CJEM
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Providing emergency mental health services for populations in remote rural areas of Canada is challenging. Program needs are distinct. We describe the emergency mental health workload and service needs at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) in northwest Ontario. ⋯ There is an increased level of mental health, addiction and self-harm presentations in this northern ED. Lack of alternative resources indicate the need for the development of an integrated model of mental health care service. Reliance on the ED for crisis management indicates the need for the development of more regionally relevant models of care.
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Gender inequities are deeply rooted in our society and have significant negative consequences. Female physicians experience numerous gender-related inequities (e.g., microaggressions, harassment, violence). These inequities have far-reaching consequences on health, well-being and career longevity and may result in the devaluing of various strengths that female emergency physicians bring to the table. This, in turn, has an impact on patient healthcare experience and outcomes. During the 2021 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, a national collaborative sought to understand gender inequities in emergency medicine in Canada. ⋯ Via the above process, 15 recommendations were developed to address five unique problem areas. There is a dearth of research in this important area and we hope this preliminary work will serve as a starting point to fuel further research. To facilitate these scholarly endeavors, we have appended additional documents identifying other key problems with gender equity in emergency medicine in Canada as well as proposed next steps for future research.
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Racism and colonialism impact health, physician advancement, professional development and medical education in Canada. The Canadian Association of Emergency Physicians (CAEP) has committed to addressing inequities in health in their recent statement on racism. The objective of this project was to develop recommendations for addressing racism and colonialism in emergency medicine. ⋯ Emergency physicians are uniquely positioned to promote equity at each encounter with patients, peers and learners. The 16 recommendations presented here are practical steps to countering racism and colonialism everyday in emergency medicine.
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While wide complex tachycardia (WCT) is potentially lethal, little is known about its incidence in the ED or about expertise of ED physicians in diagnosing and treating it. We sought to compare WCT ED cases that were primary arrhythmias versus those with rapid heart rate secondary to medical issues, as well as the accuracy of ED diagnosis and appropriateness of treatment. ⋯ WCT cases were evenly split between primary arrhythmias and secondary cases. ED physicians interpreted the ECG correctly in 81% but over-called atrial flutter and SVT. They implemented appropriate care in most cases but sometimes failed to adequately control heart rate or to treat the underlying condition, suggesting opportunities to improve care of WCT in the ED.