<p><strong>Introduction: </strong>Globally, stroke is the second-leading cause of death and the third-leading cause of combined death and disability. Stroke caused by large vessel occlusion (LVO) carries high morbidity and mortality. Endovascular thrombectomy (EVT) has improved the outcome of patients with LVO-related stroke. Despite therapeutic advances, timely access to EVT remains a critical challenge in many parts of the world, particularly large geographical areas with low population density and rural/remote regions. Our study aimed to share the real world data on the outcome of patients treated with EVT in a large geographic region with long transfer distances and high representation of rural and remote populations.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the first 103 patients treated between February 2020 and December 2022 at a newly launched regional EVT programme in Northeastern Ontario, Canada. Data included patient demographic, clinical characteristics, treatment metrics and 90-day functional outcomes assessed by modified Rankin score (mRS).</p><p><strong>Results: </strong>Establishment of a regional EVT programme led to a significant improvement in the access to EVT treatment (<1% prelaunch to ~6% postlaunch). Median transport distances between the site of initial stroke presentation to the EVT centre decreased substantially from 450.80 km pre-launch to 108.04 km post-launch. Over half of the treated patients (53/103, 51.5%) were ambulating independently (mRS 0-3) while mortality was 39.8%. Younger age (odds ratio [OR] 0.896, 95% confidence interval [CI] 0.824-0.975; P = 0.011), lower stroke severity (0.840, interquartile range [IQR] 0.745-0.946, P = 0.004) and shorter time from symptom onset to reperfusion (0.796, IQR 0.677-0.936, P = 0.006) were associated with lower odds of unfavourable outcomes (mRS 4-6).</p><p><strong>Conclusion: </strong>Our study shows improved access to EVT treatment after the establishment of a regional EVT programme. About 51.5% of patients had favourable outcomes with LVO-related stroke following EVT in a large geographic region with long transfer distances and high representation of rural and remote populations. More data are needed from similar regions across the globe to help understand treatment and outcome trends following EVT and strategies to improve EVT access.</p><p><strong>Introduction: </strong>À l'échelle mondiale, l'AVC est la deuxième cause de décès et la troisième cause de décès et d'invalidité combinés. Les AVC causés par une occlusion de gros vaisseaux (OGV) entraînent une morbidité et une mortalité élevées. La thrombectomie endovasculaire (TE) a amélioré les résultats chez les patients victimes d'un AVC lié à une OGV. Malgré les progrès thérapeutiques, l'accès rapide à la TE reste un défi majeur dans de nombreuses régions du monde, en particulier dans les zones géographiques vastes à faible densité de population et dans les régions rurales/isolées. Notre é
在全球范围内，中风是第二大死亡原因和第三大死亡和残疾原因。大血管闭塞性脑卒中的发病率和死亡率都很高。血管内血栓切除术（EVT）改善了左心室相关卒中患者的预后。尽管治疗取得了进步，但在世界许多地区，特别是人口密度低的大地理区域和农村/偏远地区，及时获得EVT仍然是一项重大挑战。我们的研究旨在分享大地理区域内EVT患者治疗结果的真实世界数据，这些区域的转移距离长，农村和偏远人口代表性高。方法：我们对2020年2月至2022年12月期间在加拿大安大略省东北部新启动的区域性EVT项目中接受治疗的前103例患者进行了回顾性分析。数据包括患者人口统计学、临床特征、治疗指标和用改良Rankin评分（mRS）评估的90天功能结局。结果：区域性EVT规划的建立显著改善了EVT治疗的可及性(结论：我们的研究表明，建立区域性EVT规划后，EVT治疗的可及性得到改善。在转移距离长、农村和偏远人口代表性高的大地理区域，约51.5%的EVT后左心室相关卒中患者预后良好。需要来自全球类似地区的更多数据，以帮助了解EVT后的治疗和结果趋势以及改善EVT获取的战略。简介：À l' mondiale, l' avc est la deuxi cause de danci.com/和la troisi cause de danci.com/和d' invalidit组合。AVC会导致运输运输运输运输运输运输运输运输运输运输运输运输运输运输运输。血管内取栓术（TE）是一种有效的血管内取栓术，它能有效地降低患者的死亡率。主要包括：主要的、普通的、世界的、特别是区域的、区域内的、人口密度的、区域内的、人口密度的、区域内的、农村的和独立的。在不同的人群中，不同的人有不同的境遇，不同的人有不同的境遇，不同的人有不同的境遇，不同的人有不同的境遇，不同的人有不同的境遇，不同的境遇。方法：Nous avons meneune对103例首次发病患者进行回顾性分析，这些患者的数据包括：2011年和2022年的 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都认为，所有的人都是健康的。