Research

Opening Plenary at SAEM!

Dear Colleagues,

I am EXTREMELY pleased to announce that the abstract entitled "A Prospective, Blinded, Randomized Controlled Trial to Evaluate Ketamine-Propofol vs. Ketamine Alone for Procedural Sedation in the Pediatric Emergency Department" submitted by Dr. Amit Shah, Dr. Greg Mosdossy, Dr. Michael Rieder, Dr. Kris Lehnhardt, Dr. Mike Peddle and Shelley McLeod has been selected from over 1200 abstracts for the OPENING PLENARY SESSION at the SAEM Annual Meeting in New Orleans, May 14 - 17.

Their work has been selected from over 1,200 abstracts to represent the best research in the field of emergency medicine!

Dr. Amit Shah will be presenting on behalf of the group on Thursday, May 14th, 8:00 am - 9:30 am.

Please join me in congratulating Amit, Greg, Mike R, Kris and Mike P!

Shelley

Call for Abstracts (SAEM)

SAEM 2009 Call for Abstracts

Call for Abstracts for the 2009 SAEM Annual Meeting in New Orleans - deadline December 4, 2008 - Thursday - A New Online Submission form is now available at http://abstracts.saem.org - please read below and download the Instructions before proceeding to the web site application.
 

Instructions for Submission

 
Either sign-in with your SAEM web account username and password or create a FREE username and password at http://apps.saem.org, or send an email from your SAEM registered email account to techsupport@saem.org if you have trouble with your username or password. We will reset your password and reply to your e-mail with your UserName. The Annual Meeting is scheduled for May 14 - 17, 2009. 

Abstracts Accepted

7 UWO Emerg Research Abstracts Accepted for ICEM & CAEP 2008!

Congratulations to Dr. Marcia Edmonds, Dr. Rob Sedran, Dr. Karl Theakston, Dr. Terry Skoretz, Dr. Daniel Grushka and Shelley McLeod on the acceptance of their research abstracts to the annual CAEP conference which will be held in Ottawa from June 7th-11th 2008.

Drs. Edmonds, Sedran, Theakston, Justin Yan (UWO medical student) and Ms. McLeod will be presenting 4 abstracts detailing the findings from their research study entitled “The Utility of Renal Ultrasound in Predicting Urologic Intervention for Emergency Department Patients with Suspected Renal Colic.”

A retrospective chart review was completed for all adult patients who had an ED-ordered US for suspected renal colic over a one-year period. Imaging results were categorized as normal, suggestive, stone seen or non-renal disease. The charts of all patients were reviewed to determine if they required any urologic intervention within 90 days after their initial ED visit. Of the 857 renal US ordered during the study period, 373 (43.5%) were classified as normal, 182 (21.2%) were classified as suggestive, 241 (28.2%) were classified as stone seen and 61 (7.1%) were classified as non-renal disease. Of the 857 renal US, 160 (18.7) patients had a CT scan and 29 patients (3.4%) required urologic intervention.

The group did further investigation and discovered that 49 (13%) of the patients who had a normal US underwent additional imaging identifying 6 (1.6%) stones, only two (< 1%) of which required urologic intervention with lithotripsy. However, 52 (28.6%) of the patients who had a suggestive US underwent additional imaging where 21 (11.5%) stones were identified. All but one of these stones was less than 7mm (mean 4.8mm; SD 1.7mm) and 13 (7.1%) of these patients required urologic intervention.

The group concluded that a normal renal US predicted a low likelihood for urologic intervention within 90 days for adult ED patients with suspected renal colic, however there was a significant rate of urologic intervention for patients with renal US suggestive of urolithiasis. Future prospective research is needed to better define the role of US in the ED management of renal colic.

On behalf on the group, Dr. Marcia Edmonds will also be giving an oral presentation at the 2008 International Conference for Emergency Medicine (ICEM) in San Francisco in April.

Congratulations to Dr. Daniel Grushka (CCFP-EM resident), Shelley McLeod and Dr. Marcia Edmonds on the acceptance of their abstract entitled, "Imaging Modalities for the Assessment of Acute Appendicitis in the Emergency Department".  Daniel has received funding to attend CAEP 2008 and present at the conference on behalf of the UWO Department of Family Medicine.

