Can J Emerg Med
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Comparative Study Observational Study
Prehospital Application of the Canadian Triage and Acuity Scale by Emergency Medical Services.
Triage is fundamental to emergency patient assessment. Effective triage systems accurately prioritize patients and help predict resource utilization. CTAS is a validated five-level triage score utilized in Emergency Departments (EDs) across Canada and internationally. Historically CTAS has been applied by triage nurses in EDs. Observational evidence suggests that the CTAS might be implemented reliably by paramedics in the prehospital setting. This is the first system-wide assessment of CTAS interrater reliability between paramedics and triage nurses during clinical practice. ⋯ Interrater reliability of CTAS scoring between triage nurses and paramedics was moderate in this system-wide implementation study.
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Review Case Reports
Diagnosis of a pericardial effusion with a thoracic aortic aneurysm by point-of-care ultrasound.
We present a rare case of a young patient with chest pain whose ascending thoracic aortic aneurysm (TAA) was detected by point-of-care ultrasound (POCUS) leading to a successful surgical repair. POCUS identified a moderate pericardial effusion and an associated severely dilated ascending aorta. In this context, it is important to rule out aortic rupture and aortic dissection. We also discuss the epidemiology, complications, and management of TAAs as well as the role of cardiac POCUS in the diagnosis of thoracic aneurysmal disease.
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Review Meta Analysis Comparative Study
Early goal-directed therapy versus usual care in the management of septic shock.
Clinical question Does early goal-directed therapy decrease mortality when compared with usual care? Article chosen Angus DC, Barnato AE, Bell D, et al. A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators. Intensive Care Med 2015;41(9):1549-60. doi:10.1007/s00134-015-3822-1.