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https://www.readbyqxmd.com/read/28534449/sweet-syndrome-presenting-as-a-febrile-rash-in-a-returning-traveller
#1
Alexander Hart, Katharina Plenk, David Carr
Sweet syndrome was discovered in 1964 and is now well described in the dermatology literature. Knowledge of this unique febrile and painful dermatosis is important for the emergency physician because the syndrome can be readily identified and is extremely responsive to oral steroid therapy. Early diagnosis can greatly improve patient satisfaction and avoid days of ineffective treatment. An accurate and timely diagnosis of Sweet syndrome is also important to guide investigation into a number of associated diseases...
May 23, 2017: CJEM
https://www.readbyqxmd.com/read/28521849/a-writer-s-guide-to-education-scholarship-qualitative-education-scholarship-part-2
#2
Teresa M Chan, Daniel K Ting, Andrew Koch Hall, Aleisha Murnaghan, Brent Thoma, Jill McEwen, Lalena M Yarris
OBJECTIVE: Education scholarship can be conducted using a variety of methods, from quantitative experiments to qualitative studies. Qualitative methods are less commonly used in emergency medicine (EM) education research but are well-suited to explore complex educational problems and generate hypotheses. We aimed to review the literature to provide resources to guide educators who wish to conduct qualitative research in EM education. METHODS: We conducted a scoping review to outline: 1) a list of journals that regularly publish qualitative educational papers; 2) an aggregate set of quality markers for qualitative educational research and scholarship; and 3) a list of quality checklists for qualitative educational research and scholarship...
May 19, 2017: CJEM
https://www.readbyqxmd.com/read/28516829/factors-associated-with-failure-of-emergency-wait-time-targets-for-high-acuity-discharges-and-intensive-care-unit-admissions
#3
Ivy Cheng, Merrick Zwarenstein, Alex Kiss, Maaret Castren, Mats Brommels, Michael Schull
OBJECTIVE: Ontario established emergency department length-of-stay (EDLOS) targets but has difficulty achieving them. We sought to determine predictors of target time failure for discharged high acuity patients and intensive care unit (ICU) admissions. METHODS: This was a retrospective, observational study of 2012 Sunnybrook Hospital emergency department data. The main outcome measure was failing to meet government EDLOS targets for high acuity discharges and ICU emergency admissions...
May 18, 2017: CJEM
https://www.readbyqxmd.com/read/28511730/simulation-in-canadian-postgraduate-emergency-medicine-training-a-national-survey
#4
Evan Russell, Andrew Koch Hall, Carly Hagel, Andrew Petrosoniak, Jeffrey Damon Dagnone, Daniel Howes
OBJECTIVES: Simulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada. METHODS: A national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE...
May 17, 2017: CJEM
https://www.readbyqxmd.com/read/28506329/what-to-do-when-a-patient-wants-to-record-a-patient-physician-interaction-in-the-emergency-department
#5
Brodie Nolan, Alun Ackery, Bryan Au
Recent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, patient privacy is highly regulated by provincial legislation, although patients themselves have little in the way of laws or regulations to observe. Patients taking video recordings of their own medical care does not currently fall under any of the provincial privacy laws. With no such governance for the general public, patients generally have greater freedom to record a patient-physician interaction...
May 16, 2017: CJEM
https://www.readbyqxmd.com/read/28487003/examining-the-utility-of-the-hamilton-early-warning-scores-hews-at-triage-retrospective-pilot-study-in-a-canadian-emergency-department
#6
Steven Skitch, Benjamin Tam, Michael Xu, Laura McInnis, Anthony Vu, Alison Fox-Robichaud
OBJECTIVES: Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis. METHODS: The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death...
May 10, 2017: CJEM
https://www.readbyqxmd.com/read/28468696/parental-experiences-and-preferences-as-participants-in-pediatric-research-conducted-in-the-emergency-department
#7
Antonia S Stang, Stephen B Freedman, Angelo Mikrogianakis, Graham C Thompson, Janie Williamson, David W Johnson
OBJECTIVE: To determine parental experiences and preferences regarding the conduct of pediatric research in an emergency department (ED) setting. METHODS: We conducted a cross-sectional study of parents of children ages 0 - 14 years who visited the ED of a tertiary care children's hospital. Parents completed a Web-based survey designed to assess perceptions regarding: 1) background/training of research personnel, 2) location and timing of research discussions, and 3) factors influencing their consent/refusal decision...
