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Publisher: Cambridge University Press   (Total: 365 journals)

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Showing 1 - 200 of 365 Journals sorted alphabetically
Acta Neuropsychiatrica     Hybrid Journal   (Followers: 4, SJR: 0.421, h-index: 23)
Acta Numerica     Hybrid Journal   (Followers: 3, SJR: 8.044, h-index: 35)
Advances in Animal Biosciences     Full-text available via subscription   (Followers: 8)
Advances in Applied Mathematics and Mechanics     Full-text available via subscription   (SJR: 0.74, h-index: 14)
Africa     Hybrid Journal   (Followers: 19, SJR: 1.02, h-index: 28)
African Studies Review     Full-text available via subscription   (Followers: 18, SJR: 0.532, h-index: 13)
Ageing & Society     Hybrid Journal   (Followers: 38, SJR: 0.87, h-index: 55)
Agricultural and Resource Economics Review     Open Access   (Followers: 5, SJR: 0.326, h-index: 19)
AI EDAM     Hybrid Journal   (SJR: 0.438, h-index: 40)
AJS Review     Full-text available via subscription   (Followers: 2, SJR: 0.203, h-index: 4)
American Political Science Review     Hybrid Journal   (Followers: 252, SJR: 6.112, h-index: 127)
Anatolian Studies     Full-text available via subscription   (Followers: 4, SJR: 0.482, h-index: 10)
Ancient Mesoamerica     Hybrid Journal   (Followers: 10, SJR: 0.507, h-index: 29)
Anglo-Saxon England     Hybrid Journal   (Followers: 33, SJR: 0.144, h-index: 12)
animal     Hybrid Journal   (Followers: 3, SJR: 1.098, h-index: 43)
Animal Health Research Reviews     Hybrid Journal   (Followers: 3, SJR: 0.838, h-index: 41)
Animal Science     Full-text available via subscription   (Followers: 9)
Annals of Actuarial Science     Full-text available via subscription   (Followers: 1)
Annual of the British School at Athens     Full-text available via subscription   (Followers: 15, SJR: 0.101, h-index: 9)
Annual Review of Applied Linguistics     Hybrid Journal   (Followers: 36, SJR: 0.753, h-index: 22)
Antarctic Science     Hybrid Journal   (Followers: 1, SJR: 0.728, h-index: 55)
Antichthon     Full-text available via subscription   (Followers: 1, SJR: 0.126, h-index: 2)
Antiquaries J., The     Full-text available via subscription   (Followers: 8, SJR: 0.156, h-index: 3)
Antiquity     Hybrid Journal   (Followers: 26, SJR: 1.133, h-index: 54)
ANZIAM J.     Open Access   (Followers: 1, SJR: 0.151, h-index: 17)
Applied Psycholinguistics     Hybrid Journal   (Followers: 19, SJR: 1.005, h-index: 59)
APSIPA Transactions on Signal and Information Processing     Open Access   (Followers: 8, SJR: 0.339, h-index: 4)
Arabic Sciences and Philosophy     Hybrid Journal   (Followers: 9, SJR: 0.138, h-index: 13)
Arbor Clinical Nutrition Updates     Full-text available via subscription   (Followers: 3)
Archaeological Dialogues     Hybrid Journal   (Followers: 34, SJR: 0.67, h-index: 17)
Archaeological Reports     Full-text available via subscription   (Followers: 5, SJR: 0.101, h-index: 1)
arq: Architectural Research Quarterly     Hybrid Journal   (Followers: 7, SJR: 0.101, h-index: 3)
Asian J. of Comparative Law     Hybrid Journal   (Followers: 9, SJR: 0.127, h-index: 5)
Asian J. of Intl. Law     Hybrid Journal   (Followers: 12, SJR: 0.218, h-index: 5)
Asian J. of Law and Society     Hybrid Journal   (Followers: 6, SJR: 0.179, h-index: 3)
Astin Bulletin     Full-text available via subscription   (Followers: 1, SJR: 0.979, h-index: 19)
Australasian J. of Organisational Psychology     Hybrid Journal   (Followers: 8)
Australasian J. of Special Education     Full-text available via subscription   (Followers: 7, SJR: 0.199, h-index: 6)
Australian J. of Environmental Education     Full-text available via subscription   (Followers: 7, SJR: 0.299, h-index: 5)
Australian J. of Indigenous Education, The     Full-text available via subscription   (Followers: 9, SJR: 0.293, h-index: 4)
Australian J. of Rehabilitation Counseling     Full-text available via subscription   (Followers: 4, SJR: 0.114, h-index: 1)
Austrian History Yearbook     Full-text available via subscription   (Followers: 8, SJR: 0.127, h-index: 3)
Behavioral and Brain Sciences     Hybrid Journal   (Followers: 32, SJR: 0.826, h-index: 127)
Behaviour Change     Full-text available via subscription   (Followers: 12, SJR: 0.362, h-index: 27)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 136, SJR: 0.831, h-index: 47)
Bilingualism: Language and Cognition     Hybrid Journal   (Followers: 37, SJR: 1.359, h-index: 33)
Biofilms     Full-text available via subscription   (Followers: 1)
Bird Conservation Intl.     Hybrid Journal   (Followers: 23, SJR: 0.831, h-index: 29)
BJPsych Advances     Full-text available via subscription   (Followers: 51)
Brain Impairment     Full-text available via subscription   (Followers: 2, SJR: 0.31, h-index: 13)
Breast Cancer Online     Full-text available via subscription   (Followers: 4)
Britannia     Full-text available via subscription   (Followers: 7, SJR: 0.112, h-index: 0)
British Actuarial J.     Full-text available via subscription  
British Catholic History     Hybrid Journal   (Followers: 1)
British J. for the History of Science     Hybrid Journal   (Followers: 20, SJR: 0.804, h-index: 21)
British J. of Anaesthetic and Recovery Nursing     Full-text available via subscription   (Followers: 7)
British J. of Music Education     Hybrid Journal   (Followers: 23, SJR: 0.391, h-index: 8)
British J. Of Nutrition     Hybrid Journal   (Followers: 73, SJR: 1.587, h-index: 139)
British J. of Political Science     Hybrid Journal   (Followers: 162, SJR: 2.505, h-index: 63)
British J. of Psychiatry     Hybrid Journal   (Followers: 179, SJR: 2.674, h-index: 178)
Bulletin of Entomological Research     Hybrid Journal   (Followers: 10, SJR: 0.918, h-index: 54)
Bulletin of Symbolic Logic     Full-text available via subscription   (Followers: 2, SJR: 1.405, h-index: 26)
Bulletin of the Australian Mathematical Society     Full-text available via subscription   (Followers: 1, SJR: 0.488, h-index: 30)
Bulletin of the School of Oriental and African Studies     Hybrid Journal   (Followers: 18, SJR: 0.122, h-index: 11)
Business and Human Rights J.     Full-text available via subscription   (Followers: 3)
Business Ethics Quarterly     Full-text available via subscription   (Followers: 12, SJR: 1.534, h-index: 46)
Business History Review     Full-text available via subscription   (Followers: 14, SJR: 0.291, h-index: 20)
Cambridge Archaeological J.     Hybrid Journal   (Followers: 126, SJR: 0.743, h-index: 32)
Cambridge Classical J.     Full-text available via subscription   (Followers: 18, SJR: 0.101, h-index: 6)