The group conducted a retrospective medical record review (n=250) of all ED patients diagnosed with of appendicitis in the last year. The study objectives were to review the utilization of imaging modalities, factors associated with choice of imaging and the negative appendectomy rate at our institution.  They observed that there was a high rate of imaging overall with 51.2% of patients receiving a CT prior to appendectomy.  Furthermore, the authors concluded that although the rate of misdiagnosis was lower in those who received imaging, the most appropriate use of these diagnostic tests warrants further study due to costs, time in the emergency department and concerns regarding the lifetime cumulative radiation exposure attributed to CT.

Congratulations to Dr. Terry Skoretz, Jennifer Tang (UWO medical student) and Shelley McLeod on the acceptance of their abstract entitled, “The Impact of Emergency Department Targeted Ultrasound on Management of Patients with Early Pregnancy Complaints.” The objective of this study was to describe the impact of Emergency Department Targeted Ultrasound (EDTU) on patient outcomes and ED length of stay (LOS). A sample of 123 (n=60 EDTU, n=63 non-EDTU) adult female patients (age > 17 years) less than 20 weeks gestational age with presentation of pelvic/abdominal pain, vaginal bleeding, syncope or shock were included in this prospective, cohort study.

The investigators found that ED LOS was significantly reduced (p<0.05) when EDTU (3.7 hrs) was used to manage patients with early pregnancy complaints compared to the non-EDTU group (4.5 hrs). A trend to lower rates in obstetrical follow-up, formal radiologic ultrasound, and return to ED was noted, but a significant difference was not detected between the EDTU and non-EDTU groups. The authors concluded that EDTU is a valuable clinical tool that may impact patient outcome and improve patient flow in the ED.

 

Research - Shoulder Dislocation Study

Dear Colleagues:

This is to update you on our research study entitled Intra-articular Lidocaine versus Conscious Sedation for the Reduction of Anterior Shoulder Dislocations. This study has been on-going for the last 15 months. Enrollment has been incredibly slow and physicians assigned to the intra-articular lidocaine group have had mixed success. Today we met with the Division of Emergency Medicine research committee and together we have come up with the following plan of action.

Regarding Intra-articular lidocaine:

We conducted another review of the literature which confirms that IAL is an effective alternative to IVS for reduction of anterior shoulder dislocations. On review of the cases in our study which required reversion to IVS, we believe our injection site recommendation was too superior resulting in the lidocaine being injected into the subacromial space instead of the glenohumeral joint.

To address this issue, we have modified the information sheet in the IAL study package and will review the anatomic marking at an up coming Grand Rounds and will attempt to review this with each of you individually Basically, using the acromion and corocoid as markers, the injection should be 2-3cm inferior along the midway point between the 2 markers. Consider using the patient's other shoulder to orient yourself to the humeral head (and therefore the glenoid) location. Use a 25g 1 1/2 inch needle inserted to the glenoid surface and aspirate hematoma, if possible, before injecting 20 ml of 1% lidocaine. Remember, pre-procedure analgesia for either IVS or IAL is not regulated by our protocol and we encourage you to use analgesia with all these patients.

Regarding Slow Enrollment:

We will continue to enroll patients for the next six months. Posters will be placed in the department and in your mailbox to remind you of the study. If you would prefer not to enroll patients into the study and a possible study candidate is in the department, consider asking your colleagues working at the time if they would like to see the patient so they have a chance to be recruited for the study. The primary outcome for this study is length of stay in the department and is therefore meant to determine whether this procedure (IAL) could help with patient flow. It is not intended to replace IVS. Please remember that patient confidence in their physician carries a great deal of weight in their decision to enroll in the study. While we appreciate that it is difficult to speak assertively about a procedure that you don't feel 100% confident about, we all had a first time doing medical procedures so please give this a try!

Reminder:

Once you have enrolled a patient in the study, please place the completed patient and physician forms back in the manilla study envelope and put the envelope in my mailbox at UH or Vic. If the paperwork is left in the chart, it goes to health records and all your hard work is lost forever!

If you have any questions, comments or concerns, please feel free to email Heather or myself. I can be reached by pager 13345 if you have questions while enrolling a patient or you can contact Shelley McLeod ext 76089.

