CJEM最新文献

{"title":"Emergency department overcrowding: a CAEP position statement.","authors":"Ming K Li, Shelley L McLeod, Andrew Affleck, Tahara Bhate, Grant Innes, Paul Parks, David A Petrie, Brian H Rowe, Carolyn Snider, James C Worrall, Fraser Mackay, Howard J Ovens","doi":"10.1007/s43678-026-01228-w","DOIUrl":"10.1007/s43678-026-01228-w","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"895-900"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431742","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 trauma brain CT scan is positive. Now what?","authors":"Pierre-Géraud Claret, Alice Theadom, Martin Than","doi":"10.1007/s43678-026-01276-2","DOIUrl":"https://doi.org/10.1007/s43678-026-01276-2","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"28 10","pages":"887-888"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169411","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":"Working through the walls: maintaining emergency department operations during major renovations in a canadian tertiary care centre.","authors":"Garrick Mok, Samuel Vaillancourt, Sadie McClure, Tom Parker, Steve Lin","doi":"10.1007/s43678-026-01295-z","DOIUrl":"https://doi.org/10.1007/s43678-026-01295-z","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083283","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":"Who works the night shift? Workforce design in emergency medicine.","authors":"Paul Atkinson, Jadyn Mah, William Lewis, David Lewis","doi":"10.1007/s43678-026-01290-4","DOIUrl":"https://doi.org/10.1007/s43678-026-01290-4","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083280","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":"Access to supervised consumption services in the emergency department: patient characteristics and outcomes.","authors":"Nina Lam, Lindsay Grant-Nunn, Lisa Ying, Klaudia Dmitrienko, Jaspreet Khangura, Rebeccah Rosenblum, Roycent Tumbare, Jake Hayward, Kathryn Dong","doi":"10.1007/s43678-026-01272-6","DOIUrl":"https://doi.org/10.1007/s43678-026-01272-6","url":null,"abstract":"<p><strong>Objectives: </strong>Supervised consumption services have rarely been integrated into hospital environments. This study aimed to describe the characteristics of the first 50 emergency department (ED) patients who accessed a hospital-based supervised consumption service. A secondary goal was to evaluate any adverse events.</p><p><strong>Methods: </strong>This study was carried out in a large urban acute care emergency department. Using a standardized data abstraction template, characteristics of the patient, emergency department visit, and supervised consumption visit were independently extracted by two reviewers from the patient's chart and electronic health record. Descriptive statistics are shown.</p><p><strong>Results: </strong>The first 50 emergency department patients to access the hospital-based supervised consumption service made a total of 66 visits between October 3, 2019, and September 10, 2020. Most were male (31, 62%) and were sleeping in shelters or outside (30, 60%); 15 (30%) were prescribed opioid agonist treatment in the community. Hospital admission was necessary for 19 patients (38%). Adverse events were infrequent.</p><p><strong>Conclusions: </strong>Emergency department patients are open to using supervised consumption services. Further research is needed to explore how access to supervised substance use in the emergency department influences patient and staff safety.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077096","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":"Point-of-care ultrasound for left ventricular function in patients with atrial fibrillation in the emergency department.","authors":"Sophia-Maria Giannakakis, Ian Stiell, Michael Y Woo, Angeline Law, Habibat Garuba, Monica Taljaard, Jeffrey J Perry","doi":"10.1007/s43678-026-01259-3","DOIUrl":"https://doi.org/10.1007/s43678-026-01259-3","url":null,"abstract":"<p><strong>Introduction: </strong>There is a knowledge gap regarding reliability of point-of-care ultrasound (POCUS) assessing left ventricular function for patients in acute rapid atrial fibrillation (AF) or flutter (AFL) in the emergency department (ED). We sought to evaluate interrater agreement of POCUS severely reduced left ventricular function in this ED population.</p><p><strong>Methods: </strong>We conducted a health records review of adult patients who presented with rapid AF/AFL, heart rate above 110, to a tertiary care hospital ED. POCUS scans archived by ED physicians were interpreted by two cardiologists and one ED POCUS expert. Left ventricular function was categorized as either 'normal or non-severely reduced' and 'severely reduced' function. Interrater agreement analysis was performed using Cohen's kappa with 95% confidence interval (CI).