CJEM最新文献

{"title":"Just the facts: peripheral vasopressors.","authors":"Sameer Sharif, Sara Gray","doi":"10.1007/s43678-024-00784-3","DOIUrl":"10.1007/s43678-024-00784-3","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"170-172"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334375","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":"Keeping the door open: virtual coverage of rural emergency departments-what works and what doesn't.","authors":"Brydon Blacklaws, John Pawlovich, Lauren Currie, Anurag Singh","doi":"10.1007/s43678-024-00855-5","DOIUrl":"https://doi.org/10.1007/s43678-024-00855-5","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461146","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":"Dr. Jill McEwen-in memoriam : July 20, 1957-November 1, 2024.","authors":"Riyad B Abu-Laban, Tamara McColl","doi":"10.1007/s43678-025-00860-2","DOIUrl":"https://doi.org/10.1007/s43678-025-00860-2","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442862","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":"Healthcare leadership in the specialty of prehospital and transport medicine: inspiring excellence and innovation.","authors":"Michael A Austin","doi":"10.1007/s43678-025-00886-6","DOIUrl":"https://doi.org/10.1007/s43678-025-00886-6","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426813","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":"Improving quality and safety in emergency department cardiac ultrasound: an urgent need for change.","authors":"Joseph Bednarczyk, Tom Jelic","doi":"10.1007/s43678-025-00889-3","DOIUrl":"https://doi.org/10.1007/s43678-025-00889-3","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412017","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":"The ultrasound competency assessment tool for evaluation of early pregnancy with POCUS.","authors":"Colin Bell, Natalie Wagner, Andrew Hall, Joseph Newbigging, Louise Rang, Tatiana Vukadinovic, Conor McKaigney","doi":"10.1007/s43678-024-00839-5","DOIUrl":"10.1007/s43678-024-00839-5","url":null,"abstract":"<p><strong>Objectives: </strong>POCUS is a core emergency medicine skill and mainstay of early pregnancy assessment. The ultrasound competency assessment tool was developed as an entrustment-based assessment tool for use by content experts evaluating trainees performing multiple POCUS study types. The objective of this study was to evaluate the scoring and extrapolation inferences of the tool within Kane's validity framework when used to assess trainees performing an early pregnancy POCUS.</p><p><strong>Methods: </strong>This was a multicentered study of emergency medicine residents participating in a POCUS assessment. After a background questionnaire, participants were read a case stem requesting a POCUS evaluation of an early pregnancy patient. Trainees were independently assessed by two fellowship-trained faculty. Descriptive statistics and two-way random, intraclass correlation coefficients, Cronbach's alpha were calculated on the merged data and used to assess all domains. Domain scores and an entrustment score for each participant were used to create a composite score. A one-way analysis of variance was performed.</p><p><strong>Results: </strong>36 trainees and 5 assessors completed the study. When used to assess trainee POCUS performance in early pregnancy, the tool demonstrated good to excellent interrater reliability for image acquisition, image generation, clinical integration, and entrustment (intraclass correlation coefficients 80-91 p < .001). The preparation domain had poor, but statistically significant interrater reliability (intraclass correlation coefficient 0.46 p = .04). An analysis of variance suggested the POCUS performance scores differed based on prior experience [F(2,32) = 3.74, p = .021).</p><p><strong>Conclusion: </strong>This study adds further validity evidence relating to scoring and extrapolation of the ultrasound competency assessment tool when used to assess trainees performing a POCUS study in early pregnancy.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"111-116"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923958","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":"Canadian POCUS Snapshot 2024: a picture of limited resources and untapped potential.","authors":"Colin Bell, Paul Olszynski, Daniel J Kim","doi":"10.1007/s43678-024-00814-0","DOIUrl":"10.1007/s43678-024-00814-0","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"151-152"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483179","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":"Global research highlights.","authors":"","doi":"10.1007/s43678-025-00871-z","DOIUrl":"10.1007/s43678-025-00871-z","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"147-150"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375012","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":"A case report of the thunderclap headache: pearls and pitfalls.","authors":"David Fine, John Teijido, Joseph Honrath","doi":"10.1007/s43678-024-00844-8","DOIUrl":"10.1007/s43678-024-00844-8","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"144-146"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923291","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":"Implementation of an electronic ordering algorithm based on the YEARS criteria to optimize pulmonary embolism diagnostic workup in the emergency department.","authors":"Juliana Duffy, Ferco H Berger, Ivy Cheng, Dominick Shelton, Jean-Philippe Galanaud, Rita Selby, Tali Fedorovsky, John Matelski, Justin N Hall","doi":"10.1007/s43678-024-00840-y","DOIUrl":"10.1007/s43678-024-00840-y","url":null,"abstract":"<p><strong>Objective: </strong>The YEARS criteria combine D-dimer testing and clinical features (hemoptysis, signs of deep vein thrombosis, and pulmonary embolism as the most likely diagnosis) to risk stratify patients with symptoms of pulmonary embolism who may undergo CT pulmonary angiography in the emergency department (ED). Electronic clinical decision support can optimize CT pulmonary angiography utilization in EDs, yet its effectiveness with the YEARS criteria remains unstudied. Our goal is to increase the percentage of CT pulmonary angiograms performed with a D-dimer by 10% within six months of integrating the YEARS criteria into our electronic ordering system.</p><p><strong>Methods: </strong>Single centre quality improvement initiative for all ED patients > 18 years investigated for pulmonary embolism with a D-dimer and/or CT pulmonary angiogram between Jan 2022 - Jan 2023. An electronic clinical decision support algorithm was created based on the YEARS criteria and a plan-do-study-act cycle was completed. Using an SPC chart, the percentage of CT pulmonary angiograms ordered with a D-dimer was identified. Process measures included the rate of CT pulmonary angiograms ordered, the rate of imaging ordered in accordance with the YEARS criteria, and diagnostic yield of imaging based on YEARS status. Balancing measures included pulmonary embolism identified on CT pulmonary angiogram with a D-dimer < 500 ug/L FEU or within 30 days of index visit after being ruled out with the YEARS criteria.</p><p><strong>Results: </strong>Over 12 months, 2639 patients were investigated for pulmonary embolism and 906 underwent CT pulmonary angiogram. The percentage of CT pulmonary angiograms ordered with a screening D-dimer increased by 14.5% (63.8%, CI 59.5-68.1% vs 78.4%, CI 74.4-82.3%) without increasing the rate of imaging ordered (34.9%, CI 32.4-37.4% vs 33.7%, CI 31.1-36.3%). The YEARS criteria were properly applied in 60% (255/425) of patients who underwent CT pulmonary angiogram. The diagnostic yield of CT pulmonary angiogram was higher if patients were YEARS positive (13.2%, CI 9.0-17.4) compared to YEARS negative (0%, CI 0-28.3) or if not applied (8.1%, CI 3.9-12.4). There were two missed pulmonary embolisms at baseline and none post-intervention.</p><p><strong>Conclusions: </strong>Implementation of the YEARS criteria using electronic ordering assistance increased the percentage of CT pulmonary angiograms ordered with a D-dimer without increasing imaging use in the ED.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"123-128"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392683","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}