1,689 results match your criteria CJEM: Canadian Journal of Emergency Medicine JCMU: Journal Canadien de la Medicine D'urgence[Journal]


Use of personal mobile devices to record patient data by Canadian emergency physicians and residents.

CJEM 2019 Apr 22:1-5. Epub 2019 Apr 22.

†Emergency Department,Vancouver General Hospital,Vancouver Coastal Health,Vancouver,BC.

Objective: Use of personal mobile devices to record patient data appears to be increasing, but remains poorly studied. We sought to determine the extent and reasons that Canadian emergency physicians (EPs) and emergency medicine residents use personal mobile devices to record patient data in the emergency department (ED).

Methods: A national survey was distributed to Canadian EPs and residents between 27/02/17 and 23/03/17. Read More

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http://dx.doi.org/10.1017/cem.2019.29DOI Listing

Point-of-care ultrasound before attempting clean-catch urine collection in infants: a randomized controlled trial.

CJEM 2019 Apr 22:1-7. Epub 2019 Apr 22.

*Department of Pediatrics,Division of Emergency Medicine,CHU Sainte-Justine,Université de Montréal,Montréal, QC.

Objective: A new non-invasive bladder stimulation technique has been described to obtain clean-catch urine specimens in infants. This study aimed to evaluate if point-of-care ultrasound (POCUS) guided feeding protocol to measure bladder volume prior to stimulation techniques improves clean-catch urine collection success.

Methods: A prospective randomized controlled trial study was conducted in a tertiary care pediatric emergency department. Read More

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http://dx.doi.org/10.1017/cem.2019.30DOI Listing

Buprenorphine/naloxone induction in a Canadian emergency department with rapid access to community-based addictions providers.

CJEM 2019 Apr 22:1-7. Epub 2019 Apr 22.

*Department of Family and Community Medicine,University of Toronto,Toronto,ON.

Objectives: Opioid-related emergency department (ED) visits have increased significantly in recent years. Our objective was to evaluate an ED-initiated buprenorphine/naloxone program, which provided rapid access to an outpatient community-based addictions clinic, for patients in opioid withdrawal.

Methods: A retrospective chart review was completed within a health system encompassing four community EDs in Ontario, Canada. Read More

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http://dx.doi.org/10.1017/cem.2019.24DOI Listing

Frequent emergency department use and mortality in patients with substance and opioid use in Alberta: A population-based retrospective cohort study.

CJEM 2019 Apr 15:1-10. Epub 2019 Apr 15.

**Department of Emergency Medicine,University of Alberta,Edmonton,AB.

Objectives: In the current opioid epidemic, identifying high-risk patients among those with substance and opioid use may prevent deaths. The objective of this study was to determine whether frequent emergency department (ED) use and degree of frequent use are associated with mortality among ED patients with substance and opioid use.

Methods: This cohort study used linked population-based ED (National Ambulatory Care Reporting System) and mortality data from Alberta. Read More

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http://dx.doi.org/10.1017/cem.2019.15DOI Listing
April 2019
1 Read

Addressing the opioid crisis in the era of competency-based medical education: recommendations for emergency department interventions.

CJEM 2019 Apr 8:1-3. Epub 2019 Apr 8.

‡Department of Emergency Medicine,Faculty of Medicine & Dentistry,University of Alberta,Edmonton,AB.

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http://dx.doi.org/10.1017/cem.2019.20DOI Listing
April 2019
1 Read

Examining Canada's return visits to the emergency department after a concussion.

CJEM 2019 Apr 5:1-5. Epub 2019 Apr 5.

‡Division of Emergency Medicine, Department of Medicine,McMaster University,Hamilton,ON.

Objectives: The purpose of this study was to identify 1) the proportion of patients discharged from the emergency department (ED) with a diagnosis of concussion and return within 14 days, and 2) the characteristics that prompt a return.

Methods: A health records review was conducted on adult patients with a discharge diagnosis of a concussion who accessed care through Hamilton Health Sciences EDs and Urgent Care Centre in 2016. Subsequent data were collected from those who returned to the ED within 14 days. Read More

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http://dx.doi.org/10.1017/cem.2019.22DOI Listing
April 2019
2 Reads

Disentangling serology to elucidate henipa- and filovirus transmission in Madagascar fruit bats.

J Anim Ecol 2019 Mar 25. Epub 2019 Mar 25.

Department of Ecology & Evolutionary Biology, Princeton University, Princeton, New Jersey.

