Current practice for primary headache disorders and perspectives on peripheral nerve blocks among emergency physicians in Canada: A national survey

Abstract

Objective: This national postal survey aimed to examine Canadian emergency physicians' practice patterns with respect to drug treatment and perspectives on peripheral nerve blocks. Background:The treatment of primary headache disorders in the emergency department is variable. Methods:We surveyed 500 emergency physicians listed in the Canadian Medical Directory according to a modified Dillman's method: an initial invitation was followed by up to four reminders to nonresponders. Physicians were asked questions regarding their frequency of medication administration and perspectives toward peripheral nerve blocks.Results: Of 500 mailed surveys, 468 were delivered and 179 physicians responded (response rate = 38.2%). The majority of physicians were men (92/144, 63.9%); 80.6% (116/144) had been in practice for greater than or equal to 10 years with 50.7% (75/148) in a community or district general teaching hospital. Commonly used pharmacotherapies for primary headaches were intravenous dopamine receptor antagonists (69%), co-administration of ketorolac and a dopamine receptor antagonist (54.2%), intravenous fluid boluses (54%), nonsteroidal anti-inflammatory drugs (NSAIDs) alone (53.5%), and acetaminophen (51.4%). Only 80 of 144 physicians (55.6%) reported previous experience with peripheral nerve blocks (95% confidence interval [CI] = 48%-65%). The majority (68/80, 85.0%) agreed peripheral nerve blocks are safe and 55.1% (43/78) agreed they are effective. The vast majority (118/140, 84.3%) would consider peripheral nerve blocks as a first-line treatment option given sufficient evidence from a future trial (95% CI = 78%-90%). Conclusion:NSAIDs alone, as well as dopamine receptor antagonists with or without ketorolac are commonly used for primary headache in Canadian emergency departments. A large proportion of physicians have never used a peripheral nerve block in their practice; among those who have experience with peripheral nerve blocks, the

Survey on the Updated German S3 Guideline for Intensive Care in Cardiac Surgery Patients

“…51 Recent surveys could not enhance return rates by adaptations of survey structure, for example, quadruple recalls. 52 Our group expected a higher response rate, based on a homogenous cohort with an assumable high intrinsic ambition for improvement in the sector of postoperative care. Group homogeneity, professional background, considering the anesthesiological and cardiosurgical background, and a highly concerning topic make a response rate bias unlikely.…”

Effect of hand versus electronic signatures on response rates in postal surveys: a randomised controlled trial among emergency physicians in Canada

“…We used a national self-administered postal survey of emergency physicians listed in the 2019 Scott’s Canadian Medical Directory, which is Canada’s leading source for contact information and claims to list over 98% of practising physicians with 97% address accuracy 8. The results from the survey are reported elsewhere 7. The survey (online supplemental appendix A) was mailed to a random sample of 500 physicians.…”

“…8 The results from the survey are reported elsewhere. 7 The survey ( online supplemental appendix A ) was mailed to a random sample of 500 physicians. Physicians were eligible for the survey if they were currently treating adults in emergency medicine.…”

“…We previously found some differences in response rates between Canadian French-speaking and English-speaking participants. 7 We; therefore, conducted a post hoc exploratory subgroup analyses to compare the effect of e-signatures versus hand signatures between English-speaking and Canadian French-speaking participants.…”

Trainee highlights

“…He was specifically interested in sphenopalatine ganglion block (intranasal lidocaine) as an alternative treatment method for primary headache disorders, which was the primary focus of his thesis. Outside of research, he loves powerlifting, soccer, photography/videography, biking, traveling, and hiking 3 …”