4
|
Kestler A, Kaczorowski J, Dong K, Orkin AM, Daoust R, Moe J, Van Pelt K, Andolfatto G, Klaiman M, Yan J, Koh JJ, Crowder K, Webster D, Atkinson P, Savage D, Stempien J, Besserer F, Wale J, Lam A, Scheueremeyer F. A cross-sectional survey on buprenorphine-naloxone practice and attitudes in 22 Canadian emergency physician groups: a cross-sectional survey. CMAJ Open 2021; 9:E864-E873. [PMID: 34548331 PMCID: PMC8476213 DOI: 10.9778/cmajo.20200190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Buprenorphine-naloxone (BUP) initiation in emergency departments improves follow-up and survival among patients with opioid use disorder. We aimed to assess self-reported BUP-related practices and attitudes among emergency physicians. METHODS We designed a cross-sectional physician survey by adapting a validated questionnaire on opioid harm reduction practices, attitudes and barriers. We recruited physician leads from 6 Canadian provinces to administer surveys to the staff physicians in their emergency department groups between December 2018 and November 2019. We included academic and community non-locum emergency department staff physicians. We excluded responses from emergency department groups with response rates less than 50% to minimize nonresponse bias. Primary (BUP prescribing practices) and secondary (willingness and attitudes) outcomes were analyzed using descriptive statistics. RESULTS After excluding 1 group for low response (9/26 physicians), 652 of 798 (81.7%) physicians responded from 22 groups serving 34 emergency departments. Among respondents, 64.1% (95% confidence interval [CI] 60.4%-67.8%, emergency department group range 7.1%-100.0%) had prescribed BUP at least once in their career, 38.4% had prescribed it for home initiation and 24.8% prescribed it at least once a month. Overall, 68.9% (95% CI 65.3%-72.4%, emergency department group range 24.1%-97.6%) were willing to administer BUP, 64.2% felt it was a major responsibility and 37.1% felt they understood people who use drugs. Respondents most frequently rated lack of adequate training (58.2%) and lack of time (55.2%) as very important barriers to BUP initiation. INTERPRETATION Two-thirds of the emergency physicians surveyed prescribed BUP, although only one-quarter did so regularly and one-third prescribed it for home initiation; wide variation between emergency department groups existed. Strategies to increase BUP initiation must address physicians' lack of time and training for BUP initiation and improve their understanding of people who use drugs.
Collapse
Affiliation(s)
- Andrew Kestler
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
| | - Janusz Kaczorowski
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Kathryn Dong
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Aaron M Orkin
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Raoul Daoust
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Jessica Moe
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Kelsey Van Pelt
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Gary Andolfatto
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Michelle Klaiman
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Justin Yan
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Justin J Koh
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Kathryn Crowder
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Devon Webster
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Paul Atkinson
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - David Savage
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - James Stempien
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Floyd Besserer
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Jason Wale
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Alice Lam
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| | - Frank Scheueremeyer
- Department of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que
| |
Collapse
|
10
|