Research focus

Current Research Funding:

 Dreyer JF (local PI). The Resuscitation Outcomes Consortium (ROC) Registry. CIHR $ 31,250

Edmonds ML (local PI). ACUTE Study: Acute Congestive Heart Failure Urgent and Transitional Care Evaluation. CIHR $161,084 (4 years)

Shepherd L, Richardson C, Innes M, Lingard L. Improving the Clinical Clerkship AMOSO Opportunity Fund $80,000

Accepted Manuscripts Awaiting Publication

Yip A, McLeod SL, McRae A, Xie B. The Influence of Electronically Available Wait-Time Data on Choice of Emergency Department for Patients with Non-Critical Medical Complaints. ACCEPTED CJEM 2011

Manuscripts in Preparation

Ahn J, Edmonds ML, McLeod SL, Dreyer JF. Ionizing radiation exposures in young adults: diagnostic imaging choices for investigating pulmonary embolism in an academic tertiary care emergency department.

Davis M, Lewell M, McLeod S, Dukelow A. A prospective evaluation of the utility of the prehospital 12-lead electrocardiogram to change the management of patients in the emergency department.

Krause J, McLeod SL, Fernandes CMB, Shah A, Jewell J. Reliability of the Canadian triage and acuity scale: Inter-rater and intra-rater agreement from a community and academic emergency department. Under review CJEM

Mal S, McLeod S, Dukelow A, Lewell M, Shepherd L, Rodriguez S. The Impact of Autopulse on the rate of return of spontaneous circulation in out of hospital cardiac arrest in Oxford County.

Woolfrey K, Meiwald A, McLeod SL. Ambulatory Visits to a Canadian Emergency Department (A.V.C.E.D.): Why Do Low Acuity Patients Come? Under review CJEM

 
Publications 2011-2012

Davis MT, Dukelow A, McLeod SL, Lewell MP. The utility of the pre-hospital electrocardiogram in the emergency department. CJEM 2011;13(6):372-77.

Hames H, McLeod SL, Millard W. Intraarticular Lidocaine vs. Intravenous Sedation for the Reduction of Anterior Shoulder Dislocations in the Emergency Department. CJEM 2011;13(6):378-83.

Hillier M, Mendelsohn D, McLeod SL, Smallfield A, Brown A, Moffatt B, Arab A, Sedran R. Emergency medicine training in Canada: a survey of medical students' knowledge, attitudes and preferences. CJEM 2011;13(4):251-258.

MacLean S, Mulla S, Jankowski M, Akl E, Vandvik P, Ebrahim S, McLeod S, Bhatnagar N, Guyatt G. Patient Values and Preferences for Decision Making in Antithrombotic Therapy: A Systematic Review: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: CHEST 2012; 141(2)(Suppl):e1S–e23S

Shah A, Mosdossy G, McLeod SL, Lehnhardt K, Peddle M, Rieder M. A Blinded, Randomized Controlled Trial to Evaluate Ketamine-Propofol vs. Ketamine alone for Procedural Sedation in Children. Ann Emerg Med. 2011 May;57(5):425-33.

 Freedman SB, Gouin S, Bhatt M, Black KJ, Johnson D, Guimont C, Joubert G, Porter R, Doan Q, van Wylick R, Schuh S, Atenafu E, Eltorky M, Cho D, Plint A; Pediatric Emergency Research Canada. Prospective assessment of practice pattern variations in the treatment of pediatric gastroenteritis. Pediatrics. 2011 Feb;127(2):e287-95.

Trojanowski J, MacDonald RD. Safe transport of patients with acute coronary syndrome or cardiogenic shock by skilled air medical crews. Prehosp Emerg Care. 2011 Apr-Jun;15(2):240-5.

Current Research Projects

Arbeau R, McLeod SL, Millard W. Ultrasound guided suprascapular nerve block for the reduction of anterior shoulder dislocation.

Baerg H, Poonai N, Lim R, McLeod SL, MacDonald C, McKillop S. Is radial metaphysis to capitellum distance in children aged 1-8 years associated with radial head subluxation?

Cram N, McLeod SL, Davis M, Lewell M, Dukelow A. The utility of the ambulance call report for emergency physicians: Is it useful?

Doran S, Syed S, Martin C, Strauss M, McLeod SL, Parry N, Young B. A comparison of outcomes in post-cardiac arrest patients with and without significant intracranial pathology on head CT.

Dreyer JF, McLeod SL (for the ROC study investigators). Prospective Observational Prehospital and Hospital Registry for Trauma (PROPHET) Study.

