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  1. Article ; Online: Clinical adaptations for advanced career emergency physicians: an approach to support practice transition.

    Abu-Laban, Riyad B / Rose, Nicholas G W / Migneault, David / Fukushima, Erin / Walker, Kerry E / McEwen, Jill

    CJEM

    2023  Volume 25, Issue 12, Page(s) 931–934

    MeSH term(s) Humans ; Surveys and Questionnaires ; Physicians ; Career Choice
    Language English
    Publishing date 2023-09-22
    Publishing country England
    Document type Editorial
    ISSN 1481-8043
    ISSN (online) 1481-8043
    DOI 10.1007/s43678-023-00591-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A Rapidly Deployable Negative Pressure Enclosure for Aerosol-Generating Medical Procedures

    Chahal, Anthony M. / Van Dewark, Kenneth / Gooch, Robert / Fukushima, Erin / Husdon, Zachary M.

    medRxiv

    Abstract: Abstract Background The coronavirus disease 2019 (COVID-19) pandemic presents significant safety challenges to healthcare professionals. In some jurisdictions, over 10% of confirmed cases of COVID-19 have been found among healthcare workers. Aerosol- ... ...

    Abstract Abstract Background The coronavirus disease 2019 (COVID-19) pandemic presents significant safety challenges to healthcare professionals. In some jurisdictions, over 10% of confirmed cases of COVID-19 have been found among healthcare workers. Aerosol-generating medical procedures (AGMPs) may increase the risk of nosocomial transmission, exacerbated by present global shortages of personal protective equipment (PPE). Improved methods for mitigating risk during AGMPs are therefore urgently needed. Methods The Aerosol Containment Enclosure (ACE) was constructed from acrylic with silicone gaskets for arm port seals and completed with a thin plastic sheet. Hospital wall suction generated negative pressure within the ACE. To evaluate protective capability, differential pressures were recorded under static conditions and during simulated AGMPs. Smoke flow patterns, fluorescence aerosolization, and sodium saccharin aerosolization tests were also conducted. Results Negative pressures of up to −47.7 mmH<sub>2</sub>O were obtained using the enclosure with two wall suction units (combined outflow of 70 L min<sup>−1</sup>), with inflow of O<sub>2</sub> of 15 L min<sup>−1</sup>. Negative pressures between −10 and −35 mmH<sub>2</sub>O were maintained during simulated AGMPs, including oxygen delivery by mask, airway suctioning, bag-mask manual ventilation and endotracheal intubation of a potential COVID-19 patient. The ACE effectively contained smoke, fluorescein aerosol, and sodium saccharin aerosol within the enclosure during use. Conclusions The ACE is capable of maintaining negative pressure during simulated AGMPs. In all cases, containment was improved relative to an identical enclosure with non-occluded ports at ambient pressure. During the current COVID-19 pandemic, the use of such a device may assist in reducing nosocomial infections among healthcare providers.
    Keywords covid19
    Language English
    Publishing date 2020-04-18
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.04.14.20063958
    Database COVID19

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  3. Article: Prevalence of advance directives among elderly patients attending an urban Canadian emergency department.

    Gina K Gill, Ginjeet / Fukushima, Erin / Abu-Laban, Riyad B / Sweet, David D

    CJEM

    2012  Volume 14, Issue 2, Page(s) 90–96

    Abstract: Introduction: To date, there has been minimal research on advance directives (ADs) among elderly patients in Canadian emergency departments (EDs). The purpose of this study was to determine the prevalence of ADs among elderly patients visiting an urban ... ...

    Abstract Introduction: To date, there has been minimal research on advance directives (ADs) among elderly patients in Canadian emergency departments (EDs). The purpose of this study was to determine the prevalence of ADs among elderly patients visiting an urban ED. We also explored whether there were factors associated with the existence of an AD and possible barriers to having one.
    Methods: This prospective study ran between October and December 2008. Individuals over the age of 70 who presented to the ED between 7 am and 7 pm, 7 days a week, were considered for enrollment. Exclusion criteria included previous enrollment and inability to provide informed consent. A team of nurses who specialize in assessment of geriatric patients administered a study instrument consisting of 28 questions. Topics included demographics, level of education, medical information, and knowledge of and attitudes toward ADs.
    Results: The results from 280 participants, with an average age of 80.6 years, were analyzed. Thirty-five percent of participants reported that they knew what an AD was; 19.3% of participants said they had an AD, but only 5.6% brought it to the hospital; 50.7% were interested in further information regarding ADs; and 67.9% of participants felt that it was important for physicians to know their wishes about life support.
    Conclusion: Knowledge of ADs among elderly patients visiting an urban Canadian ED is limited and is likely a significant factor precluding wider prevalence of ADs. There is interest in further discussion about ADs in this population group.
    MeSH term(s) Advance Directives/statistics & numerical data ; Aged ; Aged, 80 and over ; Canada/epidemiology ; Emergencies/epidemiology ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Prevalence ; Prospective Studies ; Surveys and Questionnaires ; Urban Health Services/organization & administration
    Language English
    Publishing date 2012-03-08
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2059217-6
    ISSN 1481-8035 ; 1481-8035 ; 1488-1543
    ISSN (online) 1481-8035
    ISSN 1481-8035 ; 1488-1543
    DOI 10.2310/8000.2012.110554
    Database MEDical Literature Analysis and Retrieval System OnLINE

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