Can J Emerg Med
-
The Canadian Association of Emergency Physicians (CAEP) sepsis guidelines created by the CAEP Critical Care Practice Committee (C4) and published in the Canadian Journal of Emergency Medicine (CJEM) form the most definitive publication on Canadian emergency department (ED) sepsis care to date. Our intention was to identify which of the care items in this document are specifically necessary in the ED and then to provide these items in a tiered checklist that can be used by any Canadian ED practitioner. ⋯ Sepsis care continues to be an integral and major part of the ED domain. Practice points for sepsis care that require specialized monitoring and invasive techniques are often limited to larger tertiary care EDs and, although heavily emphasized by many medical bodies, cannot be reasonably expected in all centres. When the resources of a centre limit patient care, transfer may be required.
-
Review Case Reports
Carbon monoxide poisoning in narghile (water pipe) tobacco smokers.
Narghile (water pipe, hookah, shisha, goza, hubble bubble, argeela) is a traditional method of tobacco use. In recent years, its use has increased worldwide, especially among young people. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide (CO). ⋯ Five additional cases of CO poisoning after narghile smoking were identified during a literature search, with carboxyhemoglobin levels of 20 to 30%. Each patient was treated with oxygen supplementation and did well clinically. In light of the increasing popularity of narghile smoking, young patients presenting with unexplained confusion or nonspecific neurologic symptoms should be asked specifically about this exposure, followed by carboxyhemoglobin measurement.
-
Review Case Reports
How do I find a point-of-care answer to my clinical question?
Emergency physicians often need point-of-care access to current, valid information to guide patient management. Most emergency physicians do not work in a hospital with a computerized decision support system that prompts and provides them with information to answer their clinical questions. Searching for answers to clinical questions online, especially those related to diagnosis and treatment, can be challenging, in part because determining the validity and clinical applicability of the results of individual studies is beyond the time constraints of most emergency physicians. This article describes currently available point-of-care sources of evidence-based information to answer clinical questions and provides the access information for each.
-
The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a well-established length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort. ⋯ Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy.
-
Does giving tranexamic acid to trauma patients who are actively bleeding or at risk for significant hemorrhage have an impact on mortality? ⋯ The study collaborators sought to evaluate the effect of tranexamic acid on mortality in trauma patients who were actively bleeding or at risk for significant hemorrhage. Secondary outcomes included the incidence of vascular occlusive events and the number of blood transfusions required.