结果：“方案调整方案”和“许可调整方案”认为，“调整方案调整方案”与“调整方案调整方案”相比，“调整方案调整方案”的调整幅度为1%，“调整方案调整方案”的调整幅度为6%。从距离上看，在距离上，在距离上，在距离上，在距离上，在距离上，在距离上，在距离上，在距离上，在距离上。加上de la moiti des patients trait哀伤哀伤（53/103,51,5%），民运自主游行（mRS 0-3）， tandis que le taux de mortality it哀伤哀伤（39,8%）。Un ge + jeune (OR 0,896, CI 95% 0,824-0,975；P = 0.011)，一个重力模型模型（0,840,IC 0,745-0,946, P = 0,004），以及一个与法庭中心l'apparition des symptômes et la reperfusion （0,796, IC 0,677-0,936, P = 0,006）有关的一个与危险模型模型模型相关的模型模型模型（mRS 4-6）。结论：所有的电子烟都是由电子烟和电子烟组成，所有的电子烟都是由电子烟和电子烟组成。51,5%的患者无法获得对其有利的条件，例如：AVC生活条件、OGV生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件、cv生活条件等。将所有的交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换交换
{"title":"Access to endovascular thrombectomy treatment for stroke patients with large vessel occlusion in Northern Ontario.","authors":"Konnor Kennedy, Cory Tremblay, Alice Nielissen, Karanvir Gill, Ruba Kiwan, Aviraj Deshmukh, Stefano Priola, Jaspreet Kaur, Ravinder-Jeet Singh","doi":"10.4103/cjrm.cjrm_40_24","DOIUrl":"10.4103/cjrm.cjrm_40_24","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, stroke is the second-leading cause of death and the third-leading cause of combined death and disability. Stroke caused by large vessel occlusion (LVO) carries high morbidity and mortality. Endovascular thrombectomy (EVT) has improved the outcome of patients with LVO-related stroke. Despite therapeutic advances, timely access to EVT remains a critical challenge in many parts of the world, particularly large geographical areas with low population density and rural/remote regions. Our study aimed to share the real world data on the outcome of patients treated with EVT in a large geographic region with long transfer distances and high representation of rural and remote populations.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the first 103 patients treated between February 2020 and December 2022 at a newly launched regional EVT programme in Northeastern Ontario, Canada. Data included patient demographic, clinical characteristics, treatment metrics and 90-day functional outcomes assessed by modified Rankin score (mRS).</p><p><strong>Results: </strong>Establishment of a regional EVT programme led to a significant improvement in the access to EVT treatment (<1% prelaunch to ~6% postlaunch). Median transport distances between the site of initial stroke presentation to the EVT centre decreased substantially from 450.80 km pre-launch to 108.04 km post-launch. Over half of the treated patients (53/103, 51.5%) were ambulating independently (mRS 0-3) while mortality was 39.8%. Younger age (odds ratio [OR] 0.896, 95% confidence interval [CI] 0.824-0.975; P = 0.011), lower stroke severity (0.840, interquartile range [IQR] 0.745-0.946, P = 0.004) and shorter time from symptom onset to reperfusion (0.796, IQR 0.677-0.936, P = 0.006) were associated with lower odds of unfavourable outcomes (mRS 4-6).</p><p><strong>Conclusion: </strong>Our study shows improved access to EVT treatment after the establishment of a regional EVT programme. About 51.5% of patients had favourable outcomes with LVO-related stroke following EVT in a large geographic region with long transfer distances and high representation of rural and remote populations. More data are needed from similar regions across the globe to help understand treatment and outcome trends following EVT and strategies to improve EVT access.</p><p><strong>Introduction: </strong>À l'échelle mondiale, l'AVC est la deuxième cause de décès et la troisième cause de décès et d'invalidité combinés. Les AVC causés par une occlusion de gros vaisseaux (OGV) entraînent une morbidité et une mortalité élevées. La thrombectomie endovasculaire (TE) a amélioré les résultats chez les patients victimes d'un AVC lié à une OGV. Malgré les progrès thérapeutiques, l'accès rapide à la TE reste un défi majeur dans de nombreuses régions du monde, en particulier dans les zones géographiques vastes à faible densité de population et dans les régions rurales/isolées. Notre é","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 3","pages":"132-140"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-08-13DOI: 10.4103/cjrm.cjrm_41_24
