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First described in Wuhan, China, in December 2019, The World Health Organization declared the novel coronavirus disease (COVID-19) a global pandemic on March 11th, 2020. Canada identified its first positive COVID-19 patient on January 25th, 2020. The Canadian government and heath care system immediately started discussing how best to respond to this pandemic. It was hypothesized that potentially positive and confirmed positive COVID-19 patients would present to emergency departments across the country. It has now been over a year since the first positive patient was identified in Canada, and there has yet to be a narrative review that explores how Canadian emergency departments have responded to the novel COVID-19 virus. This narrative review will discuss measures that were taken thus far, including pre-hospital care, the use and implementation of virtual care, the importance of simulation training, protocols regarding patient screening at presentation to the emergency department, the use of personal protective equipment, and lastly rural emergency department response. This narrative review may be beneficial as the COVID-19 pandemic continues, by providing a concise summary of measures that were taken in various emergency departments across Canada to prevent the spread of the virus.

Social distancing and mandatory lockdowns have resulted in a complete halt of CPR training in communities worldwide. Online classes are being offered by various organizations that do not include any real time CPR practice. 1. Multiple studies support the need for hands-on CPR practice in order to achieve proficiency. 2 We report the development and feasibility testing of a homemade CPR trainer to allow for real time CPR practice and feedback during a free online training program. Our objective was to develop a CPR trainer from material available in an average person's home. We trialed multiple readily available objects (pillow, water bottles, rolled towels, and toilet rolls). Using a Zoll X series defibrillator with CPR analysis we found that two toilet rolls stacked horizontally/longitudinally allowed for 2" of displacement when compressed and had sufficient compliance to allow for full recoil. We added a mason jar lid underneath the toilet rolls (Fig. 1). The click of the jar lid when the rolls are compressed signifies adequate depth in addition to providing audible feedback to allow for optimization of the compression rate. Using two independent operators, 2 min of CPR were performed on the toilet roll trainer and generated metrics consistent with high quality CPR as defined by the AHA 2015 guidelines. 3

Background: The field of paramedicine continues to advance in scope. Simulation training is frequently used to teach and evaluate students. Simulation examinations are often evaluated using a standardised global rating scale (GRS) that is reliable and valid. However, differential rater function over time (DRIFT) has not been evaluated when using the GRS during simulations. Aims: This study aimed to assess if DRIFT arises when applying the GRS. Methods: Data were collected at six simulation evaluations. Raters were randomly assigned to evaluate several students at the same station. Each station lasted 12 minutes and there was a total of 11 stations. A model to test DRIFT scores was created and was tested against both a leniency and perceptual model. Findings: Of the models explored, one that included students, the rater, and the dimensions had the greatest evidence (−3151 Bayes factors). This model was then tested against leniency (K=−9.1 dHart) and perceptual models (K=−7.1 dHart). This suggests a substantial finding against DRIFT; however, the tested models used a wide parameter so the possibility of a minor effect is not fully excluded. Conclusion: DRIFT was not found; however, further studies with multiple centres and longer evaluations should be conducted.

BackgroundThe field of paramedicine continues to advance in scope. Simulation training is frequently used to teach and evaluate students. Simulation examinations are often evaluated using a standardized global rating scale (GRS) that is reliable and valid. However, the effects of differential rater function over time (DRIFT) have not been evaluated on the GRS during simulations. This study aimed to assess if DRIFT exists during a GRS.MethodsData was collected at Collège Boréal, Sudbury, Ontario, Canada during the 6 simulation evaluations within the scholastic year. Raters were randomly assigned to evaluate several students at the same station. Each station lasted 12-minutes in length and there was a total of 11-stations. A model to test the scores of DRIFT was created and was tested against both a leniency and perceptual model to explain DRIFT.ResultsAmongst the explored alternatives, a model that included students, the rater, and the dimensions had the greatest evidence (-3151 Bayes Factors). This model was then tested against leniency (K= -9.1 dHart) and perceptual models (K= -7.1 dHart) suggesting a substantial finding against DRIFT, however, the tested models used a wide parameter, therefore, the possibility of a minor effect is not fully excluded.ConclusionDRIFT was not found; however, further studies with multiple centres and longer evaluations should be conducted.