Can J Emerg Med
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Comparative Study
Inhaled methoxyflurane for the reduction of acute anterior shoulder dislocation in the emergency department.
Methoxyflurane is an inhalation analgesic used in the emergency department (ED) but also has minimal sedative properties. The major aim of this study was to evaluate the success rate of methoxyflurane for acute anterior shoulder dislocation (ASD) reduction. The secondary aim was to assess the impact of methoxyflurane on ED patient flow compared to propofol. ⋯ Methoxyflurane was used successfully in 30% of the 82 patients undergoing reduction for ASD, while potentially improving ED efficiency.
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Cannabis hyperemesis syndrome is characterized by bouts of protracted vomiting in regular users of cannabis. We wondered whether this poorly understood condition is idiosyncratic, like motion sickness or hyperemesis gravidarum, or the predictable dose-response effect of prolonged heavy use. ⋯ Similar hair cannabinoid concentrations in recreational users with and without hyperemesis suggest that heavy use is necessary but not sufficient for hyperemesis cannabis. Our results underline the high prevalence of chronic heavy cannabis use in emergency department patients and our limited understanding of this plant's adverse effects.
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Quality Improvement and Patient Safety (QIPS) plays an important role in addressing shortcomings in optimal healthcare delivery. However, there is little published guidance available for emergency department (ED) teams with respect to developing their own QIPS programs. We sought to create recommendations for established and aspiring ED leaders to use as a pathway to better patient care through programmatic QIPS activities, starting internally and working towards interdepartmental collaboration. ⋯ A list of 10 recommendations is presented as guiding principles for the establishment and sustainable deployment of QIPS activities in EDs throughout Canada and abroad. ED leaders are encouraged to implement our recommendations in an effort to improve patient care.