Ken Milne - Academia.edu (original) (raw)

Papers by Ken Milne

Canadian Journal of Emergency Medicine, May 1, 2017

non-significant incidental findings of 80% (α = 5%, Power = 90%). Results: A total of 1629 studie... more non-significant incidental findings of 80% (α = 5%, Power = 90%). Results: A total of 1629 studies were included (mean 62 yrs, SD 16.7, 56.9% female, median CTAS score 2, 45.2% admitted). PE was found in 233 (14.3%) patients. 173 (10.6%) studies had a finding of an alternative diagnosis, the majority being pulmonary infiltrates (n = 130, 75.1%). In patients who underwent both CTPA and chest x-ray (CXR), CXRs alone would have led to the same alternative diagnosis in 116 (77.1%) patients. A total of 223 (13.6%) patients had an incidental finding; the majority included pulmonary nodules (n = 83, 37.2%) and adenopathy (n = 26, 11.6%). Only 26 (17.1%) incidental findings were significant; most common included pulmonary nodules (n = 6, 3.9%) and masses (n = 7, 4.6%) that lead to newly identified and biopsied lung cancer diagnoses. Incidental findings led to an additional 301 follow-up CTs with a yield of significant result of 9.2% (n = 48 CTs). Conclusion: Chest CTs ordered in the ED for clinical suspicion of PE is equally as likely to identify alternative diagnoses or incidental findings as PE. The majority of incidental findings are non-significant and result in an increased use of CT. CXRs should routinely be ordered prior to further investigation for PE with chest CT to reduce unnecessary testing and thus time and cost to the system.

The Journal of emergency medicine, Nov 1, 2015

Despite the fact that topical anesthetics provide superb analgesia to the painful eye, they are n... more Despite the fact that topical anesthetics provide superb analgesia to the painful eye, they are not prescribed routinely to patients when they are discharged from the emergency department because of concerns for delayed healing and corneal erosion. To summarize the evidence for the safety of topical proparacaine and tetracaine for pain relief in patients with corneal abrasions. This is a systematic review looking at the use of topical anesthetic agents in the treatment of corneal abrasions in the emergency department. Our literature search produced two emergency department-based, randomized, double blind, placebo-controlled studies on human patients with corneal abrasions. Additionally, we found four studies that investigated the application of topical anesthetics in patients who underwent photorefractive keratectomy. All six studies demonstrated that a short course of dilute topical anesthetic provided efficacious analgesia without adverse effects or delayed epithelial healing. Limited available data suggests that the use of dilute topical ophthalmologic proparacaine or tetracaine for a short duration of time is effective, though their safety for outpatient use is inconclusive.

Emergency Medicine Australasia

BMJ Evidence-Based Medicine, 2020

ObjectivesAlteplase is commonly recommended for acute ischaemic stroke within 4.5 hours after str... more ObjectivesAlteplase is commonly recommended for acute ischaemic stroke within 4.5 hours after stroke onset. The Third European Cooperative Acute Stroke Study (ECASS III) is the only trial reporting statistically significant efficacy for clinical outcomes for alteplase use 3–4.5 hours after stroke onset. However, baseline imbalances in history of prior stroke and stroke severity score may confound this apparent finding of efficacy. We reanalysed the ECASS III trial data adjusting for baseline imbalances to determine the robustness or sensitivity of the efficacy estimates.DesignReanalysis of randomised placebo-controlled trial. We obtained access to the ECASS III trial data and replicated the previously reported analyses to confirm our understanding of the data. We adjusted for baseline imbalances using multivariable analyses and stratified analyses and performed sensitivity analysis for missing data.SettingEmergency care.Participants821 adults with acute ischaemic stroke who could be...

CJEM, 2016

Introduction: A rapid and accurate weight of a child can be of critical importance during pediatr... more Introduction: A rapid and accurate weight of a child can be of critical importance during pediatric emergencies. The Broselow Tape (BT) is the gold standard for estimating a child’s weight based on their length. It separates children into incremental weight categories. Studies have shown that the BT is not accurate. We created a new pediatric spine board (PedEBoard) that weighs the child. The objective of this study was to compare the agreement between the actual weight vs. the PedEBoard weight and BT estimated weight of children presenting to a pediatric emergency department (ED). Methods: Ethics approval was obtained from McMaster University. A power calculation was done for sample size to detect 10% error. Consecutive children were recruited who presented to McMaster University’s Children’s ED on two days in March 2015. Children were excluded if their length was outside the BT range, non-English speaking or critically ill. Children had their weight taken by the triage nurse eithe...