Bats are reservoirs for emerging human pathogens, including Hendra and Nipah henipaviruses and Ebola and Marburg filoviruses. These viruses demonstrate predictable patterns in seasonality and age structure across multiple systems; previous work suggests that they may circulate in Madagascar's endemic fruit bats, which are widely consumed as human food. We aimed to (a) document the extent of henipa- and filovirus exposure among Malagasy fruit bats, (b) explore seasonality in seroprevalence and serostatus in these bat populations and (c) compare mechanistic hypotheses for possible transmission dynamics underlying these data. Read More

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http://dx.doi.org/10.1111/1365-2656.12985DOI Listing

A simple intervention to reduce your chance of missing an acute aortic dissection.

CJEM 2019 Mar 25:1-4. Epub 2019 Mar 25.

‡Department of Emergency Medicine,the Ottawa Hospital Research Institute, University of Ottawa,Ottawa,ON.

ABSTRACTIntroductionAcute aortic dissection (AAD) is a time sensitive, difficult to diagnose, aortic emergency. We sought to explore the quality of history taking in AAD and assess its impact on misdiagnosis.

Methods: We studied a retrospective cohort of patients >18 years old who presented to two tertiary care emergency departments from January 1st 2004 - December 31st 2012 and were diagnosed with an acute aortic dissection (AAD) on CT, MRI or TEE. Read More

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https://www.cambridge.org/core/product/identifier/S148180351
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http://dx.doi.org/10.1017/cem.2019.1DOI Listing
March 2019
10 Reads

Palliative care in emergency medicine: A perennial skill with a new emphasis.

Authors:
Jennifer Hughes

CJEM 2019 Mar;21(2):163-164

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

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http://dx.doi.org/10.1017/cem.2019.7DOI Listing

Diagnosis and Management of Non-Purulent Cellulitis in the Emergency Department.

CJEM 2019 Mar;21(2):186-189

Department of Medicine,Division of Infectious Diseases,University of Ottawa.

A 47-year-old homeless male presents to the emergency department (ED) with right lower extremity swelling, erythema and pain. He has diabetes mellitus, and had one prior episode of cellulitis three months ago affecting the same leg. He has a history of medication noncompliance. Read More

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http://dx.doi.org/10.1017/cem.2019.6DOI Listing

What is the bed availability gap underlying chronic emergency department access block?

Authors:
Peter A Cameron

CJEM 2019 Mar;21(2):165-166

*Emergency and Trauma Centre,The Alfred Hospital,Melbourne,Victoria,Australia.

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http://dx.doi.org/10.1017/cem.2019.5DOI Listing

The pain of procedural pain management education in the emergency department.

Authors:
Ran D Goldman

CJEM 2019 Mar;21(2):161-162

*Divisions of Pediatric Emergency Medicine and Pediatric Clinical Pharmacology,Department of Pediatrics,BC Children's Hospital and BC Children's Hospital Research Institute, University of British Columbia,Vancouver,BC.

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http://dx.doi.org/10.1017/cem.2019.4DOI Listing

Delving into Delphis.

CJEM 2019 Mar;21(2):167-169

‡Department of Medicine;Division of Rheumatology,Research Support Unit,Department of Innovation in Medical Education (DIME),University of Ottawa,Ottawa,ON.

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http://dx.doi.org/10.1017/cem.2019.3DOI Listing

Emergency physicians should not write orders for hospital admissions.

CJEM 2019 Mar;21(2):170-174

†Dalhousie University,Saint John Regional Hospital,NB.

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https://www.cambridge.org/core/product/identifier/S148180351
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http://dx.doi.org/10.1017/cem.2018.489DOI Listing
March 2019
3 Reads

Community paramedicine: A systematic review of program descriptions and training.

CJEM 2019 Mar 19:1-13. Epub 2019 Mar 19.

*Departments of Family Medicine.

Objectives: The aim of this study is to identify the types of community paramedicine programs and the training for each.

Methods: A systematic review of MEDLINE, Embase, grey literature, and bibliographies followed a search strategy using common community paramedicine terms. All studies published in English up to January 22, 2018, were captured. Read More

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http://dx.doi.org/10.1017/cem.2019.14DOI Listing

Simulator-based training for learning resuscitative transesophageal echocardiography.

CJEM 2019 Mar 11:1-4. Epub 2019 Mar 11.

§Department of Emergency Medicine,University of Manitoba,Winnipeg, MB.

Objectives: Transesophageal echocardiography (TEE) is a relatively new resuscitation tool in the emergency department. Recent studies have demonstrated that it can impact diagnosis and management of critically ill patients. The objective of this study is to determine the effectiveness of a simulation-based curriculum for teaching emergency medicine residents a five-view TEE protocol. Read More

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http://dx.doi.org/10.1017/cem.2019.13DOI Listing

Transition to practice: Evaluating the need for formal training in supervision and assessment among senior emergency medicine residents and new to practice emergency physicians.

