1,646 results match your criteria CJEM: Canadian Journal of Emergency Medicine JCMU: Journal Canadien de la Medicine D'urgence[Journal]


FOAMed and social media - innovation or disruption?

CJEM 2018 Nov;20(6):818-820

*Department of Emergency Medicine,University of Ottawa,Ottawa,ON.

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November 2018
2 Reads

Delirium in older emergency department patients.

Authors:
Debra Eagles

CJEM 2018 Nov;20(6):811-812

*Department of Emergency Medicine, University of Ottawa,Ottawa,ON.

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November 2018
1 Read

ST-segment elevation myocardial infarction (STEMI) bypass: The importance of paramedics in an integrated STEMI system of care.

Authors:
Alix J E Carter

CJEM 2018 Nov;20(6):813-815

*Department of Emergency Medicine,Division of EMS,Dalhousie University,Halifax,NS.

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November 2018

You don't need a mentor; you need a board of directors.

CJEM 2018 Nov;20(6):816-817

*Professor of Emergency Medicine,Assistant Dean of Health Professions Education Research,McMaster University.Correspondence to: David Braley Health Sciences Centre,Room 5003,1280 Main St W. Hamilton,ON L8S 4K1; Twitter:

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November 2018

Safety and clinically important events in PCP-initiated STEMI bypass in Ottawa.

CJEM 2018 Nov;20(6):865-873

*Department of Emergency Medicine,University of Ottawa,Ottawa,ON.

CLINICIAN'S CAPSULE What is known about the topic? Transport of STEMI patients directly to the cath lab (STEMI bypass) by advanced care paramedics (ACPs) is common practice. The safety of this practice with primary care paramedics (PCPs) is unknown. What did this study ask? What is the prevalence and breakdown of events during PCP STEMI bypass? What did this study find? Clinically important events are common in STEMI bypass patients. Read More

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November 2018

Introduction.

Authors:
Ian G Stiell

CJEM 2018 Oct;20(S2):S1

Editor-in-Chief,Canadian Journal of Emergency Medicine.

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October 2018

Outcomes and emergency medical services resource utilization among patients with syncope arriving to the emergency department by ambulance.

CJEM 2018 Nov 21:1-6. Epub 2018 Nov 21.

†Ottawa Hospital Research Institute,Ottawa, ON.

CLINICIAN'S CAPSULEWhat is known about the topic?A majority of syncope patients are transported to the emergency department by emergency medical services (EMS), yet only a small proportion are admitted or suffer serious adverse events (SAE).What did this study ask?What proportion of EMS syncope patient transports are at low risk (i.e. Read More

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November 2018
2 Reads

New Canadian guideline provides evidence-based approach to non-occupational HIV prophylaxis.

CJEM 2018 Nov 20:1-5. Epub 2018 Nov 20.

‡BC Centre for Excellence in HIV/AIDS,Vancouver, BC.

The incidence of HIV infections in Canada has increased yearly since 2014. New cases of HIV have resulted almost exclusively from non-occupational exposures, including sexual contact and needle sharing. Appropriate HIV post-exposure prophylaxis is under-prescribed to patients who present to the emergency department after a high-risk exposure. Read More

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November 2018
1 Read

The promotion dilemma for clinician teachers.

Authors:
Rick Penciner

CJEM 2018 Nov 13:1-3. Epub 2018 Nov 13.

*Division of Emergency Medicine, Department of Family & Community Medicine,University of Toronto,Toronto,ON.

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November 2018

Implementing electronic medical records in Canadian emergency departments.

CJEM 2018 Nov 9:1-3. Epub 2018 Nov 9.

*Division of Pediatric Emergency Medicine,Hospital for Sick Children,University of Toronto,Toronto,ON.

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November 2018

"Nous sommes forts" Un poème sur la résilience en médecine d'urgence.

CJEM 2018 Nov 9. Epub 2018 Nov 9.

**Département de médecine d'urgence,Université de Montréal,Montréal,QC.

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November 2018

Emergency overcrowding and access block: A smaller problem than we think.

CJEM 2018 Nov 8:1-9. Epub 2018 Nov 8.