May 4, 2017: CJEM
https://www.readbyqxmd.com/read/28460656/gamma-hydroxybutyrate-ghb-an-unusual-cause-of-high-anion-gap-metabolic-acidosis
#8
Laurence Carlier, Vincent Van Belleghem, Kathleen Croes, Frederik Hooft, Matthias Desmet, Olivier Heylen, Stijn Lambrecht, Stefaan Carlier
The causes of high anion gap metabolic acidosis (HAGMA) are well described in the literature. However, sometimes more frequent causes of HAGMA cannot explain its occurrence. In the case of HAGMA and severe neurological depression in the absence of other causes of HAGMA, clinicians should consider an intoxication with gamma-hydroxybutyrate (GHB) as a possible cause. GHB is endogenous to the mammalian central nervous system (CNS). Synthetic GHB was initially used as an anesthetic but is now only licensed for medical use in a limited number of indications such as the treatment of narcolepsy...
May 2, 2017: CJEM
https://www.readbyqxmd.com/read/28443532/a-writer-s-guide-to-education-scholarship-quantitative-methodologies-for-medical-education-research-part-1
#9
Brent Thoma, Paola Camorlinga, Teresa M Chan, Andrew Koch Hall, Aleisha Murnaghan, Jonathan Sherbino
BACKGROUND: Quantitative research is one of the many research methods used to help educators advance their understanding of questions in medical education. However, little research has been done on how to succeed in publishing in this area. OBJECTIVE: We conducted a scoping review to identify key recommendations and reporting guidelines for quantitative educational research and scholarship. METHODS: Medline, ERIC, and Google Scholar were searched for English-language articles published between 2006 and January 2016 using the search terms, "research design," "quantitative," "quantitative methods," and "medical education...
April 26, 2017: CJEM
https://www.readbyqxmd.com/read/28412987/back-pain-in-the-emergency-department-pathological-fracture-following-spinal-manipulation
#10
Christopher Skappak, Erik J Saude
Back pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks. An initial evaluation with thoracolumbar radiographs revealed no significant findings...
April 17, 2017: CJEM
https://www.readbyqxmd.com/read/28399958/the-immigrant-effect-factors-impacting-use-of-primary-and-emergency-department-care-a-canadian-population-cross-sectional-study
#11
Robert Ohle, Helena Bleeker, Krishan Yadav, Jeffrey J Perry
OBJECTIVE: In 2011, Canada had a foreign-born population of approximately 6,775,800. They represented 20.6% of the total population. Immigrants possess characteristics that reduce the use of primary care. This is thought to be, in part, due to a lower education level, employment, and better health status. Our objective was to assess whether, in an immigrant population without a primary care physician, similar socioeconomic factors would also reduce the likelihood of using the emergency department compared to a non-immigrant population without primary care...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28399946/impact-of-a-multifaceted-antimicrobial-stewardship-program-a-front-line-ownership-driven-quality-improvement-project-in-a-large-urban-emergency-department
#12
Adam Jonathan Kaufman, Janine McCready, Jeff Powis
BACKGROUND: Antibiotic overuse has promoted growing rates of antimicrobial resistance and secondary antibiotic-associated infections such as Clostridium difficile (C. difficile). Antimicrobial stewardship programs (ASPs) are effective in reducing antimicrobial use in the inpatient setting; however, the unique environment of the emergency department (ED) lends itself to challenges for successful implementation. Front-line ownership (FLO) methodology has been shown to be a potentially effective strategy for the implementation of inpatient ASPs through an iterative multi-pronged approach driven by front-line providers...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28382879/frequent-users-of-the-pediatric-emergency-department
#13
Jade Seguin, Esli Osmanlliu, Xun Zhang, Virginie Clavel, Harley Eisman, Robert Rodrigues, Maryam Oskoui
OBJECTIVES: Emergency department (ED) crowding is associated with increased morbidity and mortality. Its etiology is multifactorial, and frequent ED use (defined as more or equal to five visits per year) is a major contributor to high patient volumes. Our primary objective is to characterize the frequent user population. Our secondary objective is to examine risk factors for frequent emergency use. METHODS: We conducted a retrospective cohort study of pediatric emergency department (PED) visits at the Montreal Children's Hospital using the Système Informatique Urgence (SIURGE), electronic medical record database...