Canadian Journal of Emergency Medicine, Oct 26, 2016

As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, ... more As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/ podcast 2 and discussed by the study authors and the online EM community. A similar collaboration is underway between the SGEM and Academic Emergency Medicine. What follows is a summary of the selected article the immediate post-publication synthesis from the SGEM podcast, commentary by the first author, and the subsequent discussion from the SGEM blog and other social media. Through this series, we hope to enhance the value, accessibility, and application of important, clinically relevant EM research. In this, the third SGEM HOP hosted collaboratively with CJEM, we discuss Olszynski et al.'s randomized crossover study evaluating the use of ultrasound simulator devices during critical care simulation. 3

Canadian Journal of Emergency Medicine, Jul 1, 2016

Canadian Journal of Emergency Medicine, Sep 14, 2017

Emergency Medicine Journal, Dec 10, 2013

Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the Oc... more Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the October issue of EMJ .1 The authors did a good job covering the subject and providing a list of FOAMed resources. Social media is turning medical education on its head. The top down, 20th century, didactic method of knowledge translation is being replaced by online resources that are timely, articulate, interactive and widely distributed. The …

Canadian Journal of Emergency Medicine, Sep 1, 2016

As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, ... more As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/podcast and discussed by the study authors and the online EM community. A similar collaboration is under way between the SGEM and Academic Emergency Medicine. What follows is a summary of the selected article, the immediate post-publication synthesis from the SGEM podcast, commentary by the first author, and the subsequent discussion from the SGEM blog and other social media. Through this series, we hope to enhance the value, accessibility, and application of important, clinically relevant EM research. In this, the second SGEM HOP hosted collaboratively with CJEM, we discuss a systematic review evaluating the use of hypertonic saline in the treatment of severe traumatic brain injury. 2

CJEM, 2017

Introduction: The CJEM Social Media Team was created in 2014 to assist the journal with the disse... more Introduction: The CJEM Social Media Team was created in 2014 to assist the journal with the dissemination of its research online. It consists of two Social Media Editors (Junior and Senior) and a team of volunteer medical students and residents to assist their work. Collaborative promotional agreements were developed to promote CJEM articles on the Skeptics’ Guide to Emergency Medicine (SGEM) podcast through the ‘Hot off the Press’ (HOP) series and the CanadiEM blog through an infographic series. Methods: CJEM papers were selected for promotion by the Team based on their perceived interest to the online community of emergency physicians. Altmetric scores, which are a measure of online dissemination derived from a weighted algorithm of social media metrics, were collated for articles promoted using the SGEM HOP or CanadiEM blogs. A control group was created using the articles with the top two Altmetric scores in each CJEM issue in 2015 and 2016. Erratum, Letters, and articles written...

Annals of emergency medicine, Jan 25, 2015

This study identified the most important quality indicators for online educational resources such... more This study identified the most important quality indicators for online educational resources such as blogs and podcasts. A modified Delphi process that included 2 iterative surveys was used to build expert consensus on a previously defined list of 151 quality indicators divided into 3 themes: credibility, content, and design. Aggregate social media indicators were used to identify an expert population of editors from a defined list of emergency medicine and critical care blogs and podcasts. Survey 1 consisted of the quality indicators and a 7-point Likert scale. The mean score for each quality indicator was included in survey 2, which asked participants whether to "include" or "not include" each quality indicator. The cut point for consensus was defined at greater than 70% "include." Eighty-three percent (20/24) of bloggers and 90.9% (20/22) of podcasters completed survey 1 and 90% (18/20) of bloggers and podcasters completed survey 2. The 70% inclusion...

Emergency Medicine Journal, 2013

Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the Oc... more Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the October issue of EMJ .1 The authors did a good job covering the subject and providing a list of FOAMed resources. Social media is turning medical education on its head. The top down, 20th century, didactic method of knowledge translation is being replaced by online resources that are timely, articulate, interactive and widely distributed. The …

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...