§§§Department of Emergency Medicine,Winnipeg Regional Health Authority,University of Manitoba,Winnipeg,MB.

CLINICIAN'S CAPSULE What is known about the topic? Emergency access block is the number one emergency department (ED) safety concern; many believe it cannot be solved without increased hospital capacity. What did this study ask? The objective was to measure emergency access blocks (problem) as a fraction of inpatient capacity (potential solution). What did this study find? Delays to care space averaged 46,000 hours per ED per year - large, but only 1% of inpatient capacity. Read More

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November 2018
3 Reads

Cognitive load theory as a framework for simulation-based, ultrasound-guided internal jugular catheterization training: Once is not enough.

CJEM 2018 Nov 8:1-8. Epub 2018 Nov 8.

‡School of Computing,Queen's University, Kingston, ON.

CLINICIAN'S CAPSULE What is known about the topic? Cognitive load theory can be used to guide simulation-based training for procedural skills. What did this study ask? How can cognitive load theory be used to overcome the challenges of learning ultrasound-guided internal jugular catheterization? What did this study find? All trainees approached or exceeded expert benchmarks, with evidence of retention over time. Why does this study matter to clinicians? This curriculum may better prepare trainees for performing this important procedure in the clinical setting. Read More

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November 2018

Managing the opioid epidemic: back to the basics with resuscitation.

CJEM 2018 Nov 8:1-2. Epub 2018 Nov 8.

†Department of Emergency Medicine,Dalhousie University,Halifax,NS.

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November 2018
1 Read

Blood on board: The development of a prehospital blood transfusion program in a Canadian helicopter emergency medical service.

CJEM 2018 Nov 8:1-9. Epub 2018 Nov 8.

*Shock Trauma Air Rescue Society,Calgary,AB.

CLINICIAN'S CAPSULE What is known about the topic? Emerging evidence regarding prehospital blood transfusions for patients in hemorrhagic shock is positive. What did this study ask? Describe the implementation and stewardship of a prehospital blood transfusion program, as well as basic demographics and blood traceability. What did this study find? We provided blood transfusion to 274 mainly male trauma patients, and just 1. Read More

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November 2018

WWGD (What would Gwyneth do?).

Authors:
Deepa Soni

CJEM 2018 Nov 10;20(6). Epub 2018 Oct 10.

Staff Physician, Emergency Department,Credit Valley Hospital,Trillium Health Partners,2200 Eglinton Avenue West,Mississauga,ON L5M

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November 2018

Effects of a reminder to initiate oral anticoagulation in patients with atrial fibrillation/atrial flutter discharged from the emergency department: REMINDER study.

CJEM 2018 Nov 8;20(6):841-849. Epub 2018 Oct 8.

*Libin Cardiovascular Institute of Alberta,Department of Cardiac Sciences,University of Calgary,Calgary,AB.

CLINICIAN'S CAPSULE What is known about the topic? Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation or flutter; however, initiation rates in patients discharged from the ED are low. What did this study ask? Can a simple quality improvement intervention increase the initiation of appropriate OAC in the ED? What did this study find? The rate of OAC initiation was increased by 8.5%. Read More

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November 2018
5 Reads

Analysis of eye-tracking behaviours in a pediatric trauma simulation.

CJEM 2018 Oct 8:1-3. Epub 2018 Oct 8.

*University of Calgary Cumming School of Medicine,Calgary,AB.

ABSTRACTEye-tracking devices are able to capture eye movements, which are further characterized by fixations. The application of eye tracking in a trauma setting has not been explored. Visual fixation can be utilized as a surrogate measure of attention during the management of a trauma patient. Read More

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October 2018
6 Reads

Methotrexate for the treatment of unruptured tubal ectopic pregnancy.

CJEM 2018 Oct 8:1-4. Epub 2018 Oct 8.

*Schwartz/Reisman Emergency Medicine Institute,Toronto,ON.

