Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada
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Aboriginal people are substantially more likely to be injured or die in motor vehicle crashes (MVCs) than the general population. However, research examining MVCs among Canadian Aboriginal populations is limited. We examine trends and gaps in the Canadian literature and suggest priorities for future research. ⋯ This review indicates that rates of death, hospital admission and injury related to MVCs are twice as high among Aboriginal populations than the general Canadian population, which highlights a major public health concern. Priorities for future research should include examination of the social environment, more rigorous methods and collaborative research in partnership with Aboriginal communities.
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Aboriginal people are substantially more likely to be injured or die in motor vehicle crashes (MVCs) than the general population. However, research examining MVCs among Canadian Aboriginal populations is limited. We examine trends and gaps in the Canadian literature and suggest priorities for future research. ⋯ This review indicates that rates of death, hospital admission and injury related to MVCs are twice as high among Aboriginal populations than the general Canadian population, which highlights a major public health concern. Priorities for future research should include examination of the social environment, more rigorous methods and collaborative research in partnership with Aboriginal communities.
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Pulmonary embolism (PE) is a serious condition with mortality estimates of up to 10%. We sought to investigate the diagnosis of PE, time to access imaging and diagnostic utility of each modality in a rural emergency department (Ed). ⋯ In this ED there may be over reliance on the D-dimer test, irrespective of Wells score. Access to V/Q and CT were similar to that of an urban centre. Empiric anticoagulation was started in most patients.
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The Canadian Association of Emergency Physicians (CAEP) published a position statement in 2006 encouraging immediate access to emergency medicine ultrasonography (EMUS) 24 hours a day, 7 days a week. However, barriers to advanced imaging care still exist in many rural hospitals. Our study investigated the current availability of EMUS in rural communities and physicians' ability to use this technology. ⋯ Patients in many rural EDs do not have immediate access to EMUS, as advocated by CAEP. This gap in care needs to be addressed to ensure that all patients, no matter where they live, have access to this proven imaging modality.
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Review Meta Analysis
Use of intra-articular lidocaine as analgesia in anterior shoulder dislocation: a review and meta-analysis of the literature.
The shoulder joint is the most commonly injured major joint in patients who present to the hospital emergency department today. In the community the incidence of shoulder joint injuries is 11.2 cases per 100,000 person-years. Traditionally, procedural sedation and analgesia (PSA) has been used to facilitate the reduction of anterior shoulder dislocations. However, there are risks of complication, such as respiratory depression, particularly in certain populations. As such, the use of intra-articular lidocaine (IAL) has been suggested as an alternative method of analgesia. ⋯ Although more research is this area is merited, physicians may consider IAL as an alternative to PSA in the management of anterior shoulder dislocations.