IEE Review, 1989

... Page 3. ” ! @ # $ & * ( ) - + 6 & 8 4... more ... Page 3. ” ! @ # $ & * ( ) - + 6 & 8 4 6 + 5 K * ( n - + - ' 1 2 3 4 5 6 7 8 9 0 - = f O > % - QM t T . s * - vp QWERTYUIOP { } I ) - x ; + - C ' ( t { zr qwertyuiop [ 1 \ aa 2 # zo < 1 x 4 ...QWERTYUIOP { } I + ~ ncw % ~ : n ( I I qwertyuiop [ l \ a wc P T YU J fn [ 1 s ...

Academic Emergency Medicine, 2015

CJEM: Canadian Journal of Emergency Medical Care, Oct 26, 2016

As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, ... more As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/ podcast 2 and discussed by the study authors and the online EM community. A similar collaboration is underway between the SGEM and Academic Emergency Medicine. What follows is a summary of the selected article the immediate post-publication synthesis from the SGEM podcast, commentary by the first author, and the subsequent discussion from the SGEM blog and other social media. Through this series, we hope to enhance the value, accessibility, and application of important, clinically relevant EM research. In this, the third SGEM HOP hosted collaboratively with CJEM, we discuss Olszynski et al.'s randomized crossover study evaluating the use of ultrasound simulator devices during critical care simulation. 3

American journal of …, 1988

1. Am J Obstet Gynecol. 1988 Dec;159(6):1418-24. Circulatory responses to prolonged hypoxemia in ... more 1. Am J Obstet Gynecol. 1988 Dec;159(6):1418-24. Circulatory responses to prolonged hypoxemia in fetal sheep. Bocking AD, Gagnon R, White SE, Homan J, Milne KM, Richardson BS. Department of Obstetrics/Gynaecology, University of Western Ontario, London, Canada. ...

Objective: The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshir... more Objective: The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a wellestablished length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort. Methods: Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated. Results: A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r 5 0.95577, p , 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% 6 16.9% SD, 95% CI 226.0-40.2). The BT had an $ 10% PE 43.7% of the time. Conclusions: Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy. RÉ SUMÉ Objectif: L'é chelle de Broselow (Broselow Tape [BT]) est un outil reconnu qui sert à estimer le poids d'un enfant en fonction de sa taille lors d'une ré animation. Compte tenu de la pandé mie d'obé sité infantile, l'échelle de Broselow pourrait ne plus estimer le poids de faç on pré cise. Nous avons donc é tudié l'é chelle de Broselow chez l'enfant, en Ontario, dans une importante cohorte ré cente de patients. Mé thodes: Les tailles et poids actuels ont é té recueillis dans une zone urbaine et une zone rurale. Les enfants ont é té recruté s de faç on prospective entre avril 2007 et juillet 2008, à partir du service d'urgence et des cliniques de consultation externe du London Health Sciences Centre. Au printemps 2008, des enfants de ré gions rurales fré quentant les classes de pré maternelle à la 4 e anné e de la Avon Maitland District School Board ont é galement é té recruté s. Les donné es des enfants d'â ge pré scolaire ont é té obtenues de trois garderies et à partir des dossiers mé dicaux é lectroniques du Maitland Valley Medical Centre. Le poids estimé selon l'é chelle de Broselow a é té comparé au poids ré el au moyen de la corré lation de rangs de Spearman; la concordance et le pourcentage d'erreur (PE) ont aussi é té calculé s. Ré sultats: Un total de 6,361 enfants (46,2 % de filles) ont é té inclus dans l'é tude. L'â ge mé dian é tait de 3,9 ans (é cart interquartile [EIQ] 1,56 à 7,67 ans), le poids mé dian de 17,2 kg (EIQ de 11,6 à 25,4 kg), et la taille mé diane de 103,5 cm (EIQ de 82 à 124,4 cm). Bien que les poids estimé s à l'aide de l'é chelle de Broselow aient é té corré lé s avec les poids ré els (r 5 0,95577, p , 0,0001), l'é chelle de Broselow a sous-estimé le poids ré el de 1,62 kg (7,1 % 6 16,9 % é cart-type, IC à 95 %: 26,0 à 40,2). L'é chelle de Broselow avait un $ 10 % PE 43,7 % du temps. Conclusions: Bien que l'é chelle de Broselow reste une mé thode efficace d'estimation du poids en pé diatrie, elle ne s'est pas montré e exacte et tend à sous-estimer le poids des enfants en Ontario. Tant que l'on n'aura pas dé veloppé d'outil de mesure plus pré cis pour les services d'urgence, les mé decins doivent ê tre conscients de cette divergence.

