Dean Vlahaki - Academia.edu (original) (raw)

Papers by Dean Vlahaki

PubMed, 2008

Objective: Multiple studies conducted over many years have demonstrated that pain is poorly manag... more Objective: Multiple studies conducted over many years have demonstrated that pain is poorly managed in the emergency department (ED). This phenomenon has been referred to in the medical literature as "oligoanalgesia." However, little is known about whether oligoanalgesia occurs in a rural ED. National Ambulatory Care Reporting System data from 2003 for a small rural hospital in Ontario showed patients were satisfied with the amount of pain medicine they received in the ED. We designed a study to replicate a published urban study that investigated the use of analgesia in isolated lower limb injuries. Our objective was to see if oligoanalgesia was also a problem in a rural ED. Methods: In 2003 we conducted a retrospective chart review of patients who presented to the South Huron Hospital ED with isolated lower extremity injuries for which radiographs of the foot, ankle or both were obtained. Demographics of the ED patients with lower extremity injuries were quantified. Other parametres included whether or not patients received analgesia in the ED; how long it took to get assessed, treated and discharged; whether patients received any analgesia upon discharge; what type of analgesia they received; and whether it required a prescription. Results: A total of 189 patients met inclusion criteria, with 35 fractures identified (18.5%). Sixty-three percent of patients were male. The average age was 32.6 years. The mean Canadian Emergency Department Triage and Acuity Scale level was 4.4. The mean time to physician assessment was 31.6 minutes. The mean length of time spent in the ED was 74 minutes. Over one-half of the patients received analgesia upon discharge from the ED whether or not they had a fracture. In addition, 73% of the people in the fracture group received analgesia requiring a prescription, versus only 46% in the nonfracture group. Narcotics were used more often in the fracture group than in the nonfracture group (26% v. 6%). Conclusion: The phenomenon of oligoanalgesia was not observed as often in our rural ED for isolated lower limb injuries, when compared with the published urban study.

PubMed, 2009

Introduction: The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in... more Introduction: The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTAS aims to more accurately define patients' needs for timely care and provide operating objectives to standardize this care. These objectives are not being met across Ontario. The purpose of this study was to determine if the CTAS benchmarks were being met at a rural emergency department (ED). Methods: All ED visits to South Huron Hospital from Apr. 1, 2003, to Mar. 31, 2004, were reviewed. The percentage of visits receiving each CTAS category (I-V) was calculated. The median and 90th percentile time to physician initial assessment (PIA) were quantified by CTAS level. Results: There was a total of 10 286 ED visits with 113 (1.1%) excluded because of missing triage codes. The percentage of visits assigned to CTAS categories I to V was 0.3, 2.4, 16.0, 42.7 and 38.5, respectively. Time to PIA in minutes was 1, 12, 24, 28 and 27 for CTAS I to V, respectively. Conclusion: The CTAS guidelines for PIA were met at this rural ED.

Best Practice & Research in Clinical Obstetrics & Gynaecology, Aug 1, 2013

high reliability organizations (HROs) interprofessional communities of practice (CoPs) learning b... more high reliability organizations (HROs) interprofessional communities of practice (CoPs) learning behavioral change culture change In, 2001, the Patient Safety Division of the Society of Obstetricians and Gynaecologists of Canada initiated and championed a new program to improve patient safety performance in Canadian hospital obstetric units. This new program was developed under the banner of Managing Obstetrical Risk Efficiently and called the MORE OB Programme The MORE OB Programme was first piloted in Canadian hospitals at the beginning of May 2002 and, by mid 2004, 33 pilot sites had been implemented. In autumn 2004, this program embarked on a national launch. In 2007, the Society of Obstetricians and Gynaecologists of Canada collaborated with the Healthcare Insurance Reciprocal of Canada to form Salus Global Corporation. The birth of this corporate entity embraced the support of rapid expansion of the program within and outside of Canada. This collaboration also enabled innovation and implementation of safety programs beyond the obstetric discipline.

