CJEM最新文献

{"title":"Andexanet for factor Xa inhibitor-associated acute intracerebral hemorrhage.","authors":"Cameron Leafloor, Robert Green, Sameer Sharif","doi":"10.1007/s43678-024-00845-7","DOIUrl":"10.1007/s43678-024-00845-7","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"104-106"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934033","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":"Wake up!: a novel, cadaver-based approach to training emergency physicians in awake intubation.","authors":"Adam Parks, J Adam Law, George Kovacs","doi":"10.1007/s43678-024-00831-z","DOIUrl":"10.1007/s43678-024-00831-z","url":null,"abstract":"<p><p>Despite awake tracheal intubation being considered the safest method of intubation for patients with predicted difficult airways, there is limited evidence and poor availability of training interventions to assist emergency medicine physicians achieve competency in this technique. Here, we describe a novel, cadaver-based course for emergency medicine physicians to acquire skills in awake tracheal intubation. A convenience sample of 15 emergency medicine physicians from across Canada participated in the pilot course. Questionnaire data regarding the course's usefulness and participants' confidence in awake tracheal intubation were collected. All 15 participants completed the course, and questionnaire data showed that participants found the course useful and practice-changing. Three physicians reported successfully performing awake tracheal intubation in the emergency department during the 3-6-month follow-up period. Expansion of similar courses could help emergency medicine physicians acquire the skills necessary to safely perform awake tracheal intubation. Future studies should focus on optimizing training protocols, with a focus on practical methods to improve long-term skill retention.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"107-110"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928672","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 ophthalmoscopy: physician confidence and clinical practices.","authors":"C Ukagwu, J Teichman, M Ben-Yakov, I Dubinsky, A Théogène, R A Sharma","doi":"10.1007/s43678-024-00843-9","DOIUrl":"10.1007/s43678-024-00843-9","url":null,"abstract":"<p><strong>Objectives: </strong>Fundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians' practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed to approximately 1000 emergency physician members of the Canadian Association of Emergency Physicians between March 4 and April 10, 2024. The survey, developed with ophthalmology and emergency medicine experts, included Likert scales and multiple-choice questions addressing confidence, practices, training, and experience with various fundoscopy modalities. Demographic data and responses were analyzed using descriptive statistics. Surveys were anonymous and available in English and French.</p><p><strong>Results: </strong>Seventy-four emergency physicians participated (mean experience 17.8 years), representing all Canadian provinces and territories. Most reported experience with traditional direct ophthalmoscopes (97.3%), slit lamp fundoscopy (82.2%) and panoptic ophthalmoscopes (58.9%). Only 1.4% had used binocular indirect ophthalmoscopes. No participant had experience with fundus cameras. Confidence in identifying fundus findings was low across all modalities, with only 13.7% reporting confidence using traditional ophthalmoscopes. Fundoscopy was performed frequently or always by 57.5% of the respondents, yet only 6.8% routinely used pupil dilation. Only 35.6% of the respondents felt their training in fundoscopy was adequate.</p><p><strong>Conclusion: </strong>Emergency physicians in Canada report low confidence in fundoscopy despite its critical role in identifying vision- or life-threatening conditions. Traditional modalities are widely used but remain challenging for non-ophthalmologists. Fundus cameras, which offer ease of use and higher diagnostic accuracy, are underutilized.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"117-122"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928600","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: angioedema in the emergency department.","authors":"Derek Lanoue, Hien Reeves, Moshe Ben-Shoshan, Hans Rosenberg, Ariel Hendin","doi":"10.1007/s43678-024-00834-w","DOIUrl":"https://doi.org/10.1007/s43678-024-00834-w","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018236","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":"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":"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}

{"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}