CJEM 2019 Mar 7:1-9. Epub 2019 Mar 7.

*Department of Medicine, Division of Emergency Medicine,University of Toronto,Toronto,ON.

Objectives: Emergency medicine residents may be transitioning to practice with minimal training on how to supervise and assess trainees. Our study sought to examine: 1) physician comfort with supervision and assessment, 2) what the current training gaps are within these competencies, and 3) what barriers or enablers might exist in implementing curricular improvements.

Methods: Qualitative data were collected in two phases through individual interviews from September 2016 to November 2017, at the University of Toronto and McMaster University after receiving ethics approval from both sites. Read More

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http://dx.doi.org/10.1017/cem.2019.8DOI Listing

Are emergency medical services offload delay patients at increased risk of adverse outcomes?

CJEM 2019 Mar 7:1-8. Epub 2019 Mar 7.

*Department of Emergency Medicine,University of Calgary,Calgary, AB.

Objective: Emergency department (ED) and hospital overcrowding cause offload delays that remove emergency medical services (EMS) crews from service and compromise care delivery. Prolonged ED boarding and delays to inpatient care are associated with increased hospital length of stay (LOS) and patient mortality, but the effects of EMS offload delays have not been well studied.

Methods: We used administrative data to study all high-acuity Canadian Triage Acuity Scale 2-3 EMS arrivals to Calgary adult EDs from July 2013 to June 2016. Read More

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http://dx.doi.org/10.1017/cem.2018.478DOI Listing
March 2019
2 Reads

How to diagnose and treat acute asthma.

CJEM 2019 Mar 6:1-4. Epub 2019 Mar 6.

*Department of Emergency Medicine.

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http://dx.doi.org/10.1017/cem.2019.10DOI Listing

Hair cannabinoid concentrations in emergency patients with cannabis hyperemesis syndrome.

CJEM 2019 Feb 26:1-5. Epub 2019 Feb 26.

¶Department of Medicine,Queen's University,Kingston,ON.

Objectives: Cannabis hyperemesis syndrome is characterized by bouts of protracted vomiting in regular users of cannabis. We wondered whether this poorly understood condition is idiosyncratic, like motion sickness or hyperemesis gravidarum, or the predictable dose-response effect of prolonged heavy use.

Methods: Adults with an emergency department visit diagnosed as cannabis hyperemesis syndrome, near-daily use of cannabis for ≥6 months, and ≥2 episodes of severe vomiting in the previous year were age- and sex-matched to two control groups: RU controls (recreational users without vomiting), and ED controls (patients in the emergency department for an unrelated condition). Read More

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http://dx.doi.org/10.1017/cem.2018.479DOI Listing
February 2019
1 Read

The bougie and first-pass success in the emergency department: Journal Club review.

CJEM 2019 Feb 21:1-3. Epub 2019 Feb 21.

†Department of Emergency Medicine,The University of British Columbia,Vancouver, BC.

Clinical Question: Is bougie use associated with increased first-pass success in emergency department (ED) intubations?Article chosen: Driver et al. The Bougie and First-Pass Success in the Emergency Department. Annals of Emerg Med 2017;70(4):473-478. Read More

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http://dx.doi.org/10.1017/cem.2018.502DOI Listing
February 2019
1 Read

Potential benefits of incentive spirometry following a rib fracture: a propensity score analysis.

CJEM 2019 Feb 12:1-4. Epub 2019 Feb 12.

*Axe Santé des Populations et Pratiques optimales en santé,Centre de recherche du CHU de Québec - Université Laval,QC.

CLINICIAN'S CAPSULEWhat is known about the topic?Literature regarding the impact of incentive spirometry on patients with rib fractures is unclear; there are no recommendations for its use in the emergency department (ED).What did this study ask?The objective of this study was to assess the impact of incentive spirometry on delayed complications in patients with rib fractures in the ED.What did this study find?Unsupervised incentive spirometry use does not have a protective effect against delayed pulmonary complications after a rib fracture. Read More

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https://www.cambridge.org/core/product/identifier/S148180351
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http://dx.doi.org/10.1017/cem.2018.492DOI Listing
February 2019
2 Reads

Inhaled methoxyflurane for the reduction of acute anterior shoulder dislocation in the emergency department.

CJEM 2019 Feb 11:1-5. Epub 2019 Feb 11.

*Department of Emergency Medicine,University Hospital Galway,Galway,Ireland.