Cambridge J. of Postcolonial Literary Inquiry     Hybrid Journal   (Followers: 6)
Cambridge Law J.     Hybrid Journal   (Followers: 156, SJR: 0.173, h-index: 3)
Cambridge Opera J.     Hybrid Journal   (Followers: 5, SJR: 0.227, h-index: 9)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11, SJR: 0.295, h-index: 25)
Camden Fifth Series     Full-text available via subscription   (Followers: 2)
Canadian Entomologist     Hybrid Journal   (Followers: 5, SJR: 0.388, h-index: 34)
Canadian J. of Emergency Medicine     Hybrid Journal   (Followers: 11, SJR: 0.532, h-index: 32)
Canadian J. of Law & Jurisprudence     Full-text available via subscription   (Followers: 9)
Canadian J. of Law and Society     Hybrid Journal   (Followers: 19, SJR: 0.247, h-index: 6)
Canadian J. of Neurological Sciences     Full-text available via subscription   (SJR: 0.477, h-index: 53)
Canadian J. of Political Science/Revue canadienne de science politique     Full-text available via subscription   (Followers: 23, SJR: 1.161, h-index: 23)
Canadian J. on Aging     Hybrid Journal   (Followers: 10, SJR: 0.292, h-index: 29)
Canadian Yearbook of Intl. Law / Annuaire canadien de droit international     Full-text available via subscription   (Followers: 1)
Cardiology in the Young     Hybrid Journal   (Followers: 32, SJR: 0.312, h-index: 40)
Central European History     Full-text available via subscription   (Followers: 30, SJR: 0.201, h-index: 14)
Children Australia     Partially Free   (Followers: 2, SJR: 0.191, h-index: 2)
China Quarterly     Hybrid Journal   (Followers: 49, SJR: 1.058, h-index: 54)
Chinese J. of Agricultural Biotechnology     Full-text available via subscription   (Followers: 4)
Church History: Studies in Christianity and Culture     Full-text available via subscription   (Followers: 72, SJR: 0.113, h-index: 16)
Classical Quarterly     Full-text available via subscription   (Followers: 28, SJR: 0.151, h-index: 24)
Classical Review     Full-text available via subscription   (Followers: 24)
CNS Spectrums     Hybrid Journal   (Followers: 3, SJR: 0.885, h-index: 60)
Cognitive Behaviour Therapist     Hybrid Journal   (Followers: 13)
Combinatorics, Probability and Computing     Hybrid Journal   (Followers: 4, SJR: 1.013, h-index: 35)
Communications in Computational Physics     Full-text available via subscription   (Followers: 2, SJR: 1.198, h-index: 34)
Comparative Studies in Society and History     Full-text available via subscription   (Followers: 45, SJR: 0.725, h-index: 36)
Compositio Mathematica     Full-text available via subscription   (Followers: 1, SJR: 2.965, h-index: 37)
Contemporary European History     Hybrid Journal   (Followers: 25, SJR: 0.369, h-index: 16)
Continuity and Change     Hybrid Journal   (Followers: 12, SJR: 0.266, h-index: 19)
Dance Research J.     Full-text available via subscription   (Followers: 8, SJR: 0.144, h-index: 5)
Development and Psychopathology     Hybrid Journal   (Followers: 8, SJR: 2.342, h-index: 131)
Dialogue Canadian Philosophical Review/Revue canadienne de philosophie     Full-text available via subscription   (Followers: 3, SJR: 0.126, h-index: 7)
Diamond Light Source Proceedings     Full-text available via subscription  
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 11, SJR: 0.274, h-index: 24)
Du Bois Review: Social Science Research on Race     Full-text available via subscription   (Followers: 8, SJR: 0.307, h-index: 5)
Early China     Hybrid Journal   (Followers: 3)
Early Music History     Hybrid Journal   (Followers: 8, SJR: 0.164, h-index: 8)
Earth and Environmental Science Transactions of the Royal Society of Edinburgh     Hybrid Journal   (Followers: 5, SJR: 0.325, h-index: 41)
East Asian J. on Applied Mathematics     Full-text available via subscription   (SJR: 0.424, h-index: 6)
Ecclesiastical Law J.     Full-text available via subscription   (Followers: 6, SJR: 0.1, h-index: 2)
Econometric Theory     Hybrid Journal   (Followers: 16, SJR: 2.219, h-index: 52)
Economics and Philosophy     Hybrid Journal   (Followers: 16, SJR: 0.624, h-index: 19)
Edinburgh J. of Botany     Hybrid Journal   (SJR: 0.324, h-index: 20)
Eighteenth-Century Music     Hybrid Journal   (Followers: 11, SJR: 0.1, h-index: 4)
English Language and Linguistics     Hybrid Journal   (Followers: 24, SJR: 0.387, h-index: 18)
English Profile J.     Hybrid Journal   (Followers: 2)
English Today     Hybrid Journal   (Followers: 9, SJR: 0.302, h-index: 4)
Enterprise & Society : The Intl. J. of Business History     Hybrid Journal   (Followers: 16, SJR: 0.452, h-index: 17)
Environment and Development Economics     Hybrid Journal   (Followers: 32, SJR: 0.617, h-index: 43)
Environmental Conservation     Hybrid Journal   (Followers: 58, SJR: 1.09, h-index: 66)
Environmental Practice     Full-text available via subscription   (Followers: 3, SJR: 0.304, h-index: 15)
Epidemiology & Infection     Hybrid Journal   (Followers: 15, SJR: 1.32, h-index: 85)
Epidemiology and Psychiatric Sciences     Hybrid Journal   (Followers: 3, SJR: 0.699, h-index: 28)
Episteme     Hybrid Journal   (Followers: 11, SJR: 0.678, h-index: 2)
Equine and Comparative Exercise Physiology     Full-text available via subscription   (Followers: 6)
Ergodic Theory and Dynamical Systems     Hybrid Journal   (Followers: 2, SJR: 1.456, h-index: 43)
Ethics & Intl. Affairs     Full-text available via subscription   (Followers: 11, SJR: 0.464, h-index: 6)
European Constitutional Law Review (EuConst)     Full-text available via subscription   (Followers: 31, SJR: 1.269, h-index: 15)
European J. of Applied Mathematics     Hybrid Journal   (SJR: 0.939, h-index: 34)
European J. of Sociology     Hybrid Journal   (Followers: 28, SJR: 0.241, h-index: 26)
European Political Science Review     Hybrid Journal   (Followers: 20, SJR: 0.524, h-index: 5)
European Review     Hybrid Journal   (Followers: 17, SJR: 0.119, h-index: 17)
Experimental Agriculture     Hybrid Journal   (Followers: 12, SJR: 0.486, h-index: 31)
Expert Reviews in Molecular Medicine     Hybrid Journal   (Followers: 1, SJR: 1.776, h-index: 60)
Fetal and Maternal Medicine Review     Hybrid Journal   (Followers: 4, SJR: 0.178, h-index: 14)
Financial History Review     Full-text available via subscription   (Followers: 14, SJR: 0.342, h-index: 11)
Foreign Policy Bulletin     Hybrid Journal   (Followers: 6)
Forum of Mathematics, Pi     Open Access   (Followers: 1)
Forum of Mathematics, Sigma     Open Access   (Followers: 1)
Genetics Research     Hybrid Journal   (Followers: 4, SJR: 0.52, h-index: 59)
Geological Magazine     Hybrid Journal   (Followers: 16, SJR: 1.119, h-index: 64)