Canadian Journal of Emergency Medicine, May 1, 2017

non-significant incidental findings of 80% (α = 5%, Power = 90%). Results: A total of 1629 studie... more non-significant incidental findings of 80% (α = 5%, Power = 90%). Results: A total of 1629 studies were included (mean 62 yrs, SD 16.7, 56.9% female, median CTAS score 2, 45.2% admitted). PE was found in 233 (14.3%) patients. 173 (10.6%) studies had a finding of an alternative diagnosis, the majority being pulmonary infiltrates (n = 130, 75.1%). In patients who underwent both CTPA and chest x-ray (CXR), CXRs alone would have led to the same alternative diagnosis in 116 (77.1%) patients. A total of 223 (13.6%) patients had an incidental finding; the majority included pulmonary nodules (n = 83, 37.2%) and adenopathy (n = 26, 11.6%). Only 26 (17.1%) incidental findings were significant; most common included pulmonary nodules (n = 6, 3.9%) and masses (n = 7, 4.6%) that lead to newly identified and biopsied lung cancer diagnoses. Incidental findings led to an additional 301 follow-up CTs with a yield of significant result of 9.2% (n = 48 CTs). Conclusion: Chest CTs ordered in the ED for clinical suspicion of PE is equally as likely to identify alternative diagnoses or incidental findings as PE. The majority of incidental findings are non-significant and result in an increased use of CT. CXRs should routinely be ordered prior to further investigation for PE with chest CT to reduce unnecessary testing and thus time and cost to the system.

The Journal of emergency medicine, Nov 1, 2015

Despite the fact that topical anesthetics provide superb analgesia to the painful eye, they are n... more Despite the fact that topical anesthetics provide superb analgesia to the painful eye, they are not prescribed routinely to patients when they are discharged from the emergency department because of concerns for delayed healing and corneal erosion. To summarize the evidence for the safety of topical proparacaine and tetracaine for pain relief in patients with corneal abrasions. This is a systematic review looking at the use of topical anesthetic agents in the treatment of corneal abrasions in the emergency department. Our literature search produced two emergency department-based, randomized, double blind, placebo-controlled studies on human patients with corneal abrasions. Additionally, we found four studies that investigated the application of topical anesthetics in patients who underwent photorefractive keratectomy. All six studies demonstrated that a short course of dilute topical anesthetic provided efficacious analgesia without adverse effects or delayed epithelial healing. Limited available data suggests that the use of dilute topical ophthalmologic proparacaine or tetracaine for a short duration of time is effective, though their safety for outpatient use is inconclusive.

Emergency Medicine Australasia

BMJ Evidence-Based Medicine, 2020

ObjectivesAlteplase is commonly recommended for acute ischaemic stroke within 4.5 hours after str... more ObjectivesAlteplase is commonly recommended for acute ischaemic stroke within 4.5 hours after stroke onset. The Third European Cooperative Acute Stroke Study (ECASS III) is the only trial reporting statistically significant efficacy for clinical outcomes for alteplase use 3–4.5 hours after stroke onset. However, baseline imbalances in history of prior stroke and stroke severity score may confound this apparent finding of efficacy. We reanalysed the ECASS III trial data adjusting for baseline imbalances to determine the robustness or sensitivity of the efficacy estimates.DesignReanalysis of randomised placebo-controlled trial. We obtained access to the ECASS III trial data and replicated the previously reported analyses to confirm our understanding of the data. We adjusted for baseline imbalances using multivariable analyses and stratified analyses and performed sensitivity analysis for missing data.SettingEmergency care.Participants821 adults with acute ischaemic stroke who could be...

CJEM, 2016

Introduction: A rapid and accurate weight of a child can be of critical importance during pediatr... more Introduction: A rapid and accurate weight of a child can be of critical importance during pediatric emergencies. The Broselow Tape (BT) is the gold standard for estimating a child’s weight based on their length. It separates children into incremental weight categories. Studies have shown that the BT is not accurate. We created a new pediatric spine board (PedEBoard) that weighs the child. The objective of this study was to compare the agreement between the actual weight vs. the PedEBoard weight and BT estimated weight of children presenting to a pediatric emergency department (ED). Methods: Ethics approval was obtained from McMaster University. A power calculation was done for sample size to detect 10% error. Consecutive children were recruited who presented to McMaster University’s Children’s ED on two days in March 2015. Children were excluded if their length was outside the BT range, non-English speaking or critically ill. Children had their weight taken by the triage nurse eithe...

