CJEM
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Observational Study
The association between monthly social assistance disbursement days and emergency department visits for trauma, mental health, and substance use.
Social assistance helps fulfill the basic needs of low-income individuals. In British Columbia, social assistance is issued on the third or fourth Wednesday of every month. However, this sudden influx of resources may have negative health consequences. We investigated social assistance timing and emergency department (ED) visits related to trauma, mental health, and substance use. ⋯ Social assistance disbursement is followed by an increase in mental health and substance-related ED presentations and may be associated with an increase in trauma presentations on the day of cheque disbursement. These findings support calls for clinical and policy-level changes and support to reduce cheque day-associated harm.
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A simple bedside test, the Dix-Hallpike test (DHT), can reliably diagnose benign paroxysmal positional vertigo (BPPV) in patients with acute onset dizziness or vertigo. We evaluated patterns of DHT use by emergency physicians in patients presenting with dizziness and vertigo. Our objective was to assess the frequency and clinically appropriate use of the DHT in an emergency department. ⋯ The DHT is both underutilized and frequently applied to patients whose symptoms are not consistent with BPPV. This may result in prolonged patient discomfort and increased resource utilization, as well as increasing the risk of misdiagnosing central vertigo.
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Suicide is the 9th leading cause of death in Canada, and a common reason for patients to present to Canadian emergency departments (ED). Little knowledge exists around Canadian emergency physicians (EPs) attitudes toward and understanding of individuals with suicidal ideation. ⋯ Respondents have a generally positive attitude toward treating individuals with suicidal ideation. Respondents scored highly on the USP scale that measured willingness to provide care for and empathize with suicidal patients. Respondents felt they had the skills to adequately screen patients for suicidal ideation. Key gaps in knowledge were identified suggesting improved residency and ongoing medical education opportunities are needed to better improve care for this vulnerable population.
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Continuing professional development activities often involve interactive learning modalities, such as simulation. The COVID-19 pandemic limited many in-hospital activities, at a time when practicing high stress procedural scenarios and testing rapidly evolving processes was coveted. ⋯ This reproducible interactive virtual learning model influenced EM physician practice and confidence, improved participation in continuing professional development activities, and identified departmental areas for improvement. Participants have expressed a desire for these interactive virtual cases to continue for beyond the COVID-19 pandemic.
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Physicians working in the emergency department (ED) will interact with two-spirited, lesbian, gay, bisexual, transgender, queer/questioning and intersex (2SLGBTQI+) persons as colleagues and patients. These patients have unique healthcare needs and encounter negative experiences when seeking medical care, leading to poorer health outcomes and inequities. This study aims to explore the attitudes, behaviour, and comfort of Canadian emergency medicine (EM) physicians in caring for 2SLGBTQI+ patients. ⋯ This study suggests that Canadian EM physicians feel that 2SLGBTQI+ patients deserve equitable care when compared to cis-het patients. Future work should focus on educational needs and curricular enhancements in residency programs and continuing professional development for physicians to improve care for 2SLGBTQI+ patients in the ED.