Quinten S Paterson, Riley Hartmann, Rob Woods, Lynsey J Martin, Brent Thoma
OBJECTIVES: The Canadian Resident Matching Service (CaRMS) selection process has come under scrutiny due to the increasing number of unmatched medical graduates. In response, we outline our residency program's selection process including how we have incorporated best practices and novel techniques. METHODS: We selected file reviewers and interviewers to mitigate gender bias and increase diversity. Four residents and two attending physicians rated each file using a standardized, cloud-based file review template to allow simultaneous rating...
January 16, 2020: CJEM
Frank X Scheuermeyer, Monica Norena, Grant Innes, Brian Grunau, Jim Christenson, Eric Grafstein, David Barbic, Tyler Barrett
BACKGROUND: Emergency department (ED) patients with atrial fibrillation or flutter (AFF) with underlying occult condition such as sepsis or heart failure, and who are managed with rate or rhythm control, have poor prognoses. Such conditions may not be easy to identify early in the ED evaluation when critical treatment decisions are made. We sought to develop a simple decision aid to quickly identify undifferentiated ED AFF patients who are at high risk of acute underlying illness. METHODS: We collected consecutive ED patients with electrocardiogram-proven AFF over a 1-year period and performed a chart review to ascertain demographics, comorbidities, and investigations...
December 20, 2019: CJEM
Anna Sedlakova, Paul Olszynski, Philip Davis, John Froh
OBJECTIVES: Evidence suggests that prehospital point of care ultrasound (POCUS) may change patient management. It serves as an aid in triage, physical examination, diagnosis, and patient disposition. The rate of adoption of POCUS among aeromedical services throughout Canada is unknown. The objective of this study was to describe current POCUS use among Canadian aeromedical services providers. METHODS: This is a cross-sectional observational study. A survey was emailed to directors of government-funded aeromedical services bases in Canada...
December 9, 2019: CJEM
Douglas Sinclair, Peter Toth, Alecs Chochinov, John Foote, Kirsten Johnson, Jill McEwen, David Messenger, Judy Morris, Paul Pageau, David Petrie, Carolyn Snider
In June of 2016, the Collaborative Working Group (CWG) on the Future of Emergency Medicine presented its final report at the Canadian Association of Emergency Physicians (CAEP) annual meeting in Quebec City. The CWG report made a number of recommendations concerning physician Human Health Resource (HHR) shortfalls in emergency medicine, specific changes for both the Royal College of Physicians and Surgeons of Canada (FRCPC) and the College of Family Physicians of Canada (CCFP-EM) training programs, HHR needs in rural and remote hospitals, future collaboration of the CCFP-EM and FRCPC programs, and directions for future research...
November 26, 2019: CJEM
Miles Hunter, Nicholas Packer, Shawn Dowling
No abstract text is available yet for this article.
November 26, 2019: CJEM
Brent Thoma, Scott Goerzen, Timothy Horeczko, Damian Roland, Andrew Tagg, Teresa M Chan, Stevan Bruijns, Jeff Riddell
OBJECTIVES: Podcasts are increasingly being used for medical education. A deeper understanding of usage patterns would inform both producers and researchers of medical podcasts. We aimed to determine how and why podcasts are used by emergency medicine and critical care clinicians. METHODS: An international interprofessional sample (medical students, residents, physicians, nurses, physician assistants, and paramedics) was recruited through direct contact and a multimodal social media (Twitter and Facebook) campaign...
November 25, 2019: CJEM
Andrew Guy, Riley Golby, Rob Stenstrom
No abstract text is available yet for this article.
November 25, 2019: CJEM
Aaron K Sibley, Paul Atkinson, Kevin Lobay
A 16-month-old presents to the emergency department (ED) after a fall while running at home. Her mother noted some blood in the child's mouth and believed there was a tear in the skin above the front teeth.
November 15, 2019: CJEM
Justin W Yan, Tamara Spaic, Selina Liu
A 21-year-old male with known type 1 diabetes mellitus presented to the emergency department (ED) with two days of vomiting, polyuria, and polydipsia after several days of viral upper respiratory tract infection symptoms. Since his symptom onset, his home capillary blood glucose readings have been higher than usual. On the day of presentation, his glucometer read "high," and he could not tolerate oral fluids. On examination, his pulse was 110 beats/minute, and his respiratory rate was 24 breaths/minute...
November 14, 2019: CJEM
Hasan Sheikh
Oral health is an important part of an individual's overall health; however, dental care is not included in the Canadian public healthcare system. Many Canadians struggle to access dental care, and six million Canadians avoid visiting the dentist each year due to cost.1 The most vulnerable groups include children from low-income families, low-income adults, seniors, indigenous communities, and those with disabilities.1-5 The lack of affordable, equitable, and accessible dental care puts undue strain on emergency departments across the country, as patients desperately seek the care of a physician when they actually need the care of a dental professional...
November 14, 2019: CJEM
Riley Golby, Andrew Guy, Frank X Scheuermeyer
No abstract text is available yet for this article.
November 13, 2019: CJEM
Ariel Hendin, Matthew Lipinski
No abstract text is available yet for this article.
November 13, 2019: CJEM
Fabrice Mowbray, Audrey-Anne Brousseau, Eric Mercier, Don Melady, Marcel Émond, Andrew P Costa
BACKGROUND: The 2016 Canadian Triage and Acuity Scale (CTAS) updates introduced frailty screening within triage to more accurately code frail patients who may deteriorate waiting for care. The relationship between triage acuity and frailty is not well understood, but may help inform which supplemental geriatric assessments are beneficial to support care in the emergency department (ED). Our objectives were to investigate the relationship between triage acuity and frailty, and to compare their associations with a series of patient outcomes...
November 13, 2019: CJEM
Weiwei Beckerleg, Krista Wooller, Delvina Hasimjia
OBJECTIVES: Overcrowding in the emergency department (ED) is associated with increased morbidity and mortality. Studies have shown that consultation to decision time, defined as the time when a consultation has been accepted by a specialty service to the time when disposition decision is made, is one important contributor to the overall length of stay in the ED.The primary objective of this review is to evaluate the impact of workflow interventions on consultation to decision time and ED length of stay in patients referred to consultant services in teaching centres, and to identify barriers to reducing consultation to decision time...
November 12, 2019: CJEM
Brett H Shaw, Marshall Ross
No abstract text is available yet for this article.
November 12, 2019: CJEM
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
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