Glasgow Mathematical J.     Full-text available via subscription   (Followers: 1, SJR: 0.748, h-index: 25)
Global Constitutionalism     Hybrid Journal   (Followers: 16)
Global Mental Health     Open Access   (Followers: 6)
Government and Opposition     Full-text available via subscription   (Followers: 20, SJR: 0.611, h-index: 32)
Greece & Rome     Partially Free   (Followers: 21, SJR: 0.136, h-index: 15)
Hague J. on the Rule of Law     Full-text available via subscription   (Followers: 12, SJR: 0.12, h-index: 11)
Harvard Theological Review     Full-text available via subscription   (Followers: 63, SJR: 0.237, h-index: 17)
Health Economics, Policy and Law     Hybrid Journal   (Followers: 25, SJR: 0.441, h-index: 21)
Hegel Bulletin     Full-text available via subscription   (Followers: 1)
High Power Laser Science and Engineering     Open Access   (Followers: 3)
Historical J.     Hybrid Journal   (Followers: 32, SJR: 0.337, h-index: 23)
History in Africa     Full-text available via subscription   (Followers: 8)
Horizons     Partially Free   (Followers: 1, SJR: 0.112, h-index: 3)
Industrial and Organizational Psychology     Hybrid Journal   (Followers: 20, SJR: 0.47, h-index: 18)
Infection Control and Hospital Epidemiology     Full-text available via subscription   (Followers: 34, SJR: 1.985, h-index: 108)
Intl. & Comparative Law Quarterly     Full-text available via subscription   (Followers: 167, SJR: 0.324, h-index: 25)
Intl. J. of Asian Studies     Hybrid Journal   (Followers: 12, SJR: 0.107, h-index: 1)
Intl. J. of Astrobiology     Hybrid Journal   (Followers: 2, SJR: 0.384, h-index: 18)
Intl. J. of Cultural Property     Full-text available via subscription   (Followers: 13, SJR: 0.154, h-index: 1)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 8, SJR: 0.179, h-index: 2)
Intl. J. of Law in Context     Hybrid Journal   (Followers: 16, SJR: 0.236, h-index: 5)
Intl. J. of Microwave and Wireless Technologies     Hybrid Journal   (Followers: 7, SJR: 0.232, h-index: 11)
Intl. J. of Middle East Studies     Hybrid Journal   (Followers: 64, SJR: 0.501, h-index: 28)
Intl. J. of Technology Assessment in Health Care     Hybrid Journal   (Followers: 12, SJR: 0.854, h-index: 54)
Intl. J. of Tropical Insect Science     Hybrid Journal   (Followers: 1, SJR: 0.299, h-index: 20)
Intl. Labor and Working-Class History     Full-text available via subscription   (Followers: 11, SJR: 0.262, h-index: 14)
Intl. Organization     Full-text available via subscription   (Followers: 86, SJR: 3.67, h-index: 106)
Intl. Psychogeriatrics     Hybrid Journal   (Followers: 13, SJR: 1.068, h-index: 68)
Intl. Review of Social History     Full-text available via subscription   (Followers: 23, SJR: 0.185, h-index: 16)
Intl. Review of the Red Cross     Full-text available via subscription   (Followers: 10, SJR: 0.275, h-index: 10)
Intl. Theory: A J. of Intl. Politics, Law and Philosophy     Hybrid Journal   (Followers: 19, SJR: 0.774, h-index: 4)
Iraq     Full-text available via subscription   (Followers: 2)
Irish Historical Studies     Hybrid Journal   (Followers: 5, SJR: 0.101, h-index: 8)
Irish J. of Psychological Medicine     Hybrid Journal   (Followers: 1, SJR: 0.107, h-index: 14)
Israel Law Review     Hybrid Journal   (Followers: 3, SJR: 0.12, h-index: 2)
Itinerario     Full-text available via subscription   (Followers: 8, SJR: 0.195, h-index: 4)
J. of African History     Hybrid Journal   (Followers: 21, SJR: 0.381, h-index: 25)
J. of African Law     Full-text available via subscription   (Followers: 3, SJR: 0.125, h-index: 6)
J. of Agricultural and Applied Economics     Open Access   (Followers: 1)
J. of Agricultural Science     Full-text available via subscription   (Followers: 6, SJR: 0.56, h-index: 51)
J. of American Studies     Hybrid Journal   (Followers: 20, SJR: 0.133, h-index: 9)
J. of Anglican Studies     Hybrid Journal   (Followers: 6, SJR: 0.101, h-index: 1)
J. of Applied Animal Nutrition     Hybrid Journal   (Followers: 3)
J. of Asian Studies     Full-text available via subscription   (Followers: 36, SJR: 0.331, h-index: 31)
J. of Benefit-Cost Analysis     Hybrid Journal   (Followers: 2)
J. of Biosocial Science     Hybrid Journal   (Followers: 3, SJR: 0.561, h-index: 41)
J. of British Studies     Full-text available via subscription   (Followers: 30, SJR: 0.306, h-index: 23)
J. of Child Language     Hybrid Journal   (Followers: 20, SJR: 0.787, h-index: 55)
J. of Dairy Research     Full-text available via subscription   (Followers: 7, SJR: 0.682, h-index: 60)
J. of Demographic Economics     Hybrid Journal   (Followers: 3)
J. of Developmental Origins of Health and Disease     Hybrid Journal   (Followers: 2, SJR: 0.74, h-index: 11)
J. of Diagnostic Radiography and Imaging     Hybrid Journal   (Followers: 4)
J. of Ecclesiastical History     Hybrid Journal   (Followers: 19, SJR: 0.123, h-index: 14)
J. of Economic History     Full-text available via subscription   (Followers: 45, SJR: 1.224, h-index: 44)
J. of Experimental Political Science     Full-text available via subscription   (Followers: 5)
J. of Financial and Quantitative Analysis     Full-text available via subscription   (Followers: 33, SJR: 2.998, h-index: 80)
J. of Fluid Mechanics     Hybrid Journal   (Followers: 138, SJR: 1.45, h-index: 155)
J. of French Language Studies     Hybrid Journal   (Followers: 5, SJR: 0.158, h-index: 8)
J. of Functional Programming     Hybrid Journal   (Followers: 1, SJR: 0.917, h-index: 39)
J. of Germanic Linguistics     Full-text available via subscription   (Followers: 7, SJR: 0.219, h-index: 4)

        1 2 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover Canadian Journal of Emergency Medicine
  [SJR: 0.532]   [H-I: 32]   [11 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Online) 1481-8035
   Published by Cambridge University Press Homepage  [365 journals]
  • CEM volume 20 issue 2 Cover and Front matter
    • PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.36
      Issue No: Vol. 20, No. 2 (2018)
  • CEM volume 20 issue 2 Cover and Back matter
    • PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.47
      Issue No: Vol. 20, No. 2 (2018)
  • CJEM+20(2)&rft.title=Canadian+Journal+of+Emergency+Medicine&rft.issn=1481-8035&">Clinician’s Capsules for CJEM 20(2)
    • Pages: 155 - 157
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.23
      Issue No: Vol. 20, No. 2 (2018)
  • Model of payment should not be the key concern when it comes to emergency
           department physicians’ remuneration
    • Authors: Howard Ovens
      Pages: 158 - 159
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.16
      Issue No: Vol. 20, No. 2 (2018)
