Can J Emerg Med
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Case Reports
Just the facts: Organ donation in the emergency department: When you can't save one, save eight.
A 16-year-old female presents to a community emergency room following a suicide attempt by hanging. Prehospital, on arrival of paramedics, the patient was in a pulseless electrical activity rhythm. Paramedics provided advanced cardiac life support for 20 minutes before they obtained return of spontaneous circulation. ⋯ Her neurological exam shows pupils to be 3 mm and fixed bilaterally, absent cough and gag, and no response to central or peripheral pain. She occasionally triggers 2-3 spontaneous breaths per minute above the set rate on the ventilator. Her CT head scan shows severe anoxic changes and cerebral edema.
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Competence committees play a key role in a competency-based system of assessment. These committees are tasked with reviewing and synthesizing clinical performance data to make judgments regarding residents' competence. Canadian emergency medicine (EM) postgraduate training programs recently implemented competence committees; however, a paucity of literature guides their work. ⋯ The Canadian EM community used a structured process to develop nine best practice recommendations for competence committees addressing: committee membership, meeting processes, decision outcomes, use of high-quality performance data, and ongoing quality improvement. These recommendations can inform the structure and processes of competence committees in Canadian EM training programs.
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HealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system. ⋯ The Saskatchewan HealthLine is doing an effective job at directing callers both to and away from EDs in Saskatoon and not overburdening our local EDs with unnecessary referrals.
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Soft tissue abscess used to be an easy emergency department (ED) presentation: perform an incision and drainage (I + D) and discharge your patient. Times have changed. ⋯ Almost all Canadian strains are susceptible to vancomycin and linezolid. MRSA strains are variably susceptible to trimethoprim-sulfamethoxazole (TMP-SMX), tetra/doxycycline, and clindamycin, with pooled Canadian clindamycin resistance just over 40%.