Methodology: 3/5 Usefulness: 2.5/5 Butler CC, et al. N Engl J Med. 2019 Jul 11;381(2):111-120 Editorial: COPD Exacerbations – A Target for Antibiotic Stewardship. Question and Methods: This was a multicenter RCT to determine if POCT CRP testing vs usual care may help safely reduce unnecessary use of antibiotics. Findings: Antibiotics wereRead More →
Your friendly neighborhood Emergency doctor here with a message for Canadians. Hey Canada, sitting here on the frontlines – we see you. Staying home, helping to gather PPE, supporting us, and feeding us, you’re helping us to do our jobs. When we see you helping to support frontline workers, itRead More →
Hot off the press from CJEM; End-of-life care in the Emergency Department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19).Read More →
Guiding Principles Suspected SARS-COV-2 patients showing signs of hypoxemic respiratory failure should be intubated proactively, as early as possible. Signs may include FiO2 requirement > 50%, clinical signs of respiratory fatigue despite supplemental oxygen, or hemodynamic instability. Do not wait for rapid deterioration to act! Such unstable respiratory failure patientsRead More →
Methodology Score: 4/5 Usefulness Score: 4/5 Schüpke S, et al N Engl J Med. 2019 Oct 17;381(16):1524-1534. Editorial: Ticagrelor or Prasugrel in Acute Coronary Syndromes – The Winner Takes It All? Question and Methods: This open-label multicenter trial was the first head-to-head trial examining Ticagrelor vs Prasugrel as part ofRead More →
Some helpful tips on how to #StayHome but maintaining your sanity while practicing social distancing!Read More →
What is Bupropion? Bupropion is an anti-depressant commonly prescribed for seasonal affective disorder, as a smoking cessation aid, and off-label in the management of major depressive disorder. You may know it by the trade names Wellbutrin, Zyban or Champix. While frequently compared to SSRIs, it has a unique mechanism ofRead More →
Methodology: 4/5 Usefulness: 3/5 Fujii T, et al. JAMA. 2020 Jan 17. doi: 10.1001/jama.2019.22176. [Epub ahead of print] Editorial: Lack of Benefit of High-Dose Vitamin C, Thiamine, and Hydrocortisone Combination for Patients With Sepsis. Question and Methods: International, multicenter, open-label RCT to determine whether HAT (hydrocortisone, ascorbate, thiamine) compared withRead More →
As Bob Dylan once said; “Times, they are a-changin’”. With respect to the novel coronavirus-19 (COVID-19), the situation in Canada and around the globe is changing rapidly and aggressively. As part of the first responder network, Emergency Departments (ED) and it’s health care teams are in a powerful position toRead More →
Here we present part two on our series on hypothermia. For more on the assessment, resuscitation, and management of the hypothermic patient, see part one. Prognostication of cardiac arrest in hypothermia Indicators of cardiac arrest before cooling (Brown 2012) Major trauma Witnessed normothermic arrest Avalanche burial <35 min Patients withRead More →