Sofia Valanci-Aroesty, Mylene Juneau, Tim Lapp, Jessica Nairn, Lisa Allen, Roy Kirkpatrick
<p><strong>Introduction: </strong>Peer coaching has gained traction as a method for enhancing practical and personal skills without the hierarchical dynamic sometimes found in mentorship. It creates a collaborative environment, encourages inclusivity and community building, and supports skill development across various disciplines and levels of experience. The objective of our study was to assess the feasibility, satisfaction, and effects of a reciprocal peer coaching pilot program for practising physicians in Northern Ontario's remote and rural regions.</p><p><strong>Methods: </strong>Participants completed 'Peer coaching in practice' micromodules from The Royal College of Physicians and Surgeons of Canada and attended an in-person demonstration. Each participant committed to 2 sessions as both coach and coachee with a self-selected partner. Feedback was gathered at each study interval.</p><p><strong>Results: </strong>Our qualitative study found that peer coaching positively impacted physicians' daily habits, wellness, and professional growth. The study emphasised the importance of cohesive partnerships in peer coaching and highlighted substantial benefits for both coaches and coachees. The feasibility of peer coaching was a key finding, demonstrating its potential to build supportive communities, particularly for providers in remote areas. While in-person interaction was preferred, the study also acknowledged the potential of virtual coaching, which could benefit providers isolated by geography, demographics, or practice modality.</p><p><strong>Conclusion: </strong>Peer coaching is an alternative, novel form of continuing medical education and knowledge exchange. It is particularly relevant in rural communities offering crucial support to local providers, especially those in rural or isolated areas where access to formal continued medical education is limited. Our results suggest that peer coaching can significantly improve the daily practices and overall well-being of physicians.</p><p><strong>Introduction: </strong>Le coaching entre pairs s'est imposé comme une méthode permettant d'améliorer les compétences pratiques et personnelles sans la dynamique hiérarchique que l'on retrouve parfois dans le mentorat. Il crée un environnement collaboratif, favorise l'inclusion et le développement communautaire, tout en soutenant le développement des compétences dans diverses disciplines et à différents niveaux d'expérience. L'objectif de cette étude était d'évaluer la faisabilité, la satisfaction et les effets d'un programme pilote de coaching réciproque entre pairs destiné aux médecins en exercice dans les régions rurales et isolées du nord de l'Ontario.</p><p><strong>Mthodes: </strong>Les participants ont suivi les micromodules " Expérience Coaching entre pairs " du Collège royal des médecins et chirurgiens du Canada et ont assisté à une démonstration en personne. Chaque participant s'est engagé à participer à deux séances en tant que coach et aidé (e)
