Canadian Journal of Emergency Medicine最新文献

{"title":"Ocular point-of-care ultrasound in the detection of early endophthalmitis.","authors":"Christopher Tsoutsoulas, Joshua Ling, Frank Myslik","doi":"10.1007/s43678-023-00588-x","DOIUrl":"10.1007/s43678-023-00588-x","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"993-995"},"PeriodicalIF":2.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10145989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor re: exploring gender influences in the quality of workplace-based assessments.","authors":"Achelle Cortel-LeBlanc, Michelle Cohen","doi":"10.1007/s43678-023-00563-6","DOIUrl":"10.1007/s43678-023-00563-6","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"922-923"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9967706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just the facts: transesophageal echocardiography in cardiac arrest.","authors":"Christine Hanna, Michael Gottlieb, Katharine Burns, Tomislav Jelic","doi":"10.1007/s43678-023-00557-4","DOIUrl":"10.1007/s43678-023-00557-4","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"862-864"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of 30-day revisit to the emergency department among older adults living with dementia: a systematic review and meta-analysis.","authors":"Dana Jelinski, Olayinka I Arimoro, Caley Shukalek, Kayla R Furlong, Eddy Lang, Krista Reich, Jayna Holroyd-Leduc, Zahra Goodarzi","doi":"10.1007/s43678-023-00578-z","DOIUrl":"10.1007/s43678-023-00578-z","url":null,"abstract":"<p><strong>Objective: </strong>Older adults visit emergency departments (EDs) at higher rates than their younger counterparts. However, less is known about the rate at which older adults living with dementia visit and revisit EDs. We conducted a systematic review and meta-analysis to quantify the revisit rate to the ED among older adults living with a dementia diagnosis.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and CINAHL, as well as gray literature, to identify observational studies reporting on older adults living with dementia that revisited an ED within 30 days of a prior ED visit. We calculated pooled rates of 30-day revisit as percentages using random effects models, and conducted stratified analyses by study data source, study population, and study period. We assessed between-studies heterogeneity using the I² statistic and considered [Formula: see text] > 50% to indicate substantial heterogeneity. All analyses were performed in R software.</p><p><strong>Results: </strong>We identified six articles for inclusion. Percentages of 30-day ED revisit among older adults living with dementia ranged widely from 16.1% to 58.0%. The overall revisit rate of 28.6% showed significant heterogeneity. Between-studies heterogeneity across all stratified analyses was also high. By data source, 30-day revisit percentages were 52.3% (public hospitals) and 20.0% (administrative databases); by study population, revisit percentages were 33.5% (dementia as main population) and 19.8% (dementia as a subgroup). By study period, revisit percentages were 41.2% (5 years or greater) and 18.9% (5 years or less).</p><p><strong>Conclusion: </strong>Existing literature on ED revisits among older adults living with dementia highlights the medical complexities and challenges surrounding discharge and follow-up care that may cause these patients to seek ED care at an increased rate. ED personnel may play an important role in connecting patients and caregivers to more appropriate medical and social resources in order to deliver an efficient and more rounded approach to care.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"884-892"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10513627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Do We….","authors":"Thomas Miller","doi":"10.1007/s43678-023-00567-2","DOIUrl":"10.1007/s43678-023-00567-2","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"920-921"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hospital care and outcomes of long-term care patients treated by paramedics during an emergency call: exploring the potential impact of 'treat-and-refer' pathways and community paramedicine.","authors":"Shannon Leduc, George Wells, Venkatesh Thiruganasambandamoorthy, Zach Cantor, Peter Kelly, Micah Rietschlin, Christian Vaillancourt","doi":"10.1007/s43678-023-00590-3","DOIUrl":"10.1007/s43678-023-00590-3","url":null,"abstract":"<p><strong>Introduction: </strong>Adults living in long-term care (LTC) are at increased risk of harm when transferred to the emergency department (ED), and programs targeting treatment on-site are increasing. We examined characteristics, clinical course, and disposition of LTC patients transported to the ED to examine the potential impact of alternative models of paramedic care for LTC patients.