Can J Emerg Med
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There is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee. ⋯ We have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.
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As an aging population continues to place strain on the health care system, many older adults are living with unmet social and medical needs. In response, Emergency Medical Services (EMS) have initiated programs that encourage paramedics to refer patients in need to community based support services. This qualitative study explores frontline paramedic experiences with referral programs to identify opportunities and challenges in their practice. ⋯ In a strained health care system, EMS and paramedics have an opportunity to better serve patients by initiating referrals for patients they encounter with unmet social and medical needs. However, referral programs face a number of challenges that, if left poorly addressed, may threaten the success of such programs.
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Randomized Controlled Trial
Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial.
Article chosen Ebinger M, Winter B, Wendt M, et al. Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial. JAMA 2014;311(16):1622-31. Clinical question Does prehospital thrombolysis in specialized ambulances reduce delay to thrombolysis in acute ischemic stroke? ⋯ To determine the effect of prehospital thrombolysis for acute ischemic stroke administered in specialized ambulances on delay in thrombolytic administration, thrombolysis rate, post-thrombolysis intracerebral hemorrhage, and 7-day mortality.
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Multicenter Study
Offload zones to mitigate emergency medical services (EMS) offload delay in the emergency department: a process map and hazard analysis.
Introduction Offload delay is a prolonged interval between ambulance arrival in the emergency department (ED) and transfer of patient care, typically occurring when EDs are crowded. The offload zone (OZ), which manages ambulance patients waiting for an ED bed, has been implemented to mitigate the impact of ED crowding on ambulance availability. Little is known about the safety or efficiency. The study objectives were to process map the OZ and conduct a hazard analysis to identify steps that could compromise patient safety or process efficiency. ⋯ This process map and hazard analysis is a first step in understanding the safety and efficiency of the OZ. The results from this study will inform current policy and practice, and future work to reduce offload delay.