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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Non-medical cannabis recently became legal for adults in Canada. Legalization provides opportunity to investigate the public health effects of national cannabis legalization on presentations to emergency departments (EDs). Our study aimed to explore association between cannabis-related ED presentations, poison control and telemedicine calls, and cannabis legalization. ⋯ Overall, Canadian cannabis legalization was associated with small increases in urban Alberta cannabis-related ED visits and calls to a poison control centre.
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The aim of this study was to describe the sensitivity of various C-reactive protein (CRP) cut-off values to identify patients requiring magnetic resonance imaging evaluation for pyogenic spinal infection among emergency department (ED) adults presenting with neck or back pain. ⋯ CRP cut-offs beyond the upper limit of normal had high sensitivity for pyogenic spinal infection in this adult ED population. Elevated CRP cut-off values of 10 mg/L and 30 mg/L require validation in other settings.
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Case Reports
Just the Facts: Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest.
A 58-year-old man is brought by the ambulance to the emergency department (ED) of a tertiary care centre following an out-of-hospital cardiac arrest. Paramedics were called by the patient's wife after he had collapsed. She immediately initiated cardiopulmonary resuscitation (CPR). ⋯ An electrocardiogram shows ST-segment elevation in the anterior leads. Just prior to arrival, the patient suffers recurrent cardiac arrest with two further rounds of unsuccessful defibrillation in the ED. At this point, a decision is made to proceed with extracorporeal cardiopulmonary resuscitation (ECPR), prior to transport for cardiac catheterization.