April 6, 2017: CJEM
https://www.readbyqxmd.com/read/28367771/the-effect-of-step-stool-use-and-provider-height-on-cpr-quality-during-pediatric-cardiac-arrest-a-simulation-based-multicentre-study
#14
Adam Cheng, Yiqun Lin, Vinay Nadkarni, Brandi Wan, Jonathan Duff, Linda Brown, Farhan Bhanji, David Kessler, Nancy Tofil, Kent Hecker, Elizabeth A Hunt
OBJECTIVES: We aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality. METHODS: We analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training...
April 3, 2017: CJEM
https://www.readbyqxmd.com/read/28367768/rates-and-predictive-factors-of-return-to-the-emergency-department-following-an-initial-release-by-the-emergency-department-for-acute-heart-failure
#15
Pierre-Géraud Claret, Lisa A Calder, Ian G Stiell, Justin W Yan, Catherine M Clement, Bjug Borgundvaag, Alan J Forster, Jeffrey J Perry, Brian H Rowe
OBJECTIVES: Following release by emergency department (ED) for acute heart failure (AHF), returns to ED represent important adverse health outcomes. The objective of this study was to document relapse events and factors associated with return to ED in the 14-day period following release by ED for patients with AHF. METHODS: The primary outcome was the number of return to ED for patients who were release by ED after the initial visit, for any related medical problem within 14 days of this initial ED visit...
April 3, 2017: CJEM
https://www.readbyqxmd.com/read/28343457/development-of-a-model-to-quantify-the-accessibility-of-a-canadian-trauma-system
#16
Gavin Tansley, Nadine Schuurman, Mete Erdogan, Matthew Bowes, Robert Green, Mark Asbridge, Natalie Yanchar
OBJECTIVES: Trauma systems have been widely implemented across Canada, but access to trauma care remains a challenge for much of the population. This study aims to develop and validate a model to quantify the accessibility of definitive care within one provincial trauma system and identify populations with poor access to trauma care. METHODS: A geographic information system (GIS) was used to generate models of pre-scene and post-scene intervals, respectively. Models were validated using a population-based trauma registry containing data on prehospital time intervals and injury locations for Nova Scotia (NS)...
March 27, 2017: CJEM
https://www.readbyqxmd.com/read/28318458/first-do-no-harm-advocating-for-opioid-prescribing-guidelines-in-canadian-emergency-departments
#17
Kieran Moore, Julia Lew, Samantha Buttemer, Lauren Kielstra
No abstract text is available yet for this article.
March 20, 2017: CJEM
https://www.readbyqxmd.com/read/28294100/on-the-tip-of-the-tongue
#18
Rachel Orchard, Sheena Belisle, Rodrick Lim
No abstract text is available yet for this article.
March 15, 2017: CJEM
https://www.readbyqxmd.com/read/28294095/the-simple-query-do-you-want-more-pain-medication-is-not-a-reliable-way-to-assess-acute-pain-relief-in-patients-in-the-emergency-department
#19
Jean-Marc Chauny, Martin Marquis, Jean Paquet, Gilles Lavigne, Alexis Cournoyer, Christiane Manzini, Raoul Daoust
OBJECTIVE: The management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient's refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief. METHODS: This prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem...
March 15, 2017: CJEM
https://www.readbyqxmd.com/read/28264750/bilateral-nail-gun-traumatic-brain-injury-presents-as-intentional-overdose-a-case-report
#20
Judith Alain, Pascal Lavergne, Maude St-Onge, Myreille D'Astous, Stéphane Côté
This report describes a rare but life-threatening case of a suicide attempt initially considered as intentional overdose at the emergency department. Persistent altered mental status, despite normal toxicology investigations, led the attending team to order a head computed tomography scan, which revealed a bilateral penetrating nail gun injury with a right temporal hematoma for which a decompressive craniectomy was performed. Although voluntary intoxication is the most frequent form of suicide attempt, emergency physicians must be alert and maintain a broad differential diagnosis...
March 7, 2017: CJEM
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