Nicholas M Levin, Megan L Fix, Michael D April, Allyson A Arana, Calvin A Brown
BACKGROUND: The recommended rocuronium dose for rapid sequence intubation is 1.0 mg/kg; however, the optimal dose for emergency airway management is not clear. We assessed the relationship between rocuronium dose and first-attempt success among emergency department (ED) patients undergoing rapid sequence intubation. METHODS: This is a secondary analysis of the National Emergency Airway Registry (NEAR), an observational 25-center registry of ED intubations. Ninety percent recording compliance was required from each site for data inclusion...
April 10, 2021: CJEM
Robin Lennox, Kathryn Chan, Lauren Cook-Chaimowitz, Kathryn Dong
No abstract text is available yet for this article.
April 9, 2021: CJEM
Aleksandar Trajkovski, Eddy Lang
No abstract text is available yet for this article.
April 9, 2021: CJEM
Robert Ohle, Nicholas Fortino, Sarah McIsaac, Aaron Regis, Owen Montpellier, Mackenzie Ludgate, Owudami Bolunde, Cait Dmitriew
INTRODUCTION: The Canadian clinical practice guidelines propose a novel diagnostic pathway incorporating a clinical decision tool and D-dimer to aid in risk stratifying patients for acute aortic syndrome. The objective of this study was to assess if implementation of a diagnostic pathway incorporating D-dimer would increase the usage of D-dimer and computed tomography (CT) in a tertiary care emergency department. METHODS: Prospective single centre before and after study-recruiting patients over a 6-week period from a tertiary care emergency department...
April 6, 2021: CJEM
Nicole Kester-Greene, Caroline Filipowska, Heather Heipel, Gerhard Dashi, Dominique Piquette
OBJECTIVES: To describe postgraduate emergency medicine (EM) residents' perceptions of simulation-based curriculum immediately post-simulation training. METHODS: This interpretive qualitative study explores residents' reflections on a city-wide, adult EM simulation-based curriculum. Focus group interviews gather residents' insights immediately post-simulation. Postgraduate trainees from the University of Toronto EM residency program were eligible to participate...
April 6, 2021: CJEM
Ian G Stiell, Elisha Targonsky, Frank Scheuermeyer
No abstract text is available yet for this article.
April 6, 2021: CJEM
Jonathan Neilipovitz, Hans Rosenberg, Swapnil Hiremath, David W Savage, Robert Ohle, Amer Alaref, Krishan Yadav, Paul Atkinson
No abstract text is available yet for this article.
April 3, 2021: CJEM
Seraph L Bao, Shannon Erdelyi, Herbert Chan, Leona K Shum, John A Staples, Jeffrey R Brubacher
OBJECTIVE: Social assistance helps fulfill the basic needs of low-income individuals. In British Columbia, social assistance is issued on the third or fourth Wednesday of every month. However, this sudden influx of resources may have negative health consequences. We investigated social assistance timing and emergency department (ED) visits related to trauma, mental health, and substance use. METHODS: We conducted a retrospective multi-centre observational study using 12 years of regional ED data from Vancouver, British Columbia (2008-2020)...
April 1, 2021: CJEM
Krista Dowhos, Jonathan Sherbino, Teresa M Chan, Alim Nagji
Attendance at faculty development events are often limited to those with time and interest, but all clinical teachers should have access to continuing faculty development. A multi-channel, asynchronous, digital faculty experience strategy (MAX FacDev) was used to engage busy emergency medicine (EM) teachers associated with a distributed medical education network involving ten geographically distinct teaching sites. An evidence-informed education bundle on key principles for clinical teaching was developed. The education bundle included five topics, serialized via: an infographic series posted in distributed medical education EM departments, a podcast series and a blog...
March 31, 2021: CJEM
V Brannan, C L Dunne, A Dubrowski, M H Parsons
Tube thoracostomy is a high-acuity, low-occurrence (HALO) procedure with significant morbidity when performed incorrectly; this is amendable through simulation. Commercially available trainers exist but often have limited realism or exorbitant cost. Three-dimensional (3D) printing produces realistic and cost-effective models suitable for simulation, but no simulator has been developed for tube thoracostomy. The aim of this paper is to describe the initial development of a multifunctional 3D-printed thorax trainer for the instruction of tube thoracostomy...
March 30, 2021: CJEM
Michael K Y Wong, Paul Olszynski, Warren J Cheung, Paul Pageau, David Lewis, Charisse Kwan, Michael Y Woo
No abstract text is available yet for this article.