导读：同伴指导作为一种提高实践技能和个人技能的方法，已经获得了广泛的关注，而没有师徒关系中有时会出现的等级动态。它创造了一个协作的环境，鼓励包容性和社区建设，并支持不同学科和经验水平的技能发展。本研究的目的是评估安大略省北部偏远和农村地区执业医师互惠同伴指导试点项目的可行性、满意度和效果。方法：参与者完成了加拿大皇家内科医生和外科医生学院的“同行指导实践”微模块，并参加了现场演示。每位参与者承诺以教练和学员的身份与自己选择的合作伙伴进行2次培训。在每个研究间隔收集反馈。结果：我们的定性研究发现同伴指导对医生的日常习惯、健康和专业成长有积极的影响。该研究强调了在同侪辅导中凝聚伙伴关系的重要性，并强调了对教练和教练员的实质性好处。同侪辅导的可行性是一项重要发现，证明了其建立支持性社区的潜力，特别是对偏远地区的提供者而言。虽然面对面的交流是首选，但研究也承认虚拟教练的潜力，这可以使因地理、人口统计或实践方式而孤立的提供者受益。结论：同伴辅导是一种新颖的继续医学教育和知识交流方式。在向当地提供者提供关键支持的农村社区，特别是在获得正规继续医学教育机会有限的农村或偏远地区，这一点尤其重要。我们的研究结果表明同伴指导可以显著提高医生的日常实践和整体幸福感。导语：培训中心将“最具感染力的培训”与“最具感染力的培训”结合起来，将“最具感染力的培训”与“最具感染力的培训”结合起来，将“最具感染力的培训”与“最具感染力的培训”结合起来。我将促进与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调，赞成与环境的协调。“目标”是指，在训练中，“目标”是指，在训练中，“目标”是指，在训练中，“目标”是指，在训练中，“目标”是指，在训练中，“目标”是指，在训练中，“目标”是指，在训练中，“目标”是指，在农村，“目标”是指，在安大略北部，“目标”是指。方法：6名参与者参加加拿大皇家学院(college of royal des mims -。Chaque参与者‘ s est订婚’，参与者‘ deux ssamac ’ s en tant que coach et aidise (e) untentenaire de son choice。关于的评论- - - - - - - - - - - - - - - - - -研究结果：对普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯、普通生活习惯产生积极影响。“父母的重要性”和“指导的重要性”是一个重要的概念，“指导的重要性”和“指导的重要性”是一个重要的概念，“指导的重要性”和“指导的重要性”是一个重要的概念。最后一项结论是，如果一个人有可能成为一名社会成员，那么他就有可能成为一名社会成员，特别是一名社会成员，他就有可能成为一名社会成员。人与人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用，与个人之间的相互作用。结论：lecoaching entro pair是一种新的替代方案，可以使患者的变性和变性保持一致，也可以使患者的变性保持一致。Il est particulierement相关在communautes乡村骑警ou Il offre联合国soutien至关重要的辅助prestataires locaux, en particulier正号des区乡村骑警或隔离或l 'acces形成一个医学研究院继续formelle打工。没有任何一个组织建议，如果一个组织将其视为一个普通的组织，那么它将被认为是一个普通的组织。
{"title":"Peer coaching in a rural setting: A feasibility study.","authors":"Sofia Valanci-Aroesty, Mylene Juneau, Tim Lapp, Jessica Nairn, Lisa Allen, Roy Kirkpatrick","doi":"10.4103/cjrm.cjrm_41_24","DOIUrl":"10.4103/cjrm.cjrm_41_24","url":null,"abstract":"<p><strong>Introduction: </strong>Peer coaching has gained traction as a method for enhancing practical and personal skills without the hierarchical dynamic sometimes found in mentorship. It creates a collaborative environment, encourages inclusivity and community building, and supports skill development across various disciplines and levels of experience. The objective of our study was to assess the feasibility, satisfaction, and effects of a reciprocal peer coaching pilot program for practising physicians in Northern Ontario's remote and rural regions.</p><p><strong>Methods: </strong>Participants completed 'Peer coaching in practice' micromodules from The Royal College of Physicians and Surgeons of Canada and attended an in-person demonstration. Each participant committed to 2 sessions as both coach and coachee with a self-selected partner. Feedback was gathered at each study interval.</p><p><strong>Results: </strong>Our qualitative study found that peer coaching positively impacted physicians' daily habits, wellness, and professional growth. The study emphasised the importance of cohesive partnerships in peer coaching and highlighted substantial benefits for both coaches and coachees. The feasibility of peer coaching was a key finding, demonstrating its potential to build supportive communities, particularly for providers in remote areas. While in-person interaction was preferred, the study also acknowledged the potential of virtual coaching, which could benefit providers isolated by geography, demographics, or practice modality.</p><p><strong>Conclusion: </strong>Peer coaching is an alternative, novel form of continuing medical education and knowledge exchange. It is particularly relevant in rural communities offering crucial support to local providers, especially those in rural or isolated areas where access to formal continued medical education is limited. Our results suggest that peer coaching can significantly improve the daily practices and overall well-being of physicians.</p><p><strong>Introduction: </strong>Le coaching entre pairs s'est imposé comme une méthode permettant d'améliorer les compétences pratiques et personnelles sans la dynamique hiérarchique que l'on retrouve parfois dans le mentorat. Il crée un environnement collaboratif, favorise l'inclusion et le développement communautaire, tout en soutenant le développement des compétences dans diverses disciplines et à différents niveaux d'expérience. L'objectif de cette étude était d'évaluer la faisabilité, la satisfaction et les effets d'un programme pilote de coaching réciproque entre pairs destiné aux médecins en exercice dans les régions rurales et isolées du nord de l'Ontario.