Canadian Journal of Emergency Medicine, Oct 26, 2016

As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, ... more As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/ podcast 2 and discussed by the study authors and the online EM community. A similar collaboration is underway between the SGEM and Academic Emergency Medicine. What follows is a summary of the selected article the immediate post-publication synthesis from the SGEM podcast, commentary by the first author, and the subsequent discussion from the SGEM blog and other social media. Through this series, we hope to enhance the value, accessibility, and application of important, clinically relevant EM research. In this, the third SGEM HOP hosted collaboratively with CJEM, we discuss Olszynski et al.'s randomized crossover study evaluating the use of ultrasound simulator devices during critical care simulation. 3

Canadian Journal of Emergency Medicine, Jul 1, 2016

Canadian Journal of Emergency Medicine, Sep 14, 2017

Emergency Medicine Journal, Dec 10, 2013

Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the Oc... more Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the October issue of EMJ .1 The authors did a good job covering the subject and providing a list of FOAMed resources. Social media is turning medical education on its head. The top down, 20th century, didactic method of knowledge translation is being replaced by online resources that are timely, articulate, interactive and widely distributed. The …

Canadian Journal of Emergency Medicine, Sep 1, 2016

As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, ... more As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/podcast and discussed by the study authors and the online EM community. A similar collaboration is under way between the SGEM and Academic Emergency Medicine. What follows is a summary of the selected article, the immediate post-publication synthesis from the SGEM podcast, commentary by the first author, and the subsequent discussion from the SGEM blog and other social media. Through this series, we hope to enhance the value, accessibility, and application of important, clinically relevant EM research. In this, the second SGEM HOP hosted collaboratively with CJEM, we discuss a systematic review evaluating the use of hypertonic saline in the treatment of severe traumatic brain injury. 2

CJEM, 2017

Introduction: The CJEM Social Media Team was created in 2014 to assist the journal with the disse... more Introduction: The CJEM Social Media Team was created in 2014 to assist the journal with the dissemination of its research online. It consists of two Social Media Editors (Junior and Senior) and a team of volunteer medical students and residents to assist their work. Collaborative promotional agreements were developed to promote CJEM articles on the Skeptics’ Guide to Emergency Medicine (SGEM) podcast through the ‘Hot off the Press’ (HOP) series and the CanadiEM blog through an infographic series. Methods: CJEM papers were selected for promotion by the Team based on their perceived interest to the online community of emergency physicians. Altmetric scores, which are a measure of online dissemination derived from a weighted algorithm of social media metrics, were collated for articles promoted using the SGEM HOP or CanadiEM blogs. A control group was created using the articles with the top two Altmetric scores in each CJEM issue in 2015 and 2016. Erratum, Letters, and articles written...

Annals of emergency medicine, Jan 25, 2015

This study identified the most important quality indicators for online educational resources such... more This study identified the most important quality indicators for online educational resources such as blogs and podcasts. A modified Delphi process that included 2 iterative surveys was used to build expert consensus on a previously defined list of 151 quality indicators divided into 3 themes: credibility, content, and design. Aggregate social media indicators were used to identify an expert population of editors from a defined list of emergency medicine and critical care blogs and podcasts. Survey 1 consisted of the quality indicators and a 7-point Likert scale. The mean score for each quality indicator was included in survey 2, which asked participants whether to "include" or "not include" each quality indicator. The cut point for consensus was defined at greater than 70% "include." Eighty-three percent (20/24) of bloggers and 90.9% (20/22) of podcasters completed survey 1 and 90% (18/20) of bloggers and podcasters completed survey 2. The 70% inclusion...

Emergency Medicine Journal, 2013

Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the Oc... more Dear Editor We read with interest the article by Grundlingh, Harris and Carley on #FOAM in the October issue of EMJ .1 The authors did a good job covering the subject and providing a list of FOAMed resources. Social media is turning medical education on its head. The top down, 20th century, didactic method of knowledge translation is being replaced by online resources that are timely, articulate, interactive and widely distributed. The …

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...

