Can J Emerg Med
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Clinical questionIn emergency department patients with symptoms suggestive of acute myocardial infarction, is the absolute or relative change of cardiac troponin assays (either high sensitivity or ultrasenstive) more accurate in diagnosing acute myocardial infarction at 1 to 2 hours postpresentation?Article chosenRechlin T, Ifran A, Twerenbold R, et al. Utility of absolute and relative changes in cardiac troponin concentrations in the early diagnosis of acute myocardial infarction. Circulation 2011;124:136-45. ObjectiveTo evaluate the accuracy of new troponin assays in diagnosing acute myocardial events.
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ABSTRACTTar burns are primarily an occupational hazard associated with the road paving or roofing industry. Management of tar burns requires safe and effective removal of solidified tar from the skin using a dissolution or emulsifying agent to prevent inflicting further injury and pain. We report a case of a patient with tar burns on 10% of his body surface area involving the lower arms bilaterally and splashes to the facial area. The tar was efficiently removed with Webber Vitamin E Ointment without toxicity, irritation, or other complications.
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ABSTRACTObjectives:The level of expertise and degree of training in neonatal resuscitation (NNR) of emergency physicians is not standardized and has not been measured. We sought to determine the self-reported comfort with, knowledge of, and experience with NNR of emergency department (ED) staff in a general ED prior to the opening of a new neonatal intensive care unit (NICU) and to explore factors associated with NNR comfort. Methods:Using Dillman methodology, we electronically surveyed full-time emergency physicians and nurses. ⋯ Conclusions:Perceived comfort with, knowledge of, and preparedness for NNR were poor in an urban, general ED prior to the opening of an NICU. Recent neonatal clinical encounter and participation in the NRP course were the strongest predictors of improved NNR comfort. In future work, we intend to assess the impact of simulation-based training on comfort with NNR among ED staff who primarily treat adults.
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ABSTRACTObjectives:To systematically evaluate the accuracy of text descriptions and labeling of radiologic images published in the Canadian Journal of Emergency Medicine (CJEM). Error detection by radiologists and emergency physicians and the clinical significance and educational value of these errors were assessed. Errors were also correlated with radiologist involvement in publication and imaging modality. ⋯ In addition, 26 images were identified by emergency physicians as potentially benefiting from enhanced labeling to improve educational value. Conclusions:Radiologic images published in the CJEM are generally of high quality; however, 23 errors were found in 82 images, 18 (78%) of which were rated as potentially affecting clinical management, educational value, or both. Radiologist involvement in the publication process may be of assistance as no errors were seen in articles that included radiologists as authors.