</p><p><strong>Mthodes: </strong>Les participants ont suivi les micromodules \" Expérience Coaching entre pairs \" du Collège royal des médecins et chirurgiens du Canada et ont assisté à une démonstration en personne. Chaque participant s'est engagé à participer à deux séances en tant que coach et aidé (e)","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 3","pages":"125-131"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Introduction: </strong>A retrospective quantitative study of emergency department (ED) management of patients diagnosed with sepsis in a rural hospital in northwest Ontario was conducted to understand the management of sepsis guidelines and department performance.</p><p><strong>Methods: </strong>Our study includes all adult ED patients (18+) receiving an ED diagnosis of sepsis as identified by hospital medical records coding according to National Ambulatory Care Reporting System diagnostic codes from January 1, 2021 to December 31, 2021. Charts were reviewed for patient demographics, initial presentation, timing of ED management and outcomes. Statistical analysis involved descriptive methods.</p><p><strong>Results: </strong>Twenty-five adults were eligible, 16 female, average age 53.1 years (standard deviation [SD] = 21.9). Mortality rate was 28%. The average age of the 7 non-survivors was 64 (SD = 14.73). Time to nursing assessment averaged 8 min (SD = 7.27); time to MD assessment was 41 min (SD = 30.93). Canadian Triage and Acuity Scale scores were urgent or higher in 20 of 23 cases. Retrospective Systemic inflammatory Response Syndrome scores were elevated in 17/25 cases. Average time to fluids administration was 85 min (SD = 79.41). Sixteen of the 23 patients with recorded times of antibiotic delivery received them in 180 min or less.</p><p><strong>Conclusion: </strong>Patients with sepsis present with a variety of clinical features, and laboratory findings. Awareness of the urgency of sepsis treatment and an organised departmental approach is important in the management of potentially septic patients.</p><p><strong>Introduction: </strong>Une étude quantitative rétrospective sur la prise en charge aux urgences des patients diagnostiqués avec une septicémie dans un hôpital rural du nord-ouest de l'Ontario a été menée afin de comprendre les directives en matière de prise en charge de la septicémie et les performances du service.</p><p><strong>Mthodes: </strong>Notre étude porte sur tous les patients adultes (âgés de 18 ans et plus) admis aux urgences et ayant reçu un diagnostic de septicémie selon le codage des dossiers médicaux de l'hôpital, conformément aux codes diagnostiques du Système national d'information sur les soins ambulatoires (SNISA), entre le 1er janvier 2021 et le 31 décembre 2021. Les dossiers ont été examinés afin de recueillir des données démographiques sur les patients, les premiers symptômes, le moment de la prise en charge aux urgences et les résultats. L'analyse statistique a été réalisée à l'aide de méthodes descriptives.</p><p><strong>Rsultats: </strong>Vingt-cinq adultes étaient admissibles, dont 16 femmes, avec un âge moyen de 53.1 ans (écart-type = 21,9). Le taux de mortalité était de 28%. L'âge moyen des seven patients décédés était de 64 ans (écart-type = 14,73). Le délai moyen avant l'évaluation infirmière était de 8 min (écart-type = 7,27); le délai avant l'évaluation médicale était de 41 min (écart-typ