Kao R, Rajagopalan A, Beckett A, Beckett A, Rex R, Shah S, Waddell J, Boitano M, Faidi S, Babatunde O, Lawson F, Grant A, Sudarshan M, Sudarshan M, Takashashi M, Waggott M, Lampron J, Post A, Beale E, Bobrovitz N, Zakrison T, Smith A, Bawazeer M, Evans C, Leeper T, Kagedan D, Grenier T, Rezendo-Neto J, Roberts D, Roberts D, Stark P, Berg R, Mehta S, Gardner P, Moore L, Vassilyadi M, Moore L, Moore L, Hoshizaki B, Rezende-Neto J, Slaba I, Ramesh A, Grigorovich A, Parry N, Pajak C, Rosenbloom B, Grunfeld A, van Heest R, Fernandes J, Doucet J, Schooler S, Ali J, Klassen B, Santana M, McFarlan A, Ball C, Blackmore C, Rezende-Neto J, Kidane B, Hicks C, Brennan M, Brennan M, Harrington A, Sorvari A, Stewart TC, Biegler N, Chaubey V, Tsang B, Benjamin S, Hogan A, Fraser J, Martin M, Bridge J, Faidi S, Waligora M, Hsiao M, Sharma S, Sankarankutty A, Mckee J, Mckee J, Mckee J, Snider C, Szpakowski J, Brown R, Shah S, Shiu M, Chen M, Bell N, Besserer F, Bell N, Trudeau MO, Alhabboubi M, Rezende-Neto J, Rizoli S, Hill A, Joseph B, Lawless B, Jiao X, Xenocostas A, Rui T, Parry N, Driman D, Martin C, Stewart TC, Walsh J, Parry N, Merritt N, Elster E, Tien H, Phillips L, Bratu I, Nascimento B, Pinto R, Callum J, Tien H, Rizoli S, McMullan J, McGlasson R, Mahomed N, Flannery J, Bir C, Baillie F, Coates A, Asiri S, Foster P, Baillie F, Bhandari M, Phillips L, Bratu I, Schuurman N, Oliver L, Nathens A, Yazdani A, Alhabboubi M, St. Louis E, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, St. Louis E, Alhabboubi M, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, Takada M, Sawano M, Ito H, Tsutsumi H, Keenan A, Waggott M, Hoshizaki B, Brien S, Gilchrist M, Janis J, Phelan H, Minei J, Santana M, Stelfox H, McCredie V, Leung E, Garcia G, Rizoli S, Nathens A, Dixon E, Niven D, Kirkpatrick A, Feliciano D, D’Amours S, Ball C, Ahmed N, Izadi H, McFarlan A, Nathens A, Pavenski K, Nathens A, Bridge J, Tallon J, Leeper W, Vogt K, Stewart TC, Gray D, Parry N, Ameer A, Alhabboubi M, Alzaid S, Deckelbaum D, Fata P, Khwaja K, Razek T, Deckelbaum D, Drudi L, Boulva K, Rodrigue N, Khwaja K, Chughtai T, Fata P, Razek T, Rizoli S, Carreiro P, Lisboa T, Winter P, Ribeiro E, Cunha-Melo J, Andrade M, Zygun D, Grendar J, Ball C, Robertson H, Ouellet JF, Cheatham M, Kirkpatrick A, Ball C, Ouellet JF, McBeth P, Kirkpatrick A, Dixon E, Groff P, Inaba K, Okoye O, Pasley J, Demetriades D, Al-Harthi F, Cheng A, Lalani A, Mikrogianakis A, Cayne S, Knittel-Keren D, Gomez M, Stelfox H, Turgeon A, Lapointe J, Bourgeois G, Karton C, Rousseau P, Hoshizaki B, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Rousseau P, Braga B, Faleiro R, Magaldi M, Cardoso G, Lozada W, Duarte L, Rizoli S, Ball C, Oddone-Paolucci E, Doig C, Kortbeek J, Gomez M, Fish J, Leach L, Leelapattana P, Fleming J, Bailey C, Nolan B, DeMestral C, McFarlan A, Zakirova R, Nathens A, Dabbs J, Duff D, Michalak A, Mitchell L, Nathens A, Singh M, Topolovec-Vranic J, Tymianski D, Yetman L, Canzian S, MacPhail I, Constable L, van Heest R, Tam A, Mahadevan P, Kim D, Bansal V, Casola G, Coimbra R, Gladwin C, Misra M, Kumar S, Gautam S, Sorvari A, Blackwood B, Coates A, Baillie F, Stelfox H, Nathens A, Wong C, Straus S, Haas B, Lenartowicz M, Parkovnick M, Parry N, Inaba K, Dixon E, Salim A, Pasley J, Kirkpatrick A, Ouellet JF, Niven D, Kirkpatrick A, Ball C, Neto C, Nogueira G, Fernandes M, Almeida T, de Abreu EMS, Rizoli S, Abrantes W, Taranto V, Parry N, Forbes T, Knight H, Keenan A, Yoxon H, Macpherson A, Bridge J, Topolovec-Vranic J, Mauceri J, Butorac E, Ahmed N, Holmes J, Gilliland J, Healy M, Tanner D, Polgar D, Fraser D, McBeth P, Crawford I, Tiruta C, Ball C, Kirkpatrick A, Roberts D, Ferri M, Bobrovitz N, Khandwala F, Stelfox H, Widder S, Mckee J, Hogan A, Benjamin S, Atkinson P, Benjamin S, Watson I, Hogan A, Benjamin S, Woodford S, Jaramillo DG, Nathens A, Alonazi N, Coates A, Baillie F, Zhang C, McFarlan A, Sorvari A, Chalklin K, Canzian S, Nathens A, DeMestral C, Hill A, Langer J, Nascimento B, Alababtain I, Fung SY, Passos E, Luz L, Brnjac E, Pinto R, Rizoli S, Widder S, Widder S, Widder S, Nathens A, Van Heest R, Constable L, Mancini F, Heidary B, Bell N, Appleton L, Hennecke P, Taunton J, Khwaja K, O’Connor M, Hameed M, Garraway N, Simons R, Evans D, Taulu T, Quinn L, Kuipers D, Rizoli S, Rogers C, Geerts W, Rhind S, Rizoli S, George K, Quinn L, Babcock C, Hameed M, Simons R, Caron N, Hameed M, Simons R, Prévost F, Razek T, Khwaja K, Sudarshan M, Razek T, Fata P, Deckelbaum D, Khwaja K, de Abreu EMS, Neto C, Almeida T, Pastore M, Taranto V, Fernandes M, Rizoli S, Nascimento B, Sankarankutty A, Pinto R, Callum J, Tremblay L, Tien H, Fowler R, Pinto R, Nathens A, Sadoun M, Harris J, Friese R, Kulvantunyou N, O’Keeffe T, Wynne J, Tang