CJEM最新文献

{"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":"https://doi.org/10.1007/s43678-024-00844-8","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","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":"Adopting the human factors analysis and classification system into emergency medicine morbidity and mortality rounds: a quality improvement initiative.","authors":"Nicholas Villa, Michael Baskey, Constance LeBlanc","doi":"10.1007/s43678-024-00837-7","DOIUrl":"https://doi.org/10.1007/s43678-024-00837-7","url":null,"abstract":"<p><strong>Objectives: </strong>This initiative assessed the integration of the Human Factors Analysis and Classification System, adapted from aviation, into emergency medicine morbidity and mortality rounds. The objective was to determine whether incorporating the Human Factors Analysis and Classification System could lead to a perceived increase in the overall quality of morbidity and mortality presentations through the standardization of classifying cause factors of medical errors.</p><p><strong>Methods: </strong>This study involved eight emergency medicine residents who applied the adapted Human Factors Analysis and Classification System framework to their morbidity and mortality case presentations over 6 months. Data were collected through surveys completed by presenters and morbidity and mortality audience members. These assessed four main outcomes: relevance, feasibility, quality, and acceptability of the Human Factors Analysis and Classification System framework.</p><p><strong>Results: </strong>The integration of the Human Factors Analysis and Classification System was positively perceived across all outcome measures. Presenters and audience members rated cause factor identification as important (100%), indicating the relevance of Human Factors Analysis and Classification System in morbidity and mortality rounds. Feasibility assessments showed a mean score of 4.25 out of 5, indicating favorable ease of use. The quality assessment mean score was 3.97 out of 5, indicating perceived improvement in cause factor identification. Presenters (62.5% Strongly Agree, 37.5% Agree) and audience members (73% Yes, 21.62% Undecided, 5.4% No) expressed acceptability and support for continued Human Factors Analysis and Classification System use.</p><p><strong>Conclusion: </strong>Integrating the Human Factors Analysis and Classification System into morbidity and mortality rounds in the Department of Emergency Medicine was well-received and led to a perceived increase in the quality of cause factor identification. Both presenters and audience members endorsed the use of the Human Factors Analysis and Classification System, suggesting its desirability for sustained integration. The results of this study pave the way for future quality improvement initiatives, including the adaptability of the Human Factors Analysis and Classification System across various medical departments and its potential to enhance cause factor classification in morbidity and mortality rounds.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923496","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: considerations and management of fever in the returning traveler.","authors":"John C Lam, Samuel Bourassa-Blanchette, Stuart J Netherton","doi":"10.1007/s43678-024-00833-x","DOIUrl":"https://doi.org/10.1007/s43678-024-00833-x","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923952","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":"Emergency department trends for inguinal hernia and gallbladder disease before and after COVID-19 scheduled surgery interruptions: lessons for hospital capacity management.","authors":"Conné Lategan, Xiaoming Wang, Cassandra Chisholm, Zoe Hsu, Eddy Lang","doi":"10.1007/s43678-024-00832-y","DOIUrl":"https://doi.org/10.1007/s43678-024-00832-y","url":null,"abstract":"<p><strong>Objectives: </strong>Postponing scheduled surgeries may alleviate emergency department (ED) crowding by increasing inpatient beds for ED patients but the impact of such measures are unclear. We determined if scheduled surgery cancellations for inguinal hernia and gallbladder disease during the coronavirus pandemic affected ED presentations, hospitalizations, and complications.</p><p><strong>Methods: </strong>This database review included Albertans ≥ 18 with ED presentations for inguinal hernia and gallbladder disease from March 1, 2018 to May 31, 2022. The primary outcome examined ED hospitalizations and complications in the pre- (March 1, 2018-March 18, 2020) and post-cancellation (May 4, 2020-May 31, 2022) periods utilizing interrupted time series analysis. The secondary outcome reported scheduled surgery trends.</p><p><strong>Results: </strong>78,315 (10.6% inguinal hernia n = 8268; 89.4% gallbladder disease n = 70,064; n = 17 both inguinal hernia and gallbladder disease) patients were included. The post-cancellation period experienced a decreased trend change for inguinal hernia patients who received hospital admission (- 146.0%; p < 0.001), urgent interventions (- 171.0%; p < 0.001), and hernia repairs (- 164.0%; p < 0.001). For gallbladder disease patients, the post-cancellation period demonstrated a decreased trend in hospital admission (- 106.0%; p = 0.038) and an increased trend in day surgery transfers (- 1285.0%; p = 0.015) and median ED length of stay (82.0%; p = 0.0042). During the cancellation period, inguinal hernia and gallbladder disease surgeries decreased by 66.7% and 55.6%, respectively.