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CJEM

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https://www.readbyqxmd.com/read/28077195/evidence-based-medicine-in-the-era-of-social-media-scholarly-engagement-through-participation-and-online-interaction
#1
Teresa Chan, N Seth Trueger, Damian Roland, Brent Thoma
The integration of new knowledge into clinical practice continues to lag behind discovery. The use of Free Open Access Medical education (FOAM) has disrupted communication between emergency physicians, making it easy for practicing clinicians to interact with colleagues from around the world to discuss the latest and highest impact research. FOAM has the potential to decrease the knowledge translation gap, but the concerns raised about its growing influence are 1) research that is translated too quickly may cause harm if its findings are incorrect; 2) there is little editorial oversight of online material; and 3) eminent online individuals may develop an outsized influence on clinical practice...
January 12, 2017: CJEM
https://www.readbyqxmd.com/read/28069098/bolus-dose-of-epinephrine-for-refractory-post-arrest-hypotension
#2
Michael Gottlieb
Post-cardiac arrest hypotension is associated with worse outcomes. However, a significant proportion of patients may not be responsive to intravenous (IV) fluids, and vasopressor infusions require significant time to initiate. This case series describes the successful use of a bolus dose of epinephrine to rapidly treat IV fluid refractory hypotension among three patients in the post-arrest period. A bolus dose of epinephrine may be considered as a treatment for post-arrest hypotension that does not respond to IV fluids, but further studies should be performed prior to routine use...
January 10, 2017: CJEM
https://www.readbyqxmd.com/read/28067181/pediatric-information-seeking-behaviour-information-needs-and-information-preferences-of-health-care-professionals-in-general-emergency-departments-results-from-the-translating-emergency-knowledge-for-kids-trekk-needs-assessment
#3
Shannon D Scott, Lauren Albrecht, Lisa M Given, Lisa Hartling, David W Johnson, Mona Jabbour, Terry P Klassen
: The majority of children requiring emergency care are treated in general emergency departments (EDs) with variable levels of pediatric care expertise. The goal of the Translating Emergency Knowledge for Kids (TREKK) initiative is to implement the latest research in pediatric emergency medicine in general EDs to reduce clinical variation. OBJECTIVES: To determine national pediatric information needs, seeking behaviours, and preferences of health care professionals working in general EDs...
January 9, 2017: CJEM
https://www.readbyqxmd.com/read/28065207/text-messaging-research-participants-as-a-follow-up-strategy-to-decrease-emergency-department-study-attrition
#4
Catherine Varner, Shelley McLeod, Negine Nahiddi, Bjug Borgundvaag
OBJECTIVE: Collecting patient-reported follow-up data for prospective studies in the emergency department (ED) is challenging in this minimal continuity setting. The objective of this study was to determine whether text messaging study participants involved in an ongoing randomized trial resulted in a lower rate of attrition as compared to conventional telephone follow-up. METHODS: This was a nested cohort analysis of research participants enrolled in a randomized controlled trial assessing head injury discharge instructions...
January 9, 2017: CJEM
https://www.readbyqxmd.com/read/27998322/international-federation-for-emergency-medicine-consensus-statement-sonography-in-hypotension-and-cardiac-arrest-shoc-an-international-consensus-on-the-use-of-point-of-care-ultrasound-for-undifferentiated-hypotension-and-during-cardiac-arrest
#5
Paul Atkinson, Justin Bowra, James Milne, David Lewis, Mike Lambert, Bob Jarman, Vicki E Noble, Hein Lamprecht, Tim Harris, Jim Connolly
: Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest. METHODS: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol...
December 21, 2016: CJEM
https://www.readbyqxmd.com/read/27993182/young-man-with-persistent-calf-pain
#6
Regan F Lyon, Kristen Kann
No abstract text is available yet for this article.
December 20, 2016: CJEM
https://www.readbyqxmd.com/read/27989251/priapism-as-the-presenting-complaint-in-fatal-group-a-streptococcal-induced-disseminated-intravascular-coagulation
#7
Richard J Baverstock, Colleen Carey
A 60-year-old male presented to an emergency department (ED) with priapism following a sore throat illness. He did not have typical findings of sepsis. The patient then developed severe headache, mental status changes, and hypertension, then suffered a cardiopulmonary arrest. Autopsy showed group A streptococcal (GAS) sepsis, disseminated intravascular coagulation (DIC), and a septic thrombosis to the penile vein. This is the first known case of priapism being the presenting symptom of DIC.
