Yesterday was the first day of summer and if the past few have been any indication, this may be an awful, awful summer for ER closures. Our PM has told Canadians to get out there and explore your own wondrous country but if you are unfortunate enough to encounter, on your travels, a medical or traumatic emergency, getting medical care might be akin to winning the Lotto.

Lives Lived: Hilary Drummond, 28

Published March 29, 2016
Alan Drummond

Contributed to The Globe and Mail Triplet, teacher, cancer warrior, lover of life. Born on May 2, 1987, in Ottawa; died on Jan. 28, 2016, in Perth, Ont., of metastatic breast cancer, aged 28.

The six myths of ER crowding 1) Crowding is due to problems in the ER

Nope. ER crowding has fundamentally nothing to do with the ER. It's largely about HOSPITAL capacity and the boarding of hospitalized patients waiting for beds to become available on the wards.

This, in turn, is due to inadequate LTC.

I am somewhat saddened by the response to the death of a young Montrealer who died of an aneurysm. He had left the ER without being assessed after a prolonged wait for care - care that never came.

We should never, ever, blame the victim. The truth is that prolonged waits for ER care have become entrenched in Canada and though the causes and solutions are well-known, multiple provincial governments, of all stripes, absolutely refuse to resolve it.

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.