前言：回顾性定量研究安大略省西北部一家农村医院急诊部（ED）对脓毒症患者的管理，以了解脓毒症的管理指南和科室表现。方法：我们的研究纳入了2021年1月1日至2021年12月31日期间，根据国家门诊报告系统诊断代码，所有接受败血症ED诊断的成人ED患者（18岁以上）。我们回顾了患者的人口统计资料、初次表现、急症治疗的时机和结果。统计分析采用描述性方法。结果：成人25例，女性16例，平均年龄53.1岁（标准差[SD] = 21.9）。死亡率为28%。7例非幸存者的平均年龄为64岁（SD = 14.73）。护理评估时间平均为8 min (SD = 7.27)；到MD评估时间为41 min （SD = 30.93）。加拿大分诊和视力分级评分在23例中有20例为紧急或更高。25例患者中有17例系统性炎症反应综合征评分升高。平均给药时间85 min （SD = 79.41）。有记录的23例患者中有16例在180分钟或更短时间内接受了抗生素治疗。结论：脓毒症患者具有多种临床特征和实验室检查结果。意识到脓毒症治疗的紧迫性和有组织的部门方法对潜在脓毒症患者的管理很重要。导言：单一的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的可变数量的。方法：根据成人患者的健康状况（ 18岁及以上的成年患者的健康状况），按照 18岁及以上的成年患者的健康状况，按照 18岁及以上的成年患者的健康状况，按照 18岁及以上的成年患者的健康状况，按照 18岁及以上的成年患者的健康状况，按照 18岁及以上的成年患者的健康状况，按照国家信息系统诊断标准（SNISA）的健康状况，按照2011年及2021年的31岁及以上的成年患者的健康状况进行诊断。这些档案包括：档案内的交换器、档案内的交换器、档案内的交换器、档案内的交换器、档案内的交换器、档案内的交换器、档案内的交换器、档案内的。我分析了一个统计数据，即：对所有的数据进行统计分析。结果：成年男性有58例，女性16例，平均有53.1例（男性21,9）。死亡率为28%。L' 格莫因（L' 格莫因）研究了7例患者，他们的年龄分别为64岁和64岁。是平均delai先锋派的l”infirmiere是德8分钟(典型误差= 7,27);le delai先锋派的l”医学研究院是de 41分钟(典型误差= 30,9)。Les scores de l' samuchelle canadienne de triage et d' acuit samuastrient ent在20 cas sur 23中要求你的超级samurieurs。Les scores rsamac trospectifs du syndrome de rsamac inflamoire system（炎症系统）。ledsamaimoyen avant l'administration de liquides samtade85 min （samtatype = 79,41）。在180分钟的时间里，23名患者被发现服用了抗生素和其他药物。结论：在临床和实验室均可观察到患者有不同的症状。我认为重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是，我认为最重要的是。
{"title":"Sepsis management in a rural hospital in Northwest Ontario.","authors":"Len Kelly, Sharen Madden, Catherine Wong, Sonya Fewer, Tamar Shemesh-Lobl, Shanthive Asokan, Laurel Laakso","doi":"10.4103/cjrm.cjrm_60_24","DOIUrl":"10.4103/cjrm.cjrm_60_24","url":null,"abstract":"<p><strong>Introduction: </strong>A retrospective quantitative study of emergency department (ED) management of patients diagnosed with sepsis in a rural hospital in northwest Ontario was conducted to understand the management of sepsis guidelines and department performance.</p><p><strong>Methods: </strong>Our study includes all adult ED patients (18+) receiving an ED diagnosis of sepsis as identified by hospital medical records coding according to National Ambulatory Care Reporting System diagnostic codes from January 1, 2021 to December 31, 2021. Charts were reviewed for patient demographics, initial presentation, timing of ED management and outcomes. Statistical analysis involved descriptive methods.</p><p><strong>Results: </strong>Twenty-five adults were eligible, 16 female, average age 53.1 years (standard deviation [SD] = 21.9). Mortality rate was 28%. The average age of the 7 non-survivors was 64 (SD = 14.73). Time to nursing assessment averaged 8 min (SD = 7.27); time to MD assessment was 41 min (SD = 30.93). Canadian Triage and Acuity Scale scores were urgent or higher in 20 of 23 cases. Retrospective Systemic inflammatory Response Syndrome scores were elevated in 17/25 cases. Average time to fluids administration was 85 min (SD = 79.41). Sixteen of the 23 patients with recorded times of antibiotic delivery received them in 180 min or less.</p><p><strong>Conclusion: </strong>Patients with sepsis present with a variety of clinical features, and laboratory findings. Awareness of the urgency of sepsis treatment and an organised departmental approach is important in the management of potentially septic patients.</p><p><strong>Introduction: </strong>Une étude quantitative rétrospective sur la prise en charge aux urgences des patients diagnostiqués avec une septicémie dans un hôpital rural du nord-ouest de l'Ontario a été menée afin de comprendre les directives en matière de prise en charge de la septicémie et les performances du service.</p><p><strong>Mthodes: </strong>Notre étude porte sur tous les patients adultes (âgés de 18 ans et plus) admis aux urgences et ayant reçu un diagnostic de septicémie selon le codage des dossiers médicaux de l'hôpital, conformément aux codes diagnostiques du Système national d'information sur les soins ambulatoires (SNISA), entre le 1er janvier 2021 et le 31 décembre 2021. Les dossiers ont été examinés afin de recueillir des données démographiques sur les patients, les premiers symptômes, le moment de la prise en charge aux urgences et les résultats. L'analyse statistique a été réalisée à l'aide de méthodes descriptives.