Can J Emerg Med
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Emergency department (ED) crowding is associated with increased morbidity and mortality. Its etiology is multifactorial, and frequent ED use (defined as more or equal to five visits per year) is a major contributor to high patient volumes. Our primary objective is to characterize the frequent user population. Our secondary objective is to examine risk factors for frequent emergency use. ⋯ Our study is the first Canadian study to assess risk factors of frequent pediatric emergency use. The identified risk factors and diagnoses highlight the need for future evidence-based, targeted innovative research evaluating strategies to minimize ED crowding, to improve health outcomes and to improve patient satisfaction.
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Emergency physicians (EPs) interpret plain radiographs for management and disposition of patients. Radiologists subsequently conduct their own interpretations, which may differ. The purposes of this study were to review the rate and nature of discrepancies between radiographs interpreted by EPs and those of radiologists in the pediatric emergency department, and to determine their clinical significance. ⋯ There is a low rate of discrepancy in the interpretation of pediatric emergency radiographs between emergency department physicians and radiologists. The majority of errors occur with radiographs of the chest and upper extremities. The low rate of clinically significant discrepancy allows safe management based on EP interpretation.
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Recent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, patient privacy is highly regulated by provincial legislation, although patients themselves have little in the way of laws or regulations to observe. Patients taking video recordings of their own medical care does not currently fall under any of the provincial privacy laws. ⋯ Patients are legally allowed to record a patient-physician interaction without consent of their physician, because the patient can provide the "one-party consent" for the conversation to be recorded. Physicians should accept the possibility that they are being recorded at all times and should strive to communicate as clearly and effectively as possible. Physicians should strive to provide the same level of care that they would even if they were not being recorded, and not let it interfere with their clinical decision-making.