Dreyer JF, McLeod SL (for the ROC study investigators). The Resuscitation Outcomes Consortium (ROC) EPISTRY III.

Dreyer JF, McLeod SL (on behalf of the ROC Investigators): Resuscitation Outcomes Consortium (ROC) - Trial of Continuous Compressions versus Standard CPR in Patients with Out-of-Hospital Cardiac Arrest (ROC CCC)

Edmonds ME, Dreyer JF, McLeod SL (for the CHF study investigators). Acute Congestive Heart Failure Urgent and Transitional Care Evaluation (ACUTE) study.

Edmonds ME, Dreyer JF, McLeod SL (for the CHF study investigators). Emergency department Heart failure Mortality Risk (EHMR) Study.

Gagnier R, McLeod SL, Richardson C. What is the current initial LHSC emergency physician assessment and management of stable patients with first trimester bleeding?

Garnett M, Ng V, McLeod SL, Millard W. Prevalence of pulmonary embolism in new-onset atrial fibrillation in a tertiary care emergency department: A retrospective chart review.

Hayman K, Lewell M, Dukelow A, McLeod S, Rodriguez S. Can Primary Care Paramedics Safely Transport Patients with ST segment myocardial infarction (STEMI) to a PCI-Capable Center Within a 45 Minute Transport Window?

Keeler A, McLeod SL, Mann M. A novel approach to patient care using medical directives in a small community emergency department: A retrospective review of the use of a strep throat checklist that allows patient discharge from triage.

Lane S, Pinto F, McLeod SL, Sedran R. Obtaining patient outcome feedback in the emergency department.

Lee C, McLeiod SL, Peddle MP. First-responder accuracy using Sort-Assess-Life-saving interventions-Treatment and/or Transport (SALT) after brief initial training.

Lewell M, McLeod SL, Bradford P. Pre-hospital pain control for trauma patients.

Mal S, McLeod SL. Does the use of CPAP in the pre-hospital setting for acute exacerbation of COPD or acute cardiogenic pulmonary edema in adult patients reduce in-hospital mortality and hospital length of stay compared to standard therapy?

Meiwald A, McLeod SL, Leung A, Cooper P, Pelz D, Gulka I, Theakston K. MRI Abnormalities in ED Patients with a Diagnosis of TIA: A Pilot Study.

Mian A, McLeod SL, Dreyer JF. In patients ultimately diagnosed with intestinal (bowel) ischemia is the initial lactate value indicative of the likelihood of disease?

Peterson D, McLeod SL, McRae A, Woolfrey K. Predictors of standard cellulitis treatment failure in London emergency departments.

Peterson D, Arntfield R, McLeod SL. Assessing LV function using ultrasound.

Riggan M, McLeod SL, Ouellette D. Frequent users of the emergency department on London, Ontario.

Shah A, McLeod SL, Theakston K. Abscess management in the emergency department: Packing vs. no packing.

Sharma M, McLeod SL, Shah A. The use of antibiotics in corneal abrasion and corneal foreign bodies in the emergency department.

Syed S, Doran S, McLeod SL, Martin C, Strauss M, Young B. Initial rhythm, therapeutic hypothermia and patient outcomes in cardiac arrest patients.

Tillman B, Joubert G, McLeod SL, Baker S. Can emergency physicians correctly identify palliative care patients?

Yan J, Theakston K, Sedran R, McLeod SL, Edmonds ML. Outcomes and intervention rates of emergency department patients with suspected renal colic: a comprehensive renal colic database.

Research abstracts presented at NAEMSP (National Association of EMS Physicians) annual conference Tucson, Arizona Jan 2012

Davis M, Lewell M, McLeod S, Dukelow A. A prospective evaluation of the utility of the prehospital 12-lead electrocardiogram to change the management of patients in the emergency department.

Davis M, Levy M. Proportion of emergency department medical records containing the electronic prehospital care record (ePCR) after the implementation ePCR "pull" system.

Hayman K, McLeod SL, Allegretti M, Dukelow A, Lewell. Can paramedics safely transport patients with ST-segment elevation myocardial infarction (STEMI) directly to a PCI-capable centre?

Mal S, McLeod S, Dukelow A, Lewell M, Shepherd L, Rodriguez S. The Impact of Autopulse on the rate of return of spontaneous circulation in out of hospital cardiac arrest in Oxford County.

