CJEM
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Despite awake tracheal intubation being considered the safest method of intubation for patients with predicted difficult airways, there is limited evidence and poor availability of training interventions to assist emergency medicine physicians achieve competency in this technique. Here, we describe a novel, cadaver-based course for emergency medicine physicians to acquire skills in awake tracheal intubation. A convenience sample of 15 emergency medicine physicians from across Canada participated in the pilot course. ⋯ Three physicians reported successfully performing awake tracheal intubation in the emergency department during the 3-6-month follow-up period. Expansion of similar courses could help emergency medicine physicians acquire the skills necessary to safely perform awake tracheal intubation. Future studies should focus on optimizing training protocols, with a focus on practical methods to improve long-term skill retention.
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Postponing scheduled surgeries may alleviate emergency department (ED) crowding by increasing inpatient beds for ED patients but the impact of such measures are unclear. We determined if scheduled surgery cancellations for inguinal hernia and gallbladder disease during the coronavirus pandemic affected ED presentations, hospitalizations, and complications. ⋯ Despite a two-month surgery cancellation period, inguinal hernia and gallbladder disease patients demonstrated minimal differences in outcomes. During periods of ED boarding and crowding, scheduled surgery cancellations may be considered with minimal risk of potential adverse patient effects.
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POCUS is a core emergency medicine skill and mainstay of early pregnancy assessment. The ultrasound competency assessment tool was developed as an entrustment-based assessment tool for use by content experts evaluating trainees performing multiple POCUS study types. The objective of this study was to evaluate the scoring and extrapolation inferences of the tool within Kane's validity framework when used to assess trainees performing an early pregnancy POCUS. ⋯ This study adds further validity evidence relating to scoring and extrapolation of the ultrasound competency assessment tool when used to assess trainees performing a POCUS study in early pregnancy.
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This initiative assessed the integration of the Human Factors Analysis and Classification System, adapted from aviation, into emergency medicine morbidity and mortality rounds. The objective was to determine whether incorporating the Human Factors Analysis and Classification System could lead to a perceived increase in the overall quality of morbidity and mortality presentations through the standardization of classifying cause factors of medical errors. ⋯ Integrating the Human Factors Analysis and Classification System into morbidity and mortality rounds in the Department of Emergency Medicine was well-received and led to a perceived increase in the quality of cause factor identification. Both presenters and audience members endorsed the use of the Human Factors Analysis and Classification System, suggesting its desirability for sustained integration. The results of this study pave the way for future quality improvement initiatives, including the adaptability of the Human Factors Analysis and Classification System across various medical departments and its potential to enhance cause factor classification in morbidity and mortality rounds.