Canadian Journal of Emergency Medicine, May 17, 2018

Objectives: Appendicitis is a common surgical condition that frequently requires diagnostic imagi... more Objectives: Appendicitis is a common surgical condition that frequently requires diagnostic imaging. Abdominal computed tomography (CT) is the gold standard for diagnosing appendicitis. Ultrasound offers a radiation-free modality; however, its availability outside business hours is limited in many emergency departments (EDs). The purpose of this study is to evaluate the test characteristics of emergency physician-performed point-of-care ultrasound (POCUS) to diagnose appendicitis in a Canadian ED. Methods: A health records review was performed on all ED patients who underwent POCUS to diagnose appendicitis from December 1, 2010 to December 4, 2015. The sensitivity, specificity, and likelihood ratios were calculated. The gold standard used for diagnosis was pathology, laparoscopy, CT scans, and a radiologist-performed ultrasound. Results: Ninety patients were included in the study, and 24 were diagnosed with appendicitis on POCUS. Ultimately, 18 were confirmed to have appendicitis through radiologistperformed imaging, laparoscopy, and pathology. The sensitivity and specificity of POCUS to diagnose appendicitis were 69.2% (95% CI, 48.1%-84.9%) and 90.6% (95% CI, 80.0%-96.1%), respectively. Conclusion: POCUS has a high specificity for diagnosing acute appendicitis and has very similar characteristics to those of a radiologist-performed ultrasound. These findings are consistent with the current literature and have the potential to decrease patient morbidity, diagnostic delays, ED length of stay, and need for additional imaging. RÉSUMÉ Objectif: L'appendicite est une affection fréquente, qui impose une résection chirurgicale et qui exige souvent le recours à l'imagerie diagnostique. La tomodensitométrie (TDM) abdominale est l'examen de référence dans le diagnostic d'appendicite. L'échographie, elle, constitue une solution de rechange exempte de rayonnement, mais sa disponibilité en dehors des heures habituelles de travail est limitée dans de nombreux services des urgences (SU). L'étude avait donc pour but d'évaluer les caractéristiques de l'échographie au point d'intervention (EPI), effectuée par un urgentologue, dans le diagnostic d'appendicite au SU, au Canada. Méthode: Nous avons procédé à un examen des dossiers médicaux de tous les patients qui ont passé une EPI, au SU, en vue du diagnostic d'appendicite, du 1 er décembre 2010 au 4 décembre 2015. Ont été calculés la sensibilité, la spécificité et les rapports de vraisemblance. Les examens de référence utilisés dans le diagnostic étaient l'examen histopathologique, la laparoscopie, la TDM et l'échographie effectuée par un radiologiste. Résultats: Au total, 90 patients ont été retenus dans l'étude et un diagnostic d'appendicite a été posé à l'aide de l'EPI chez 24 d'entre eux. Finalement, 18 cas d'appendicite ont été confirmés à l'aide de l'examen d'imagerie effectué par un radiologiste, de la laparoscopie ou de l'examen histopathologique. La sensibilité et la spécificité de l'EPI dans le diagnostic d'appendicite s'élevaient à 69,2 % (IC à 95 % : 48,1 %-84,9 %) et à 90,6 % (IC à 95 % : 80,0 %-96,1 %) respectivement. Conclusions: L'échographie au point d'intervention jouit d'une forte spécificité dans le diagnostic d'appendicite aiguë et présente des caractéristiques très comparables à celles de l'échographie effectuée par un radiologiste. Les résultats vont dans le même sens que ceux relevés dans la documentation actuelle, et l'examen offre la possibilité de réduire la morbidité, le temps écoulé avant la pose du diagnostic, la durée de séjour au SU et la nécessité de recourir à d'autres examens par imagerie.

