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1. Canadian Emergency Department Best Practices Checklist for Skin and Soft Tissue Infections Part 1: Cellulitis

Author

Yadav, Krishan, Ohle, Robert, Yan, Justin W., Eagles, Debra, Perry, Jeffrey J., Zvonar, Rosemary, Keller, Maria, Nott, Caroline, Corrales-Medina, Vicente, Shoots, Laura, Tran, Evelyn, Suh, Kathryn N., Lam, Philip W., Fagan, Laura, Song, Nuri, Dobson, Erica, Hawken, Denise, Taljaard, Monica, Sikora, Lindsey, Brehaut, Jamie, Stiell, Ian G., and Graham, Ian D.

Published
2024
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2. Canadian emergency department best practices checklist for skin and soft tissue infections part 2: skin abscess

Author

Yadav, Krishan, Ohle, Robert, Yan, Justin W., Eagles, Debra, Perry, Jeffrey J., Zvonar, Rosemary, Keller, Maria, Nott, Caroline, Corrales-Medina, Vicente, Shoots, Laura, Tran, Evelyn, Suh, Kathryn N., Lam, Philip W., Fagan, Laura, Song, Nuri, Dobson, Erica, Hawken, Denise, Taljaard, Monica, Sikora, Lindsey, Brehaut, Jamie, Stiell, Ian G., and Graham, Ian D.

Published
2024
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3. Canadian Emergency Department Best Practices Checklist for Skin and Soft Tissue Infections Part 3: Necrotizing Fasciitis

Author

Yadav, Krishan, Ohle, Robert, Yan, Justin W., Eagles, Debra, Perry, Jeffrey J., Zvonar, Rosemary, Keller, Maria, Nott, Caroline, Corrales-Medina, Vicente, Shoots, Laura, Tran, Evelyn, Suh, Kathryn N., Lam, Philip W., Fagan, Laura, Song, Nuri, Dobson, Erica, Hawken, Denise, Taljaard, Monica, Sikora, Lindsey, Brehaut, Jamie, Stiell, Ian G., and Graham, Ian D.

Published
2024
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6. Opioid prescribing requirements to minimize unused medications after an emergency department visit for acute pain: a prospective cohort study

Author

Daoust, Raoul, Paquet, Jean, Emond, Marcel, Iseppon, Massimiliano, Williamson, David, Yan, Justin W., Perry, Jeffrey J., Huard, Verilibe, Lavigne, Gilles, Lee, Jacques, Lessard, Justine, Lang, Eddy, and Cournoyer, Alexis

Subjects
Chronic pain -- Drug therapy -- Patient outcomes, Opioids -- Dosage and administration -- Complications and side effects, Prescription writing -- Evaluation, Health
Abstract

Background: Unused opioid prescriptions can be a driver of opioid misuse. Our objective was to determine the optimal quantity of opioids to prescribe to patients with acute pain at emergency department discharge, in order to meet their analgesic needs while limiting the amount of unused opioids. Methods: In a prospective, multicentre cohort study, we included consecutive patients aged 18 years and older with an acute pain condition present for less than 2 weeks who were discharged from emergency department with an opioid prescription. Participants completed a pain medication diary for real-time recording of quantity, doses, and names of all analgesics consumed during a 14-day follow-up period. Results: We included 2240 participants, who had a mean age of 51 years; 48% were female. Over 14 days, participants consumed a median of 5 (quartiles, 1-14) morphine 5 mg tablet equivalents, with significant variation across pain conditions (p < 0.001). Most opioid tablets prescribed (63%) were unused. To meet the opioid need of 80% of patients for 2 weeks, we found that those experiencing renal colic or abdominal pain required fewer opioid tablets (8 morphine 5 mg tablet equivalents) than patients who had fractures (24 tablets), back pain (21 tablets), neck pain (17 tablets), or other musculoskeletal pain (16 tablets). Interpretation: Two-thirds of opioid tablets prescribed at emergency department discharge for acute pain were unused, whereas opioid requirements varied significantly based on the cause of acute pain. Smaller, cause-specific opioid prescriptions could provide adequate pain management while reducing the risk of opioid misuse. Trial registration: ClinicalTrials.gov, no. NCT03953534., Opioid overdoses killed 68 630 people in the United States (1) in 2020 and 7560 in Canada (2) in 2021, and these numbers are projected to continue to rise until [...]

