CJEM最新文献

{"title":"Correction: Disparities in emergency department boarding: contrasting mental health and non-mental health patients.","authors":"Cassandra Chisholm, Xiaoming Wang, Conné Lategan, Zoe Hsu, Amelia Ridout, Eddy Lang","doi":"10.1007/s43678-025-00904-7","DOIUrl":"https://doi.org/10.1007/s43678-025-00904-7","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding meaning amidst the noise.","authors":"Michael J Schull","doi":"10.1007/s43678-025-00903-8","DOIUrl":"https://doi.org/10.1007/s43678-025-00903-8","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of activated charcoal in poisoned patients aged over than 5 year old.","authors":"Sophie Gilbert, Maude St-Onge, Xavier Neveu","doi":"10.1007/s43678-025-00881-x","DOIUrl":"https://doi.org/10.1007/s43678-025-00881-x","url":null,"abstract":"<p><strong>Background: </strong>Activated charcoal is the primary agent recommended for gastrointestinal decontamination. Current Canadian practices regarding its administration in poisoned patients are not well known. Our objectives were to measure the frequency of administration of activated charcoal in poisoned patient over the age of five, identify the potential determinants of its use, and describe the characteristics as well as the clinical outcomes in intoxicated patients.</p><p><strong>Methods: </strong>In a multicenter health records review, we reviewed poisonings using data collected from health records between January 2015 and January 2016, at different hospitals in Quebec, Canada. We included all poisoned patients over the age of 5 who presented and were managed in the emergency department within 12 h of ingestion of a potentially toxic dose of a carbo-absorbable substance. The primary endpoint was the progression of toxicity, and the secondary endpoints were mortality and length of stay. We calculated the incidence of administration of activated charcoal and identified the observed side effects.</p><p><strong>Results: </strong>A total of 120 of the 935 poisoned patients received activated charcoal (12.8%). A short post-ingestion time (< 90 min) was the preferred indication for its administration. Charcoal-treated patients had a 9.2% lower risk of increased toxicity in the first 12 h, but twice the likelihood of being admitted to the hospital, and of having a length of stay of 12 h or more. The most common side effect was vomiting (20.8%). Only one of the patients who received it had aspiration pneumonia (0.01%) and two patients subsequently had gastrointestinal obstruction after receiving activated charcoal (0.02%).</p><p><strong>Conclusion: </strong>Among patients who were poisoned with a carbo-absorbable substance, 12.8% were treated with activated charcoal in the emergency department. The majority of patients progressed well clinically. Our results will contribute to developing a protocol for a pan-Canadian prospective multicenter randomized controlled trial to evaluate the efficacy of activated charcoal in this population.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does a Targeted Engagement and Diversion program reduce emergency department utilization?","authors":"Rebecca Seliga, Krishan Yadav, Caroline Hodgins, Maria Jaramillo, Christina Masters, Jamie Muckle, Marie-Joe Nemnom, Ariel Hendin, Debra Eagles, Rakesh Patel","doi":"10.1007/s43678-025-00888-4","DOIUrl":"https://doi.org/10.1007/s43678-025-00888-4","url":null,"abstract":"<p><strong>Objectives: </strong>The Targeted Engagement and Diversion (TED) program in Ottawa provides health care to unhoused or shelter/community housed adults outside of an emergency department (ED) setting. We sought to determine the proportion of patients diverted away from the ED by the TED program.</p><p><strong>Methods: </strong>We conducted a health records review of adult patients who visited the TED program from January to December 2022 using random sampling to account for seasonal variation. Data were extracted from the Ottawa Inner City Health database and hospital records from two university-affiliated EDs. The primary outcome was successful diversion from the ED, defined as any of the following: TED program patients (i) presenting in the evening or overnight; (ii) brought in by police/paramedic services; (iii) referred from the safe consumption site; (iv) assessed by a nurse or physician; (v) admitted for higher level of observation; or (vi) that received an antidote (e.g., naloxone). Data were described using descriptive statistics.