English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Almost 2 million people visited Canadian emergency departments (ED) with injuries in 2013, accounting for 10% of ED visits. Only 4% of these were admitted. With injury being the number one killer of young people in Canada and a huge burden on our health care system, there is no doubt that Canadian emergency physicians must play a role in injury prevention. Yet, in the heat of a shift, all of us find it hard to fit in the counselling that may potentially help that patient avoid a future injury or even death. Finding effective injury prevention tools that will not impact our productivity, yet potentially decrease the numbers of patients coming to our ED, is difficult. In this month’s CJEM, Dr. Emily Sullivan and colleagues present a study on a novel ED-based prevention program to improve counselling on the use of bicycling helmets. The randomized control trial tested the hypothesis that if a physician wears a scrub top with the injury prevention message, “Put me out of work: wear your bike helmet,” time spent at the bedside counselling on injury prevention would increase. They also tested whether this would change bike helmet wearing behaviour. The results were negative in all outcomes. There was a minimal change in length of injury prevention counselling among those who were treated by a scrub-wearing physician versus a non-scrub-wearing physician and no change in helmet-wearing behaviour. This is likely disappointing to the authors and to others who are looking for quick opportunities to provide injury prevention counselling in the ED. The authors humbly note many limitations to their study such as the small sample size and high loss to follow-up. Would education of physicians on how to effectively counsel on bike helmet use have changed their results? Would only targeting those with cycling injuries change their results? Importantly, this study raises questions on how we can better advocate as emergency physicians in injury prevention. Our job doesn’t end at shift change. I am not alone in perseverating at home after seeing too many injuries caused by various risk-taking activities. As emergency physicians, we have a powerful voice in our community – both locally and nationally. Injury prevention can take many forms. Commonly, injury prevention practitioners acknowledge the importance of change in environment and legislation that will affect entire populations, and many physicians have been successful in initiating major changes. In the 1940s, Dr. Jay Arena saw a second child die from an aspirin (acetylsalicylic acid or ASA) overdose. He contacted the head of the pharmaceutical company that manufactured ASA, and both brainstormed ways to make the product safer – including tops that are hard for children to remove. Twenty years later, these closures became mandatory and have saved many lives. Canadian emergency physicians have lobbied for legislative change in drinking and driving, cell phone use while driving, and gun control. Yet all of the engineering and legislation cannot eliminate unsafe behaviours and resultant visits to the ED. What can we do in the ED during that teachable moment – that moment when a patient is often reflective on their risky behaviour and receptive to change?

cjem. canadian journal of emergency medical care/cjem

Injury prevention in the emergency department: An ongoing challenge Reference to: Emergency Physicians as human billboards for injury prevention: A randomized controlled trial by Emily Sullivan et al.