Published
2024
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8. Development of practice recommendations based on the Canadian Syncope Risk Score and identification of barriers and facilitators for implementation

Author

Hudek, Natasha, Brehaut, Jamie C., Rowe, Brian H., Nguyen, Phuong Anh, Ghaedi, Bahareh, Ishimwe, Aline Christelle, Fabian, Christopher, Yan, Justin W., Sivilotti, Marco L. A., Ohle, Robert, Le Sage, Natalie, Mercier, Eric, Archambault, Patrick M., Plourde, Miville, Davis, Philip, McRae, Andrew D., Hegdekar, Mona, and Thiruganasambandamoorthy, Venkatesh

Published
2023
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10. Intubation practices and outcomes for patients with suspected or confirmed COVID-19: a national observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN)

Author

Leeies, Murdoch, Rosychuk, Rhonda J., Ismath, Muzeen, Xu, Ke, Archambault, Patrick, Fok, Patrick T., Audet, Thomas, Jelic, Tomislav, Hayward, Jake, Daoust, Raoul, Chandra, Kavish, Davis, Phil, Yan, Justin W., Hau, Jeffrey P., Welsford, Michelle, Brooks, Steven C., and Hohl, Corinne M.

Published
2023
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12. Treatments, resource utilization, and outcomes of COVID-19 patients presenting to emergency departments across pandemic waves: an observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN)

Author

Hohl, Corinne M., Rosychuk, Rhonda J., Hau, Jeffrey P., Hayward, Jake, Landes, Megan, Yan, Justin W., Ting, Daniel K., Welsford, Michelle, Archambault, Patrick M., Mercier, Eric, Chandra, Kavish, Davis, Philip, Vaillancourt, Samuel, Leeies, Murdoch, Small, Serena, and Morrison, Laurie J.

Published
2022
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14. The HEARTRISK6 Scale

Author

Stiell, Ian G., primary, Perry, Jeffrey J., additional, Eagles, Debra, additional, Yadav, Krishan, additional, Clement, Catherine M., additional, McRae, Andrew D., additional, Yan, Justin W., additional, Mielniczuk, Lisa, additional, Rowe, Brian H., additional, Borgundvaag, Bjug, additional, Dreyer, Jonathan, additional, Brown, Erica L., additional, Nemnom, Marie-Joe, additional, and Taljaard, Monica, additional

Published
2024
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22. Characteristics and outcomes of patients with COVID-19 who return to the emergency department: a multicentre observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN)

Author

Rosychuk, Rhonda J, primary, Khangura, Jaspreet K, additional, Ortiz, Sylvia S, additional, Cheng, Ivy, additional, Bielska, Iwona A, additional, Yan, Justin, additional, Morrison, Laurie J, additional, Hayward, Jake, additional, Grant, Lars, additional, and Hohl, Corinne M, additional

Published
2024
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23. Factors associated with frequent buprenorphine / naloxone initiation in a national survey of Canadian emergency physicians

Author

MacKinnon, Nathalie, primary, Lane, Daniel, additional, Scheuermeyer, Frank, additional, Kaczorowski, Janusz, additional, Dong, Kathryn, additional, Orkin, Aaron M., additional, Daoust, Raoul, additional, Moe, Jessica, additional, Andolfatto, Gary, additional, Klaiman, Michelle, additional, Yan, Justin, additional, Koh, Justin J., additional, Crowder, Kathryn, additional, Atkinson, Paul, additional, Savage, David, additional, Stempien, James, additional, Besserer, Floyd, additional, Wale, Jason, additional, and Kestler, Andrew, additional

Published
2024
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24. Correction to: Treatments, resource utilization, and outcomes of COVID-19 patients presenting to emergency departments across pandemic waves: an observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN)

Author

Hohl, Corinne M., Rosychuk, Rhonda J., Hau, Jeffrey P., Hayward, Jake, Landes, Megan, Yan, Justin W., Ting, Daniel K., Welsford, Michelle, Archambault, Patrick M., Mercier, Eric, Chandra, Kavish, Davis, Philip, Vaillancourt, Samuel, Leeies, Murdoch, Small, Serena, and Morrison, Laurie J.