Objectives: Methoxyflurane is an inhalation analgesic used in the emergency department (ED) but also has minimal sedative properties. The major aim of this study was to evaluate the success rate of methoxyflurane for acute anterior shoulder dislocation (ASD) reduction. The secondary aim was to assess the impact of methoxyflurane on ED patient flow compared to propofol. Read More

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http://dx.doi.org/10.1017/cem.2018.493DOI Listing
February 2019
4 Reads

Paramedics providing palliative care at home: A mixed-methods exploration of patient and family satisfaction and paramedic comfort and confidence.

CJEM 2019 Feb 11:1-10. Epub 2019 Feb 11.

¶Pallium Canada,Ottawa, ON.

Objective: Paramedics Providing Palliative Care at Home was launched in two provinces, including a new clinical practice guideline, database, and paramedic training. The aim of this study was to evaluate patient/family satisfaction and paramedic comfort and confidence.

Methods: In Part A, we gathered perspectives of patients/families via surveys mailed at enrolment and telephone interviews after an encounter. Read More

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http://dx.doi.org/10.1017/cem.2018.497DOI Listing
February 2019

Active management of atrial fibrillation or flutter in emergency department patients with renal impairment is associated with a higher risk of adverse events and treatment failure.

CJEM 2019 Feb 6:1-9. Epub 2019 Feb 6.

§Department of Emergency Medicine,Rockyview Hospital and the University of Calgary,Calgary,AB.

Objective: Atrial fibrillation or flutter (AFF) patients with renal impairment have poor long-term prognosis, but their emergency department (ED) management has not been described. We investigated the association of renal impairment upon outcomes after rate or rhythm control (RRC) including ED-based adverse events (AE) and treatment failure.

Methods: This cohort study used an electrocardiogram database from two urban centres to identify consecutive AFF patients and reviewed charts to obtain comorbidities, ED management, including RRC, prespecified AE, and treatment failure. Read More

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http://dx.doi.org/10.1017/cem.2018.475DOI Listing
February 2019
2 Reads

Palliative and end-of-life care education in Canadian emergency medicine residency programs: A national cross-sectional survey.

CJEM 2019 Mar 30;21(2):219-225. Epub 2019 Jan 30.

‡University of British Columbia,Vancouver, BC.

Objectives: Emergency physicians play an important role in providing care at the end-of-life as well as identifying patients who may benefit from a palliative approach. Several studies have shown that emergency medicine (EM) residents desire further training in palliative care. We performed a national cross-sectional survey of EM program directors. Read More

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http://dx.doi.org/10.1017/cem.2018.470DOI Listing

Does the addition of dextrose to IV crystalloid therapy provide clinical benefit in acute dehydration? A systematic review and meta-analysis.

CJEM 2019 Jan 30:1-8. Epub 2019 Jan 30.

†Department of Emergency Medicine,Indiana University School of Medicine,Indianapolis, IN.

Objectives: Intravenous dextrose aids in the resolution of ketosis in dehydrated patients not tolerating oral glucose and is often recommended in this clinical scenario. Our aim was to determine whether the addition of dextrose to intravenous rehydration solutions results in decreased hospital admissions or other clinically important benefits among dehydrated children or adults.

Methods: MEDLINE, EMBASE, Web of Science, SCOPUS, and the Cochrane Library were searched by a medical librarian from inception through November 2017. Read More

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http://dx.doi.org/10.1017/cem.2018.500DOI Listing
January 2019
5 Reads

Trauma recidivism in a Canadian province: a 14-year registry review.

CJEM 2019 Jan 30:1-4. Epub 2019 Jan 30.

*Trauma Nova Scotia,Department of Health and Wellness,Halifax,NS.

Objectives: To determine the rate of recurrent major trauma (i.e., trauma recidivism) using a provincial population-based trauma registry. Read More

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http://dx.doi.org/10.1017/cem.2018.496DOI Listing
January 2019

The diagnostic accuracy of a point-of-care ultrasound protocol for shock etiology: A systematic review and meta-analysis.

CJEM 2019 Jan 30:1-12. Epub 2019 Jan 30.

†Department of Emergency Medicine,Good Samaritan Hospital Medical Center,West Islip, NY.

Objective: The aim of this study was to perform a systematic review and meta-analysis of the diagnostic accuracy of a point-of-care ultrasound exam for undifferentiated shock in patients presenting to the emergency department.

Methods: Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and research meeting abstracts were searched from 1966 to June 2018 for relevant studies. QUADAS-2 was used to assess study quality, and meta-analysis was conducted to pool performance data of individual categories of shock. Read More

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http://dx.doi.org/10.1017/cem.2018.498DOI Listing
January 2019

Peak performance: Simulation and the nature of expertise in emergency medicine.