  • One size does not fit all for Canadian trauma systems
    • Authors: Robert S. Green; Natalie Yanchar
      Pages: 160 - 161
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.24
      Issue No: Vol. 20, No. 2 (2018)
  • Finding FOAM and not Froth
    • Authors: Heather Murray
      Pages: 162 - 163
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.21
      Issue No: Vol. 20, No. 2 (2018)
  • Education scholarship in Canadian emergency medicine: The past, present,
           and future
    • Authors: Rob Woods; Teresa Chan, Brent Thoma, Jonathan Sherbino
      Pages: 164 - 166
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.19
      Issue No: Vol. 20, No. 2 (2018)
  • Trauma systems and emergency medical services: The missing link for
           tranexamic acid utilization in major trauma
    • Authors: John M. Tallon
      Pages: 167 - 169
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.22
      Issue No: Vol. 20, No. 2 (2018)
  • CJEM+Debate+Series:+#ChoosingWisely+–+The+Choosing+Wisely+campaign+will+not+impact+physician+behaviour+and+choices&rft.title=Canadian+Journal+of+Emergency+Medicine&rft.issn=1481-8035&,+Meaghan+Mackenzie,+Rashi+Hirandani,+Rebecca+Lys,+Megan+Laupacis,+Heather+Murray&rft_id=info:doi/10.1017/cem.2017.402">CJEM Debate Series: #ChoosingWisely – The Choosing Wisely campaign will
           not impact physician behaviour and choices
    • Authors: Paul Atkinson; Eddy Lang, Meaghan Mackenzie, Rashi Hirandani, Rebecca Lys, Megan Laupacis, Heather Murray
      Pages: 170 - 175
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.402
      Issue No: Vol. 20, No. 2 (2018)
  • The core emergency ultrasound curriculum project: A report from the
           Curriculum Working Group of the CAEP Emergency Ultrasound Committee
    • Authors: Paul Olszynski; Dan Kim, Jordan Chenkin, Louise Rang
      Pages: 176 - 182
      Abstract: Emergency ultrasound (EUS) is now widely considered to be a “skill integral to the practice of emergency medicine.” 1 The Canadian Association of Emergency Physicians (CAEP) initially issued a position statement in 1999 supporting the availability of focused ultrasound 24 hours per day in the emergency department (ED). 2
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.44
      Issue No: Vol. 20, No. 2 (2018)
  • Impact of physician payment mechanism on emergency department operational
    • Authors: Grant D. Innes; Frank X. Scheuermeyer, Julian Marsden, Chad Kim Sing, Dan Kalla, Rob Stenstrom, Michael Law, Eric Grafstein
      Pages: 183 - 190
      Abstract: CLINICIAN’S CAPSULE What is known about the topic' Fee-for-service compensation may motivate physicians to see more patients and improve throughput, or drive excessive testing and referral behaviour that undermine emergency performance. What did this study ask' Does fee-for-service payment reduce emergency wait times, length of stay, and left without being seen rates' What did this study find' We observed an unsustained 24% reduction in time to physician, but no change in length of stay or left without being seen rates. Why does this study matter to clinicians' Fee-for-service compensation may have transient motivational effect but is unlikely to generate system-level improvement.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2018.10
      Issue No: Vol. 20, No. 2 (2018)
  • A traumatic tale of two cities: a comparison of outcomes for adults with
           major trauma who present to differing trauma centres in neighbouring
           Canadian provinces
    • Authors: Jefferson Hayre; Colin Rouse, James French, Jacqueline Fraser, Ian Watson, Sue Benjamin, Allison Chisholm, George Stoica, Beth Sealy, Mete Erdogan, Robert Green, Paul Atkinson
      Pages: 191 - 199
      Abstract: Objectives While the use of formal trauma teams is widely promoted, the literature is not clear that this structure provides improved outcomes over emergency physician delivered trauma care. The goal of this investigation was to examine if a trauma team model with a formalized, specialty-based trauma team, with specific activation criteria and staff composition, performs differently than an emergency physician delivered model. Our primary outcome was survival to discharge or 30 days. Methods An observational registry-based study using aggregate data from both the New Brunswick and Nova Scotia trauma registries was performed with data from April 1, 2011 to March 31, 2013. Inclusion criteria included patients 16 years-old and older who had an Injury Severity Score greater than 12, who suffered a kinetic injury and arrived with signs of life to a level-1 trauma centre. Results 266 patients from the trauma team model and 111 from the emergency physician model were compared. No difference was found in the primary outcome of proportion of survival to discharge or 30 days between the two systems (0.88, n=266 vs. 0.89, n=111; p=0.8608). Conclusions We were unable to detect any difference in survival between a trauma team and an emergency physician delivered model.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.352
      Issue No: Vol. 20, No. 2 (2018)
  • Models of care for traumatically injured patients at trauma centres in
           British Columbia: variability and sustainability
    • Authors: Benjamin Tuyp; Kasra Hassani, Lisa Constable, Joseph Haegert
      Pages: 200 - 206
      Abstract: Background Successful trauma systems employ a network of variably-resourced hospitals, staffed by experienced providers, to deliver optimal care for injured patients. The “model of care”—the manner by which inpatients are admitted and overseen, is an important determinant of patient outcomes. Objectives To describe the models of inpatient trauma care at British Columbia’s (BC’s) ten adult trauma centres, their sustainability, and their compatibility with accreditation guidelines. Methods Questionnaires were distributed to the trauma medical directors at BC’s ten Level I-III adult trauma centres. Follow-up semi-structured interviews clarified responses. Results Three different models of inpatient trauma care exist within BC. The “admitting trauma service” was a multidisciplinary team providing exclusive care for injured patients. The “on-call consultant” assisted with Emergency Department (ED) resuscitation before transferring patients to a non-trauma admitting service. The single “short-stay trauma unit” employed on-call consultants who also oversaw a 48-hour short-stay ward. Both level I trauma centres utilized the admitting trauma service model (2/2). All Level II sites employed an on-call consultant model (3/3), deviating from Level II trauma centre accreditation standards. Level III sites employed all three models in similar proportions. None of the on-call consultant sites believed their current care model was sustainable. Inadequate compensation, insufficient resources, and difficulty recruiting physicians were cited barriers to sustainability and accreditation compliance. Conclusions Three distinct models of care are distributed inconsistently across BC’s Level I-III trauma hospitals. Greater use of admitting trauma service and short-stay trauma unit models may improve the sustainability and accreditation compliance of our trauma system.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.50