</p><p><strong>Rsultats: </strong>Vingt-cinq adultes étaient admissibles, dont 16 femmes, avec un âge moyen de 53.1 ans (écart-type = 21,9). Le taux de mortalité était de 28%. L'âge moyen des seven patients décédés était de 64 ans (écart-type = 14,73). Le délai moyen avant l'évaluation infirmière était de 8 min (écart-type = 7,27); le délai avant l'évaluation médicale était de 41 min (écart-typ","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 3","pages":"119-124"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Introduction: </strong>In Canada, 18% of the population lives in rural areas, yet only 8% of practising physicians work rurally. Rural communities face ongoing challenges in both recruitment and retention of physicians and other healthcare professionals. Improving quality and access to care for rural Canadians rests on the successful recruitment and retention of community-based physicians. The aim of this study was a broad exploration of the roles, experiences, and strategies of physician recruiters. Their stories, when woven together, provide us with valuable insights from the "front lines."</p><p><strong>Methods: </strong>Using a grounded theory approach, we conducted semi-structured interviews with Northern Ontario Physician Recruiters.</p><p><strong>Results: </strong>Twelve physician recruiters were interviewed. Six themes were identified: (1) Community engagement: Big and small 'e' engagement, (2) Recruiter role: Know thyself, know thy community, (3) Strategies: It is all about movement: reaching people, pulling strings and dodging bullets, (4) Outcomes: listening, learning, liaising, (5) LEARN (er) ING opportunities and (6) A PanNorthern approach: Their success is our success. Comments from recruiters provide insight and valuable information on their role in securing adequate health professionals in their area.</p><p><strong>Conclusion: </strong>Physician Recruiters have a very challenging job. They are expected to generate results with scant resources within a complex environment that poorly understands or values their role. Yet, their stories highlighted the relevance and joy in their challenges.</p><p><strong>Introduction: </strong>Au Canada, 18% de la population vit en milieu rural, mais seulement 8% des médecins en exercice travaillent dans ces régions. Les communautés rurales sont confrontées à des défis permanents en matière de recrutement et de maintien en poste des médecins et autres professionnels de la santé. L'amélioration de la qualité et de l'accès aux soins pour les Canadiennes et Canadiens vivant en milieu rural repose sur le recrutement et le maintien en poste de médecins exerçant en milieu communautaire. L'objectif de cette étude était d'explorer de manière approfondie les rôles, les expériences et les stratégies des recruteurs de médecins. Une fois mises en perspective, leurs histoires nous fournissent des informations précieuses provenant directement du terrain.</p><p><strong>Mthodes: </strong>À l'aide d'une approche fondée sur la théorie, nous avons mené des entrevues semi-structurées auprès de recruteurs de médecins du Nord de l'Ontario.</p><p><strong>Rsultats: </strong>Douze recruteurs de médecins ont été interviewés. Six thèmes ont été identifiés: 1) Engagement communautaire: engagement avec un grand " E " et un petit " e ", 2) Rôle du recruteur: se connaître soi-même, connaître sa communauté, 3) Stratégies: tout est question de mouvement: aller vers les gens, tirer les ficelles et esquiver les obstacles,
