CJEM
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The primary objective was to quantify the prognostic association between various D-dimer thresholds and 30-day PE diagnosis among emergency department (ED) patients with suspected SARS-CoV-2 infection. ⋯ Among ED patients with suspected SARS-CoV-2, the standard 500 ng/mL and age-adjusted D-dimer thresholds were comparable for the prediction of PE at 30-days. The prognostic performance of D-dimer was lower among SARS-CoV-2 positive patients.
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Approximately one-quarter of emergency department (ED) visits for alcohol withdrawal result in unscheduled 1-week ED return visits, but it is unclear what patient and clinical factors may impact this outcome METHODS: From January 1, 2015, to December 31, 2018, at three urban EDs in Vancouver, Canada, we studied patients who were discharged with a primary or secondary diagnosis of alcohol withdrawal. We performed a structured chart review to ascertain patient characteristics, ED treatments, and the outcome of an ED return within 1 week of discharge. We used univariable and multivariable Bayesian binomial regression to identify characteristics associated with being in the upper quartile of 1-week ED revisits. ⋯ Among discharged ED patients with alcohol withdrawal, we describe high-risk patient characteristics associated with 1-week ED revisits, and these findings may assist clinicians to facilitate appropriate discharge planning with access to integrated follow-up support.
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Supervisors in postgraduate medical education may deliver different feedback for the same quality of performance. Residents may struggle to make sense of inconsistent and sometimes contradictory information. We sought to explore how residents experience feedback from different supervisors, how they process inconsistent information, and what factors influence their experiences. ⋯ The findings of this study show that while residents are regular consumers of feedback, not all feedback is used equally. Residents actively reconcile sometimes-contradictory feedback and must work to balance a general reluctance to discard feedback, while developing an understanding of its credibility. This work reinforces the importance of pedagogical relationships and identifies that facilitated reflection that explicitly acknowledges feedback inconsistencies may be important in the reconciliation process.