Canadian Journal of Emergency Medicine, May 1, 2016

Introduction: The accurate interpretation of potential ST-segment elevations on electrocardiogram... more Introduction: The accurate interpretation of potential ST-segment elevations on electrocardiograms (ECGs) to diagnose acute myocardial infarction (MI) is a critical competency for emergency physicians (EPs) and cardiologists. There is conflicting evidence on the diagnostic accuracy of EPs and cardiologists interpreting potential STEMI ECGs. Methods: We conducted a web-based assessment of the diagnostic accuracy of potential STEMI ECGs of Canadian EPs and cardiologists. They were identified using the membership lists of the Canadian Association of Emergency Physicians and the academic departments of cardiology at Canadian medical schools. When provided with 20 ECGs of confirmed STEMI patients, EPs and cardiologists were asked to provide a binary Yes/No answer to the question, "In a patient with ischemic chest pain, does this ECG represent a STEMI?" EPs and cardiologists were blinded to the correct answers while completing the web-based assessment. Descriptive statistics were used to described frequencies and counts. Analysis using Rasch Measurement Theory was used to explore the relationship between correct interpretation of ECGs and predictive variables such as age, years in practice or type of practice. Results: Two hundred and fifty EPs and 30 cardiologists (n = 280) responded to our survey (total response rate 25%). Average years in practice were 12.5 for EPs (SD 10.6; median 10) and 14.6 for cardiologists (SD 10.6; median 11); 52% of EPs and 93% of cardiologists practiced in an academic setting. Seven of the cardiologists were interventionalists, while 47.6% of EPs and 97% of cardiologists practiced at hospitals with 24-hour catheterization capability. The diagnostic accuracy of EPs for identifying STEMI ECGs was 75% (SD 15%); cardiologists' accuracy was 76% (SD 15.5%). The ability to correctly interpret the ECGs was independent of age, years in practice, or type of practice (community vs academic). Conclusion: EPs and cardiologists display similar diagnostic accuracy for interpreting STEMI ECGs, regardless of age, years in practice or type of practice. The findings of our study suggest the need for focused ECG education for both EPs and cardiologists.

Canadian Journal of Emergency Medicine, May 1, 2010

Objective: The Joint Commission on Accreditation of Healthcare Organizations recommends that pati... more Objective: The Joint Commission on Accreditation of Healthcare Organizations recommends that patients admitted to hospital with pneumonia receive their first dose of antibiotics within 6 hours of presenting to the emergency department (ED). Previous research in the United States indicates that rural hospitals may be better at achieving this benchmark than urban centres. This particular quality indicator has not yet been evaluated in Canada. The purpose of this study was to determine whether the target door-to-antibiotic (DTA) time of 6 hours or less could be met in a rural ED. Methods: We conducted a retrospective chart review of patients admitted to hospital with a diagnosis of pneumonia. Descriptive data for each case was collected, including demographic and timeline information. We analyzed DTA time, antibiotic type, route of administration, hospital length of stay and disposition at discharge. Results: We reviewed a total of 320 charts from Apr. 1, 2003, to Mar. 31, 2008. The final sample consisted of 143 patients (50.3% women) whose median age was 79 years. The median DTA time was 151 minutes and 81.8% of patients received their first dose of antibiotics within 6 hours. Patients received antibiotics either orally (47.6%), intravenously (47.6%) or both (4.8%). Single-agent respiratory fluoroquinolones were used 71.4% of the time. Median length of hospital stay was 4 days; most patients were discharged home (79.7%), 11 died, 11 were transferred and 7 were discharged to a nursing home. Conclusion: A DTA time of 6 hours or less is achievable in a rural ED.

Canadian Journal of Emergency Medicine, 2021

Objectives Cholelithiasis and cholecystitis are common conditions that frequently require patient... more Objectives Cholelithiasis and cholecystitis are common conditions that frequently require patients to come to the Emergency Department (ED) and undergo diagnostic imaging. The purpose of this study was to evaluate the test characteristics of emergency physician performed point-of-care ultrasound (POCUS) to diagnose cholelithiasis and cholecystitis in a Canadian ED. Methods A health records review was performed on all ED patients > 17 years of age for whom POCUS was performed to diagnose cholelithiasis and cholecystitis in a Canadian academic ED over a 5-year period. The sensitivity, specificity, predictive values, and likelihood ratios were calculated. The gold standard used for diagnosis was pathology, laparoscopy, radiology-performed comprehensive ultrasonography, followed by computed tomography scans. Results A total of 577 patients were included in the study. The sensitivity and specificity of POCUS to diagnose cholelithiasis was 95.2% (95% CI 91.1-97.8%) and 93.1% (95% CI 90.1-95.4%). The positive and negative likelihood ratios for POCUS to diagnose cholelithiasis were found to be 14 and 0.05; the negative predictive value was 97.6% (95% CI 95.5-98.7%). The sensitivity and specificity of POCUS to diagnose cholecystitis was 67.1% (95% CI 54.9-77.9%) and 97.6% (95% CI 95.9-98.8%). The positive and negative likelihood ratios for POCUS to diagnose cholecystitis were found to be 28 and 0.34; the negative predictive value was 95.6% (95% CI 93.9-96.8%). Conclusion POCUS is reliable for the diagnosis of cholelithiasis and for ruling in cholecystitis. In cases where POCUS is negative or indeterminate for cholecystitis, further imaging should be obtained as clinical suspicion warrants. Keywords Retrospective • Point-of-care ultrasound • Cholelithiasis • Cholecystitis Résumé Objectifs La cholélithiase et la cholécystite sont des troubles médicaux courants qui obligent fréquemment les patients à se rendre aux urgences et subir une imagerie diagnostique. Le but de cette étude était d'évaluer les caractéristiques des tests de l'échographie au point d'intervention (POCUS) effectuée par des médecins urgentistes pour diagnostiquer la cholélithiase et la cholécystite dans une urgence canadienne.