CLINICIAN'S CAPSULE What is known about the topic? Methotrexate is widely accepted as first-line treatment of non-ruptured ectopic pregnancy and may be considered for women with a suspected ectopic pregnancy. What did this study ask? What are the outcomes of pregnant women with suspected ectopic pregnancy who received methotrexate as first-line treatment? What did this study find? Of patients treated with methotrexate, 18% went on to require surgical management, with 11.2% having ruptured on surgical evaluation. Read More

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October 2018
4 Reads

The effect of an infographic promotion on research dissemination and readership: A randomized controlled trial.

CJEM 2018 Nov 5;20(6):826-833. Epub 2018 Oct 5.

*Department of Emergency Medicine,University of Saskatchewan,Saskatoon,SK.

CLINICIAN'S CAPSULE What is known about the topic? Infographics are graphical illustrations of complex ideas that are broadly shared on social media platforms. What did this study ask? What is the effect of a social media strategy using infographics on the readership and dissemination of research articles? What did this study find? Infographic articles were associated with increased Altmetric scores and abstract views, but not full-text views. Why does this study matter to clinicians? The promotion of articles with infographics may increase awareness and dissemination of research findings among clinicians. Read More

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November 2018
1 Read

Comparison of PECARN, CATCH, and CHALICE clinical decision rules for pediatric head injury in the emergency department.

CJEM 2018 Oct 2:1-5. Epub 2018 Oct 2.

†Department of Emergency Medicine,Saint John Regional Hospital,St. John,NB.

Clinical questionWhat is the diagnostic accuracy of the PECARN, CATCH, and CHALICE clinical decision rules for pediatric head injury, and are the clinical decision rules valid when applied to a novel data set?Article chosenBabl FE, Borland ML, Phillips N, et al. Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. Lancet (London, England) 2017;389(10087):2393-402. Read More

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October 2018

Evaluation of emergency department ultrasound machines for the presence of occult blood.

CJEM 2018 Oct 2:1-4. Epub 2018 Oct 2.

*Department of Emergency Medicine,College of Medicine,University of Saskatchewan,Saskatoon,SK.

CLINICIAN'S CAPSULE What is known about the topic? Bedside ultrasound is a frequently used tool in the emergency department (ED), with no standard cleaning protocols in place. What did this study ask? Is there visible and occult contamination of the ED ultrasound machine after daily use and in trauma? What did this study find? This study found that the ultrasound machine tested positive for occult blood contamination on 10% of daily tests and on 43% of assessments after use in trauma. Why does this study matter to clinicians? Standard cleaning practices should be implemented to reduce contamination rates. Read More

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October 2018
1 Read

Retrospective evaluation of a clinical decision support tool for effective computed tomography angiography utilization in urgent brain imaging of suspected TIA/minor stroke in the emergency department.

CJEM 2018 Oct 2:1-9. Epub 2018 Oct 2.

§Departments of Neurosciences (Stroke Rapid Assessment Clinic),Island Health Authority,Victoria,BC.

CLINICIAN'S CAPSULE What is known about the topic? Canadian guidelines recommend that suspected transient ischemic attack (TIA) patients receive brain imaging in the emergency department; yet, high requisition rates for non-cerebrovascular patients exist. What did this study ask? What is the hypothetical impact that a clinical decision support tool (CDST) would have on computed tomography angiography (CTA) requisitions for suspected TIA patients. What did this study find? CDST use would have resulted in more TIA patients receiving CTA, while imaging fewer non-cerebrovascular patients. Read More

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October 2018

Sex-specific, high-sensitivity cardiac troponin T cut-off concentrations for ruling out acute myocardial infarction with a single measurement.

CJEM 2018 Sep 28:1-8. Epub 2018 Sep 28.

**Department of Pathology and Molecular Medicine,McMaster University,Hamilton,ON.

CLINICIAN'S CAPSULE What is known about the topic? Sex-specific, high-sensitivity cardiac troponin T (hs-cTnT) cut-offs increase the specificity of a myocardial infarction (MI) diagnosis. What did this study ask? Do sex-specific, hs-cTnT rule-out cut-offs enable ruling out MI in more patients while maintaining sensitivity? What did this study find? Sex-specific, hs-cTnT cut-offs ruled out MI in more patients than universal cut-offs; however, differences between sex-specific and universal cut-offs are small. Why does this study matter to clinicians? Sex-specific, rule-out, hs-cTnT cut-offs may enable more patients to be ruled out after a single hs-cTnT measurement. Read More

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September 2018
7 Reads

The practicalities and barriers of using TEG6s in code red traumas: an observational study in one London major trauma centre.