</p><p><strong>Methods: </strong>We conducted a health records review of paramedic and ED records between April 1, 2016, and March 31, 2017. We included emergency calls originating from LTC centers and patients transported to either ED campus of The Ottawa Hospital. We excluded scheduled or deferrable transfers, and patients with Canadian Triage and Acuity Scale of 1. We categorized patients into groups based on care they received in the ED. We calculated standardized differences to examine differences between groups.</p><p><strong>Results: </strong>We identified four groups: (1) patients requiring no treatment or diagnostics in the ED (7.9%); (2) patients receiving ED treatment within current paramedic directives and no diagnostics (3.2%); (3) patients requiring diagnostics or ED care outside current paramedic directives (54.9%); and (4) patients requiring admission (34.1%).</p><p><strong>Conclusion: </strong>This study found 7.9% of LTC patients transported to the ED did not receive diagnostics, medications, or treatment, and overall 11.1% of patients could have been treated by paramedics within current medical directives using 'treat-and-refer' pathways. This group could potentially expand utilizing community paramedics with expanded scopes of practice.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"873-883"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10628026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just the facts: diagnosing and managing syphilis in the emergency department.","authors":"Victoria K Weaver, K Anne Sutherland, Justin Jek-Kahn Koh","doi":"10.1007/s43678-023-00556-5","DOIUrl":"10.1007/s43678-023-00556-5","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"858-861"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on the past and optimism for the future: the potential for paramedicine to contribute to health care system improvements and the critical need for research.","authors":"Ian E Blanchard, Jan L Jensen, Blair L Bigham","doi":"10.1007/s43678-023-00585-0","DOIUrl":"10.1007/s43678-023-00585-0","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"855-857"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency medicine resident perceptions of simulation-based training and assessment in competence by design.","authors":"Lorne L Costello,&nbsp;Dennis D Cho,&nbsp;Ryan C Daniel,&nbsp;Joana Dida,&nbsp;Jodie Pritchard,&nbsp;Kaif Pardhan","doi":"10.1007/s43678-023-00577-0","DOIUrl":"10.1007/s43678-023-00577-0","url":null,"abstract":"<p><strong>Objectives: </strong>With the launch of competence by design (CBD) in emergency medicine (EM) in Canada, there are growing recommendations on the use of simulation for the training and assessment of residents. Many of these recommendations have been suggested by educational leaders and often exclude the resident stakeholder. This study sought to explore their experiences and perceptions of simulation in CBD.</p><p><strong>Methods: </strong>Qualitative data were collected from November 2020 to May 2021 at McMaster University and the University of Toronto after receiving ethics approval from both sites. Eligible participants included EM residents who were interviewed by a trained interviewer using a semi-structured interview guide. All interviews were recorded, transcribed, coded, and collapsed into themes. Data analysis was guided by constructivist grounded theory.</p><p><strong>Results: </strong>A total of seventeen residents participated. Thematic analysis revealed three major themes: 1) impact of CBD on resident views of simulation; 2) simulation's role in obtaining entrustable professional activities (EPAs) and filling educational gaps; and 3) conflicting feelings on the use of high-stakes simulation-based assessment in CBD.</p><p><strong>Conclusions: </strong>EM residents strongly support using simulation in CBD and acknowledge its ability to bridge educational gaps and fulfill specific EPAs. However, this study suggests some unintended consequences of CBD and conflicting views around simulation-based assessment that challenge resident perceptions of simulation as a safe learning space. As CBD evolves, educational leaders should consider these impacts when making future curricular changes or recommendations.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"828-835"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just the facts: precipitous deliveries in the emergency department.","authors":"Alexandra Hamelin,&nbsp;Dante Pascali,&nbsp;Jennifer Leppard","doi":"10.1007/s43678-023-00552-9","DOIUrl":"10.1007/s43678-023-00552-9","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":" ","pages":"799-801"},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9771449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}