Australasian Journal of Paramedicine, 2016

Introduction Pre-hospital analgesia is administered at a suboptimal rate. We aimed to identify ba... more Introduction Pre-hospital analgesia is administered at a suboptimal rate. We aimed to identify barriers to pre-hospital oral analgesia administration to adult patients, as perceived by paramedics, using qualitative methods. Methods Paramedics from a county emergency medical service were invited to participate in semi-structured interviews. The interviews consisted of two questions regarding barriers to pre-hospital administration of oral analgesia using a previously established medical directive. The same investigator completed all interviews, which were audio recorded and transcribed verbatim. Barriers to analgesia administration to adult patients were identified from the interview transcripts using open coding of the data. Two investigators completed the coding process independently and discrepancies were then resolved by consensus. Code frequencies were tabulated and thematic analysis was used to organise the data into broad domains and themes. Results In total, 44 paramedics of a possible 46 (95.7%) completed a semi-structured interview. The final sample size was 43 after exclusion criteria were applied. The median paramedic age and practice experience was 39 and 9.5 years respectively, and 58% of the participants were male. Barriers to oral analgesia administration emerged in the domains of patient, medical directive, and paramedic factors. Conclusion Paramedic perceived barriers to pre-hospital oral analgesia administration were identified and include those related to patient, medical directive, and paramedic factors. Minimising these barriers should be undertaken to reduce rates of pre-hospital undertreatment of pain and improve pre-hospital pain management.

CJEM, 2018

ABSTRACTObjectivesAppendicitis is a common surgical condition that frequently requires diagnostic... more ABSTRACTObjectivesAppendicitis is a common surgical condition that frequently requires diagnostic imaging. Abdominal computed tomography (CT) is the gold standard for diagnosing appendicitis. Ultrasound offers a radiation-free modality; however, its availability outside business hours is limited in many emergency departments (EDs). The purpose of this study is to evaluate the test characteristics of emergency physician-performed point-of-care ultrasound (POCUS) to diagnose appendicitis in a Canadian ED.MethodsA health records review was performed on all ED patients who underwent POCUS to diagnose appendicitis from December 1, 2010 to December 4, 2015. The sensitivity, specificity, and likelihood ratios were calculated. The gold standard used for diagnosis was pathology, laparoscopy, CT scans, and a radiologist-performed ultrasound.ResultsNinety patients were included in the study, and 24 were diagnosed with appendicitis on POCUS. Ultimately, 18 were confirmed to have appendicitis th...

CJEM, 2016

Introduction: Appendicitis is a common surgical condition that frequently requires patients to un... more Introduction: Appendicitis is a common surgical condition that frequently requires patients to undergo diagnostic imaging. Abdominal computed tomography is the gold standard imaging technique for the diagnosis of appendicitis, but exposes patients to radiation. Ultrasound offers an alternate radiation-free imaging modality for appendicitis. However, the availability of ultrasound during off-hours is limited in many Emergency departments (EDs). Clinician performed point-of-care ultrasound (POCUS) is increasingly used by emergency physicians as a bedside tool to evaluate suspected appendicitis. The purpose of this study is to evaluate the test characteristics of emergency physician performed POCUS to diagnose appendicitis in a Canadian ED. Methods: A pragmatic, retrospective chart review was performed on all patients for whom a POCUS was performed to diagnose appendicitis at St. Joseph’s Healthcare Hamilton in Ontario from December 1, 2010 to December 4, 2015. All POCUS scans were per...

