CJEM
-
Meta Analysis
Inhaled nitrous oxide for painful procedures in children and youth: a systematic review and meta-analysis.
The objective of this study was to synthesize indication-based evidence for N2O for distress and pain in children. ⋯ There is sufficient evidence to recommend N2O plus topical anesthetic for IV insertion and laceration repair. Adverse effects are greater when combined with other sedating agents.
-
Workplace-based assessments are an important tool for trainee feedback and as a means of reporting expert judgments of trainee competence in the workplace. However, the literature has demonstrated that gender bias can exist within these assessments. We aimed to determine whether gender differences in the quality of workplace-based assessment data exist in our residency training program. ⋯ We did not find faculty or resident gender differences in the quality of workplace-based assessments completed in our training program. While the literature has previously demonstrated gender bias in trainee assessments, our results are not surprising as assessment culture varies by institution and program. Our study cautions against generalizing gender bias across contexts, and offers an approach that educators can use to evaluate whether gender bias in the quality of trainee assessments exists within their program.
-
Multicenter Study
Do patient outcomes differ when the trauma team leader is a surgeon or non-surgeon? A multicentre cohort study.
Trauma team leaders (TTLs) have traditionally been general surgeons; however, some trauma centres use a mixed model of care where both surgeons and non-surgeons (primarily emergency physicians) perform this role. The objective of this multicentre study was to provide a well-powered study to determine if TTL specialty is associated with mortality among major trauma patients. ⋯ After risk adjustment, there was no difference in mortality between trauma patients treated by surgeon or non-surgeon TTLs. Our study supports emergency physicians performing the role of TTL at level 1 trauma centres.
-
Over the last two decades, there has been a steady rise in severe maternal morbidity and pregnancy-related deaths in Canada and the USA. The Modified Early Obstetric Warning System (MEOWS) is a risk stratification tool designed to predict severe maternal morbidity and mortality and has been validated for use in obstetrical wards. The objective of this study was to determine if MEOWS could accurately identify patients at risk of severe maternal morbidity and mortality in the ED setting. ⋯ This study is the first to explore the utility of MEOWS in postpartum ED patients. The presence of a MEOWS trigger at ED triage or the first ED nursing assessment was associated with severe maternal morbidity. Thus, MEOWS may be a valuable tool to identify postpartum patients at risk of severe outcomes early in an ED visit.