Lack of CT scanner in a rural emergency department increases inter-facility transfers: a pilot study

Bergeron, Chantal; Fleet, Richard; Tounkara, Fatoumata Korika; Lavallée-Bourget, Isabelle; Turgeon-Pelchat, Catherine

doi:10.1186/s13104-017-3071-1

Cited by 30 publications

(25 citation statements)

References 19 publications

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“…Unfortunately, only about 15% of Canadian rural EDs have access to a CT scanner 24/7. 12 In the USA, similar trends are observed with less access to CT in smaller, rural hospitals. 42 Another tool available is carotid duplex ultrasonography (DUS) with sensitivity for stenosis ≥ 50% of 96-98% and specificities of 83-88%.…”

Section: How Does This Improve Population Health?mentioning

confidence: 70%

Can Emergency Physicians Perform Carotid Artery Point-of-Care Ultrasound to Detect Stenosis in Patients with TIA and Stroke? A Pilot Study

Suttie

Woo

Park

et al. 2020

WestJEM

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Section: How Does This Improve Population Health?mentioning

confidence: 70%

Can Emergency Physicians Perform Carotid Artery Point-of-Care Ultrasound to Detect Stenosis in Patients with TIA and Stroke? A Pilot Study

Suttie

Woo

Park

et al. 2020

WestJEM

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“…18 Studies of interfacility transfer suggest that Ontario rural hos pitals transfer patients to larger referral centres at a rate of about 1-3 per 100 population. 19,20 Although one might inter pret the Ornge transport rate as similar to provincial land ambulance or interfacility transfer numbers, these services are not comparable. In remote First Nations communities in northern Ontario, there is no 911 emergency telephone num ber or ambulance service.…”

Section: Discussionmentioning

confidence: 99%

“…When patients are transferred between facilities else where in Canada, it is often for reasons such as computed tomography imaging, critical care, orthopedic care or pediatric care. [19][20][21] For patients in this study, emergency air transfer was for their initial hospital assessment. Our data therefore…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic features of medical emergencies in remote First Nations in northern Ontario: a cross-sectional descriptive study using air ambulance transport data

VanderBurgh

Savage

Dubois

et al. 2020

cmajo

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A lmost all residents of Ontario, Canada live within 30 minutes of an emergency department. 1 However, for about 25 000 Ontarians living in remote commun ities, accessing a doctor in an emergency department requires flying in a plane or helicopter. 1 Patients in these northern com munities access medical care through a local nursing station, with intermittent incommunity physician coverage. Patients with highacuity conditions are transported from remote com munities to hospital by Ornge, the provincial medical air ambulance service provider. 2,3 Even under ideal conditions, these transfers take several hours. Air transports from these communities can face delays due to weather, visibility, mechan ical issues and personnel issues. More than half of the associ ated remote airports do not have key visual aids that pilots use to land aircraft during periods of reduced visibility, which makes medical transports dependent on weather conditions. 4 First Nations populations living in remote communities are known to face challenging social determinants of health: isolated geography, insufficient housing, unemployment, and the cultural impact of colonialism and residential schools. 5 Access to potable water is an issue in many communities, with 188 boil water advisories in First Nations in the Sioux Look out area between 2007 and 2016. 6 These populations face trauma at rates 2.5-8 times greater than the Canadian aver age. 7-10 People living in these communities face elevated rates of chronic disease, which manifest as critical health emergen cies including mental health, infectious disease, diabetic and cardiovascular emergencies. 11-14 The characteristics of patients requiring air medical trans port in this region have not been well described, with only a handful of published papers describing medical emergencies in these remote communities over the last 35 years. 2,6,7,15,16 We aimed to describe who is transported from 26 remote Nish nawbe Aski Nation communities in northern Ontario to access hospitalbased emergency medical care and to describe the primary clinical reason for their transport as stated in the

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“…Most EDs in the USA and the province of Quebec have this essential equipment to diagnose many acute conditions. 33,34 The project aims to:…”

Section: Background and Objectivesmentioning

confidence: 99%

A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care

Fleet

2020

Future Healthcare Journal

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Introduction More than 6 million Canadians live in rural areas (approximately 20% of the population) and emergency services are a critical safety net for them. Objectives We want to create, in Baie-Saint-Paul (rural emergency department, Québec, Canada), an experimental milieu where all stakeholders develop, implement and evaluate solutions to address the problems that beset their environment. Method The Living Lab will rely on the quadruple aim approach to improve health system performance and will use a multimethod approach based on the philosophy of open and user-driven innovation. Three pilot projects will be implemented (quality of work life programme, computed tomography implementation study and telemedicine in ambulances). Other possible solutions will be evaluated and prioritised (in situ simulation, care protocol, telemedicine, point-of-care ultrasound, helicopters and drones). Conclusion We are confident that this Living Lab will contribute to saving lives, will improve the quality of work life for rural healthcare professionals, and will inspire similar innovation internationally.

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Lack of CT scanner in a rural emergency department increases inter-facility transfers: a pilot study

Cited by 30 publications

References 19 publications

Can Emergency Physicians Perform Carotid Artery Point-of-Care Ultrasound to Detect Stenosis in Patients with TIA and Stroke? A Pilot Study

Can Emergency Physicians Perform Carotid Artery Point-of-Care Ultrasound to Detect Stenosis in Patients with TIA and Stroke? A Pilot Study

Epidemiologic features of medical emergencies in remote First Nations in northern Ontario: a cross-sectional descriptive study using air ambulance transport data

A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care

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