Ahmed A, Rice A, Mal S, McLeod S, Bradford P, Eby D. Frequency and description of documentation error types by electronic vs paper ambulance call reports.

Research Abstracts Accepted for Presentation at the Annual Conference of the Society of Academic Emergency Medicine (SAEM) in Chicago May 2012

Doran S, Syed S, Martin C, Strauss M, McLeod SL, Parry N, Young B. A comparison of outcomes in post-cardiac arrest patients with and without significant intracranial pathology on head CT.

Peterson D, McLeod SL, McRae A, Woolfrey K. Predictors of standard cellulitis treatment failure in London emergency departments.

Syed S, Doran S, McLeod SL, Martin C, Strauss M, Young B. Initial rhythm, therapeutic hypothermia and patient outcomes in cardiac arrest patients.

Yan JW, Edmonds ML, McLeod SL, Sedran RJ, Theakston KD. Delayed Outcomes For Patients With Suspected Renal Colic After Discharge From The Emergency Department (oral presentation).

Yan JW, McLeod SL, Edmonds ML, Theakston KD and RJ Sedran. Analgesic Use For The Management Of Suspected Acute Renal Colic In The Emergency Department

Research Abstracts Presented at the Annual Conference of the Canadian Association of Emergency Physicians (CAEP) June 2012

2012 Scientific Committee Chair: Dr. Karen Woolfrey

CAEP 2012 TRACK CHAIRS

Advocacy - Patient Safety

Dr. David Ouellette

Disaster Medicine

Dr. Michael Peddle

Knowledge Translation

Dr. Christopher Fernandes

Medical Simulation

Dr. Damon Dagnone and Dr. Karen Woolfrey

Paediatrics

Dr. Gary Joubert

Ultrasound

Dr. Robert Arntfield

ORAL PRESENTATIONS:

Davis M*, Lewell M, McLeod SL, Dukelow A. A prospective evaluation of the utility of the prehospital 12-lead electrocardiogram to change the management of patients in the emergency department

* Winner of Top-8 Canadian Resident Research Award.

Meiwald A*, Theakston K, McLeod SL, Cooper P, Pelz D, Gulka I, Leung A, Lee D. MRI abnormalities in ED patients with a diagnosis of TIA: A pilot study.

* Winner of Top-8 Canadian Resident Research Award.

Peterson DR*, McLeod SL, McRae A, Woolfrey KGH. Predictors of failure of empiric outpatient antibiotic therapy in emergency department patients with uncomplicated cellulitis.

* Winner of Top-8 Canadian Resident Research Award.

 Yan JW*, McLeod SL, Edmonds ML, Sedran RJ, Theakston KD. Normal renal ultrasound identifies renal colic patients at low risk for urologic intervention: A prospective study.

* Winner of Top-8 Canadian Resident Research Award.

Yan JW*, McLeod SL, Edmonds ML, Sedran RJ, Theakston KD. Risk factors associated with the need for urologic intervention in emergency department patients with suspected renal colic.

* Winner of Top-8 Canadian Resident Research Award.

MODERATED POSTERS:

Chuang E, McLeod SL, Richardson CA. Do emergency physicians know the costs of commonly ordered emergency department investigations?

Gregory J, Lim R, Van Osch S, Andrusiak T, Mekhaiel S, Joubert G, Poonai N. Does Pelvic Ultrasound Lead to a Significant Delay in Management of Acute Pediatric Appendicitis?

Joffe R, McLeod SL, Edmonds ML. Extending the hours of Doppler ultrasound availability to rule out deep vein thrombosis in the emergency department.    

McNeil CJ, McLeod SL, Dukelow A, Lewell MP. Demographic Predictors of Poor Performance on the National Registry of Emergency Medical Technicians Exam by Southwest Ontario Paramedics.

Syed S, Doran S, McLeod SL, Martin C, Strauss M, Young B. Initial rhythm, therapeutic hypothermia and patient outcomes in cardiac arrest patients.

Wishlow KA, McLeod SL, Millard W. Assessment of emergency department timeliness to remove cervical spine immobilized patients from rigid backboards.

Yan JW, McLeod SL, Edmonds ML, Sedran RJ, Theakston KD. Factors affecting choice of imaging investigations for patients with suspected renal colic in the emergency department.

POSTERS:

Ahmed A, Rice A, Mal S, McLeod SL, Bradford P, Eby D. Frequency and description of documentation error types by electronic vs paper ambulance call reports.        

