Can J Emerg Med
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Multicenter Study
Evaluating mental health service use during and after emergency department visits in a multisite cohort of Canadian children and youth.
The goal of this study was to examine the mental health needs of children and youth who present to the emergency department (ED) for mental health care and to describe the type of, and satisfaction with, follow-up mental health services accessed. ⋯ Children and youth and their families presenting to the ED with mental health needs had substantial clinical morbidity, were connected with services, were satisfied with their ED visit, and accessed follow-up care within 1-month with some variability.
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Problematic alcohol use is associated with detrimental cognitive, physiological and social consequences. In the emergency department (ED), Screening, Brief Intervention, and Referral to Treatment (SBIRT) is the recommended approach to identify and treat adolescent alcohol-related concerns, but is underused by physicians. ⋯ Pediatric emergency physicians acknowledge the need to address problematic adolescent alcohol use, but routine SBIRT use is lacking. Strategies to educate physicians about SBIRT and enhance perceived self-competency may improve SBIRT use. Effectiveness trials to establish SBIRT impact on patient outcomes are also needed.
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The main objective of this study was to use the principles of cognitive load theory to design a curriculum that incorporates a progressive part practice approach to teaching ultrasound-guided (USG) internal jugular catheterization (IJC) to novices. A secondary objective was to compare the technical proficiency of residents trained using this curriculum with the technical proficiency of residents trained with the current local standard of a single simulation session. ⋯ These results support multiple sessions of progressive part practice in a simulation lab as an effective competency-based approach to teaching USG IJC in preparation for the clinical setting.
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Multicenter Study
A system-wide solution to antidote stocking in emergency departments: the Nova Scotia antidote program.
Inadequate stocking of essential antidotes in hospitals is an internationally documented problem. A concrete and sustainable system-wide solution for easy access to antidotes in emergency departments (EDs) was developed and implemented in Nova Scotia, Canada. ⋯ The Nova Scotia Antidote Program demonstrates that a solution to inadequate antidote stocking is achievable and requires a system-wide approach with ongoing maintenance and surveillance. The frequency and distribution of antidote usage documented in this program supports the need for enhancement of emergency preparedness. The poison centre and hospital pharmacies are crucial to surveillance and maintenance of this program.
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The objective of this study was to determine the proportion of women who had a ruptured ectopic pregnancy after being discharged from the emergency department (ED) where ectopic pregnancy had not yet been excluded. ⋯ These results may be useful for ED physicians counselling women with symptomatic early pregnancies about the risk of ectopic pregnancy after they are discharged from the ED.