CJEM
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To determine the association between neighborhood marginalization and rates of pediatric ED visits in Ottawa, Ontario. Secondary objectives investigated if the association between neighborhood marginalization and rates varied by year, acuity, and distance to hospital. ⋯ Neighborhood residential instability and material deprivation should be considered when locating alternatives to emergency care.
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Electrical cardioversion for atrial fibrillation/atrial flutter (AF/AFL) is common in the ED. Our previous work showed that hypotension and respiratory events were important adverse events that occurred in patients undergoing electrical cardioversion for AF/AFL. The purpose of this study was to examine if (1) beta-blockers or calcium channel blocker use prior to ECV were associated with hypotension and (2) medications used for procedural sedation were associated with respiratory events. ⋯ Beta-blocker or calcium channel blocker use prior to ECV for AF/AFL was not associated with hypotension. However, sedation with fentanyl and home beta-blocker use was associated with hypotension. The use of midazolam for procedural sedation was significantly associated with respiratory events.
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Mental practice is an effective method for skill acquisition in medicine. We describe the integration of interview-derived sensory cues with a list of procedural steps into a cohesive script to facilitate mental practice for a High Acuity, Low-Occurrence procedure, the bougie-assisted cricothyrotomy. Data collection occurred through interviews with emergency physicians. ⋯ On average, each participant identified 13.7 cues per procedure. This represents the first attempt to combine cues identified by practitioners along with procedural steps with the aim of supporting rich mental representations of a procedure. We expect that this script will be useful to physicians seeking to improve their skills in this rare procedure.
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As digital technologies continue to impact medicine, emergency medicine providers have an opportunity to work together to harness these technologies and shape their implementation within our healthcare system. COVID-19 and the rapid scaling of virtual care provide an example of how profoundly emergency medicine can be affected by digital technology, both positively and negatively. ⋯ As virtual care becomes a permanent fixture of our system, and other technologies such as AI and wearables break into Canadian healthcare, more advocacy, research, and health system leadership will be required to best leverage these tools. This paper outlines the purpose and outputs of the newly founded CAEP Digital Emergency Medicine (DigEM) Committee, with the hope of inspiring further interest amongst CAEP members and creating opportunities to collaborate with other organizations within CAEP and across EM groups nationwide.