A, Green D, Rhee P, Trpkovski J, Blount V. Trauma Association of Canada Annual Scientific Meeting abstractsErythroopoietin resuscitated with normal saline, Ringer’s lactate and 7.5% hypertonic saline reduces small intestine injury in a hemorrhagic shock and resuscitation rat model.Analgesia in the management of pediatric trauma in the resuscitative phase: the role of the trauma centre.Multidisciplinary trauma team care in Kandahar, Afghanistan: current injury patterns and care practices.Does computed tomography for penetrating renal injury reduce renal exploration? An 8-year review at a Canadian level 1 trauma centre.The other side of pediatric trauma: violence and intent injury.Upregulation of activated protein C leads to factor V deficiency in early trauma coagulopathy.A provincial integrated model of improved care for patients following hip fracture.Sports concussion: an Olympic boxing model comparing sex with biomechanics and traumatic brain injury.A multifaceted quality improvement strategy to optimize monitoring and management of delirium in trauma patients: results of a clinician survey.Risk factors for severe all-terrain vehicle injuries in Alberta.Evaluating potential spatial access to trauma centre care by severely injured patients.Incidence of brain injury in facial fractures.Surgical outcomes and the acute care surgery service.The acute care general surgery population and prognostic factors for morbidity and mortality.Disaster preparedness of trauma.What would you like to know and how can we help you? Assessing the needs of regional trauma centres.Posttraumatic stress disorder screening for trauma patients at a level 1 trauma centre.Physical and finite element model reconstruction of a subdural hematoma event.Abdominal wall reconstruction in the trauma patient with an open abdomen.Development and pilot testing of a survey to measure patient and family experiences with injury care.Occult shock in trauma: What are Canadian traumatologists missing?Timeliness in obtaining emergent percutaneous procedures for the severely injured patient: How long is too long?97% of massive transfusion protocol activations do not include a complete hemorrhage panel.Trauma systems in Canada: What system components facilitate access to definitive care?The role of trauma team leaders in missed injuries: Does specialty matter?The adverse consequences of dabigatran among trauma and acute surgical patients.A descriptive study of bicycle helmet use in Montréal.Factor XIII, desmopressin and permissive hypotension enhance clot formation compared with normotensive resuscitation: uncontrolled hemorrhagic shock model.Negative pressure wound therapy for critically ill adults with open abdominal wounds: a systematic review.The “weekend warrior:” Fact or fiction for major trauma?Canadian injury preventon curriculum: a means to promote injury prevention.Penetrating splenic trauma: Safe for nonoperative management?The pediatric advanced trauma life support course: a national initiative.The effectiveness of a psycho-educational program among outpatients with burns or complex trauma.Trauma centre performance indicators for nonfatal outcomes: a scoping review.The evaluation of short track speed skating helmet performance.Complication rates as a trauma care performance indicator: a systematic review.Unplanned readmission following admission for traumatic injury: When, where and why?Reconstructions of concussive impacts in ice hockey.How does head CT correlate with ICP monitoring and impact monitoring discontinuation in trauma patients with a Marshall CT score of I–II?Impact of massive transfusion protocol and exclusion of plasma products from female donors on outcome of trauma patients in Calgary region of Alberta Health Services.Primary impact arthrodesis for a neglected open Weber B ankle fracture dislocation.Impact of depression on neuropsychological functioning in electrical injury patients.Predicting the need for tracheostomy in patients with cervical spinal cord injury.Predicting crumping during computed tomography imaging using base deficit.Feasibility of using telehomecare technology to support patients with an acquired brain injury and family care-givers.Program changes impact the outcomes of severely injured patients.Do trauma performance indicators accurately reflect changes in a maturing trauma program?One-stop