CJEM 2018 Sep 20:1-4. Epub 2018 Sep 20.

*St George's Hospital,Blackshaw Road,London,the United Kingdom.

CLINICIAN'S CAPSULE What is known about the topic? Thromboelastography (TEG) can identify trauma-induced coagulopathy and guide blood product management. What did this study ask? What currently limits the utilization of TEG in one major trauma centre, and can it be used practically? What did this study find? TEG can be successfully run during a major trauma, but a lack of knowledge relating to interpretation hinders its impact on blood component management. Why does this study matter to clinicians? Prior to introducing point-of-care tests, e. Read More

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September 2018

A new era in stroke care.

Authors:
Devin R Harris

CJEM 2018 Sep;20(5):656-657

Department of Emergency,University of British Columbia,Vancouver,BC.

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September 2018

Should you adjust your D-dimer?

Authors:
Kerstin de Wit

CJEM 2018 Sep;20(5):660-661

*Department of Medicine,McMaster University,Hamilton,ON.

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September 2018

From abstraction to action: Making wellness practical during residency training.

CJEM 2018 Sep;20(5):662-664

*Department of Emergency Medicine,University of British Columbia,Kelowna,BC.

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September 2018

A tale of two cities: Divergent management of patients with ureteral colic.

CJEM 2018 Sep;20(5):658-659

†Department of Urology,University of Michigan Medical School,Ann Arbor,MI.

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September 2018
3 Reads

#Triage - Formal emergency department triage tools are inefficient, unfair, and they waste time and resources.

CJEM 2018 Sep;20(5):665-670

‡Department of Emergency Medicine,Dalhousie University,Saint John Regional Hospital,Saint John,NB.

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September 2018

Topical tranexamic acid for the treatment of epistaxis in patients using antiplatelet agents.

CJEM 2018 Sep;20(5):774-776

‡Emergency Medicine,Cumming School of Medicine,University of Calgary,Calgary,AB.

ABSTRACTClinical questionDoes the addition of topical tranexamic acid to anterior nasal packing decrease bleeding in patients with epistaxis who are taking antiplatelet medications?Article chosenZahed R, Jayazeri M, Naderi A, et al. Topical tranexamic acid compared with anterior nasal packing for treatment of epistaxis in patients taking antiplatelet drugs: randomized controlled trial. Acad Emerg Med 2018;25(3):261-6. Read More

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September 2018
7 Reads

Back in Print.

Authors:
Ian G Stiell

CJEM 2018 Sep;20(5):655

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September 2018
4 Reads

Emergency medicine resident wellness: Lessons learned from a national survey.

CJEM 2018 Sep;20(5):721-724

*Division of Emergency Medicine.

CLINICIAN'S CAPSULEWhat is known about the topic?Emergency medicine (EM) residents face many wellness challenges during residency.What did this study ask?What was the current landscape of Canadian EM resident wellness?What did this study find?Canadian EM residents face a multitude of psychosocial and physical wellness challenges, while supports may not be adequate.Why does this study matter to clinicians?Opportunities exist to further investigate resident wellness with validated tools, engage stakeholders, and advance the EM resident wellness agenda. Read More

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September 2018

Risk factors associated with acute in-hospital delirium for patients diagnosed with a hip fracture in the emergency department.

CJEM 2018 Nov 11;20(6):911-919. Epub 2018 Sep 11.

*Schwartz/Reisman Emergency Medicine Institute,Toronto,ON.

CLINICIAN'S CAPSULE What is known about the topic? Delirium, or acute confusion, occurs in up to 62% of patients who have experienced a hip fracture. What did this study ask? What risk factors are associated with acute in-hospital delirium for ED patients diagnosed with a hip fracture? What did this study find? History of neurodegenerative disease or dementia, age>75 years, and absence of analgesia in the ED were associated with acute in-hospital delirium. Why does this study matter to clinicians? Although many variables associated with delirium may not be easily modified, more careful attention to ED pain management and the provision of better analgesia are important. Read More

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November 2018

Analysis of emergency department length of stay for mental health visits: A case study of a Canadian academic hospital.

