Can J Emerg Med
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Multicenter Study Observational Study
Rhythm and rate control of atrial fibrillation in the emergency department - A large community-based observational study.
Atrial fibrillation (AF) is the most common arrhythmia presentation to the emergency department (ED) and frequently results in admission to the hospital. Although rarely life-threatening and not usually an emergent condition, AF places a large burden on our health-care system. The objective of this study was to describe the practices of ED physicians in the management of AF in a large urban Canadian city. ⋯ Our data suggest a wide range of practice amongst ED physicians treating patients presenting to the ED with a primary diagnosis of AF. A randomized trial is needed to better understand the optimal management strategy in this patient population and setting.
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Clinical questionWhat is the prevalence of Salter-Harris type I distal fibula fractures in children with lateral ankle injuries?Article chosenBoutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children occult growth plate fracture or sprain? JAMA Pediatr 2016;170(1):e154114.
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Studies suggest that addressing the needs of the older population in rural areas may substantially reduce their low-urgency use of emergency medical services (LUEMS). It may ultimately also help improve the efficiency in our health system. There is, however, a dearth of evidence substantiating geographic patterns in LUEMS by different age cohorts. This exploratory study was aimed to clarify the understanding of emergency medical services (EMS) use in Nova Scotia through a geographic analysis. ⋯ High LUEMS incidence rates are rural phenomena but not specific to the older population. However, the absolute number of LUEMS by the older cohort is significant, and elder-specific interventions in rural regions could still lead to effective cost savings. Further investigation of other factors, such as distance to the emergency department, availability of public transportation, and socioeconomic conditions of EMS users, is needed.