Another garbage week for Emergency Medicine in Canada.
Interior BC ERs dropping like flies; Newfoundland gives up and promotes telephone calls with a granny figure; Nova Scotia and Alberta now report shuttered ERs like they do road closures.
Crisis? What crisis? Another installment of the Dead Canary Chronicles:

Want evidence that emergency medicine in Canada is totally fucked? Look no further than the last couple of days Fort St. John emergency department on diversion as hospital deals with physician shortage
CJDC June 19

Last week I received a faxed Meds Check for a patient of mine who happens to be a physician.

I found that odd since the patient wouldn't need any help, at all, with medications. Last night I had dinner with the patient who told me they had received a cold call from the local big chain pharmacy, at dinner time, and was told they were "just checking in". There was no announcement of this being a formal medication review.

Are people with non-urgent problems clogging up Ontario ERs? Here's what the data shows via @torontostarthestar.com/news/canada/ar… "In fact, data compiled by the Star from 19 EDs across 10 health networks and hospitals in the GTA and Ottawa makes clear that the vast majority of people in those crowded emergency rooms need to be there"

Another, depressing, truly bad, horrible week for Canada's emergency department staff and the 15 million people we serve. Canada’s health care crunch has become ‘horrific and inhumane,’ doctors warn
Global News, January 14

Delays, falls, errors led to deaths, worsening care for patients in Manitoba hospitals, report says
Wait times more than 32 hours
CBC Manitoba, Jan 14

Well, finally, the moribund Ontario Coroners Association has come out against cost cutting measures of the Ford government that may prevent Ontario coroners from fulfilling their mandate "to speak for the dead to protect the living"

Here, in part, is their statement. For many years, Ontario families faced with the sudden and unexpected death of a loved one, have been helped by trained and independent medical doctors called Coroners.

One gun-control measure that will save lives thestar.com/opinion/contri… via @TorontoStar The Canadian Association of Emergency Physicians has, for over three decades, called for a medical reporting system of individuals at risk of inappropriate firearm use.

Analysis: It's high time for a national inquiry into Canada's ER crisis montrealgazette.com/news/local-new… via @mtlgazette Last November, Maclean’s magazine featured a stark cover story by veteran Ontario ER doctor Alan Drummond describing the depth of the crisis. Seven months later, Drummond told the Montreal Gazette he has not witnessed any signs of improvement.

Ontario needs a new health minister;
(My letter in today's Star)
thestar.com/opinion/letter… via @TorontoStar Death of an ER. Why the closure of a rural Ontario emergency room spells trouble for our health care system, June 10

The Star’s editorial was insightful and totally on point.

Ontario has not had a closure of an ER since 2008.

Five takeaways from the final report into the 2020 Nova Scotia mass shooting /via @globeandmail theglobeandmail.com/canada/article… The commission heard from gun advocacy groups arguing that since Mr. Wortman was already operating well outside the law, recommending new gun controls would be a wasted effort.

Today's report from the Mass Casualty Commission reaffirms the position of @CAEP_Docs that gun violence is a Public Health Issue of concern That far from a strict issue of urban gang violence with smuggled handguns, this is an issue with much broader health and safety implications for Canadians, including rural Canadians with long guns.

Mass Casualty Commission

"Our core finding is that Canada’s firearms regime was inadequate to prevent the perpetrator from acquiring the means to carry out the April 2020 mass casualty" As of December 31, 2020, the Canadian Firearms Program recorded a total of 2,206,755 valid firearms licences, which is roughly 5.6 percent of the Canadian population

The Mass Casualty Commission

Gender Based Violence is a compelling reason to restrict firearms ownership of perpetrators Intimate partner violence

• In 2018, 44% percent of women reported experiencing some form of IPV
[intimate partner violence] in their lifetime (since the age of 15).

Mass Shooting Commission

A lot to unpack and consider and this will take time.

However, there are a few things to consider that are consistent with @CAEP_Docs position that firearm injury and death is a Public Health issue that needs to be viewed from that lens. The Role of Gun Culture

"Nations with more civilian-owned firearms have more mass shootings.

Canada has a relatively high rate of gun ownership (only five countries have a higher rate)

Doctors and hospitals can help prevent gun deaths. Here’s how
aamc.org/news-insights/… “If it’s not a public health problem, then why are all these people dying from it?”

Suicide prevention: Protective factors can build hope and mitigate risks nationalpost.com/pmn/news-pmn/s… via @nationalpost Suicidal thoughts (ideation), plans and attempts are suprisingly common: 12 per cent of Canadians have thought about suicide during their lifetime, 4.3 per cent made a plan and 3.1 per cent attempted it.

6 Gun Safety Rules All Parents Should Follow in the Home
When it comes to reducing children's risk of injury or worse, there is zero margin for error.
goodhousekeeping.com/life/parenting… Suicide — no matter how unthinkable — does happen

Suicide is the biggest cause of gun deaths overall, and firearm suicides in young people are up 53% over the last ten years, according to CDC data.

As rural emergency department closings continue, some look warily toward summer ottawacitizen.com/news/local-new… via @OttawaCitizen Perth emergency physician Dr. Alan Drummond says the precariousness of the situation throughout Lanark County and beyond is worrisome, especially since summer is often the busiest season in rural emergency departments and the hospital is losing some nurses.

‘Probably the biggest issue that we face every day’: ER deaths national concern, doctor
WFP, March 3
thttps://www.winnipegfreepress.com/breakingnews/2023/03/03/probably-the-biggest-issue-that-we-face-every-day-er-deaths-national-concern-doctor-says Such deaths are a longstanding concern in all provinces, said Dr. Michael Howlett, president of the Canadian Association of Emergency Physicians.

Patient décédé après 16 heures aux urgences : « La population est à risque »
Radio Canada
Publié le 22 octobre 2022 Le ministre de la Santé du Québec, Christian Dubé, qualifie de « troublants » et d’« inacceptables » les détails entourant le décès d’une femme de 86 ans dans des urgences, la semaine dernière.
LaPresse, Publié le 2 mars

Assessment of Firearm Storage Practices in the US, 2022 ja.ma/3mpwVlF via @JAMANetworkOpen part of @JAMANetwork Firearm injury and death are substantial public health concerns in the US.