      Issue No: Vol. 20, No. 2 (2018)
  • All-terrain vehicle–related injuries and deaths in Newfoundland and
           Labrador between 2003 and 2013: a retrospective trauma registry review
    • Authors: Holly Black; Desmond Whalen, Sabrina Alani, Peter Rogers, Cathy MacLean
      Pages: 207 - 215
      Abstract: Background Injury and death involving all-terrain vehicles (ATV) has been reported in a number of Canadian provinces. The objective of this study is to describe the frequency, nature, severity, population affected, immediate health costs, efficacy of related legislation, and helmet use in ATV related injuries and deaths in Newfoundland and Labrador (NL). Methods A retrospective review of injured or deceased ATV riders of all ages entered in the Newfoundland and Labrador Trauma Registry from 2003 to 2013 was conducted. Variables studied included demographics, injury type and severity, use of helmets, admission/discharge dates, and referring/receiving institution. Data was also obtained from the Newfoundland and Labrador Center for Health Information (NLCHI) and included all in-hospital deaths and hospitalizations due to ATVs between 1995 and 2013. Results There were a total of 298 patients registered in the trauma registry, resulting in 2759 admission days, nine deaths, and a total estimated immediate healthcare system cost in excess of $1.6 million. More males (N=253, 84.9%) than females (N=45, 15.1%) were injured in ATV related incidents, t(20)=7.12, p
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.51
      Issue No: Vol. 20, No. 2 (2018)
  • Compliance of tranexamic acid administration to trauma patients at a
           level-one trauma centre
    • Authors: Abeer Ghawnni; Angela Coates, Julian Owen
      Pages: 216 - 221
      Abstract: Introduction Current practice for the treatment of traumatic hemorrhage includes fluid resuscitation and the administration of blood products. The administration of tranexamic acid (TXA) within 8 hours of injury has been shown to significantly reduce mortality in a large, prospective, randomized controlled trial. As a result, TXA is widely used in trauma centres to manage trauma patients with major bleeding. The primary aim of this study was to assess the compliance of TXA administration at a level-one trauma centre in Hamilton, Ontario, Canada. Methods We conducted a retrospective medical record review of consecutive adult trauma patients received at the Hamilton General Hospital between January 1, 2012 and December 31, 2014. Compliance with TXA administration was based on the inclusion criteria of the CRASH–2 trial. Results Five hundred and thirty-four of 2,475 trauma patients met the inclusion criteria for TXA administration. Twenty-one patients who received TXA at peripheral hospital prior to their arrival at the level-one trauma centre were excluded from the analysis, and 18 patients were excluded due to missing data. One hundred and thirty-four patients received TXA, representing a compliance rate of 27%. Mean time from arrival to TXA administration was 47 minutes. Compliance increased for those who required massive transfusion and as the number of criteria for TXA administration increased. Conclusions Compliance with TXA administration to trauma patients with suspected major bleeding was low. Quality improvement strategies aimed at increasing appropriate use of TXA are warranted.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.349
      Issue No: Vol. 20, No. 2 (2018)
  • Rates and predictive factors of return to the emergency department
           following an initial release by the emergency department for acute heart
    • Authors: Pierre-Géraud Claret; Lisa A. Calder, Ian G. Stiell, Justin W. Yan, Catherine M. Clement, Bjug Borgundvaag, Alan J. Forster, Jeffrey J. Perry, Brian H. Rowe
      Pages: 222 - 229
      Abstract: Objectives Following release by emergency department (ED) for acute heart failure (AHF), returns to ED represent important adverse health outcomes. The objective of this study was to document relapse events and factors associated with return to ED in the 14-day period following release by ED for patients with AHF. Methods The primary outcome was the number of return to ED for patients who were release by ED after the initial visit, for any related medical problem within 14 days of this initial ED visit. Results Return visits to the EDs occurred in 166 (20%) patients. Of all patients who returned to ED within the 14-day period, 77 (47%) were secondarily admitted to the hospital. The following factors were associated with return visits to ED: past medical history of percutaneous coronary intervention or coronary artery bypass graft (aOR=1.51; 95% CIs [1.01-2.24]), current use of antiarrhythmics medications (1.96 [1.05-3.55]), heart rate above 80 /min (1.89 [1.28-2.80]), systolic blood pressure below 140 mm Hg (1.67[1.14-2.47]), oxygen saturation (SaO2) above 96% (1.58 [1.08-2.31]), troponin above the upper reference limit of normal (1.68 [1.15-2.45]), and chest X-ray with pleural effusion (1.52 [1.04-2.23]). Conclusions Many heart failure patients (i.e. 1 in 5 patients) are released from the ED and then suffer return to ED. Patients with multiple medical comorbidities, and those with abnormal initial vital signs are at increased risk for return to ED and should be identified.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.14
      Issue No: Vol. 20, No. 2 (2018)
  • Sentinel visits in emergency department patients with diabetes mellitus as
           a warning sign for hyperglycemic emergencies
    • Authors: Justin W. Yan; Katherine M. Gushulak, Melanie P. Columbus, Alexandra L. Hamelin, George A. Wells, Ian G. Stiell
      Pages: 230 - 237