December 19, 2016: CJEM
https://www.readbyqxmd.com/read/27974079/positive-correlation-between-regional-emergency-medical-resources-and-mortality-in-severely-injured-patients-results-from-the-korean-national-hospital-discharge-in-depth-survey
#8
Hyo Jung Lee, Yeong Jun Ju, Eun-Cheol Park
OBJECTIVES: In South Korea, injury is a public health problem due to its high incidence and high mortality. To improve emergency medical systems, the government announced plans to increase the emergency medical resources for each region. This study investigated the association between regional emergency medical resources and mortality during hospitalization in severely injured inpatients. METHODS: To analyse mortality for severely injured inpatients, we used the Korean National Hospital Discharge In-depth Survey data, consisting of 18,621 hospitalizations from 2005-2012...
December 15, 2016: CJEM
https://www.readbyqxmd.com/read/27927264/factors-influencing-the-intentions-of-nurses-and-respiratory-therapists-to-use-automated-external-defibrillators-during-in-hospital-cardiac-arrest-a-qualitative-interview-study
#9
Jessica Andrews, Christian Vaillancourt, Jan Jensen, Ann Kasaboski, Manya Charette, Catherine M Clement, Jamie C Brehaut, Martin H Osmond, George A Wells, Ian G Stiell, Jeremy Grimshaw
OBJECTIVES: Nurses and respiratory therapists are seldom allowed to use automated external defibrillators (AED) during in-hospital cardiac arrest. This can result in significant time delays before defibrillation occurs and lower survival for cardiac arrest victims. We sought to identify barriers and facilitators to AED use by nurses and respiratory therapists. METHODS: We conducted semi-structured qualitative interviews with a purposeful sample of nurses and respiratory therapists...
December 8, 2016: CJEM
https://www.readbyqxmd.com/read/27927258/a-case-of-tetanus-secondary-to-an-odontogenic-infection
#10
Majid Darraj, James Stone, Yoav Keynan, Kristjan Thompson, Carolyn Snider
Tetanus is a life-threatening clinical syndrome that commonly presents with muscular spasms, rigidity, and autonomic instability. It is considered rare in industrialized countries, and tetanus occurring secondary to dental abscesses, procedures, or infections has been infrequently reported. We describe the case of a patient inadequately immunized for tetanus, who presented to the emergency department with muscular spasms, rigidity, and autonomic instability in the setting of an odontogenic infection. A clinical diagnosis of tetanus was made and subsequently managed successfully...
December 8, 2016: CJEM
https://www.readbyqxmd.com/read/27927257/unusual-diagnosis-in-a-patient-with-minor-ankle-trauma
#11
Zoƫ Piggott, Donna Clark
We present the case of a 23 year-old male who sustained an anterior tibial artery pseudoaneurysm after an apparently innocuous soccer injury. The patient presented with sudden onset severe pain and swelling one week after the injury. The diagnosis was made using duplex ultrasound, and confirmed with CT angiography. Definitive management consisted of endovascular platinum microcoiling. One year later, the patient is asymptomatic and remains active. A review of the epidemiology, diagnosis, and treatment of arterial pseudoaneurysm is presented...
December 8, 2016: CJEM
https://www.readbyqxmd.com/read/27917744/a-determination-of-emergency-department-pre-triage-times-in-patients-not-arriving-by-ambulance-compared-to-widely-used-guideline-recommendations
#12
Martin Betz, James Stempien, Sachin Trevidi, Rhonda Bryce
OBJECTIVES: Emergency department (ED) lengths of stay are measured from the time of patient registration or triage. The time that patients wait in line prior to registration and triage has not been well described. We sought to characterize pre-triage wait times and compare them to recommended physician response times, as per the Canadian Triage and Acuity Scale (CTAS). METHODS: This observational study documented the time that consenting patients entered the ED and the time that they were formally registered and triaged...
December 5, 2016: CJEM
https://www.readbyqxmd.com/read/27916022/a-wandering-tube
#13
Ina Dubin, Moshe Gelber, Ami Schattner
The predominant causes of acute mechanical small bowel obstruction in geriatric patients are adhesions and hernias, which is not much different than in other adult age groups. Unusual etiologies may be encountered, such as volvulus or gallstone ileus, but a displaced feeding gastrostomy tube is a distinctly rare cause of intestinal obstruction which needs to be considered by emergency physicians as it may be increasingly encountered.