</p><p><strong>Conclusions: </strong>Despite a two-month surgery cancellation period, inguinal hernia and gallbladder disease patients demonstrated minimal differences in outcomes. During periods of ED boarding and crowding, scheduled surgery cancellations may be considered with minimal risk of potential adverse patient effects.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923941","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 on healthier shift scheduling: \"We're tired of being tired\".","authors":"Sara Gray, Brittany Cameron, Louise Rang","doi":"10.1007/s43678-024-00835-9","DOIUrl":"https://doi.org/10.1007/s43678-024-00835-9","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923946","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: evaluation and management of hemophilia.","authors":"Brit Long, Roy Khalife, Hans Rosenberg","doi":"10.1007/s43678-024-00780-7","DOIUrl":"10.1007/s43678-024-00780-7","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"7-10"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334374","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 new approach to follow-up of survivors of sexual assault in the emergency department?","authors":"Eric Revue, Anthony Chauvin, Hillary Minka","doi":"10.1007/s43678-024-00846-6","DOIUrl":"https://doi.org/10.1007/s43678-024-00846-6","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"27 1","pages":"3-4"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018239","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":"Low caregiver health literacy is associated with non-urgent pediatric emergency department use.","authors":"Katharine V Jensen, Andrea Morrison, Keon Ma, Waleed Alqurashi, Tannis Erickson, Janet Curran, Ran D Goldman, Serge Gouin, April Kam, Naveen Poonai, Tania Principi, Shannon Scott, Antonia Stang, Patricia Candelaria, Kurt Schreiner, Maryna Yaskina, Samina Ali","doi":"10.1007/s43678-024-00771-8","DOIUrl":"10.1007/s43678-024-00771-8","url":null,"abstract":"<p><strong>Objective: </strong>Caregivers with low health literacy are more likely to overestimate illness severity and have poor adherence with health-promoting behaviors. Our primary objective was to relate caregiver health literacy to the urgency of emergency department (ED) utilization. The secondary objective was to explore the relationship between social and demographic characteristics, health literacy, and urgency of ED use.</p><p><strong>Methods: </strong>This sub-study was a descriptive cross-sectional survey with health record review. Data were collected from ten Canadian pediatric EDs. Study variables included demographics, visit details, and the Newest Vital Sign measurement of health literacy. ED visits were classified as urgent or non-urgent based on the resource utilization method.</p><p><strong>Results: </strong>The response rate was 97.6% (n = 2005). Mean (SD) caregiver age was 37.0 (7.7) years, 74.3% (n = 1950) were mothers, 72.6% (n = 1953) spoke English as a primary language, 51.0% (n = 1946) had a university degree, and 45.1% (n = 1699) had a household income greater than $100,000. The mean (SD) age of the children was 5.9 (5.0) years and 48.1% (n = 1956) were female. 43.7% (n = 1957) of caregivers had low health literacy. Being a caregiver with a child < 2 years old [aOR 1.83 (1.35, 2.48)] and low health literacy [aOR 1.56 (1.18, 2.05)] were associated with greater non-urgent pediatric ED use. Interprovincial variation was evident: Quebec caregivers were less likely to use the pediatric ED for non-urgent presentations compared to Alberta, while those in Nova Scotia, Manitoba, British Columbia, and Ontario were more likely compared to Alberta.</p><p><strong>Conclusion: </strong>Almost half of caregivers presenting to Canadian pediatric EDs have low health literacy, which may limit their ability to make appropriate healthcare decisions for their children. Low caregiver health literacy is a modifiable factor associated with increased non-urgent ED utilization. Efforts to address this may positively influence ED utilization.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"17-26"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334376","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":"Letter to the Editor: The current state of emergency medicine is a long-term threat to EM residency training.","authors":"Aaron Johnston, Avik Nath, Sheila Smith, Peter Rogers","doi":"10.1007/s43678-024-00813-1","DOIUrl":"10.1007/s43678-024-00813-1","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"74-75"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483180","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":"Busier emergency departments: same triage systems-can AI solve the \"next-to-be-seen\" problem?","authors":"Jessalyn K Holodinsky, Lisa Sabir, Andrew D McRae, Suzanne M Mason","doi":"10.1007/s43678-024-00847-5","DOIUrl":"https://doi.org/10.1007/s43678-024-00847-5","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"27 1","pages":"5-6"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018160","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}