</p><p><strong>Results: </strong>We identified 332 ED patients with acute rapid AF/AFL during our study period, of which 128(38%) had POCUS assessing left ventricular function. All archived POCUS scans (100/128) were used for agreement analysis. We found a moderate level of agreement between cardiologists and ED POCUS expert (k = 0.63 CI 95% 0.43-0.82) with an 88% raw agreement (74% normal or non-severe, 14% severely reduced). Fair agreement was found between cardiologists and ED physicians (k = 0.34 CI 95% 0.10-0.58) 85% raw agreement (80% normal or non-severe, 5% severely reduced).</p><p><strong>Conclusion: </strong>Among patients with rapid AF/AFL evaluated in the ED, one-third had POCUS left ventricular function assessments. ED physicians and ED POCUS expert agreement with cardiologists ranged from fair to moderate when distinguishing severely reduced left ventricular function from normal or non-severely reduced function in patients with rapid AF/AFL. These findings are a first step in demonstrating the reliability of POCUS left ventricular function assessment in patients presenting with rapid AF/AFL to the ED.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077082","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":"Prevalence of Lyme disease in patients with peripheral facial palsy in the province of Quebec: a prospective multicenter Canadian study.","authors":"Matthieu Vincent, Éloïk Guay, Laura Blais, Justin Foo, Mystelle Labrosse, Agnès Côté, Béatrice Emond, Djamal Berbiche, Amélie Thuot, Katia Hamelin, Antoine Brouillard","doi":"10.1007/s43678-026-01271-7","DOIUrl":"https://doi.org/10.1007/s43678-026-01271-7","url":null,"abstract":"<p><strong>Objectives: </strong>Lyme disease is a recognized cause of peripheral facial palsy, but its estimated prevalence in affected patients varies widely, ranging from 2 to 65%. There are no clear guidelines to assist clinicians in the empiric management of undifferentiated peripheral facial palsy in regions where Lyme disease is prevalent. This prospective multicenter study aimed to determine the prevalence of Lyme disease-associated facial palsy in patients presenting with peripheral facial palsy in four emergency departments in the most endemic regions of Quebec, Canada (Estrie and Montérégie).</p><p><strong>Methods: </strong>Emergency physicians at four Quebec hospitals completed a brief online questionnaire for each patient presenting with peripheral facial palsy from February 2022 to September 2023; they were also encouraged to order Lyme disease testing. A subsequent search was conducted in the electronic medical records of each participating hospital to retrieve Borrelia burgdorferi serology results (ELISA and/or Western blot).</p><p><strong>Results: </strong>Among the 83 patients who consulted for peripheral facial palsy, Lyme disease serology testing was performed in 68 cases. Of these, only two had a positive ELISA screening test. None of these patients had a confirmed diagnosis based on confirmatory Western blot testing.</p><p><strong>Conclusions: </strong>The findings of this study indicate a low prevalence of Lyme disease among patients presenting with peripheral facial palsy in Quebec. While the authors recommend testing for Lyme disease as per local guidelines in patients presenting with peripheral facial palsy in endemic regions, empiric treatment should not be routinely initiated in the absence of other clinical signs or symptoms suggestive of the disease given the absence of confirmed cases in this cohort.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077111","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":"Simulation training in Canadian College of Family Physicians Emergency Medicine (CCFP-EM) programs.","authors":"Aajab Abdulhussein, Susan Humphrey-Murto, Avik Nath, Warren J Cheung, Andrew K Hall","doi":"10.1007/s43678-026-01268-2","DOIUrl":"https://doi.org/10.1007/s43678-026-01268-2","url":null,"abstract":"<p><strong>Objectives: </strong>The Canadian College of Family Physicians Emergency Medicine (CCFP-EM) program offers 1 year of enhanced emergency training following a 2-year family medicine residency. Due to limited training time and unpredictable exposure to high-acuity scenarios, simulation-based education plays a critical role in developing procedural and crisis resource management competencies. This study aimed to characterize simulation use across Canadian CCFP-EM programs, with objectives to 1) describe the volume and delivery of simulation programs, 2) outline curricular content, and 3) explore how simulation is used for assessment.