Published
2022
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28. Treatment of Critical Bleeding Events in Patients with Immune Thrombocytopenia: A Systematic Review

Author

Sirotich, Emily, primary, Chowdhury, Saifur, additional, Guyatt, Gordon, additional, Gill, Daya, additional, Modi, Dimpy, additional, Venier, Laura, additional, Eisa, Kerolos, additional, Beck, Carolyn E, additional, Breakey, Vicky R., additional, de Wit, Kerstin, additional, Porter, Stephen, additional, Webert, Kathryn Elizabeth, additional, Cuker, Adam, additional, O'Connor, Clare, additional, MacWhirter - DiRaimo, Jennifer, additional, Yan, Justin, additional, Manski, Charles, additional, Kelton, John G., additional, Kang, Matthew, additional, Strachan, Gail, additional, Hassan, Ziauddin, additional, Pruitt, Barbara, additional, Pai, Menaka, additional, Grace, Rachael F., additional, Paynter, Dale, additional, Charness, Jay, additional, Cooper, Nichola, additional, Fein, Steven, additional, Nazaryan, Hasmik, additional, Agarwal, Arnav, additional, Siddiqui, Ishaq, additional, Leong, Russell, additional, Pallapothu, Sushmitha, additional, Wen, Aaron, additional, Xu, Emily, additional, Liu, Bonnie, additional, Rathod, Preksha, additional, Kwon, Henry, additional, Dookie, Jared, additional, Shafiee, Amirmohammad, additional, Couban, Rachel, additional, and Arnold, Donald, additional

Published
2023
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29. Benefit of hospital admission for detecting serious adverse events among emergency department patients with syncope: a propensity-score-matched analysis of a multicentre prospective cohort

Author

Krishnan, Rohin J., Mukarram, Muhammad, Ghaedi, Bahareh, Sivilotti, Marco L.A., Sage, Natalie Le, Yan, Justin W., Huang, Paul, Hegdekar, Mona, Mercier, Eric, Nemnom, Marie-Joe, Calder, Lisa A., McRae, Andrew D., Rowe, Brian H., and Wells, George A.

Subjects
Hospital emergency services -- Analysis, Hospital admission and discharge -- Analysis, Medical research -- Analysis, Fainting -- Complications and side effects, Health
Abstract

BACKGROUND: The benefit of hospital admission after emergency department evaluation for syncope is unclear. We sought to determine the association between hospital admission and detection of serious adverse events, and whether this varied according to the Canadian Syncope Risk Score (CSRS). METHODS: We conducted a secondary analysis of a multicentre prospective cohort of patients assessed in the emergency department for syncope. We compared patients admitted to hospital and discharged patients, using propensity scores to match 1:1 for risk of a serious adverse event. The primary outcome was detection of a serious adverse event in hospital for admitted patients or within 30 days after emergency department disposition for discharged patients. RESULTS: We included 8183 patients, of whom 743 (9.1%) were admitted; 658/743 (88.6%) were matched. Admitted patients had higher odds of detection of a serious adverse event (odds ratio [OR] 5.0, 95% confidence interval [CI] 3.3-7.4), nonfatal arrhythmia (OR 5.1, 95% CI 2.9-8.8) and nonarrhythmic serious adverse event (OR 6.3, 95% CI 2.9-13.5). There were no significant differences between the 2 groups in death (OR 1.0, 95% CI 0.4-2.7) or detection of ventricular arrhythmia (OR 2.0, 95% CI 0.7-6.0). Differences between admitted and discharged patients in detection of serious adverse events were greater for those with a CSRS indicating medium to high risk (p = 0.04). INTERPRETATION: Patients with syncope were more likely to have serious adverse events identified within 30 days if they were admitted to hospital rather than discharged from the emergency department. However, the benefit of hospital admission is low for patients at low risk of a serious adverse event., Syncope accounts for 1%-2% of all emergency department visits. (1) Although syncopal events are usually benign, a serious underlying condition (e.g., arrythmia, myocardial infarction, severe hemorrhage) is identified within 30 [...]

Published
2020
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30. Diagnosing acute aortic syndrome: a Canadian clinical practice guideline

Author

Ohle, Robert, Yan, Justin W., Yadav, Krishan, Cournoyer, Alexis, Savage, David W., Jetty, Prasad, Atoui, Rony, Bittira, Bindu, Wilson, Brock, Gupta, Ashish, Coffey, Niamh, Callaway, Yvonne, Middaugh, Jeffrey, Ansell, Dominique, Rubens, Fraser, Bignucolo, Stephen J., Scott, Terena-Marie, McIsaac, Sarah, and Lang, Eddy

Subjects
Back pain -- Prognosis, Practice guidelines (Medicine) -- Health aspects, Anabolic steroids -- Health aspects, Health
Abstract

Acute aortic syndrome (AAS) is a life-threatening emergency, accounting for 1/2000 presentations of acute chest or back pain to the emergency department. (1) It is a clinical spectrum of diagnoses [...]

