A female in her 70s from a nursing home with a past medical history of dementia, obesity, COPD, and CHF presents to the emergency department with a decreased level of consciousness and shortness of breath. Seven days ago she was assessed in the ER with a diagnosis of aspiration pneumoniaRead More →
Opioid and narcotic abuse has been a problem in Canada for some time, but nothing compares to the rapid sweep of opioid-related deaths and hospitalizations that have occurred over the past 2-3 years. While at one time, this problem was limited to a few pockets on the west coast, weRead More →
Recently, Dr. Venkatesh Thiruganasambandamoorthy et al published the Canadian Syncope Risk Score, for the assessment of adult patients with syncope. He has previously helped provide some insight into the decision rule, and we now present an infographic and memory aid to help recall the score!Read More →
Journal Club Summary Seymour CW, et al. Journal N Engl J Med. 2017 Jun 8;376(23):2235-2244. EDITORIAL: State Sepsis Mandates – A New Era for Regulation of Hospital Quality. Hershey TB, et al. N Engl J Med. 2017 May 21. Methodology Score: 3.5/5 Usefulness Score: 3/5 This large retrospective review ofRead More →
Physiologically difficult airway: airway management in the critically ill patient, whose underlying physiology puts them at higher risk of cardiovascular collapse with intubation and conversion to positive pressure ventilation. This is important for in the Emergency Department as airway management is fundamental in the care of critically ill patients, butRead More →
Describe the pathophysiology of Pulmonary Hypertension (PH), and how it can be dangerous Who to suspect and workup for PH in the ED Describe the POCUS findings in PH Describe the management of these patients and how to avoid causing harm Physiology Definition Pulmonary hypertension (PH) is defined as aRead More →
Objectives: Explore the data for safety and efficacy of urgent blood pressure lowering in hemorrhagic stroke. Is there any benefit from management of elevated blood pressure in acute ischemic stroke that is not a candidate for tPA? What is the data for blood pressure target in subarachnoid hemorrhage awaiting definitiveRead More →
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4.5/5 D’Onofrio G, et al JAMA. 2015 Apr 28;313(16):1636-44. Full Article This single, urban center RCT including 329 patients showed that buprenorphine initiated in the ED was more likely to increase engagement in addiction care at 30 days (78%) compared to referralRead More →
Journal Clubs Summary Methodology Score: 3/5 Usefulness Score: 3.5/5 Rehrer MW, et al. Ann Emerg Med. 2016 Nov;68(5):608-613. Abstract Link This single centre, randomized, triple-blinded, control trial did not demonstrate noninferiority of a single dose of dexamethasone compared to standard 5 day course of prednisone for adult asthma exacerbations. InRead More →
What is Quality Improvement (QI)? You have all heard the latest buzzword in healthcare: “quality improvement”, or QI. Yet many healthcare professionals still only have a vague idea of what that truly means, and likely an even poorer understanding of how it might apply to their frontline practice. Conceptually, QIRead More →