IEE Review, 1989

... Page 3. ” ! @ # $ & * ( ) - + 6 & 8 4... more ... Page 3. ” ! @ # $ & * ( ) - + 6 & 8 4 6 + 5 K * ( n - + - ' 1 2 3 4 5 6 7 8 9 0 - = f O > % - QM t T . s * - vp QWERTYUIOP { } I ) - x ; + - C ' ( t { zr qwertyuiop [ 1 \ aa 2 # zo < 1 x 4 ...QWERTYUIOP { } I + ~ ncw % ~ : n ( I I qwertyuiop [ l \ a wc P T YU J fn [ 1 s ...

Academic Emergency Medicine, 2015

CJEM: Canadian Journal of Emergency Medical Care, Oct 26, 2016

As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, ... more As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/ podcast 2 and discussed by the study authors and the online EM community. A similar collaboration is underway between the SGEM and Academic Emergency Medicine. What follows is a summary of the selected article the immediate post-publication synthesis from the SGEM podcast, commentary by the first author, and the subsequent discussion from the SGEM blog and other social media. Through this series, we hope to enhance the value, accessibility, and application of important, clinically relevant EM research. In this, the third SGEM HOP hosted collaboratively with CJEM, we discuss Olszynski et al.'s randomized crossover study evaluating the use of ultrasound simulator devices during critical care simulation. 3

American journal of …, 1988

1. Am J Obstet Gynecol. 1988 Dec;159(6):1418-24. Circulatory responses to prolonged hypoxemia in ... more 1. Am J Obstet Gynecol. 1988 Dec;159(6):1418-24. Circulatory responses to prolonged hypoxemia in fetal sheep. Bocking AD, Gagnon R, White SE, Homan J, Milne KM, Richardson BS. Department of Obstetrics/Gynaecology, University of Western Ontario, London, Canada. ...

Objective: The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshir... more Objective: The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a wellestablished length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort. Methods: Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated. Results: A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r 5 0.95577, p , 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% 6 16.9% SD, 95% CI 226.0-40.2). The BT had an $ 10% PE 43.7% of the time. Conclusions: Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy. RÉ SUMÉ Objectif: L'é chelle de Broselow (Broselow Tape [BT]) est un outil reconnu qui sert à estimer le poids d'un enfant en fonction de sa taille lors d'une ré animation. Compte tenu de la pandé mie d'obé sité infantile, l'échelle de Broselow pourrait ne plus estimer le poids de faç on pré cise. Nous avons donc é tudié l'é chelle de Broselow chez l'enfant, en Ontario, dans une importante cohorte ré cente de patients. Mé thodes: Les tailles et poids actuels ont é té recueillis dans une zone urbaine et une zone rurale. Les enfants ont é té recruté s de faç on prospective entre avril 2007 et juillet 2008, à partir du service d'urgence et des cliniques de consultation externe du London Health Sciences Centre. Au printemps 2008, des enfants de ré gions rurales fré quentant les classes de pré maternelle à la 4 e anné e de la Avon Maitland District School Board ont é galement é té recruté s. Les donné es des enfants d'â ge pré scolaire ont é té obtenues de trois garderies et à partir des dossiers mé dicaux é lectroniques du Maitland Valley Medical Centre. Le poids estimé selon l'é chelle de Broselow a é té comparé au poids ré el au moyen de la corré lation de rangs de Spearman; la concordance et le pourcentage d'erreur (PE) ont aussi é té calculé s. Ré sultats: Un total de 6,361 enfants (46,2 % de filles) ont é té inclus dans l'é tude. L'â ge mé dian é tait de 3,9 ans (é cart interquartile [EIQ] 1,56 à 7,67 ans), le poids mé dian de 17,2 kg (EIQ de 11,6 à 25,4 kg), et la taille mé diane de 103,5 cm (EIQ de 82 à 124,4 cm). Bien que les poids estimé s à l'aide de l'é chelle de Broselow aient é té corré lé s avec les poids ré els (r 5 0,95577, p , 0,0001), l'é chelle de Broselow a sous-estimé le poids ré el de 1,62 kg (7,1 % 6 16,9 % é cart-type, IC à 95 %: 26,0 à 40,2). L'é chelle de Broselow avait un $ 10 % PE 43,7 % du temps. Conclusions: Bien que l'é chelle de Broselow reste une mé thode efficace d'estimation du poids en pé diatrie, elle ne s'est pas montré e exacte et tend à sous-estimer le poids des enfants en Ontario. Tant que l'on n'aura pas dé veloppé d'outil de mesure plus pré cis pour les services d'urgence, les mé decins doivent ê tre conscients de cette divergence.