Ahn JS, Edmonds ML, McLeod SL, Dreyer JF. Do emergency physicians consider radiation doses when investigating for acute pulmonary embolism?

Arbeau RP, McLeod SL, Doran S, Sedran RJ. Sepsis and cultures, what are we looking for? A retrospective review of patient mortality and culture results.

Davis M & Levy MK. Proportion of emergency department medical records containing the electronic prehospital care record (ePCR) after the implementation ePCR "pull" system.

Doran S, Syed S, Martin C, Strauss M, McLeod SL, Parry N, Young B. Outcomes in post-cardiac arrest patients with and without significant intracranial pathology on head CT.

Hayman K, McLeod SL, Allegretti M, Dukelow A, Lewell M. Can paramedics safely transport patients with ST-segment elevation myocardial infarction (STEMI) directly to a PCI-capable centre?

Marchie A, McLeod SL, Shah A. The incidence of acute myocardial infarction following a previous discharge within 30 days from the emergency department.

Melnychuck D, MacDonald C, McLeod SL. Pain Management of Ankle Fractures in the Emergency Department.

Pinto F, Carter K, Bhimani M. Procedural Sedation use in Rural and Regional Emergency Departments.

Yathindra YK, McLeod SL, Regan K. Are CT scans routinely done before lumbar puncture in suspected cases of meningitis?

 
Resident Research Day 2012

Ahn JS and Kendall JL. Does ultrasound-supplemented teaching enhance medical student competency in examining the femoral vasculature?

Arbeau RP, McLeod SL, Doran S, Sedran RJ. Sepsis and cultures, what are we looking for?  A retrospective review of patient mortality and culture results.

Cram N, Davis M, Dukelow A, McLeod SL, Lewell M. A prospective evaluation of the utility of the Ambulance Call Record to change the management of patient care in the emergency department

Doran S, Syed S, Martin C, Strauss M, McLeod SL, Parry N, Young B.

Outcomes in post-cardiac arrest patients with and without significant intracranial pathology on head CT

Gagnier RM, Richardson CA, McLeod SL. Initial assessment and Disposition for the Stable Patient with First Trimester Bleeding in the London Health Sciences Centre Emergency Departments.

Garnett M, Ng V, McLeod SL, Millard W. Prevalence of pulmonary embolism in new-onset atrial fibrillation in a tertiary care centre emergency department: A retrospective chart review

Gladwell H*, MacDonald C, McKillop S, Lim R, McLeod SL, Poonai N. Is increased radial metaphysis to capitellum distance in children aged 1-8 years associated with radial head subluxation?

* Runner-Up Best CCFP-EM Presentation

Hayman K, McLeod SL, Allegretti M, Dukelow A, Lewell MP. Can paramedics safely transport patients with ST-segment elevation myocardial infarction (STEMI) directly to a PCI-capable centre?

Keeler A*, McLeod SL, Mann M. A novel approach to patient care using medical directives in a moderate-sized community emergency department: A retrospective review of the use of a strep throat checklist that allows patient discharge from triage.

* Winner Best CCFP-EM Presentation

Krause J, McLeod SL, Sedran RJ. Caring for Disadvantaged Populations in the Emergency Department.

Lee CWC, McLeod SL, Peddle M. First-Responder Accuracy Using SALT After Brief Initial Training.

Mal S, McLeod SL, Iansavitchene A, Lewell M, Dukelow A. The impact of pre-hospital non-invasive positive pressure support ventilation in adult patients with acute respiratory distress: A systematic review and meta-analysis.

Mian A, McLeod SL, Schappert A, Dreyer JF. The utility of serum lactate ordered in the emergency department  in diagnosing mesenteric ischemia:  A 3-year retrospective review.

Riggan M, McLeod SL, Fielding K, Tran A, Ouellette D. Demographic characteristics and resource utilization of emergency department frequent users.

Sharma M, Shah A, McLeod SL. The use of antibiotics in corneal abrasion and corneal foreign bodies in the emergency department.

Tillmann B, Baker S, McLeod SL, Joubert G. Identification of Palliative Care Patients in the Emergency Department

Peterson DR*, McLeod SL, McRae A, Woolfrey KGH. Predictors of failure of empiric outpatient antibiotic therapy in emergency department patients with uncomplicated cellulitis.