</p><p><strong>Methods: </strong>From June 2023 to January 2024, we interviewed 16 out of 17 program representatives from Canadian CCFP-EM programs. Data were collected via both a pre-interview survey and a semi-structured interview. Program representatives included program directors, assistant program directors, or simulation directors.</p><p><strong>Results: </strong>All programs reported access to a simulation center, with 25% offering remote or virtual simulation. The median simulation hours provided across programs was 42 h annually, with individual residents participating 40 h on average. Most programs covered core national emergency medicine simulation topics, obtaining cases from their own case bank, or using open-access simulation resources. Most program representatives supported developing a standardized national simulation curriculum, emphasizing the need for flexibility for local adaptation. Only 31% of programs used simulation for assessment, citing concerns over psychological safety, feasibility and standardization. Faculty time and cost were the most cited barriers to simulation in general. Notable innovations included disaster simulations, resident-led peer teaching, and specialist-assisted procedural curriculum.</p><p><strong>Conclusion: </strong>Our results provide a starting point for discussion and collaboration across programs, creating opportunities to optimize curricular development and the use of simulation for assessment, while considering resource availability and learner psychological safety. Simulation-based education has been a key educational tool, and educators and program leaders must understand how we are using simulation to teach our residents.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042819","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":"Extended-release subcutaneous buprenorphine vs. daily sublingual buprenorphine for opioid use disorder in the emergency department.","authors":"Matthew Hacker Teper, Ian V Beamish, Hasan Sheikh","doi":"10.1007/s43678-026-01282-4","DOIUrl":"https://doi.org/10.1007/s43678-026-01282-4","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066339","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 impact of faculty development interventions on supervisor narrative feedback quality in competency-based medical education.","authors":"Rob Woods, Max Spadafore, Brent Thoma, Lynsey Martin, Teresa Chan, Venkat Bandi","doi":"10.1007/s43678-026-01267-3","DOIUrl":"https://doi.org/10.1007/s43678-026-01267-3","url":null,"abstract":"<p><strong>Objectives: </strong>Improving the feedback that supervisors provide trainees in medical education is challenging. The development of automated methods of rating the quality of narrative feedback has created an opportunity to quantify the impact of interventions focused on this goal.</p><p><strong>Methods: </strong>We used a previously developed natural language processing model based on the Quality Assessment of Learning (QuAL) score to rate the quality of each comment in our Royal College Emergency Medicine specialty training program from July 2018 to June 2024. We quantified the effectiveness of three faculty development interventions (e-mail feedback, audit and feedback workshops, and assessment form modifications) by comparing pre- and post-intervention QuAL scores.</p><p><strong>Results: </strong>During the study period 9709 narrative comments were scored. The average QuAL score rose from 3.2/5 in 2019 to 4.5/5 in 2024. All interventions resulted in an overall improvement in the mean QuAL score as measured by assessor weighted mean: individual e-mail with suggestions for improvement (35.1%), assessment form template change (24.3%), workshop (19.1%) and individual e-mail thanking them for their high-quality comments (11.0%).</p><p><strong>Conclusions: </strong>By combining a multi-faceted faculty development approach with a scalable measurement of our outcome, we have demonstrated an improvement in supervisor narrative comment quality and quantified the impact of each intervention. While it is likely that the interventions were complementary, individual e-mails to faculty with suggestions for improvement and modifications to the assessment form were associated with largest improvements in quality. These results may guide to other programs seeking to improve the quality of supervisor narrative comments.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042753","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}