CJEM 2019 Jan;21(1):9-10

*St. Michael's Hospital,Toronto, ON.

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http://dx.doi.org/10.1017/cem.2018.490DOI Listing
January 2019

Using single sex-specific high-sensitivity cardiac troponin cut-off values for ruling out myocardial infarction - Are we there yet?

CJEM 2019 Jan;21(1):7-8

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

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http://dx.doi.org/10.1017/cem.2018.488DOI Listing
January 2019

Indigenous health research in emergency medicine.

CJEM 2019 Jan;21(1):5-6

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

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http://dx.doi.org/10.1017/cem.2018.487DOI Listing
January 2019

How do I rule out aortic dissection?

CJEM 2019 Jan;21(1):34-36

Dalhousie University,Saint John Regional Hospital,Saint John, NB.

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http://dx.doi.org/10.1017/cem.2018.484DOI Listing
January 2019
1 Read

Broken promise.

Authors:
Brian Deady

CJEM 2019 Mar 25;21(2):306-307. Epub 2019 Jan 25.

*Clinical Associate Professor,Department of Emergency Medicine,University of British Columbia; andEmergency Department,Royal Columbian Hospital,New Westminster,BC.

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http://dx.doi.org/10.1017/cem.2018.480DOI Listing

A lung ultrasound score for early triage of elderly patients with acute dyspnea.

CJEM 2019 Jan 25:1-7. Epub 2019 Jan 25.

*Department of Emergency Medicine and Intensive Care,Timone University Hospital,Marseille,France.

Objectives: Lung ultrasound has value in diagnosing dyspnea. The main objective of this study was to evaluate the accuracy of a modified lung ultrasound (MLUS) score to predict the severity of acute dyspnea in elderly patients.

Methods: This was an observational single-centre study including patients over age 64 admitted to the emergency department for acute dyspnea with hypoxia. Read More

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http://dx.doi.org/10.1017/cem.2018.483DOI Listing
January 2019

Age modifiers for triage scores of older patients would not be helpful for emergency care.

CJEM 2019 Jan 17. Epub 2019 Jan 17.

*Seaforth Community Hospital,Seaforth, ON.

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http://dx.doi.org/10.1017/cem.2018.495DOI Listing
January 2019
1 Read

Is an IOTA of evidence enough?

CJEM 2019 Mar 17;21(2):296-298. Epub 2019 Jan 17.

*Emergency Medicine Residency Program,Faculty of Medicine,McGill University,Montreal,QC.

Clinical questionDo patients with acute illness admitted to the hospital and treated with liberal oxygen therapy compared with those treated with conservative oxygen therapy have differences in mortality and morbidity?Article chosenChu DK, Kim LH, Young PJ, et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet 2018;391(10131):1693-705. Read More

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http://dx.doi.org/10.1017/cem.2018.482DOI Listing
March 2019
1 Read

The empathy deficit in health care.

Authors:
Alicia Cundall

CJEM 2019 Mar 17;21(2). Epub 2019 Jan 17.

CCFP-EM Resident,Western University.

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http://dx.doi.org/10.1017/cem.2018.477DOI Listing
March 2019
1 Read

FOAMed and social media - innovation or disruption?

CJEM 2018 11;20(6):818-820

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

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http://dx.doi.org/10.1017/cem.2018.471DOI Listing
November 2018
8 Reads

Delirium in older emergency department patients.

Authors:
Debra Eagles

CJEM 2018 11;20(6):811-812

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

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http://dx.doi.org/10.1017/cem.2018.468DOI Listing
November 2018
3 Reads

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 11;20(6):813-815

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

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http://dx.doi.org/10.1017/cem.2018.467DOI Listing
November 2018
1 Read

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

CJEM 2018 11;20(6):816-817

*Professor of Emergency Medicine,Assistant Dean of Health Professions Education Research,McMaster University.

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http://dx.doi.org/10.1017/cem.2018.465DOI Listing
November 2018
1 Read

CJEM Debate Series#PhysicianProductivity - Measuring and understanding causes of variability in emergency physician performance are essential to improve emergency department efficiency.

CJEM 2018 11;20(6):821-825

§Department of Emergency Medicine,Dalhousie University (Halifax, NS),Saint John Regional Hospital,Saint John,NB.

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http://dx.doi.org/10.1017/cem.2018.459DOI Listing
November 2018
1 Read

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

CJEM 2018 11;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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http://dx.doi.org/10.1017/cem.2018.452DOI Listing
November 2018
1 Read