      Abstract: Objectives Patients with poorly controlled diabetes mellitus may have a sentinel emergency department (ED) visit for a precipitating condition prior to presenting for a hyperglycemic emergency, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). This study’s objective was to describe the epidemiology and outcomes of patients with a sentinel ED visit prior to their hyperglycemic emergency visit. Methods This was a 1-year health records review of patients≥18 years old presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, DKA, or HHS. Trained research personnel collected data on patient characteristics, management, disposition, and determined whether patients came to the ED within the 14 days prior to their hyperglycemia visit. Descriptive statistics were used to summarize the data. Results Of 833 visits for hyperglycemia, 142 (17.0%; 95% CI: 14.5% to 19.6%) had a sentinel ED presentation within the preceding 14 days. Mean (SD) age was 50.5 (19.0) years and 54.4% were male; 104 (73.2%) were discharged from this initial visit, and 98/104 (94.2%) were discharged either without their glucose checked or with an elevated blood glucose (>11.0 mmol/L). Of the sentinel visits, 93 (65.5%) were for hyperglycemia and 22 (15.5%) for infection. Upon returning to the ED, 61/142 (43.0%) were admitted for severe hyperglycemia, DKA, or HHS. Conclusion In this unique ED-based study, diabetic patients with a sentinel ED visit often returned and required subsequent admission for hyperglycemia. Clinicians should be vigilant in checking blood glucose and provide clear discharge instructions for follow-up and glucose management to prevent further hyperglycemic emergencies from occurring.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.338
      Issue No: Vol. 20, No. 2 (2018)
  • A survey of front-line paramedics examining the professional relationship
           between paramedics and physician medical oversight
    • Authors: Christopher R. Foerster; Walter Tavares, Ilkka Virkkunen, Antti Kämäräinen
      Pages: 238 - 246
      Abstract: Objective Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. Methods All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey. Results Five hundred and four paramedics were invited to participate in the study, with 242 completing the survey (48% response rate); 66% male, 76% primary care paramedics with an average of 13 (SD=9) years of experience. Paramedics had neutral or positive perceptions regarding their autonomy, opportunities to interact with their medical director, and medical director understanding of the prehospital setting. Paramedics perceived medical directives as rigid and ambiguous. A significant amount of respondents reported a perception of having provided suboptimal patient care due to fear of legal or disciplinary consequences. Issues of a lack of support for critical thinking and a lack of trust between paramedics and medical oversight groups were often raised. Conclusions Paramedic perceptions of physician medical oversight were mixed. Concerning areas identified were perceptions of ambiguous written directives and concerns related to the level of trust and support for critical thinking. These perceptions may have implications for the system of care and should be explored further.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.36
      Issue No: Vol. 20, No. 2 (2018)
  • Can a single primary care paramedic configuration safely transport
           low-acuity patients in air ambulances'
    • Authors: Homer Tien; Bruce Sawadsky, Michael Lewell, Sean Moore, Michael Peddle, Alun Ackery, Brodie Nolan, Russell D. MacDonald
      Pages: 247 - 255
      Abstract: Objective To determine if utilizing a single paramedic crew configuration is safe for transporting low acuity patients requiring only a primary care paramedic (PCP) level of care in Air Ambulances. Methods We studied single-PCP transports of low acuity patients done by contract air ambulance carriers, organized by Ornge (Ontario’s Air Ambulance Service) for one year. We only included interfacility transports. We excluded all scene calls, and all Code 4 (emergent) calls. Our primary outcome was clinical deterioration during transport. We then asked a panel to analyze each case of deterioration to determine if a dual-PCP configuration might have reasonably prevented the deterioration or have better treated the deterioration, compared to a single-PCP configuration. Results In one year, contract carriers moved 3264 patients, who met inclusion criteria. 85% were from Northern Ontario. There were 21 cases of medical deterioration (0.6%±0.26%). Paper charts were found for 20 of these cases. Most were self-limited cases of pain or nausea. A small number of cases (n=5) were cardiorespiratory decompensation. There was 100% consensus amongst the panel that all cases of clinical deterioration were not related to team size. There was also 100% consensus that a dual-PCP team would not have been better able to deal with the deterioration, compared to a single-PCP crew. Conclusions We found that using a single-PCP configuration for transporting low acuity patients is safe. This finding is particularly important for rural areas where air ambulance is the only means for accessibility to care and where staffing issues are magnified.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.392
      Issue No: Vol. 20, No. 2 (2018)
  • Intensive blood-pressure lowering in patients with acute cerebral
    • Authors: Sufyan Alrahbi; Rashid Alaraimi, Abdalla Alzaabi, Sophie Gosselin
      Pages: 256 - 259
      Abstract: Clinical question Is intensive blood pressure (BP) treatment (systolic BP target 110-139 mm Hg) better than standard antihypertensive treatment (systolic BP target 140-179 mm Hg) in reducing mortality and disability in patients with acute intracerebral hemorrhage (ICH)' Article chosen Qureshi AI, Palesch YY, Barsan WG, et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med 2016;375(11):1033-43. Objective To determine the therapeutic benefit of intensive BP treatment compared to standard BP treatment in reducing death and disability after 3 months of follow-up among patients with ICH treated within 4.5 hours from onset of symptoms.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.35
      Issue No: Vol. 20, No. 2 (2018)
  • The immigrant effect: factors impacting use of primary and emergency
           department care – a Canadian population cross-sectional study
    • Authors: Robert Ohle; Helena Bleeker, Krishan Yadav, Jeffrey J. Perry
      Pages: 260 - 265
