CJEM最新文献

{"title":"Just the facts: who needs telemetry in the emergency department?","authors":"Lucy Karp, Shahbaz Syed","doi":"10.1007/s43678-026-01111-8","DOIUrl":"https://doi.org/10.1007/s43678-026-01111-8","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222313","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: bronchiolitis in the pediatric population.","authors":"Jason Emsley, Breanna Hargreaves, Rachel Creighton","doi":"10.1007/s43678-026-01130-5","DOIUrl":"https://doi.org/10.1007/s43678-026-01130-5","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204240","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":"Association between cold weather and emergency department utilization among patients experiencing houselessness in a northern Canadian city.","authors":"Jesse Hill, Esther H Yang, Nana O M Essel, Brian H Rowe","doi":"10.1007/s43678-026-01120-7","DOIUrl":"https://doi.org/10.1007/s43678-026-01120-7","url":null,"abstract":"<p><strong>Introduction: </strong>Lack of secure shelter is a contributing factor for healthcare utilization. Weather extremes, specifically extreme cold, is common in Canada. Because of the safety-net function of emergency departments (EDs), their use as shelters or warming centers is common in cold weather. Timely diversion resources may help mitigate ED crowding.</p><p><strong>Methods: </strong>We conducted a cohort study using linked administrative data between April 2018 and March 2024 of all adult (> 17 years old) patients presenting to any EDs in the greater Edmonton area with an International Classification of Diseases, 10th revision diagnostic code with houselessness, unspecified. We obtained weather data from environment Canada for each day. The primary outcome was ED visits associated with houselessness based on mean daily temperature.</p><p><strong>Results: </strong>Between April 1st, 2018, and March 31st, 2024, there were 2,433,282 total ED visits recorded in the study area. There were 13,421 unique patients with ED visits associated with houselessness; more were male, and the median age was 39 (31, 49). The median visits per year were 5.2 (2.1, 12.4) for patients with a visit associated with houselessness compared to 1.2 (1.0, 3.3) for patients with stable housing. Proportion of ED visits associated with houselessness as a function of mean daily temperature revealed higher ED utilization with colder temperatures (< 0.0001). There was a 21% increase in expected ED visits associated with houselessness during periods of extreme cold.</p><p><strong>Conclusion: </strong>Patients experiencing houselessness access EDs much more frequently than patients with stable housing. There was a much higher number of unique patients experiencing houselessness than expected. Utilization increases during times of extreme cold weather; and interventions to address these capacity issues are urgently needed.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208090","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: approach to adult patients with immune thrombocytopenic purpura in the emergency department.","authors":"Brit Long, Roy Khalife, Hans Rosenberg","doi":"10.1007/s43678-025-01024-y","DOIUrl":"10.1007/s43678-025-01024-y","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"100-103"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety profile of midazolam for minimal sedation in the pediatric emergency department.","authors":"Ehud Rosenbloom, Guy Aviv, Dana Schujovizky, Nir Friedman","doi":"10.1007/s43678-025-01072-4","DOIUrl":"10.1007/s43678-025-01072-4","url":null,"abstract":"<p><strong>Objective: </strong>Although minimal sedation with midazolam is frequently performed in the pediatric emergency department (ED) for various procedures, limited research exists regarding its safety profile, and no clear guidelines define the resources required for minimal sedation. The main objective of this study was to determine the proportion of children who developed adverse events after receiving oral or intranasal midazolam for minimal sedation in our pediatric ED.</p><p><strong>Methods: </strong>We conducted an observational, single center study including all children who presented to the pediatric ED between January 1, 2015, and December 31, 2021, and underwent minimal sedation with oral or intranasal midazolam.</p><p><strong>Results: </strong>A total of 2544 children with a median age of 4 years (IQR 2-6 years) were included. We identified a total of 12 (0.47%) adverse events: 9 (0.35%) minimal, 2 (0.08%) minor, and 1 (0.04%) moderate. There were no sentinel adverse events. All children were discharged home from the pediatric ED, and none required hospitalization.