Can J Emerg Med
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ABSTRACTObjective:We conducted a needs assessment to identify knowledge gaps in the management of tropical diseases by Canadian emergency physicians and identify available, related continuing medical education (CME) resources. Methods:A literature review was conducted to summarize challenges in the management of commonly encountered tropical diseases. An anonymous online survey was administered to Canadian emergency physicians using the Canadian Association of Emergency Physicians survey deployment service in July and August 2012. ⋯ Correct answers to case vignettes ranged from 30.7 to 58.4%. Although 2,038 CME titles were extracted from extensive searches, only 6 were deemed relevant. Conclusions:Most Canadian emergency physicians have had minimal training in tropical diseases, reported a low comfort level in their management, and identified a high need for CME opportunities, which are lacking.
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Letter Review Case Reports
Air in the spinal canal associated with cardiopulmonary resuscitation in an infant.
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ABSTRACTPatients with lateral medullary syndrome classically present with crossed hemisensory disturbance, ipsilateral Horner syndrome, and cerebellar signs, all of which are attributable to infarction of the lateral medulla. However, variability in the presentation of this syndrome is the rule, as illustrated in this case presentation and literature review. ⋯ The importance of recognition of this condition in the emergency department is underscored by the association between lateral medullary infarction and vertebral artery dissection. With optimal therapy, the prognosis for recovery from lateral medullary syndrome is good.
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ABSTRACTIntroduction:The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum. Methods:A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. ⋯ Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion. Conclusions:Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.
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Clinical questionAre four common clinical decision rules, in combination with normal D-dimer results, comparable in their ability to clinically exclude the diagnosis of pulmonary embolism?Article chosenDouma RA, Mos ICM, Erkens PMG, et al. Performance of 4 clinical decision rules in the diagnostic management of acute pulmonary embolism: a prospective cohort study. Ann Intern Med 2011;154:709-18. ObjectiveTo directly compare the performance of four different clinical decision rules, the Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score, in combination with D-dimer results, to exclude pulmonary embolism.