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Boulet S, Gagnon AP, Nadeau A, Mowbray F, Mercier É. Characteristics of Older Adults Attending the Emergency Department for Suicidal Thoughts or Voluntary Intoxication: A Multicenter Retrospective Cohort Study. Cureus 2022; 14:e30428. [DOI: 10.7759/cureus.30428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/05/2022] Open
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Baril L, Nguyen E, Dufresne-Santerre L, Émond V, Émond M, Berthelot S, Gagnon AP, Nadeau A, Carmichael PH, Mercier E. Pain induced by investigations and procedures commonly administered to older adults in the emergency department: a prospective cohort study. Emerg Med J 2021; 38:825-829. [PMID: 34344731 DOI: 10.1136/emermed-2020-210535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 07/16/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study aimed to assess the level of pain induced by common interventions performed in older adults consulting to the ED. METHODS We conducted a prospective multicentre observational cohort study in two academic EDs (Quebec City, Canada) between June 2018 and December 2019. A convenience sample of well-oriented and haemodynamically stable older adults (≥65 years old) who underwent at least two interventions during their ED stay was recruited. The level of pain was assessed using an 11-point Numerous Rating Scale (NRS) and is presented using median and IQR or categorised as no pain (0), mild (1-3), moderate (4-6) or severe pain (7-10). RESULTS A total of 318 patients were included. The mean age was 77.8±8.0 years old and 54.4% were female . The number of pain assessments per intervention ranged between 22 (urinary catheterisation) and 240 (intravenous catheter). All imaging investigations (X-rays, CT and bedside ultrasound) were associated with a median level of pain of 0. The median level of pain for other interventions was as follows: blood samplings (n=231, NRS 1 (IQR 0-3)), intravenous catheters (n=240, NRS 2 (IQR 0-4)), urinary catheterisations (n=22, NRS 4.5 (IQR 2-6)), cervical collars (n=50, NRS 5 (IQR 0-8)) and immobilisation mattresses (n=34, NRS 5 (IQR 0-8)). Urinary catheterisations (63.8%), cervical collars (56.0%) and immobilisation mattresses (52.9%) frequently induced moderate or severe pain. CONCLUSIONS Most interventions administered to older adults in the ED are associated with no or low pain intensity. However, urinary catheterisation and spinal motion restriction devices are frequently associated with moderate or severe pain.
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Affiliation(s)
- Laurence Baril
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Elisabeth Nguyen
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | | | - Virginie Émond
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Marcel Émond
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.,Emergency Department, CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - Simon Berthelot
- Emergency Department, CHU de Québec - Université Laval, Quebec City, Quebec, Canada.,Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgences - Soins Intensifs, Centre de recherche du CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - Ann-Pier Gagnon
- Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgences - Soins Intensifs, Centre de recherche du CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - Alexandra Nadeau
- Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgences - Soins Intensifs, Centre de recherche du CHU de Québec - Université Laval, Quebec City, Quebec, Canada.,VITAM - Centre de recherche en santé durable de l'Université Laval, Quebec City, Quebec, Canada
| | | | - Eric Mercier
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada .,VITAM - Centre de recherche en santé durable de l'Université Laval, Quebec City, Quebec, Canada
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Michaud-Germain C, Tardif PA, Nadeau A, Gagnon AP, Mercier É. Contribution of Substance Use in Acute Injuries With Regards to the Intent, Nature and Context of Injury: A CHIRPP Database Study. Cureus 2020; 12:e10282. [PMID: 33042717 PMCID: PMC7538210 DOI: 10.7759/cureus.10282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Using the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) sentinel surveillance system, the objective of this study was to compare intent, circumstances, injury type and patient demographics in patients who used a substance prior to the injury versus those who did not use any substances. Methods Data were retrospectively collected from November 1st 2016 to October 31st 2017. All patients presenting to the Hôpital de l’Enfant-Jésus ED following trauma were included, aside from those who left without seeing a physician or had no physical injury (e.g., overdose without any trauma was excluded). Patients voluntarily completed a standardised form or agreed to be contacted later. Medical charts of all attendances were reviewed by the CHIRPP’s program coordinator. Substance use included illicit drugs, medications for recreational purposes, alcohol or other used either by the patient or another person involved. Results A total of 12,857 patients were included. Substance use was involved in 701 (5.5%) cases and was associated with injuries sustained by males (p < .001). The mean age of patients injured while using substances was 42.8 years, compared to 45.5 years in those who did not use substances (p < .001). Substance use was involved in 3.6% of unintentional injuries, compared to 26.2% of injuries intentionally inflicted by other and 38.9% for self-inflicted injuries (p < 0.0001). When substances were used, the odds of intentional injuries were 7.5 times greater compared to non-intentional injuries (95% CI 6.7, 8.5). Burns, head injuries and polytraumas were more prevalent when drugs or alcohol were involved. Conclusion This study outlines the significant contribution of substance use in intentional injuries, suggesting that it could potentially be beneficial to specifically target patients who present with deliberate physical injuries in preventive and therapeutic interventions offered in the ED.
