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CJEM

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27819205/iron-deficiency-anemia-in-the-emergency-department-over-utilization-of-red-blood-cell-transfusion-and-infrequent-use-of-iron-supplementation
#10
Jordan Spradbrow, Yulia Lin, Dominick Shelton, Jeannie Callum
OBJECTIVES: Three are no clinical practice guidelines that specifically address the management of patients with iron deficiency anemia (IDA) in the emergency department (ED). The goal of this study was to describe the characteristics of IDA patients who present to the ED, documentation of IDA by emergency physicians, utilization of iron supplementation, and the appropriateness of red blood cell (RBC) transfusions ordered in the ED. METHODS: A retrospective medical chart review was performed of IDA patients who visited the ED of a large tertiary center over a three-month period...
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27819196/a-5-year-retrospective-study-of-emergency-department-use-in-northwest-ontario-a-measure-of-mental-health-and-addictions-needs
#11
Cai-Lei Matsumoto, Terry O'Driscoll, Jennifer Lawrance, Andre Jakubow, Sharen Madden, Len Kelly
OBJECTIVE: The main objective of this study was to understand the five-year trend in total emergency department (ED) visits, frequency of use, and diagnoses and disposition of patients. Since the region has experienced a profound increase in opioid use disorder since 2009, we were particularly interested in changes in the volume of mental health and addiction (MHA) ED presentations. METHODS: Retrospective aggregate data analysis of ED visits to the Sioux Lookout Meno Ya Win Health Centre 2010-2014...
November 7, 2016: CJEM
https://www.readbyqxmd.com/read/27788698/a-pilot-study-examining-the-speed-and-accuracy-of-triage-for-simulated-disaster-patients-in-an-emergency-department-setting-comparison-of-a-computerized-version-of-canadian-triage-acuity-scale-ctas-and-simple-triage-and-rapid-treatment-start-methods
#12
Gwynn Curran-Sills, Jeffrey M Franc
OBJECTIVE: To compare emergency department triage nurses' time to triage and accuracy of a simulated mass casualty incident (MCI) population using a computerized version of CTAS or START systems. METHODS: This pilot study was a prospective trial using a convenience sample. A total of 20 ED triage nurses, 10 in each arm of the study, were recruited. The paper-based questionnaire contained nine simulated MCI vignettes. An expert panel arrived at consensuses on the wording of the vignettes and created a standard triage score from which to compare the study participants...
October 28, 2016: CJEM
https://www.readbyqxmd.com/read/27781970/sgem-hot-off-the-press-ultrasound-during-critical-care-simulation-a-randomized-crossover-study
#13
Paul McKenna, Brent Thoma, Ken Milne, Chris Bond
As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/podcast 2 and discussed by the study authors and the online EM community. A similar collaboration is underway between the SGEM and Academic Emergency Medicine...
October 26, 2016: CJEM
https://www.readbyqxmd.com/read/27748231/feasibility-of-emergency-department-point-of-care-ultrasound-for-rib-fracture-diagnosis-in-minor-thoracic-injury
#14
Élizabeth Lalande, Chantal Guimont, Marcel Émond, Marc Charles Parent, Claude Topping, Brice Lionel Batomen Kuimi, Valérie Boucher, Natalie Le Sage
OBJECTIVES: The main objective of this study was to evaluate the feasibility of emergency department (ED) point-of-care ultrasound (PoCUS) for rib fracture diagnosis in patients with minor thoracic injury (mTI). Secondary objectives were to 1) evaluate patients' pain during the PoCUS procedure, 2) identify the limitations of the use of PoCUS technique, and 3) compare the diagnosis obtained with PoCUS to radiography results. METHODS: Adult patients who presented with clinical suspicion of rib fractures after mTI were included...
October 17, 2016: CJEM
https://www.readbyqxmd.com/read/27748221/impact-of-process-improvements-on-measures-of-emergency-department-efficiency
#15
Alexander K Leung, Shawn D Whatley, Dechang Gao, Marko Duic
OBJECTIVE: To study the operational impact of process improvements on emergency department (ED) patient flow. The changes did not require any increase in resources or expenditures. METHODS: This was a 36-month pre- and post-intervention study to evaluate the effect of implementing process improvements at a community ED from January 2010 to December 2012. The intervention comprised streamlining triage by having patients accepted into internal waiting areas immediately after triage...