Published
2020
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40. Novel Local Anesthetics in Clinical Practice: Pharmacologic Considerations and Potential Roles for the Future

Author

Kaye, Alan D., primary, Edinoff, Amber N., additional, Yan, Justin Y., additional, Kaye, Aaron J., additional, Alvarado, Michael A., additional, Pham, Alex D., additional, Chami, Azem A., additional, Shah, Rutvij J., additional, Dixon, Bruce M., additional, Shafeinia, Amineh, additional, Cornett, Elyse M., additional, and Fox, Charles, additional

Published
2022
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41. The diagnostic value of hepatobiliary scintigraphy for choledochal cysts in the era of magnetic resonance imaging with cholangiopancreatography and contrast-enhanced hepatobiliary phase: a case report and review

Author

Tak Kwong Chan, Yan Ho Hui, Fung Him Ng, Rois L.S. Chan, Chung Yan Justin Chan, Wai Hung Cheung, and Wing Hang Luk

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, media_common.quotation_subject, Magnetic resonance imaging, General Medicine, Scintigraphy, medicine.disease, Hepatobiliary phase, Extrahepatic biliary tract, Medicine, Contrast (vision), Choledochal cysts, Radiology, business, Value (mathematics), media_common
Abstract

Objective: Choledochal cysts (CCs) represent cystic dilatations of the intra- or extrahepatic biliary tract. The diagnosis of CCs may not always be straightforward particularly for the intrahepatic subtype. Whereas the gold standard for diagnosing CCs is endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP) is commonly used as primary diagnostic tool for delineation of biliary pathologies including CCs. Methods: We report a case of cystic hepatic lesion near the confluence of bilateral intrahepatic ducts. MRCP shows direct anatomical communication between the lesion and the biliary tract, raising suspicion of a CC. Endoscopic ultrasound shows no communication between the lesion and biliary system. 99mTc-hepatic iminodiacetic acid scintigraphy (hepatobiliary scintigraphy) was subsequently performed, showing no tracer uptake in the concerned cystic hepatic lesion despite visualisation of gallbladder and transit of tracer into the intestine. Overall scintigraphic findings speak against a CC. Conclusion: The case showed conflicting anatomical findings of a CC on MRCP and endoscopic ultrasound. Hepatobiliary scintigraphy and hepatobiliary contrast MRI may both functionally demonstrate communication of a hepatic lesion with the biliary tract. But hepatobiliary scintigraphy offers the advantage of much higher hepatic extraction and hence higher resistance to competition from plasma bilirubin compared with hepatobiliary contrast MRI. The better pharmacokinetics of HIDA confer superior lesion contrast that may offset inferior image spatial resolution, in particular for large lesions and patients with hyperbilirubinaemia. Hepatobiliary scintigraphy should be considered a suitable functional diagnostic modality for CCs even in the era of magnetic resonance imaging with cholangiopancreatography and contrast-enhanced hepatobiliary phase.

Published
2021
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43. Association between fentanyl treatment for acute pain in the emergency department and opioid use two weeks after discharge

Author

Daoust, Raoul, primary, Paquet, Jean, additional, Huard, Verilibe, additional, Chauny, Jean-Marc, additional, Lavigne, Gilles, additional, Williamson, David, additional, Choinière, Manon, additional, Lang, Eddy, additional, Yan, Justin W., additional, Perry, Jeffrey J., additional, Emond, Marcel, additional, Gosselin, Sophie, additional, and Cournoyer, Alexis, additional

Published
2021
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45. Personalised risk prediction following emergency department assessment for syncope

Author

Thiruganasambandamoorthy, Venkatesh, primary, Yan, Justin W, additional, Rowe, Brian H, additional, Mercier, Éric, additional, Le Sage, Natalie, additional, Hegdekar, Mona, additional, Finlayson, Anne, additional, Huang, Paul, additional, Mohammad, Hassan, additional, Mukarram, Muhammad, additional, Nguyen, Phuong Anh (Iris), additional, Syed, Shahbaz, additional, McRae, Andrew D, additional, Nemnom, Marie-Joe, additional, Taljaard, Monica, additional, and Silviotti, Marco LA, additional

Published
2021
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47. Performance Benchmark Metrics and Clinicopathologic Outcomes of MRI-Guided Breast Biopsies: A Systematic Review and Meta-Analysis.

Author

Özcan, Berat Bersu, Yan, Justin, Yin Xi, Baydoun, Serine, Scoggins, Marion E., and Doğan, Başak E.

