Hyperbaric Oxygen Post Established Stroke.

Background And Purpose: Hyperbaric oxygen therapy (HBOT) has been reported to improve neurological function in the chronic phase of stroke in a single trial having significant limitations, including a lack of a sham control.

Methods: We conducted a single-center, parallel-group, randomized trial to determine the effectiveness of HBOT compared with a sham control in adults who were 6 to 36 months post-ischemic stroke. The treatment group received 40 sessions of HBOT at the Vancouver General Hospital Hyperbaric Unit.

A Global Survey of Emergency Care Clinical Networks: Discussion and Implications for Canadian Learning Health Systems.

Clinical networks (CNs) can promote innovation and collaboration across providers and stakeholders. However, little is known about the structure and operations of CNs, particularly in emergency care. As Canada advances learning health systems (LHSs), foundational research is essential to enable future comparisons across CNs to identify those that contribute to positive system change.

Concordance between 8-1-1 HealthLink BC Emergency iDoctor-in-assistance (HEiDi) virtual physician advice and subsequent health service utilization for callers to a nurse-managed provincial health information telephone service.

Background: British Columbia 8-1-1 callers who are advised by a nurse to seek urgent medical care can be referred to virtual physicians (VPs) for supplemental assessment and advice. Prior research indicates callers' subsequent health service use may diverge from VP advice. We sought to 1) estimate concordance between VP advice and subsequent health service use, and 2) identify factors associated with concordance to understand potential drivers of discordant cases.

Health system use and outcomes of urgently triaged callers to a nurse-managed telephone service for provincial health information after initiation of supplemental virtual physician assessment: a descriptive study.

Background: British Columbia's 8-1-1 telephone service connects callers with nurses for health care advice. As of Nov. 16, 2020, callers advised by a registered nurse to obtain in-person medical care can be subsequently referred to virtual physicians.

College complaints against resident physicians in Canada: a retrospective analysis of Canadian Medical Protective Association data from 2013 to 2017.

Background: An understanding of regulatory complaints against resident physicians is important for practice improvement. We describe regulatory college complaints against resident physicians using data from the Canadian Medical Protective Association (CMPA).

Methods: We conducted a retrospective analysis of college complaint cases involving resident doctors closed by the CMPA, a mutual medicolegal defence organization for more than 100 000 physicians, representing an estimated 95% of Canadian physicians.

Integration of virtual physician visits into a provincial 8-1-1 health information telephone service during the COVID-19 pandemic: a descriptive study of HealthLink BC Emergency iDoctor-in-assistance (HEiDi).

Background: British Columbia, like many jurisdictions, has a health information telephone service (8-1-1) to provide callers with information by registered nurses and help them decide whether to attend an emergency department or primary care clinic, or manage their concern at home. We describe a new service, HealthLink BC Emergency iDoctor-in-assistance (HEiDi), that partnered physicians available by videoconferencing with 8-1-1 registered nurses to support callers.

Methods: From Apr.

Epinephrine in cardiac arrest: The PARAMEDIC2 trial.

Link:http://www.nejm.org/doi/10.

Process and findings informing the development of a provincial emergency medicine network.

We describe the process undertaken to inform the development of the recently launched British Columbia (BC) Emergency Medicine Network (EM Network). Five methods were undertaken: (1) a scoping literature review, (2) a survey of BC emergency practitioners and EM residents, (3) key informant interviews, (4) focus groups in sites across BC, and (5) establishment of a brand identity. There were 208 survey respondents: 84% reported consulting Internet resources once or more per emergency department shift; however, 26% reported feeling neutral, somewhat unsatisfied, or very unsatisfied with searching for information on the Internet to support their practice.

Use of personal mobile devices to record patient data by Canadian emergency physicians and residents.

Objective: Use of personal mobile devices to record patient data appears to be increasing, but remains poorly studied. We sought to determine the extent and reasons that Canadian emergency physicians (EPs) and emergency medicine residents use personal mobile devices to record patient data in the emergency department (ED).

Methods: A national survey was distributed to Canadian EPs and residents between 27/02/17 and 23/03/17.

The bougie and first-pass success in the emergency department: Journal Club review.

Clinical Question: Is bougie use associated with increased first-pass success in emergency department (ED) intubations?Article chosen: Driver et al. The Bougie and First-Pass Success in the Emergency Department. Annals of Emerg Med 2017;70(4):473-478.

Reasons and outcomes for patients receiving ICS/LABA agents prior to, and one month after, emergency department presentations for acute asthma.

: Asthma is a common emergency department (ED) presentation. This study examined factors associated with inhaled corticosteroids/long-acting beta-agonist (ICS/LABA) use; and management and outcomes before and after ED presentation. : Secondary analysis of a prospective cohort study; adults treated for acute asthma in Canadian EDs underwent a structured interview before discharge and were followed-up four weeks later.

Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

Objective: Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care.

Methods: We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR).

Prediction and risk stratification of survival in accidental hypothermia requiring extracorporeal life support: An individual patient data meta-analysis.

Background: Extra-corporeal life support (ECLS) is a life-saving intervention for patients with hypothermia induced cardiac arrest or severe cardiovascular instability. However, its application is highly variable due to a paucity of data in the literature to guide practice. Current guidelines and recommendations are based on expert opinion, single case reports, and small case series.

The British Columbia Emergency Medicine Network: A Paradigm Shift in a Provincial System of Emergency Care.

As generalists, emergency practitioners face challenges in providing state-of-the-art care owing to the broad spectrum of practice and the rapid rate of new knowledge generation. Networks have become increasingly prevalent in health care, and it was in this backdrop, and the resulting opportunity to advance evidence-informed emergency care in the Canadian province of British Columbia (BC), that a new "Emergency Medicine Network" (EM Network) was launched in 2017. The EM Network consists of four programs, each led by a physician with expertise and a track record in the domain: (1) Clinical Resources; (2) Innovation; (3) Continuing Professional Development; and (4) Real-time Support.

Effect of a Multi-Diagnosis Observation Unit on Emergency Department Length of Stay and Inpatient Admission Rate at Two Canadian Hospitals.

Background: Observation units (OUs) have been shown to reduce emergency department (ED) lengths of stay (LOS) and admissions. Most published studies have been on OUs managing single complaints.

Objective: Our aim was to determine whether an OU reduces ED LOS and hospital admission rates for adults with a variety of presenting complaints.

A Systematic Review of Randomized Controlled Trials Comparing Hypertonic Sodium Solutions and Mannitol for Traumatic Brain Injury: Implications for Emergency Department Management.

Objective: To comparatively evaluate hypertonic sodium (HTS) and mannitol in patients following acute traumatic brain injury (TBI) on the outcomes of all-cause mortality, neurological disability, intracranial pressure (ICP) change from baseline, ICP treatment failure, and serious adverse events.

Data Sources: PubMed, EMBASE, CENTRAL, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, and WHO ICTRP (World Health Organization International Clinical Trials Registry Platform) were searched (inception to November 2015) using hypertonic saline solutions, sodium chloride, mannitol, osmotic diuretic, traumatic brain injury, brain injuries, and head injury.