{"title":"A rolodex of skills and roles: listening and learning from northern physician recruiters.","authors":"Cheri Heather Bethune, Holly M Fleming, Eloho Ukochovwera Ologan, Ghislaine Attema, Erin Cameron","doi":"10.4103/cjrm.cjrm_58_24","DOIUrl":"10.4103/cjrm.cjrm_58_24","url":null,"abstract":"<p><strong>Introduction: </strong>In Canada, 18% of the population lives in rural areas, yet only 8% of practising physicians work rurally. Rural communities face ongoing challenges in both recruitment and retention of physicians and other healthcare professionals. Improving quality and access to care for rural Canadians rests on the successful recruitment and retention of community-based physicians. The aim of this study was a broad exploration of the roles, experiences, and strategies of physician recruiters. Their stories, when woven together, provide us with valuable insights from the \"front lines.\"</p><p><strong>Methods: </strong>Using a grounded theory approach, we conducted semi-structured interviews with Northern Ontario Physician Recruiters.</p><p><strong>Results: </strong>Twelve physician recruiters were interviewed. Six themes were identified: (1) Community engagement: Big and small 'e' engagement, (2) Recruiter role: Know thyself, know thy community, (3) Strategies: It is all about movement: reaching people, pulling strings and dodging bullets, (4) Outcomes: listening, learning, liaising, (5) LEARN (er) ING opportunities and (6) A PanNorthern approach: Their success is our success. Comments from recruiters provide insight and valuable information on their role in securing adequate health professionals in their area.</p><p><strong>Conclusion: </strong>Physician Recruiters have a very challenging job. They are expected to generate results with scant resources within a complex environment that poorly understands or values their role. Yet, their stories highlighted the relevance and joy in their challenges.</p><p><strong>Introduction: </strong>Au Canada, 18% de la population vit en milieu rural, mais seulement 8% des médecins en exercice travaillent dans ces régions. Les communautés rurales sont confrontées à des défis permanents en matière de recrutement et de maintien en poste des médecins et autres professionnels de la santé. L'amélioration de la qualité et de l'accès aux soins pour les Canadiennes et Canadiens vivant en milieu rural repose sur le recrutement et le maintien en poste de médecins exerçant en milieu communautaire. L'objectif de cette étude était d'explorer de manière approfondie les rôles, les expériences et les stratégies des recruteurs de médecins. Une fois mises en perspective, leurs histoires nous fournissent des informations précieuses provenant directement du terrain.</p><p><strong>Mthodes: </strong>À l'aide d'une approche fondée sur la théorie, nous avons mené des entrevues semi-structurées auprès de recruteurs de médecins du Nord de l'Ontario.</p><p><strong>Rsultats: </strong>Douze recruteurs de médecins ont été interviewés. Six thèmes ont été identifiés: 1) Engagement communautaire: engagement avec un grand \" E \" et un petit \" e \", 2) Rôle du recruteur: se connaître soi-même, connaître sa communauté, 3) Stratégies: tout est question de mouvement: aller vers les gens, tirer les ficelles et esquiver les obstacles, ","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 3","pages":"141-147"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-08-13DOI: 10.4103/cjrm.cjrm_82_24
Lindsay Dolomount, Paul Crocker
{"title":"How to rescue a crashing asthmatic patient in a remote emergency department: Ketamine and non-invasive ventilation.","authors":"Lindsay Dolomount, Paul Crocker","doi":"10.4103/cjrm.cjrm_82_24","DOIUrl":"10.4103/cjrm.cjrm_82_24","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 3","pages":"148-150"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-08-13DOI: 10.4103/cjrm.cjrm_14_25
Peter Hutten-Czapski
{"title":"The Occasional insertion of intrauterine devices: new approaches.","authors":"Peter Hutten-Czapski","doi":"10.4103/cjrm.cjrm_14_25","DOIUrl":"10.4103/cjrm.cjrm_14_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 3","pages":"151-156"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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