CJEM
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To characterize unidentified patients presenting to a single, urban emergency department (ED) in Canada. We report their demographics, ED course, post-ED discharge outcomes, and mode of identification. ⋯ Unidentified patients are a high-needs demographic that present mostly with substance misuse or trauma. Repeat ED attendance, sometimes as unidentified patients again, calls for initiatives that facilitate prompt identification, better discharge planning, and linkage to social supports.
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To determine how many Level 1 and Level 2 trauma centres in Canada have implemented a resuscitative endovascular balloon occlusion of the aorta (REBOA) program, and to identify facilitators and barriers to successful implementation of REBOA programs. ⋯ As of July 2021, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have a REBOA program. Physician champions and a patient population with sufficient numbers of REBOA candidates were the most important factors contributing to successful implementation of these programs.
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We sought to evaluate the factors associated with better outcomes for emergency department (ED) patients treated for primary headache. ⋯ We determined that use of dopamine antagonists and NSAIDs were associated with a reduced need for second round medications in ED primary headache patients. Conversely, non-dopamine antagonist antiemetic medications and intravenous fluids were associated with a significantly increased need for second round medications. Careful choice of initial therapy may optimize management for these patients.
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Non-fatal strangulation is a dangerous mechanism of injury among survivors of intimate partner violence and sexual assault, with inadequate evidence to guide investigation in the emergency department (ED). The primary objective is to identify the proportion of intimate partner violence and sexual assault where non-fatal strangulation occurs, and to describe the sequelae of injuries. ⋯ We found over 10% prevalence of non-fatal strangulation in survivors of intimate partner violence and sexual assault. There was a low rate of clinically important injury on the index ED visit secondary to non-fatal strangulation. Severe injury was primarily secondary to concomitant trauma, and utilization of CTA in this cohort was low. Increased awareness is needed among ED physicians regarding the need to consider CTA head and neck.
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To determine if caregivers of children presenting to pediatric emergency departments (EDs) during the COVID-19 pandemic are delaying presenting to care for fear of contracting COVID-19. ⋯ Almost one in five caregivers reported delaying ED presentation for their ill or injured child specifically due to fear of contracting COVID-19 while in hospital, with mothers, younger caregivers, caregivers of children with chronic illness, and those concerned about lost work more likely to report delaying ED presentation.