Subjects
*BREAST biopsy, *MAGNETIC resonance imaging, *SYSTEMATIC reviews, *TREATMENT effectiveness, *HISTOPATHOLOGY, *FOLLOW-up studies (Medicine)
Abstract

Objective: To determine key performance metrics of magnetic resonance imaging (MRI)-guided breast biopsies (MRGB) to help identify reference benchmarks. Materials and Methods: We identified studies reporting MRGB results up to 04.01.2021 in the Embase database, Ovid Medline (R) Process, Other Non-Indexed Citations, Ovid Medline (R) and completed a PRISMA checklist and sources of bias (QUADAS-2). The inclusion criteria were English language, available histopathological outcomes, or at least one imaging follow-up after biopsy. A random intercept logistic regression model was used to pool rates. Between-study heterogeneity was quantified by the I2 statistic. Results: A total of 11,215 lesions in 50 articles were analyzed. The technical success rate was 99.10% [95% confidence interval (CI): 97.89–99.62%]. The MRI indications were staging in 1,496 (28.05%, 95% CI: 26.85–29.28%), screening in 1,427 (26.76%, 95% CI: 25.57–27.97%), surveillance in 1,027 (19.26%, 95% CI: 18.21–20.34%), diagnostic in 1,038 (19.46%, 95% CI: 18.41–20.55%), unknown primary in 74 (1.39%, 95% CI: 1.09–1.74%), and other in 271 (5.08%, 95% CI: 4.51–5.71%). Histopathology was benign in 65.06% (95% CI: 59.15–70.54%), malignant in 29.64% (95% CI: 23.58–36.52%) and high risk in 16.69% (95% CI: 9.96–26.64%). Detection of malignancy was significantly lower in those patients who underwent MRI for screening purposes (odds ratio 0.47, 95% CI: 0.25–0.87; p = 0.02), while mass lesions were more likely to yield malignancy compared to non-mass and foci [27.39% vs 11.36% (non-mass),18.03% (foci); p<0.001]. Surgical upgrade to invasive cancer occurred in 12.24% of ductal carcinoma in situ (95% CI: 7.76–18.77%) and malignancy in 15.14% of high-risk lesions (95% CI: 10.69–21.17%). MRI follow-up was performed in 1,651 (20.92%) patients after benign results [median=25 months (range: 0.4–117)]. Radiology-pathology discordance (2.48%, 95% CI: 1.62–3.77%), false negative after a benignconcordant biopsy (0.75%, 95% CI: 0.34–1.62%) and biopsy complications (2.36%, 95% CI: 2.03–2.72%) were rare. Conclusion: MRGB is a highly accurate minimally-invasive diagnostic technique with low false-negative and complication rates. MRI indication and lesion type should be considered when evaluating the performance of institutional MRGB programs. [ABSTRACT FROM AUTHOR]

Published
2023
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49. TREATMENTS, RESOURCE UTILIZATION, AND OUTCOMES OF COVID-19 PATIENTS PRESENTING TO EMERGENCY DEPARTMENTS ACROSS PANDEMIC WAVES: AN OBSERVATIONAL STUDY BY THE CANADIAN COVID-19 EMERGENCY DEPARTMENT RAPID RESPONSE NETWORK (CCEDRRN)

Author

Hohl, Corinne M., primary, Rosychuk, Rhonda J., additional, Hau, Jeffrey P., additional, Hayward, Jake, additional, Landes, Megan, additional, Yan, Justin W., additional, Ting, Daniel K., additional, Welsford, Michelle, additional, Archambault, Patrick M, additional, Mercier, Eric, additional, Chandra, Kavish, additional, Davis, Philip, additional, Vaillancourt, Samuel, additional, Leeies, Murdoch, additional, Small, Serena, additional, and Morrison, Laurie J., additional

Published
2021
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50. Definition of a critical bleed in patients with immune thrombocytopenia: Communication from the ISTH SSC Subcommittee on Platelet Immunology

Author

Sirotich, Emily, primary, Guyatt, Gordon, additional, Gabe, Caroline, additional, Ye, Zhikang, additional, Beck, Carolyn E, additional, Breakey, Vicky, additional, Cooper, Nichola, additional, Cuker, Adam, additional, Charness, Jay, additional, de Wit, Kerstin, additional, DiRaimo, Jennifer, additional, Fein, Steven G., additional, Grace, Rachael F., additional, Hassan, Ziauddin, additional, Jamula, Erin, additional, Kang, Matthew, additional, Manski, Charles F., additional, O'Connor, Clare, additional, Pai, Menaka, additional, Paynter, Dale, additional, Porter, Stephen C., additional, Pruitt, Barbara, additional, Strachan, Gail, additional, Webert, Kathryn E., additional, Yan, Justin W., additional, Kelton, John G., additional, Bakchoul, Tamam, additional, and Arnold, Donald M., additional

Published
2021
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