March 29, 2021: CJEM
Joseph Levi, Tara Stansbury, Matthew D Marschall, Jamie Allen, Andrew Steele, Lauren M Crowley, Kristine L Schultz, Kevin R Weaver, Yee Cheng Low, Jeanne L Jacoby
No abstract text is available yet for this article.
March 25, 2021: CJEM
Frank X Scheuermeyer, Elisha Targonsky, Ian Stiell
No abstract text is available yet for this article.
March 25, 2021: CJEM
Kia Dullemond, Colby Renschler, Jan Trojanowski, Frank Scheuermeyer, Rob Stenstrom, Donald Griesdale, Ruth MacRedmond, Elan Nattrass, Lena Farina, Jeff Yoo
No abstract text is available yet for this article.
March 22, 2021: CJEM
Sean Hurley, Mete Erdogan, Nelofar Kureshi, Patrick Casey, Matthew Smith, Robert S Green
OBJECTIVES: To perform a province-wide evaluation of adult major traumas and determine the proportion of patients who met clinical and/or anatomical criteria for resuscitative endovascular balloon occlusion of the aorta (REBOA). METHODS: This is a retrospective analysis of all major trauma patients (age > 16) presenting to the sole adult level 1 trauma centre in Nova Scotia over a 5-year period (2012-2017). Data were collected from the Nova Scotia Trauma Registry and medical charts...
March 22, 2021: CJEM
Robin Clouston, Paul Atkinson, Donaldo D Canales, Jacqueline Fraser, Dylan Sohi, Scott Lee, Michael Howlett
INTRODUCTION: Emergency department (ED) crowding compromises patient outcomes. Existing crowding measures are complex and difficult to use in real-time. This study evaluated readily available single flow variables as crowding measures. METHODS: Over 2 weeks in a tertiary Canadian ED, we recorded the following potential crowding measures during 168 consecutive two-hour study intervals: total ED patients (census), patients in beds, patients in waiting rooms, patients in treatment areas awaiting MD assessment; number of inpatients boarding, and ED occupancy...
March 21, 2021: CJEM
Myla E Moretti, Wendy J Ungar, Stephen B Freedman, Suzanne Schuh
BACKGROUND: While electrolyte maintenance solution is recommended and commonly used in pediatric gastroenteritis, it can be more costly and less palatable than preferred fluids such as apple juice. OBJECTIVE: To assess the incremental cost-effectiveness of apple juice/preferred fluids versus electrolyte maintenance solution in reducing treatment failures in children in an emergency department from societal and health care perspectives. METHODS: A probabilistic cost-effectiveness analysis was performed using clinical trial and chart data...
March 21, 2021: CJEM
Harrison Carmichael, Christian Vaillancourt, Ian Shrier, Manya Charette, Elisabeth Hobden, Ian G Stiell
OBJECTIVES: We sought to compare the ability of the prehospital Canadian C-Spine Rule to selectively recommend immobilization in sport-related versus non-sport-related injuries and describe sport-related mechanisms of injury. METHODS: We reviewed data from the prospective paramedic Canadian C-Spine Rule validation and implementation studies in 7 Canadian cities. A trained reviewer further categorized sport-related mechanisms of injury collaboratively with a sport medicine physician using a pilot-tested standardized form...
March 15, 2021: CJEM
A Zohaib Siddiqi, Daniel Grigat, Shabnam Vatanpour, Andrew McRae, Eddy S Lang
BACKGROUND: In 2016, based on recommendations of the American Association of Blood Banks (AABB), Choosing Wisely Canada released transfusion guidelines for patients with Iron Deficiency Anemia. The goal of the present study was to examine the number of transfusions given in Calgary emergency departments (EDs) before and after the release of these guidelines. METHODS: We analyzed 11,786 anemia encounters from January 2014 to December 2019. A transfusion was considered potentially avoidable if the patient's hemoglobin was > 70 g/L and if the patient was hemodynamically stable...
March 15, 2021: CJEM
Brenton M Wong, Jeffrey J Perry, Wei Cheng, Bo Zheng, Kevin Guo, Monica Taljaard, Allan C Skanes, Ian G Stiell
BACKGROUND: Recent studies have presented concerning data on the safety of cardioversion for acute atrial fibrillation and flutter. We conducted this meta-analysis to evaluate the effect of oral anticoagulation use on thromboembolic events post-cardioversion of low-risk acute atrial fibrillation and flutter patients of < 48 h in duration. METHODS: We searched MEDLINE, Embase, and Cochrane from inception through February 6, 2020 for studies reporting thromboembolic events post-cardioversion of acute atrial fibrillation and flutter...
March 14, 2021: CJEM
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