Can J Emerg Med
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Multicenter Study
Discrepancy between information provided and information required by emergency physicians for long-term care patients.
The primary objective of this study was to identify information included in long-term care (LTC) transfer documentation and to compare it to the information required by local emergency department (ED) physicians to provide optimal care and make decisions for LTC patients. ⋯ Our study demonstrates a clear discrepancy between information provided and information required by emergency physicians for LTC patients. Quality improvement initiatives at the local level may help reduce this discrepancy.
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Sweet syndrome was discovered in 1964 and is now well described in the dermatology literature. Knowledge of this unique febrile and painful dermatosis is important for the emergency physician because the syndrome can be readily identified and is extremely responsive to oral steroid therapy. Early diagnosis can greatly improve patient satisfaction and avoid days of ineffective treatment. An accurate and timely diagnosis of Sweet syndrome is also important to guide investigation into a number of associated diseases.
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Clinical questionHow often is pulmonary embolism (PE) found in patients admitted for syncope?Article chosenPrandoni P, Lensing A, Prins M, et al. Prevalence of pulmonary embolism among patients hospitalized for syncope (PESIT). N Engl J Med 2016;375:1524-31, doi: 10.1056/NEJMoa1602172.
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We wished to determine the impact of emergency department (ED) mobility assessments for older patients on hospitalization, return visits, future falls, and frailty. ⋯ Despite multiple guidelines recommending a mobility assessment prior to ED discharge for older patients, we found that such assessments were neither associated with nor predictive of adverse outcomes. Robust research is required to guide clinicians on the utility of physical mobility assessments in older ED patients.
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Although procedural sedation for cardioversion is a common event in emergency departments (EDs), there is limited evidence surrounding medication choices. We sought to evaluate geographic and temporal variation in sedative choice at multiple Canadian sites, and to estimate the risk of adverse events due to sedative choice. ⋯ There is marked variability in procedural sedation medication choice for a direct current cardioversion in Canadian EDs, with increased use of propofol alone as a sedation agent over time. The risk of adverse events from procedural sedation during cardioversion is low but not insignificant. We did not identify an increased risk of adverse events with the addition of fentanyl as an adjunctive analgesic to propofol.