</p><p><strong>Results: </strong>We reviewed 500 total visits of 241 unique patients (76.3% male, median age 38 years). The most common reason for presentation was unspecified intoxication (83.4%, n = 417). A total of 359 visits met criteria for successful diversion from the ED (71.8%, 95% confidence interval (CI) 67.7-75.6). Most patients who met diversion criteria revisited the TED program within 7 days (82.8%, n = 323), whereas 7.9% (n = 31) visited an ED within 7 days. At 2 years, 39% (n = 94) of all patients were stably housed and 10.8% (n = 26) died.</p><p><strong>Conclusion: </strong>The TED program may be successful at attracting patients and diverting their care away from busy local EDs, and few patients treated by the TED program visited the ED within the subsequent 7 days. This model of care may provide a solution to offload from overcrowded EDs and improve access to comprehensive care for patients who are unhoused.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing for elder abuse after a low-level fall, we need to do better.","authors":"Eric Mercier, Kerstin de Wit","doi":"10.1007/s43678-025-00910-9","DOIUrl":"https://doi.org/10.1007/s43678-025-00910-9","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just the facts: diagnosis and management of generalized pustular psoriasis.","authors":"Jensen Yeung, Vimal H Prajapati, Eric Mutter, Melinda Gooderham","doi":"10.1007/s43678-025-00883-9","DOIUrl":"https://doi.org/10.1007/s43678-025-00883-9","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just the facts: diagnosis and management of heat stroke.","authors":"Steven Sanders, Matthew Lipinski, Jonathan Hooper","doi":"10.1007/s43678-025-00867-9","DOIUrl":"https://doi.org/10.1007/s43678-025-00867-9","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back so soon?: the role of initial triage category in ED return visits.","authors":"P R Atkinson, D Lewis, J Fraser, M Howlett","doi":"10.1007/s43678-025-00890-w","DOIUrl":"https://doi.org/10.1007/s43678-025-00890-w","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just the facts: erector spinae plane blocks for rib fractures in the emergency department.","authors":"Michael Y Woo, Pierre-Marc Dion, Reva Ramlogan, Yuqi Gu","doi":"10.1007/s43678-025-00868-8","DOIUrl":"https://doi.org/10.1007/s43678-025-00868-8","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonality and school day-based trends in mental-health-related pediatric emergency department visits during COVID-19 in British Columbia.","authors":"Mikayla Fan, Tyler Black, Jeffrey N Bone, Quynh Doan","doi":"10.1007/s43678-025-00892-8","DOIUrl":"https://doi.org/10.1007/s43678-025-00892-8","url":null,"abstract":"<p><strong>Objectives: </strong>The association between mental health related pediatric emergency department (ED) visits and school attendance during the COVID-19 pandemic remains unclear. We aimed to determine the change in rate of mental health-related pediatric ED visits related to type of school day (i.e., school closure days, school days, winter/summer break days) during the pandemic. We also aimed to compare the number of presentations per week during pandemic school periods to expected values based on pre-pandemic trends.</p><p><strong>Methods: </strong>We included all pediatric ED visits by children aged 2-17 years between January 1st, 2014, and December 31st, 2022, at a single quaternary pediatric center. We calculated the rate (number of mental health pediatric ED visits by 100,000 children) in British Columbia per day on each type of school day, as well as the rate of visits per week during each school period of the pandemic in comparison to the expected values.</p><p><strong>Results: </strong>There was a 36% decrease in presentation rates on non-school days relative to school days in both pre-pandemic and pandemic periods. During the two periods of school closure due to pandemic protocols, mental health visits were substantially lower compared to school days during the pandemic. There were fewer mental health pediatric ED visits for three of the four pandemic school years when compared to pre-pandemic trends.</p><p><strong>Conclusions: </strong>Mental health-related pediatric ED visits were consistently higher on school days than non-school days, including COVID-19 school closure days. In comparison to expected rates based on pre-pandemic trends, mental health-related pediatric ED visits decreased in three of the four school years during the pandemic. Our findings suggest an increased need for mental health support in the ED on school days. They also suggest that EDs should be prepared for mental health demands alongside surges and pandemics.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}