Can J Emerg Med
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Subarachnoid hemorrhage (SAH) is an important but uncommon condition in the differential diagnosis of acute headache. Most authorities recommend that patients with suspected SAH undergo noncontrast computed tomography (CT) as a first diagnostic intervention. ⋯ Many nonurban Canadian hospitals do not have CT scanners and must either transfer patients or consider performing lumbar puncture prior to CT. In selected patients, performing lumbar puncture first may be an option, but timing of the procedure and the interpretation of results is important.
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To develop an operational definition and a parsimonious list of postulated determinants for urban emergency department (ED) overcrowding. ⋯ These results help to clarify the conceptual framework around ED overcrowding, and may provide a guide for future research. The relative importance of the determinants must be assessed by prospective studies.
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This paper is Part I of a 2-part series to describe the background and methodology for the Canadian C-Spine Rule study to develop a clinical decision rule for rational imaging in alert and stable trauma patients. Current use of radiography is inefficient and variable, in part because there has been a lack of evidence-based guidelines to assist emergency physicians. ⋯ Part I details the background and rationale for the development of the Canadian C-Spine Rule. Part II will describe in detail the objectives and methods of the Canadian C-Spine Rule study.
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Urethral catheterization is a technique frequently used in the pediatric emergency department. Intravesicular knotting of the catheter is a rare but potentially preventable complication that can involve significant morbidity. ⋯ The risk of intravesicular catheter knotting can be reduced with proper technique and the correct choice of catheters. We present a case report and list recommendations to minimize the risk of occurrence.