Olusegun Oyedokun
OBJECTIVE: HealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system. METHODS: A list of callers referred from HealthLine to Saskatoon EDs from January 1, 2014, to March 31, 2014 was obtained...
October 24, 2019: CJEM
Brian Deady
No abstract text is available yet for this article.
October 24, 2019: CJEM
Carolyn E Snider, Depeng Jiang, Sarvesh Logsetty, Wanda Chernomas, Elaine Mordoch, Carla Cochrane, Jamil Mahmood, Heather Woodward, Terry P Klassen
OBJECTIVES: To determine feasibility and efficacy of an Emergency Department Violence Intervention Program (EDVIP) to reduce violence related injuries in youth. METHODS: One hundred and thirty youth aged 14-24 presenting to an emergency with violence related injury were randomized in parallel to receive EDVIP for 1 year (n = 65) or a waitlist control (n = 65). The primary outcome was to determine feasibility. Secondary outcomes are incidence, number/severity of repeat violence related injury, justice and education systems interactions, substance misuse and mental health presentations, and ED length of stay (LOS)...
October 24, 2019: CJEM
Leo R Carroll
No abstract text is available yet for this article.
October 1, 2019: CJEM
Cameron W Leafloor, Patrick Jiho Hong, Muhammad Mukarram, Lindsey Sikora, Jesse Elliott, Venkatesh Thiruganasambandamoorthy
INTRODUCTION: Long-term outcomes among syncope patients are not well studied to guide physicians regarding outpatient testing and follow-up. The objective of this study was to conduct a systematic review for outcomes at 1-year or later among ED syncope patients. METHODS: We searched Cochrane Central, Medline, Medline in Process, PubMed, Embase, and the Cumulative Index to Nursing databases from inception to December 2018. We included studies that reported long-term outcomes among ED syncope patients...
October 1, 2019: CJEM
Nicole Beckett, Paul Atkinson, Jacqueline Fraser, Ankona Banerjee, James French, Jo-Ann Talbot, George Stoica, David Lewis
OBJECTIVES: Point-of-care ultrasound (POCUS) is used increasingly during resuscitation. The aim of this study was to assess whether combining POCUS and electrocardiogram (ECG) rhythm findings better predicts outcomes during cardiopulmonary resuscitation in the emergency department (ED). METHODS: We completed a health records review on ED cardiac arrest patients who underwent POCUS. Primary outcome measurements included return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge...
September 30, 2019: CJEM
Leizl Joy Nayahangan, Lars Konge
No abstract text is available yet for this article.
September 30, 2019: CJEM
Margaret Hull
No abstract text is available yet for this article.
September 30, 2019: CJEM
Samuel G Campbell, Sean Teed
No abstract text is available yet for this article.
September 26, 2019: CJEM
Timothy Chaplin, Brent Thoma, Andrew Petrosoniak, Kyla Caners, Tamara McColl, Chantal Forristal, Christa Dakin, Jean-Francois Deshaies, Eliane Raymond-Dufresne, Mary Fotheringham, David Ha, Nicole Holm, James Huffman, Ann-Marie Lonergan, George Mastoras, Michael O'Brien, Marie-Rose Paradis, Nicholas Sowers, Errol Stern, Andrew K Hall
OBJECTIVE: Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM). METHODS: Simulation-leads from Canadian departments or divisions of EM associated with a general FRCP-EM training program surveyed and documented active EM simulation-based research at their institutions and identified the perceived facilitators and barriers...
September 26, 2019: CJEM
John Tuinema, Aaron M Orkin, Stephanie Y Cheng, Kinwah Fung, Fiona G Kouyoumdjian
OBJECTIVES: The aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare with ED utilization for the general population. METHODS: We linked correctional and health administrative data for people released from provincial prison in Ontario in 2010. We matched each person by age and sex with four people in the general population. We compared ED utilization rates using generalized estimating equations, by sex and for high urgency and ambulatory care sensitive conditions...
September 17, 2019: CJEM
Vanessa Rojas-Luengas, Bianca Seaton, Katie Dainty, Shelley McLeod, Catherine Varner
OBJECTIVE: The purpose of this qualitative study was to explore the experiences and perceptions of care of women treated for early pregnancy complications in a Canadian emergency department (ED) and early pregnancy clinic (EPC). METHODS: We conducted a descriptive qualitative study to understand the perceptions, meanings, and perspectives of women of 18 years and older who presented to the ED or EPC of an urban, tertiary care hospital with early pregnancy complications or loss...
September 16, 2019: CJEM
Andrew K Hall, Rob Woods, Jason R Frank
No abstract text is available yet for this article.
September 16, 2019: CJEM
Sarah Felder, Kristine VanAarsen, Matthew Davis
INTRODUCTION: Four percent of ST-elevation myocardial infarctions (STEMIs) are complicated by an out-of-hospital cardiac arrest (OHCA). Research has shown that shorter time to initial defibrillation in patients with ventricular fibrillation/tachycardia (VF/VT) arrests increases favourable neurologic survival. The purpose of this study is to determine whether routine application of defibrillation pads in patients with prehospital STEMI decreases the time to initial defibrillation in those who suffer OHCA...
August 30, 2019: CJEM
Saahil Vij, Amy Burton, Heather Murray, Melanie Walker
No abstract text is available yet for this article.
August 30, 2019: CJEM
Isabelle H Miles, Russell D MacDonald, Sean W Moore, James Ducharme, Christian Vaillancourt
OBJECTIVES: With regionalized trauma care, medical transport times can be prolonged, requiring paramedics to manage patient care and symptoms. Our objective was to evaluate pain management during air transport of trauma patients. METHODS: We conducted a 12-month review of electronic paramedic records from a provincial critical care transport agency. Patients were included if they were ≥18 years old and underwent air transport to a trauma centre, and excluded if they were Glasgow Coma Scale score <14, intubated, or accompanied by a physician or nurse...
August 20, 2019: CJEM
Nicholas Packer, Miles Hunter, Shawn Dowling
No abstract text is available yet for this article.
August 20, 2019: CJEM
Aaron Johnston, Kylie Booth, Jim Christenson, David Fu, Shirley Lee, Yasmine Mawji, Doug Myhre, Etienne van der Linde, Eddy Lang
OBJECTIVES: Make recommendations on approaches to building and strengthening relationships between academic departments or divisions of Emergency Medicine and rural and regional emergency departments. METHODS: A panel of leaders from both rural and urban/academic practice environments met over 8 months. Draft recommendations were developed from panel expertise as well as survey data and presented at the 2018 Canadian Association of Emergency Physicians (CAEP) Academic Symposium...
September 2019: CJEM
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