CJEM
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ECGs performed at ED triage are mandatorily assessed by an emergency physician contributing to task interruptions, decreased quality of care and increased error risk. Recent literature suggests that a triage ECG interpreted as normal by the ECG machine software correlates with benign interpretation from attending cardiologists. Ambiguity persists regarding the safety of the normal computerized ECG interpretation and whether real-time physician review is needed. ⋯ A normal ECG interpretation from the GE Marquette 12SL ECG software at ED triage has a very high accuracy and a very low probability of clinically relevant change in patient outcome and ED trajectory.
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Multicenter Study
Pathways to cancer care after a suspected cancer diagnosis in the emergency department: a survey of emergency physicians across Ontario.
Little is known about how patients are managed after a suspected cancer diagnosis through the emergency department. The objective of this study was to examine the ED management, specifically referral practices, for ten suspected cancer diagnoses by emergency physicians across Ontario and to explore variability in management by cancer-type and centre. ⋯ Physician management of new suspected cancer varies between EDs and is specific to cancer type. Strategies to standardize access to cancer care in a timely and equitable way for patients with newly suspected cancer in the ED are needed.
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Nonconvulsive status epilepticus is a severe complication of lithium intoxication that requires prompt diagnosis and treatment. While conventional electroencephalography (EEG) remains the gold standard for diagnosis for nonconvulsive status epilepticus, its implementation in emergency settings can be challenging and time-consuming. We present a case in which simplified EEG with six electrodes enabled rapid detection and monitoring of nonconvulsive status epilepticus in lithium intoxication in the emergency setting. ⋯ This case demonstrates the utility of simplified EEG in emergency settings for early detection and monitoring of nonconvulsive status epilepticus in lithium intoxication. The ability of emergency physicians to apply and interpret simplified EEG enabled timely intervention and prevention of neurological complications. While further research is needed to validate interpretation protocols by non-EEG specialists, simplified EEG shows promise as an accessible tool for rapid assessment of neurotoxicity in lithium intoxication, potentially improving patient outcomes through earlier intervention.