falls prevention information for clinicians: a multidisciplinary interactive algorithm for the prevention of falls in older adults.Use of focused assessment with sonography for trauma (FAST) for combat casualties in forward facilities.Alberta All-terrain Vehicle Working Group: a call to action.Observations and potential role for the rural trauma team development course (RTTDC) in India.An electronic strategy to facilitate information-sharing among trauma team leaders.Development of quality indicators of trauma care by a consensus panel.An evaluation of a proactive geriatric trauma consultation service.Celebrity injury-related deaths: Is a gangster rapper really gangsta?Prevention of delirium in trauma patients: Are we giving thiamine prophylaxis a fair chance?Intra-abdominal injury in patients who sustain more than one gunshot wound to the abdomen: Should non-operative management be used?Retrospective review of blunt thoracic aortic injury management according to current treatment recommendations.Telemedicine for trauma resuscitation: developing a regional system to improve access to expert trauma care in Ontario.Comparing trauma quality indicator data between a pediatric and an adult trauma hospital.Using local injury data to influence injury prevention priorities.Systems saving lives: a structured review of pediatric trauma systems.What do students think of the St. Michael’s Hospital ThinkFirst Injury Prevention Strategy for Youth?An evidence-based method for targeting a shaken baby syndrome prevention media campaign.The virtual mentor: cost-effective, nurse-practitioner performed, telementored lung sonography with remote physician guidance.Quality indicators used by teaching versus nonteaching international trauma centres.Compliance to advanced trauma life support protocols in adult trauma patients in the acute setting.Closing the quality improvement loop: a collaborative approach.National Trauma Registry: “collecting” it all in New Brunswick.Does delay to initial reduction attempt affect success rates for anterior shoulder dislocation (pilot study)?Use of multidisciplinary, multi-site morbidity and mortality rounds in a provincial trauma system.Caring about trauma care: public awareness, knowledge and perceptions.Assessing the quality of admission dictation at a level 1 trauma centre.Trauma trends in older adults: a decade in review.Blunt splenic injury in patients with hereditary spherocytosis: a population-based analysis.Analysis of trauma team activation in severe head injury: an institutional experience.ROTEM results correlate with fresh frozen plasma transfusion in trauma patients.10-year trend of assault in Alberta.10-year trend in alcohol use in major trauma in Alberta.10-year trend in major trauma injury related to motorcycles compared with all-terrain vehicles in Alberta.Referral to a community program for youth injured by violence: a feasibility study.New impaired driving laws impact on the trauma population at level 1 and 3 trauma centres in British Columbia, Canada.A validation study of the mobile medical unit/polyclinic team training for the Vancouver 2010 Winter Games.Inferior vena cava filter use in major trauma: the Sunny-brook experience, 2000–2011.Relevance of cellular microparticles in trauma-induced coagulopathy: a systemic review.Improving quality through trauma centre collaboratives.Predictors of acute stress response in adult polytrauma patients following injury.Patterns of outdoor recreational injury in northern British Columbia.Risk factors for loss-to-follow up among trauma patients include functional, socio-economic, and geographic determinants: Would mandating opt-out consent strategies minimize these risks?Med-evacs and mortality rates for trauma from Inukjuak, Nunavik, Quebec.Review of open abdomens in McGill University Health Centre.Are surgical interventions for trauma associated with the development of posttraumatic retained hemothorax and empyema?A major step in understanding the mechanisms of traumatic coagulopathy: the possible role of thrombin activatable fibrinolysis inhibitor.Access to trauma centre care for patients with major trauma.Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted.Improving trauma system governance. Can J Surg 2012. [DOI: 10.1503/cjs.006312] [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] [Indexed: 11/01/2022] Open
|