      Abstract: Objective In 2011, Canada had a foreign-born population of approximately 6,775,800. They represented 20.6% of the total population. Immigrants possess characteristics that reduce the use of primary care. This is thought to be, in part, due to a lower education level, employment, and better health status. Our objective was to assess whether, in an immigrant population without a primary care physician, similar socioeconomic factors would also reduce the likelihood of using the emergency department compared to a non-immigrant population without primary care. Methods Data regarding individuals ≥ 12 years of age from the Canadian Community Health Survey from 2007 to 2008 were analysed (n=134,073; response rate 93%). Our study population comprised 15,554 individuals identified without a primary care physician who had a regular place for medical care. The primary outcome was emergency department as a regular care access point. Socioeconomic variables included employment, health status, and education. Covariates included chronic health conditions, mobility, gender, age, and mental health. Weighted logistic regression models were constructed to evaluate the importance of individual risk factors. Results The sample of 15,554 (immigrants n=1,767) consisted of 57.3% male and 42.7% female respondents from across Canada. Immigrants were less likely than Canadian-born respondents to use the emergency department as a regular access point for health care (odds ratio=0.48 [95% CI 0.40 – 0.57]). Adjusting for health, education, or employment had no effect on this reduced tendency (odds ratio=0.47 [95% CI 0.38 – 0.58]). Conclusion In a Canadian population without a primary care physician, immigrants are less likely to use the emergency department as a primary access point for care than Canadian-born respondents. However, this effect is independent of previously reported social and economic factors that impact use of primary care. Immigration status is an important but complex component of racial and ethnic disparity in the use of health care in Canada.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.4
      Issue No: Vol. 20, No. 2 (2018)
  • Examining the utility of the Hamilton early warning scores (HEWS) at
           triage: Retrospective pilot study in a Canadian emergency department
    • Authors: Steven Skitch; Benjamin Tam, Michael Xu, Laura McInnis, Anthony Vu, Alison Fox-Robichaud
      Pages: 266 - 274
      Abstract: Objectives Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis. Methods The study population included admissions to two hospitals over a 6-month period. Cases experienced a critical event defined by unplanned intensive care unit admission, cardiopulmonary resuscitation, or death. Controls were randomly selected from the database in a 2-to-1 ratio to match cases on the burden of comorbid illness. Receiver operating characteristic (ROC) curves were used to evaluate HEWS as a predictor of the likelihood of critical deterioration and sepsis. Results The sample included 845 patients, of whom 270 experienced a critical event; 89 patients were excluded because of missing vitals. An ROC analysis indicated that HEWS at ED triage had poor discriminative ability for predicting the likelihood of experiencing a critical event 0.62 (95% CI 0.58-0.66). HEWS had a fair discriminative ability for meeting criteria for sepsis 0.77 (95% CI 0.72-0.82) and good discriminative ability for predicting the occurrence of a critical event among septic patients 0.82 (95% CI 0.75-0.90). Conclusion This study indicates that HEWS at ED triage has limited utility for identifying patients at risk of experiencing a critical event. However, HEWS may allow earlier identification of septic patients. Prospective studies are needed to further delineate the utility of the HEWS to identify septic patients in the ED.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.21
      Issue No: Vol. 20, No. 2 (2018)
  • Self-awareness of computed tomography ordering in the emergency department
    • Authors: Amjed Kadhim-Saleh; James C. Worrall, Monica Taljaard, Mathieu Gatien, Jeffrey J. Perry
      Pages: 275 - 283
      Abstract: Objectives Physician variation in the use of computed tomography (CT) is concerning due to the risks of ionizing radiation, cost, and downstream effects of unnecessary testing. The objectives of this study were to describe variation in CT-ordering rates among emergency physicians (EPs), to measure correlation between perceived and actual CT-ordering rates, to assess attitudes that influence decisions to order imaging tests, and to identify EP attitudes associated with higher CT utilization. Methods This study was a retrospective review of imaging and administrative billing records at two emergency department sites of a tertiary care adult teaching hospital. The study also included a cross-sectional survey of EPs at this hospital. We asked physicians about their perceived ordering behaviour, and what factors influenced their decision to order a CT. We examined correlations between perceived and actual CT-ordering rates. We adjusted ordering rates for shift distribution using a logistic regression model and identified outlier physicians whose ordering rate was significantly lower or higher than expected. We used multivariable regression analysis to determine which survey responses predicted higher CT utilization. Results During the study period, 59 EPs saw 45,854 patients, and ordered 6,609 CTs — a mean ordering rate of 14.4% (standard deviation (SD)=4.3%). The ordering rate for individual physicians ranged from 5.9% to 25.9%. Of the 59 EPs, 13 EPs were low-ordering outliers; 12 were high-ordering outliers. Forty-five EPs (76.3%) completed the survey. Mean perceived ordering rate was 12.6%, and was weakly correlated with actual ordering (r=0.19, p=0.21). 42 EPs (93.3%) believed they ordered “about the same” or “fewer” CTs than their peers. Of the 17 EPs in the two highest ordering quintiles, only 3 (18%) knew they were high orderers. In the multivariable analysis, higher ordering was associated with increasing strength of response to the following predictors: medico-legal risk (relative risk [RR]=1.18, 95% CI: 1.03–1.21), risk of contrast (RR=1.14, 95% CI: 1.07–1.22), what colleagues would do (RR=1.09, 95% CI: 0.99–1.19), risk of missing a diagnosis (RR=1.08, 95% CI: 0.98–1.21), and patient wishes (RR=1.07, 95% CI: 0.97–1.17). Conclusions There is large variation in CT ordering among EPs. Physicians’ self-reported ordering rate correlates poorly with actual ordering. High CT orderers were rarely aware that they ordered more than their colleagues. Higher rates of ordering were observed among physicians who reported increased concern with 1) risk of missing a diagnosis, 2) medico-legal risk, 3) risk of contrast, 4) patient wishes, and 5) what colleagues would do.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.45
