Variability of Renal Colic Management and Outcomes in Two Canadian Cities
Grant Innes, MD, MHSc; Andrew McRae, MD, PhD; Eric Grafstein, MD; Michael Law, PhD; Joel M.H. Teichman, MD; Bryce Weber, MD; Kevin Carlson, MD; Heidi Boyda, PhD; James Andruchow, MD, MScdoi: 10.1017/cem.2018.31
What is known about the topic?
Optimal treatment for acute ureteral colic is unclear.
What did this study ask?
We compared outcomes in Calgary (interventional approach) and Vancouver (medical approach).
What did this study find?
Index intervention rates were 52% in Calgary and 7.5% in Vancouver with more ED revisits and hospitalizations during follow-up in Calgary.
Why does this study matter to clinicians?
More standardized approach to early management may improve utilization and outcomes.
A Comparison of Work Stressors in Higher and Lower Resourced Emergency Medicine Health Settings
Sebastian de Haan, MBChB; Hein Lamprecht, MBChB; Michael K Howlett MD, MHSA; Jacqueline Fraser BN; Dylan Sohi BSc; Anil Adisesh MBChB, MSc, MD; Paul R Atkinson MB BCh BAO, MAdoi: 10.1017/cem.2018.14
What is known about the topic?
Emergency physicians and trainees have high rates of stress and burnout.
What did this study ask?
How do reported stressors for emergency physicians and trainees differ between high and low resource settings?
What did this study find?
Trainees in the low resource setting reported higher stressors. Trainees reported higher levels of stressors than specialists in general.
Why does this study matter to clinicians?
High levels of reported stressors among trainees, and in low resource settings should be acknowledged and mitigated where possible
Point-of-care ultrasound to diagnose appendicitis in a Canadian emergency department
Sameer Sharif MD, Steven Skitch MD PhD RDMS, Dean Vlahaki MBBS RDMS, Andrew Healey MD RDMSdoi: 10.1017/cem.2018.373
What is known about the topic?
While computed tomography is often used, ultrasound is increasingly utilized to avoid radiation when diagnosing appendicitis.
What did this study ask?
What are the test characteristics of emergency physician-performed point-of-care ultrasound (POCUS) to diagnose appendicitis in the emergency department (ED)?
What did this study find?
This health-records review found that POCUS has a specificity of 90.6% for diagnosing appendicitis.
Why does this study matter to clinicians?
Using POCUS for appendicitis has the potential to decrease patient morbidity, diagnostic delays, ED length-of-stay, and need for further imaging.
Accuracy of the Ottawa Ankle Rules Applied by Non-physician Providers in a Pediatric Emergency Department
Joe MacLellan, MD; Teya Smith, BSc; Jason Baserman, MD; Shawn Dowling, MDdoi: 10.1017/cem.2017.399
What is known about the topic?
The OAR are a reliable tool to exclude fractures in children over 5 years of age when applied by physicians.
What did this study ask?
What is the accuracy of the OAR when applied by non-physician providers (NPP’s) in children.
What did this study find?
Only one clinically significant fracture was missed by NPP’s; it was detected on subsequent physician assessment.
Why does this study matter to clinicians?
NPP’s order nearly 40% of ankle radiographs thus accurate application of the OAR among NPP’s is necessary to minimize unnecessary imaging.
Using the Bergman-Paris Question to screen seniors in the emergency department
Antoine Laguë; Philippe Voyer, PhD; Marie-Christine Ouellet, PhD; Valérie Boucher, BA; Marianne Giroux, MSc; Mathieu Pelletier, MD; Émilie Gouin, MD; Raoul Daoust, MD, MSc; Simon Berthelot, MD; Michèle Morin, MD, MSc; Thien Tuong Minh Vu, MD; Jacques Lee, MD, MSc; Audrey-Anne Brousseau, MD, MS; Marie-Josée Sirois, PhD; Marcel Émond, MD, MScdoi: 10.1017/cem.2017.412
What is known about the topic?
The Bergman-Paris Question (BPQ) is a one-question screening test aiming to detect the presence of dementia in memory clinic patients.
What did this study ask?
We aimed to explore the BPQ’s usefulness to expose potential undetected geriatric syndromes (cognitive & functional impairment and frailty) in the ED.
What did this study find?
The BPQ had a sensitivity of 85.4% and a specificity of 35.4% for the detection of 1/3 geriatric syndrome.
Why does this study matter to clinicians?
A positive BPQ could help better identify patients who need further investigations in the ED, leading to better resources utilization.