</p><p><strong>Conclusion: </strong>The incidence of adverse events during minimal sedation with oral or intranasal midazolam in our pediatric ED was low, and interventions were rarely required. Minimal sedation with oral or intranasal midazolam appears to be a safe and well-tolerated procedure. Our findings support the safety of minimal sedation with midazolam in a structured, well-monitored ED setting.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"156-161"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954262","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":"Sex differences in the one-year outcomes of emergency department patients with alcohol withdrawal.","authors":"Jeremy Palomares, Sophie Gosselin","doi":"10.1007/s43678-026-01097-3","DOIUrl":"https://doi.org/10.1007/s43678-026-01097-3","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"28 2","pages":"83-84"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346046","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":"How health systems learn to fail : Emergency departments and the normalization of breakdown.","authors":"Paul Atkinson, Alecs Chochinov, David Petrie","doi":"10.1007/s43678-026-01090-w","DOIUrl":"10.1007/s43678-026-01090-w","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"90-92"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108990","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/s43678-026-01115-4","DOIUrl":"10.1007/s43678-026-01115-4","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"166-170"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313437","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":"Multicenter review of antimicrobial stewardship in the emergency department through pharmacist-led culture review and follow-up programs in Alberta.","authors":"Ivy Nhan, Tracy Chin, Elissa Rennert-May, Thomas Brownlee, Micheal Guirguis, Irina Rajakumar","doi":"10.1007/s43678-025-00940-3","DOIUrl":"10.1007/s43678-025-00940-3","url":null,"abstract":"<p><strong>Background: </strong>In some emergency departments (EDs), pharmacists review and follow-up on microbiological test results for recently discharged patients, intervening when empiric therapy is missing or inadequate to ensure appropriate antimicrobial use. Currently, this practice is not well described in Canada. Characterizing these ED pharmacist activities can help identify antimicrobial stewardship opportunities and allow for more tailored education and training.</p><p><strong>Objectives: </strong>The primary objective of this study was to describe culture review and follow-up pharmacy practice in terms of antimicrobial stewardship interventions. Secondary objectives included describing the types of cultures being managed and the antimicrobials prescribed empirically and post-culture review.</p><p><strong>Methods: </strong>A retrospective chart review was conducted using pharmacist workload tracking documentation to identify patients with eligible cultures from six EDs in Alberta.</p><p><strong>Results: </strong>Three hundred cultures were included in this study, and one hundred twenty-nine interventions (40.7% of all cultures reviewed) were performed by ED pharmacists. Initiation of therapy was the most common (33.3%), followed by tailoring therapy (21.7%). Urine cultures were predominant (55.7%), and the antibiotics most prescribed, empirically, and post-culture for urine, were cefixime (44%) and trimethoprim-sulfamethoxazole (34%), respectively. Five patients with asymptomatic bacteriuria were treated with antibiotics. Five patients with skin and soft tissue infections were treated with dual oral antibiotics when culture and sensitivity results indicated monotherapy would have been sufficient. Eight extra days of cefixime therapy were prescribed due to unaccounted doses administered in the ED.</p><p><strong>Conclusion: </strong>This study highlights the critical role of ED pharmacists in culture review and follow-up activities and their contributions to antimicrobial stewardship. By characterizing culture review and follow-up practices, several opportunities for minimizing unnecessary antimicrobial use were identified. These findings will help inform the development of targeted education and training programs to help strengthen the stewardship capabilities of ED pharmacists and prescribers.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"111-118"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217857","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: approach to cardiogenic shock in the emergency department.","authors":"Marie-Eve Mathieu, Rebecca Mathew, Brit Long, Hans Rosenberg","doi":"10.1007/s43678-025-01021-1","DOIUrl":"10.1007/s43678-025-01021-1","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"96-99"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287819","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}