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Affiliation(s)
| | - Pier-Alexandre Tardif
- Axe Santé Des Populations Et Pratiques Optimales En Santé, Centre De Recherche Du Chu De Québec - Université Laval, Quebec, CAN
| | - Alexandra Nadeau
- Axe Santé Des Populations Et Pratiques Optimales En Santé, Centre De Recherche Du Chu De Québec - Université Laval, Quebec, CAN
| | - Ann-Pier Gagnon
- Axe Santé Des Populations Et Pratiques Optimales En Santé, Centre De Recherche Du Chu De Québec - Université Laval, Quebec, CAN
| | - Éric Mercier
- Emergency Department, CHU De Québec - Université Laval, Quebec, CAN
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Le Sage N, Tardif PA, Prévost ML, Batomen Kuimi BL, Gagnon AP, Émond M, Chauny JM, Frémont P. Impact of wearing a helmet on the risk of hospitalization and intracranial haemorrhage after a sports injury. Brain Inj 2018; 32:1766-1772. [PMID: 30234396 DOI: 10.1080/02699052.2018.1512717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Despite their reported protective effect against the occurrence of head injuries, helmets are still used inconsistently in sports in which they are optional. We aimed to assess the impact of helmet use on the risk of hospitalization and intracranial haemorrhage for trauma occurring during sport activities. METHODS Retrospective cohort of all patients who presented themselves, over an 18-month period, at the emergency department of a tertiary trauma centre for an injury sustained in a sport or leisure activity where the use of a helmet is optional. Impact of helmet use was assessed using multivariable regression analyses (relative risks, RR). RESULTS Among the 1,022 patients included in the study, half were cyclists and 40% were skiers or snowboarders. A total of 40 % of patients wore a helmet at the time of injury, 18% had a head injury, 16% were hospitalized and 13% of patients with a head injury had an intracranial haemorrhage. Among all patients, no association was observed between hospital admission and helmet use. However, helmet use in patients with a head injury was associated with significant reductions in the risks of hospitalization (RR 0.41 [95% CI: 0.22-0.76]) and intracranial haemorrhage (RR 0.28 [95% CI: 0.11-0.71]). CONCLUSIONS Results suggest that, in recreational athletes who sustain a head injury, helmet use is associated with a reduced risk of hospitalization (all sports) and intracranial haemorrhage (cyclists).
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Affiliation(s)
- Natalie Le Sage
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada.,b Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , QC , Canada.,c Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), Public Health Agency of Canada , Hôpital de l'Enfant-Jésus , Québec , QC , Canada
| | - Pier-Alexandre Tardif
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada
| | - Marie-Laurence Prévost
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada
| | - Brice Lionel Batomen Kuimi
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada
| | - Ann-Pier Gagnon
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada.,c Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), Public Health Agency of Canada , Hôpital de l'Enfant-Jésus , Québec , QC , Canada
| | - Marcel Émond
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada.,b Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , QC , Canada.,d Centre d'Excellence sur le Vieillissement de Québec, Centre de recherche sur les soins et les services de première ligne de l'Université Laval , Québec , QC , Canada
| | | | - Pierre Frémont
- f Département de réadaptation, Faculté de Médecine , Université Laval , Québec , QC , Canada
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