The Bottom Line: Hemorrhoids and Anal Fissures in the ED

Anorectal issues commonly present to the Emergency Department (ED), however, the evidence around many of these conditions is sparse and practice varies widely. ED providers should have a grasp on the management and disposition of common anorectal complaints. In part one of this two-part series we will be focusing on issues related to hemorrhoids and anal fissures. Where relevant, we […]

Wake Up! Awake Intubation in the ED

Here we seek to provide a guide on when to consider awake intubation in the Emergency Department (ED), with an approach to the procedure! The Difficult Airway When assessing patients who may require any form of airway intervention, we should be assessing for two main entities: Difficult anatomy. Ask yourself: Do I feel like intubation will be difficult? If intubation […]

Extreme Ownership: How to Own the Trauma Bay and Lead High-Stakes Resuscitations

In this post, we’re going to do something a little different. Instead of reviewing a specific Emergency Medicine topic, we’re going to discuss Leadership – How to lead your team and make things happen during a high-stakes resuscitation. As the Leadership principles are transferable between medical and trauma resuscitations, for brevity, we will refer in this article to trauma team […]

Evaluating Effectiveness of Nasal Compression With Tranexamic Acid Compared With Simple Nasal Compression and Merocel Packing: A Randomized Controlled Trial

Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Akkan S, et al. Ann Emerg Med. 2019 Jul;74(1):72-78 Question and Methods: Prospective RCT comparing compression with saline, compression with tranexamic acid, and nasal packing with merocel for anterior epistaxis. Findings: No difference in 15-minute bleeding cessation for TXA (91.1%) or packing (93.3%), v/s saline (71.1%).  Lower 24h rebleeding for TXA (86.7%) compared to packing (74%). Limitations: Blinding not […]

Coronary Angiography after Cardiac Arrest without ST-Segment Elevation

Methodology Score: 4.5/5 Usefulness Score: 3.5/5 Lemkes JS, et al. N Engl J Med. 2019 Apr 11;380(15):1397-1407. Editorial: Coronary Angiography after Cardiac Arrest – The Right Timing or the Right Patients? Question and Methods: Patients with out-of-hospital cardiac arrest (OHCA) and shockable rhythm, but without STEMI on ECG following ROSC were randomized 1:1 to either immediate angiography (within 2 hours) […]

Artificial Intelligence & Big Data in the ED

In today’s post, we seek to: Understand what artificial intelligence (AI) is Generate a basic understanding of how AI works Review applications of AI in the Emergency Department (ED): Patient care Predictive Analytics ED Operations Intelligence Intelligence represents the ability to perceive information, retain it as knowledge, and apply it towards adaptive behaviours within an environment or context. Evolution of Artificial Intelligence  Artificial […]