Can J Emerg Med
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Bystander resuscitation efforts, such as cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED), save lives in cardiac arrest cases. School training in CPR and AED use may increase the currently low community rates of bystander resuscitation. The study objective was to determine the rates of CPR and AED training in Toronto secondary schools and to identify barriers to training and training techniques. ⋯ CPR training rates for staff and students were moderate overall and lowest in private schools, whereas training rates in AED use were poor in all schools. Identified barriers to training include cost and student population size (perceived to be too small to be cost-effective or too large to be implemented). Future studies should assess the application of convenient and cost-effective teaching alternatives not presently in use.
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Multicenter Study
Does the sedation regimen affect adverse events during procedural sedation and analgesia in injection drug users?
Injection drug users (IDUs) often undergo procedural sedation and analgesia (PSA) as part of emergency department (ED) treatment. We compared adverse events (AEs) using a variety of sedation regimens. ⋯ For IDU PSA, the overall AE rate was 6.5%, and propofol appeared to have a significantly lower rate.
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To assess the prevalence of an unfavourable outcome among children leaving without being seen by a physician in the emergency department (ED). ⋯ Approximately 2% of children who left without being seen by a physician at a tertiary care pediatric ED had an unfavourable outcome.
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Because a majority of urinary tract stones (UTSs) pass spontaneously and clinically significant alternative pathology is rare, we hypothesize that many computed tomographic (CT) scans to diagnose them are likely unnecessary. We sought to measure the impact of renal CT scans on resource use and to justify a prospective study to derive a score that predicts an emergent diagnosis in patients with suspected UTS by doing so in our retrospective series. ⋯ A sensible, relevant score derived and validated on all patients presenting with symptoms suggestive of renal colic could be useful in reducing abdominal CT scan ordering.
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Are four common clinical decision rules, in combination with normal D-dimer results, comparable in their ability to clinically exclude the diagnosis of pulmonary embolism? ⋯ To directly compare the performance of four different clinical decision rules, the Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score, in combination with D-dimer results, to exclude pulmonary embolism.