CJEM 2018 Aug 28:1-10. Epub 2018 Aug 28.

*Department of Mechanical and Industrial Engineering,University of Toronto,Toronto,ON.

CLINICIAN'S CAPSULE What is known about the topic? Little is available in Canadian literature regarding emergency department (ED) use by mental health patients. What did this study ask? Is the number of mental health visits to the ED increasing? Are there differences in ED length of stay between mental health and non-mental health visits? What did this study find? The number of mental health visits to the ED is increasing, and mental health patients experience longer wait times in the ED. Why does this study matter to clinicians? It informs clinicians who work with mental health patients of current ED demand trends and wait times for patients whom they see. Read More

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August 2018
1 Read

Self-documentary in the emergency department: Perspectives on patients recording their own procedures.

CJEM 2018 Aug 20:1-7. Epub 2018 Aug 20.

‡Academic Family Medicine,Research Division,University of Saskatchewan,Saskatoon,SK.

CLINICIAN'S CAPSULE What is known about the topic? Taking photographs and educational videos are common in emergency departments (EDs), but little research exists about patients recording their own procedures. What did this study ask? What are patients' reasons for video recording in the ED and the views of patients and clinicians toward this practice? What did this study find? Patients were in favour of ED video recording, whereas clinicians were not. Patients' reasons and clinicians' caveats for recording are provided. Read More

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Oh, the places we'll go! Emergency department extracorporeal cardiopulmonary resuscitation (ECPR) in Canada.

CJEM 2018 Jul;20(4):489-490

*Department of Emergency Medicine,Dalhousie University,Halifax,NS;and.

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July 2018
11 Reads

An epidemic we must address.

CJEM 2018 Jul;20(4):493-494

†Critical Care,Department of Pediatrics,BC Children's Hospital and BC Children's Hospital Research Institute,University of British Columbia,Vancouver,BC.

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July 2018
2 Reads

A Message from our New CAEP President.

Authors:
Alecs Chochinov

CJEM 2018 Jul;20(4):485-486

1Head,Department of Emergency Medicine,Rady Faculty of Health Sciences,University of Manitoba.

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Emergency medicine definitions, CAEP, and the journey to excellence.

Authors:
Douglas Sinclair

CJEM 2018 Jul;20(4):487-488

*Department of Emergency Medicine,St. Michael's Hospital,Toronto,ON.

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Stories, voices, and explanations: How qualitative methods may help augment emergency medicine research.

CJEM 2018 Jul;20(4):491-492

‡Division of Emergency Medicine,Department of Medicine.

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The novel role of paramedics in collaborative emergency centres aligns with their professional identity: A qualitative analysis.

CJEM 2018 Jul;20(4):518-522

†Department of Emergency Medicine,Division of Emergency Medical Services,Dalhousie University,Halifax,NS.

CLINICIAN'S CAPSULE What is known about the topic? Little is known about the experiences of paramedics working in CECs. What did this study ask? This study sought to ascertain the attitudes, feelings and experiences of paramedics working within the Nova Scotia CEC construct. What did this study find? Positive collaboration between RNs and paramedics, need for improved support from leadership, value placed on CECs by communities and this new role aligning with paramedic professional identity. Read More

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Impact of premix antimicrobial preparation and time to administration in septic patients.

CJEM 2018 Jul;20(4):565-571

*Department of Pharmacy,Upstate University Hospital,Syracuse,NY.

Objective: Strategies that reduce the time to antimicrobial administration, such as the availability of premix antimicrobials (PMAs) in the emergency department (ED), may better align with the goals of the Surviving Sepsis Campaign and improve outcomes in septic patients. The objective of this study was to evaluate the impact of antimicrobial preparation on time to administration in septic patients located in the emergency department (ED).

Methods: This was a retrospective, single-center, cohort study and adult patients with a diagnosis of sepsis who received at least one initial intravenous (IV) antimicrobial in the ED were included. Read More

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July 2018
1 Read