December 5, 2016: CJEM
https://www.readbyqxmd.com/read/27916021/use-of-point-of-care-ultrasound-in-long-bone-fractures-a-systematic-review-and-meta-analysis
#14
Lucas B Chartier, Laura Bosco, Lauren Lapointe-Shaw, Jordan Chenkin
OBJECTIVES: Long bone fractures (LBFs) are among the most frequent traumatic injuries seen in emergency departments. Reduction and immobilization is the most common form of treatment for displaced fractures. Point-of-care ultrasound (PoCUS) is a promising technique for diagnosing LBFs and assessing the success of reduction attempts. This article offers a comprehensive review of the use of PoCUS for the diagnosis and reduction of LBFs. Data source MEDLINE and EMBASE databases were searched through July 19, 2015...
December 5, 2016: CJEM
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#15
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27876104/a-cohort-study-of-unstable-overdose-patients-treated-with-intravenous-lipid-emulsion-therapy
#16
Shazma Mithani, Kathryn Dong, Ashlea Wilmott, Heather Podmoroff, Nadim Lalani, Rhonda J Rosychuk, Ryan Chuang, Mark C Yarema
OBJECTIVES: Intravenous lipid emulsion (ILE) has been used increasingly over the last decade for a range of drug overdoses. Although the use of ILE in local anesthetic toxicity (LAST) is well established, the hemodynamic effectiveness of ILE in non-LAST poisonings is still unclear. Thus, the primary objective of this study was to examine a cohort of poisoned patients in whom ILE was administered. METHODS: Consecutive patients were identified by calls to a regional poison center from May 1, 2012 to May 30, 2014...
November 23, 2016: CJEM
https://www.readbyqxmd.com/read/27866507/simulation-and-web-based-learning-increases-utilization-of-bier-block-for-forearm-fracture-reduction-in-the-pediatric-emergency-department
#17
Brett Burstein, Emmanuelle Fauteux-Lamarre, Adam Cheng, Dominic Chalut, Adam Bretholz
OBJECTIVES: Bier block (BB) is a safe and effective alternative to procedural sedation for analgesia during forearm fracture reductions, yet remains infrequently used in the pediatric emergency department (PED). No standardized methods of BB training have previously been described. The objective of this study was to determine whether a multimodal instructional course increases comfort with BB and translates to increased use of this technique. METHODS: A novel interdisciplinary simulation and Web-based training course was developed to teach the use of BB for forearm fracture reduction at a tertiary PED...
November 21, 2016: CJEM
https://www.readbyqxmd.com/read/27819222/can-an-emergency-department-clinical-triggers-program-based-on-abnormal-vital-signs-improve-patient-outcomes-corrigendum
#18
Jason Imperato, Tyler Mehegan, Daniel J Henning, John Patrick, Chase Bushey, Gary Setnik, Leon D Sanchez
No abstract text is available yet for this article.
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27819221/concealed-resuscitation-related-injuries-as-reversible-cause-of-recurrent-arrest-following-extracorporeal-cardiopulmonary-resuscitation
#19
Kap Su Han, Sung Woo Lee, Kwang Hoon Park, Jong Su Park, Jae Seung Jung, Cheol Woong Yu, Su Jin Kim
A life-threatening cardiopulmonary resuscitation (CPR)-related injury can cause recurrent arrest after return of circulation. Such injuries are difficult to identify during resuscitation, and their contribution to failed resuscitation can be missed given the limitations of conventional CPR. Extracorporeal cardiopulmonary resuscitation (ECPR), increasingly being considered for selected patients with potentially reversible etiology of arrest, may identify previously occult CPR-related injuries by restoring arterial pressure and flow...
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27819217/slow-or-swift-your-patients-experience-won-t-drift-absence-of-correlation-between-physician-productivity-and-the-patient-experience
#20
Kasia Lenz, Andrew McRae, Dongmei Wang, Benjamin Higgins, Grant Innes, Timothy Cook, Eddy Lang
: Absract OBJECTIVES: To evaluate the relationship between Emergency Physician (EP) productivity and patient satisfaction with Emergency Department (ED) care. METHODS: This retrospective observational study linked administrative and patient experience databases to measure correlations between the patient experience and EP productivity. The study was performed across three Calgary EDs (from June 2010 to July 2013). Patients>16 years old with completed Health Quality Council of Alberta (HQCA) ED Patient Experience Surveys were included...
November 7, 2016: CJEM
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