Can J Emerg Med
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The Ottawa Emergency Department Shift Observation Tool (O-EDShOT) is a workplace-based assessment designed to assess a trainee's performance across an entire shift. It was developed in response to validity concerns with traditional end-of-shift workplace-based assessments, such as the daily encounter card. The O-EDShOT previously demonstrated strong psychometric characteristics; however, it remains unknown whether the O-EDShOT facilitates measurable improvements in the quality of documented assessments compared to daily encounter cards. ⋯ The O-EDShOT yields higher quality documented assessments when compared to the traditional end-of-shift daily encounter card. Our results provide additional validity evidence for the O-EDShOT as an assessment tool for capturing trainee on-shift performance that can be used as a stimulus for actionable feedback and as a source for high-quality workplace-based assessment data to inform decisions about emergency medicine trainee progress and promotion.
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Multicenter Study
Post-concussion symptoms in sports-related mild traumatic brain injury compared to non-sports-related mild traumatic brain injury.
To compare post-concussion symptoms in patients who sustained a sports-related mild traumatic brain injury (TBI) to those with non-sports-related mild TBI at 7 and 90 days post-injury. ⋯ Patients who sustained sports-related mild TBI could be at lower risk of experiencing symptoms such as fatigue and dizziness 90 days post-injury. Clinicians should be mindful that non-sports-related mild TBI patients may experience more post-concussion symptoms and that the level of physical activity may influence the patient's rehabilitation.
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Case Reports
Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department.
A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for "red flag symptoms," including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). ⋯ Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).
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Deaths due to opioid overdose have reached unprecedented levels in Canada; over 12,800 opioid-related deaths occurred between January 2016 and March 2019, and overdose death rates increased by approximately 50% from 2016 to 2018.1 In 2016, Health Canada declared the opioid epidemic a national public health crisis,2 and life expectancy increases have halted in Canada for the first time in decades.3 Children are not exempt from this crisis, and the Chief Public Health Officer of Canada has recently prioritized the prevention of problematic substance use among Canadian youth.4.