      Issue No: Vol. 20, No. 2 (2018)
  • A writer’s guide to education scholarship: Qualitative education
           scholarship (part 2)
    • Authors: Teresa M. Chan; Daniel K. Ting, Andrew Koch Hall, Aleisha Murnaghan, Brent Thoma, Jill McEwen, Lalena M. Yarris
      Pages: 284 - 292
      Abstract: Objective Education scholarship can be conducted using a variety of methods, from quantitative experiments to qualitative studies. Qualitative methods are less commonly used in emergency medicine (EM) education research but are well-suited to explore complex educational problems and generate hypotheses. We aimed to review the literature to provide resources to guide educators who wish to conduct qualitative research in EM education. Methods We conducted a scoping review to outline: 1) a list of journals that regularly publish qualitative educational papers; 2) an aggregate set of quality markers for qualitative educational research and scholarship; and 3) a list of quality checklists for qualitative educational research and scholarship. Results We found nine journals that have published more than one qualitative educational research paper in EM. From the literature, we identified 39 quality markers that were grouped into 10 themes: Initial Grounding Work (preparation, background); Goals, Problem Statement, or Question; Methods (general considerations); Sampling Techniques; Data Collection Techniques; Data Interpretation and Theory Generation; Measures to Optimize Rigour and Trustworthiness; Relevance to the Field; Evidence of Reflective Practice; Dissemination and Reporting. Lastly, five quality checklists were found for guiding educators in reporting their qualitative work. Conclusion Many problems that EM educators face are well-suited to exploration using qualitative methods. The results of our scoping review provide publication venues, quality indicators, and checklists that may be useful to EM educators embarking on qualitative projects.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.25
      Issue No: Vol. 20, No. 2 (2018)
  • Four strategies to find, evaluate, and engage with online resources in
           emergency medicine
    • Authors: Andrea Lo; Eric Shappell, Hans Rosenberg, Brent Thoma, James Ahn, N. Seth Trueger, Teresa M. Chan
      Pages: 293 - 299
      Abstract: Despite the rapid expansion of online educational resources for emergency medicine, barriers remain to their effective use by emergency physicians and trainees. This article expands on previous descriptions of techniques to aggregate online educational resources, outlining four strategies to help learners navigate, evaluate, and contribute online. These strategies include 1) cultivating digital mentors, 2) browsing the most popular free open access medical education (FOAM) websites, 3) using critical appraisal tools developed for FOAM, and 4) contributing new online content.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.387
      Issue No: Vol. 20, No. 2 (2018)
  • The impact of social media promotion with infographics and podcasts on
           research dissemination and readership
    • Authors: Brent Thoma; Heather Murray, Simon York Ming Huang, William Ken Milne, Lynsey J. Martin, Christopher M. Bond, Rohit Mohindra, Alvin Chin, Calvin H. Yeh, William B. Sanderson, Teresa M. Chan
      Pages: 300 - 306
      Abstract: Objective In 2015 and 2016, the Canadian Journal of Emergency Medicine (CJEM) Social Media (SoMe) Team collaborated with established medical websites to promote CJEM articles using podcasts and infographics while tracking dissemination and readership. Methods CJEM publications in the “Original Research” and “State of the Art” sections were selected by the SoMe Team for podcast and infographic promotion based on their perceived interest to emergency physicians. A control group was composed retrospectively of articles from the 2015 and 2016 issues with the highest Altmetric score that received standard Facebook and Twitter promotions. Studies on SoMe topics were excluded. Dissemination was quantified by January 1, 2017 Altmetric scores. Readership was measured by abstract and full-text views over a 3-month period. The number needed to view (NNV) was calculated by dividing abstract views by full-text views. Results Twenty-nine of 88 articles that met inclusion were included in the podcast (6), infographic (11), and control (12) groups. Descriptive statistics (mean, 95% confidence interval) were calculated for podcast (Altmetric: 61, 42-80; : 1795, 1135-2455; Full-text: 431, 0-1031), infographic (Altmetric: 31.5, 19-43; : 590, 361-819; Full-text: 65, 33-98), and control (Altmetric: 12, 8-15; : 257, 159-354; Full-Text: 73, 38-109) articles. The NNV was 4.2 for podcast, 9.0 for infographic, and 3.5 for control articles. Discussion Limitations included selection bias, the influence of SoMe promotion on the Altmetric scores, and a lack of generalizability to other journals. Conclusion Collaboration with established SoMe websites using podcasts and infographics was associated with increased Altmetric scores and abstract views but not full-text article views.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.394
      Issue No: Vol. 20, No. 2 (2018)
  • Back pain in the emergency department: Pathological fracture following
           spinal manipulation
    • Authors: Christopher Skappak; Erik J. Saude
      Pages: 307 - 312
      Abstract: Back pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks. An initial evaluation with thoracolumbar radiographs revealed no significant findings. Following initial presentation to the family physician, the patient underwent three treatments of spinal manipulation from his local chiropractor, which resulted in worsening lower back pain. A re-examination and new radiographs in the hospital revealed multiple compression fractures and an underlying diagnosis of multiple myeloma. We have explored current literature examining the prevalence of lower back pain, as well as the incidence of spinal fracture following chiropractic manipulation, and have highlighted a potential complication from chiropractic manipulation in a patient with an undiagnosed underlying neoplastic disorder.
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.19
      Issue No: Vol. 20, No. 2 (2018)
  • Man with back pain and fever
    • Authors: Andrew Fu Wah Ho; Pin Pin Pek, Hong Chuen Toh
      Pages: 313 - 314
      PubDate: 2018-03-01T00:00:00.000Z
      DOI: 10.1017/cem.2017.336
      Issue No: Vol. 20, No. 2 (2018)
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