October 17, 2016: CJEM
https://www.readbyqxmd.com/read/27748218/prevalence-of-potential-smoking-related-conditions-among-tobacco-users-in-the-emergency-department-and-their-perception-that-their-visit-may-be-smoking-related
#16
Amy Po Yu Tsai, Jimmy Po-Nien Tsai, Lauren Stewart, Jeffrey Brubacher, Ka Wai Cheung
OBJECTIVES: Patients who are tobacco users present to the emergency department (ED) with many medical conditions that are causally or potentially causally related to smoking. Previous studies have shown increased cessation rates for patients who accurately perceive that their ED visit is smoking-related. Our study goals were 1) to determine the prevalence of potential smoking-related conditions among tobacco users at a tertiary care academic ED, and 2) to determine which medical conditions are more or less likely to be perceived by patients as smoking-related...
October 17, 2016: CJEM
https://www.readbyqxmd.com/read/27748215/do-neighbourhoods-in-vancouver-and-surrounding-areas-demonstrate-different-rates-of-bystander-cpr-and-survival-for-out-of-hospital-cardiac-arrest
#17
David Barbic, Brian Klinkenberg, Brian Grunau, Jim Christenson
OBJECTIVE: No prior work exists examining the relation between the geographic distribution of out-of-hospital cardiac arrest (OHCA) in the city of Vancouver and surrounding areas that may exhibit a clustering of cases. The primary objective of this study was to describe the distribution of OHCA within the Vancouver Coastal Health region using a geographic information system (GIS) analysis and appropriate statistical analyses. METHODS: This study was a post-hoc GIS-based analysis of OHCA patients in the city of Vancouver and surrounding areas, using data collected by the Resuscitation Outcomes Consortium between September 2007 and December 2011...
October 17, 2016: CJEM
https://www.readbyqxmd.com/read/27692013/a-comparative-study-of-patient-characteristics-opinions-and-outcomes-for-patients-who-leave-the-emergency-department-before-medical-assessment
#18
Jacqueline Fraser, Paul Atkinson, Audra Gedmintas, Michael Howlett, Rose McCloskey, James French
OBJECTIVE: The emergency department (ED) left-without-being-seen (LWBS) rate is a performance indicator, although there is limited knowledge about why people leave, or whether they seek alternate care. We studied characteristics of ED LWBS patients to determine factors associated with LWBS. METHODS: We collected demographic data on LWBS patients at two urban hospitals. Sequential LWBS patients were contacted and surveyed using a standardized telephone survey. A matched group of patients who did not leave were also surveyed...
October 3, 2016: CJEM
https://www.readbyqxmd.com/read/27681663/a-prospective-evaluation-of-the-availability-and-utility-of-the-ambulance-call-record-in-the-emergency-department-erratum
#19
Natalie Cram, Shelley McLeod, Michael Lewell, Matthew Davis
No abstract text is available yet for this article.
September 29, 2016: CJEM
https://www.readbyqxmd.com/read/27681496/reperfusion-treatment-delays-amongst-patients-with-painless-st-segment-elevation-myocardial-infarction
#20
Pin Pin Pek, En Yun Loy, Win Wah, Andrew Fu Wah Ho, Huili Zheng, Stephanie Man Chung Fook-Chong, Terrance Siang Jin Chua, Tian Hai Koh, Khuan Yew Chow, Nan Liu, Marcus Eng Hock Ong
OBJECTIVE: Early reperfusion therapy in the treatment of ST segment elevation myocardial infarction (STEMI) patients can improve outcomes. Silent myocardial infarction is associated with poor prognosis, but little is known about its effect on treatment delays. We aimed to characterize STEMI patients presenting without complaints of pain to the emergency departments (EDs) in Singapore. METHODS: Retrospective data were requested from the Singapore Myocardial Infarction Registry (SMIR), a national level registry in Singapore...
September 29, 2016: CJEM
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