CJEM, 2008

Objective: The Canadian Emergency Cardiac Care Coalition, the American Heart Association and simi... more Objective: The Canadian Emergency Cardiac Care Coalition, the American Heart Association and similar groups have established a benchmark for the administration of thrombolytics in acute myocardial infarction (AMI) care as a door-to-needle (DTN) time of 30 minutes or less. Previous research suggests that this goal is not being achieved in Canada. The purpose of this study was to determine whether the target DTN time of 30 minutes or less for thrombolysis could be met in 2 rural Ontario emergency departments (EDs). Methods: We conducted a retrospective chart review and obtained descriptive data for each case, including demographic information and the Canadian Emergency Department Triage and Acuity Scale (CTAS) score. Visit timeline data were also collected and included the time during which patients saw a physician, had an electrocardiogram (ECG), received thrombolytic therapy and were discharged from the ED. Relevant time intervals, such as the median DTN time, were calculated. Resul...

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2009

The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTA... more The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTAS aims to more accurately define patients' needs for timely care and provide operating objectives to standardize this care. These objectives are not being met across Ontario. The purpose of this study was to determine if the CTAS benchmarks were being met at a rural emergency department (ED). All ED visits to South Huron Hospital from Apr. 1, 2003, to Mar. 31, 2004, were reviewed. The percentage of visits receiving each CTAS category (I-V) was calculated. The median and 90th percentile time to physician initial assessment (PIA) were quantified by CTAS level. There was a total of 10 286 ED visits with 113 (1.1%) excluded because of missing triage codes. The percentage of visits assigned to CTAS categories I to V was 0.3, 2.4, 16.0, 42.7 and 38.5, respectively. Time to PIA in minutes was 1, 12, 24, 28 and 27 for CTAS I to V, respectively. The CTAS guidelines for PIA were met at this ru...

CJEM, 2010

ABSTRACTObjective:The Joint Commission on Accreditation of Healthcare Organizations recommends th... more ABSTRACTObjective:The Joint Commission on Accreditation of Healthcare Organizations recommends that patients admitted to hospital with pneumonia receive their first dose of antibiotics within 6 hours of presenting to the emergency department (ED). Previous research in the United States indicates that rural hospitals may be better at achieving this benchmark than urban centres. This particular quality indicator has not yet been evaluated in Canada. The purpose of this study was to determine whether the target door-to-antibiotic (DTA) time of 6 hours or less could be met in a rural ED.Methods:We conducted a retrospective chart review of patients admitted to hospital with a diagnosis of pneumonia. Descriptive data for each case was collected, including demographic and timeline information. We analyzed DTA time, antibiotic type, route of administration, hospital length of stay and disposition at discharge.Results:We reviewed a total of 320 charts from Apr. 1, 2003, to Mar. 31, 2008. The...

Http Dx Doi Org 10 1016 J Bpobgyn 2013 02 008, May 1, 2013

Canadian Journal of Rural Medicine the Official Journal of the Society of Rural Physicians of Canada Journal Canadien De La Medecine Rurale Le Journal Officiel De La Societe De Medecine Rurale Du Canada, Feb 1, 2009

The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTA... more The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTAS aims to more accurately define patients&amp;amp;amp;#39; needs for timely care and provide operating objectives to standardize this care. These objectives are not being met across Ontario. The purpose of this study was to determine if the CTAS benchmarks were being met at a rural emergency department (ED). All ED visits to South Huron Hospital from Apr. 1, 2003, to Mar. 31, 2004, were reviewed. The percentage of visits receiving each CTAS category (I-V) was calculated. The median and 90th percentile time to physician initial assessment (PIA) were quantified by CTAS level. There was a total of 10 286 ED visits with 113 (1.1%) excluded because of missing triage codes. The percentage of visits assigned to CTAS categories I to V was 0.3, 2.4, 16.0, 42.7 and 38.5, respectively. Time to PIA in minutes was 1, 12, 24, 28 and 27 for CTAS I to V, respectively. The CTAS guidelines for PIA were met at this rural ED.

Multiple studies conducted over many years have demonstrated that pain is poorly managed in the e... more Multiple studies conducted over many years have demonstrated that pain is poorly managed in the emergency department (ED). This phenomenon has been referred to in the medical literature as "oligoanalgesia." However, little is known about whether oligoanalgesia occurs in a rural ED. National Ambulatory Care Reporting System data from 2003 for a small rural hospital in Ontario showed patients were satisfied with the amount of pain medicine they received in the ED. We designed a study to replicate a published urban study that investigated the use of analgesia in isolated lower limb injuries. Our objective was to see if oligoanalgesia was also a problem in a rural ED. In 2003 we conducted a retrospective chart review of patients who presented to the South Huron Hospital ED with isolated lower extremity injuries for which radiographs of the foot, ankle or both were obtained. Demographics of the ED patients with lower extremity injuries were quantified. Other parametres included...

