CJEM
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Little evidence exists studying the benefits of pre-hospital trauma team activation. Our study measured the impact of pre-hospital trauma team activation on 24-h survival. Our secondary objectives assessed the effects of pre-hospital trauma team activation on time to emergency procedure, computed tomography, blood transfusion, and critical administration threshold, as well as emergency department length of stay. ⋯ When controlling for key covariates, pre-hospital trauma team activation did not have a significant effect on 24-h mortality, but did result in a significant reduction in time to emergency procedure, computed tomography, and blood transfusion, as well as emergency department length of stay. Our study demonstrates that pre-hospital trauma team activation can expedite patient intervention and disposition.
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Pediatric emergency departments are overcrowded, in part due to many non-emergent visits. We aimed to assess the proportion of parents interested in leaving the pediatric emergency department (ED) prior to physician assessment if they could be offered a scheduled community healthcare appointment. We explored differences in care children received in the ED stratified by interest in a community healthcare appointment and parents' reasons when they were not interested. ⋯ Our study provides evidence that there is interest in an alternative care access model positioned to reduce pediatric ED congestion. We found that parents would be interested in leaving the pediatric ED in favor of a community healthcare appointment, provided it was with a physician and available in a timely manner.
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Mass-casualty incidents have a significant global impact. Despite calls for improved disaster-preparedness training, most medical curriculums do not include formal disaster-medicine education. In 2021, the Medical Council of Canada introduced new disaster-medicine learning objectives. ⋯ Few formal medical student mass-casualty-incident courses exist. Combining "Dark-team-members" with live actors, imbedding clinician facilitators with medical students, and having a simulation with a continuous disaster scene to the ED are unique to this course. The methodology is presented for future replication.