* Winner Best FRCP Presentation

Yan JW*, McLeod SL, Edmonds ML, Sedran RJ, Theakston KD. Risk factors associated with the need for urologic intervention in emergency department patients with suspected renal colic.

* Winner Best FRCP Presentation

Emergency Medicine Research

Emergency Medicine Research

The Division of Emergency Medicine at UWO has a fully supported Research Program, with Shelley McLeod (clinical epidemiologist) as Research Manager and Dr. Jonathan Dreyer (emergency physician) as Medical Research Director. Dr. Rob Sedran (FRCPC Program Director) and Dr. Mike Peddle (Assistant FRCPC Program Director) serve as joint Resident Research Coordinators and assist residents in finding an appropriate project as well as faculty supervisor. The Division also has part-time research assistants who help with prospective data collection, data analysis and interpretation.

Residents in the RCPS program are required to complete at least one research project during their training. These projects are done with the assistance/supervision of faculty members, and are presented at the annual Residents Research Day. The Faculty in the Division of Emergency Medicine has varied research interests which include: Pre-hospital Care, Procedural Sedation, Sports Medicine, Medical Education, Sepsis, Toxicology, Clinical Decision Rules, Administrative Research and Trauma. A list of Faculty members and their areas of interest are listed on the www.emlondon.ca website, as well as current projects, publications and grants. Last year at CAEP 2010, our group presented 16 abstracts and won 2 awards. To learn more about the Research program, please contact Shelley McLeod (shelley.mcleod@lhsc.on.ca)

Division of Emergency Medicine's Annual Resident Research Day

The Division of Emergency Medicine hosted its annual Resident Research Day on March 27th, 2008 at the West Haven Golf Club. Eighteen Royal College and CCFP-EM residents presented their research projects, which included two moderated poster sessions and two oral presentation sessions, followed by a congratulatory dinner hosted by the EM Associates.
Dr. Chris Martin won the $500.00 Royal College Resident Research Award for his oral presentation entitled "LHSC ST-elevation Myocardial Infarction Emergency Medicine Times."
Dr. Dan Grushka won the $500.00 CCFP-EM Resident Research Award for his poster entitled "Imaging Modalities for the Assessment of Acute Appendicitis in the Emergency Department."
Congratulations to Chris and Dan and the entire resident group for a job well done. Special thanks to Shelley McLeod, our Research Coordinator, for her efforts in making the day a great success.

Research Grant Awarded

The Division of Emergency Medicine is extremely pleased to announce that Dr. Cimi Achiam (LHSC PGY 2) has been selected from a huge group of applicants to receive a $5,000 research award (maximum amount that can be awarded to a resident) from the Canadian Association of Emergency Physicians (CAEP) for her innovative research study entitled "What is the Prevalence of Methicillin-Resistant Staphlococcus aureus in Skin and Soft Tissue Infections Presenting to the Emergency Department of an Academic Health Care Centre?"

Please congratulate Cimi along with Dr. Chris Fernandes and Dr. Karl Theakston (LHSC staff consultants) who are the senior lead investigators of this study. 

Research Question

Dr. Wanda Millard and Dr. Heather Hames are conducting a research project entitled "Intraarticular Lidocaine vs. Intravenous Sedation for the Reduction of Anterior Shoulder Dislocations in the Emergency Department."

The objectives of this study are to determine if intraarticular lidocaine is as effective as IV sedation in facilitating the reduction of an anterior shoulder dislocation and to determine if the use of intraarticular lidocaine results in any change in the average ED length of stay. The hypothesis of this study is that intraarticular lidocaine will be equally effective as IV sedation and will result in significantly shorter ED stays. Please see the attached document for additional information.

We are having difficulty recruiting patients for this study and would like to know your thoughts. Please take one minute to answer the following question. Simply reply to this e-mail with the number corresponding to the response you believe is most accurate in the subject line.

Why do you think there is difficulty in patient recruitment for the anterior shoulder dislocation study?

  • 1. I haven't come across any eligible patients.
  • 2. I can't find the study envelopes.
  • 3. I am not comfortable with the technique/study design.
  • 4. I ask, but the patients refuse to be enrolled.
  • 5. I forgot about the study.

Many thanks,
Shelley

Shelley McLeod MSc., BSc
Research Coordinator
Department of Emergency Medicine