CJEM, 2010

The Joint Commission on Accreditation of Healthcare Organizations recommends that patients admitt... more The Joint Commission on Accreditation of Healthcare Organizations recommends that patients admitted to hospital with pneumonia receive their first dose of antibiotics within 6 hours of presenting to the emergency department (ED). Previous research in the United States indicates that rural hospitals may be better at achieving this benchmark than urban centres. This particular quality indicator has not yet been evaluated in Canada. The purpose of this study was to determine whether the target door-to-antibiotic (DTA) time of 6 hours or less could be met in a rural ED. We conducted a retrospective chart review of patients admitted to hospital with a diagnosis of pneumonia. Descriptive data for each case was collected, including demographic and timeline information. We analyzed DTA time, antibiotic type, route of administration, hospital length of stay and disposition at discharge. We reviewed a total of 320 charts from Apr. 1, 2003, to Mar. 31, 2008. The final sample consisted of 143 p...

Best Practice & Research Clinical Obstetrics & Gynaecology, 2013

Canadian Journal of Emergency Medicine, Sep 1, 2008

OBJECTIVE: The Canadian Emergency Cardiac Care Coalition, the American Heart Association and simi... more OBJECTIVE: The Canadian Emergency Cardiac Care Coalition, the American Heart Association and similar groups have established a benchmark for the administration of thrombolytics in acute myocardial infarction (AMI) care as a door-to-needle (DTN) time of 30 minutes or less. Previous research suggests that this goal is not being achieved in Canada. The purpose of this study was to determine whether the target DTN time of 30 minutes or less for thrombolysis could be met in 2 rural Ontario emergency departments (EDs).METHODS: We conducted a retrospective chart review and obtained descriptive data for each case, including demographic information and the Canadian Emergency Department Triage and Acuity Scale (CTAS) score. Visit timeline data were also collected and included the time during which patients saw a physician, had an electrocardiogram (ECG), received thrombolytic therapy and were discharged from the ED. Relevant time intervals, such as the median DTN time, were calculated.RESULTS: A total of 454 charts were reviewed for patients with a diagnosis of AMI who were seen between 1996 and 2007. The final sample consisted of 101 patients who received thrombolytics (63% men) whose median age was 67 years and median CTAS score was Level II (Emergent). The median door-to-ECG time was 6 minutes, door-to-physician time was 8 minutes and DTN time was 27 minutes; 58% of patients received thrombolytics within 30 minutes.CONCLUSION: A DTN time of 30 minutes or less is achievable in rural EDs.

PubMed, 2008

PubMed, 2009

Best Practice & Research in Clinical Obstetrics & Gynaecology, Aug 1, 2013

Canadian Journal of Emergency Medicine, May 17, 2018

Canadian Journal of Emergency Medicine, May 1, 2016

Canadian Journal of Emergency Medicine, May 1, 2010

Canadian Journal of Emergency Medicine, 2021

Australasian Journal of Paramedicine, 2016

CJEM, 2018

CJEM, 2016

CJEM, 2008

CJEM, 2010

Http Dx Doi Org 10 1016 J Bpobgyn 2013 02 008, May 1, 2013

The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTA... more The Canadian Emergency Department Triage and Acuity Scale (CTAS) was implemented in 1999. The CTAS aims to more accurately define patients&amp;amp;amp;#39; needs for timely care and provide operating objectives to standardize this care. These objectives are not being met across Ontario. The purpose of this study was to determine if the CTAS benchmarks were being met at a rural emergency department (ED). All ED visits to South Huron Hospital from Apr. 1, 2003, to Mar. 31, 2004, were reviewed. The percentage of visits receiving each CTAS category (I-V) was calculated. The median and 90th percentile time to physician initial assessment (PIA) were quantified by CTAS level. There was a total of 10 286 ED visits with 113 (1.1%) excluded because of missing triage codes. The percentage of visits assigned to CTAS categories I to V was 0.3, 2.4, 16.0, 42.7 and 38.5, respectively. Time to PIA in minutes was 1, 12, 24, 28 and 27 for CTAS I to V, respectively. The CTAS guidelines for PIA were met at this rural ED.

CJEM, 2010

Best Practice & Research Clinical Obstetrics & Gynaecology, 2013

Canadian Journal of Emergency Medicine, Sep 1, 2008