Case: You are the emergency physician taking care of a 45-year-old male who has a background history of hypertension and dyslipidemia for which he is on a ACEi and a statin. He presents with 2.5 hours of ongoing non-radiating chest discomfort while at work. His presenting ECG shows normal sinus rhythm without ischemic changes. His initial high-sensitivity troponin T (hs-cTnT) […]
Status epilepticus (SE) is considered one of the most common neurological emergencies with an estimated incidence of 20 cases/100,000 people worldwide. Just the facts The distribution is bimodal, peaking in patients <1 and >60 years old. In children, the cause is predominantly from febrile illnesses, with or without infection, and in adults it is largely secondary to acute damage from […]
Migraine headaches are not a benign disease – they have a significant impact on quality of life, ability to function, and pose a considerable economic and societal burden. Prevalence tends to peak during peoples’ period of highest productivity. According to the World Health Organization’s (WHO) update on Global Burden of Disease (2004), a severe migraine is considered to be as disabling […]
It’s July 1st. A brand new gaggle (gaggle: a flock of geese when not in flight) of residents has started at the hospital. The beginning of residency is a pretty stressful time, especially when the last few months of med school were on zoom. This year is certainly a little extra special. The end of med school is supposed to […]
Assisted reproductive technology (ART) is an evolving field with many therapies that have a common goal: to maximize the chance of pregnancy while minimizing the risk of multiple gestations. As the Canadian infertility rate approaches 15%, the use of ART is steadily increasing (1). In fact, 1-4% of all newborns in industrialized nations are conceived with assisted reproductive technology (2). […]
Here, we seek to explore some controversial, poorly known, or irrelevant drugs in medicine in a menagerie of drug cocktails. 1. What drugs best treat SVT? A patient presents with the following rhythm strip, they’re totally stable, on no medications and with no significant medical problems. Take a minute, think about how you are going to treat it. Thought about […]
In the past 5-10 years we have seen a significant increase in mental health-related complaints in the Emergency Department (ED), and during COVID this is especially noticeable. Historically, we’ve classically been taught to focus on performing safety assessments, and as a result, we don’t often end up doing anything helpful for these patients, or we end up consulting psychiatry for […]
Epidemiology of pulmonary embolism in pregnancy The rate of pulmonary embolism (PE) in pregnancy is 5.4 per 10 000 pregnancies. This is 5x the risk of the general non-pregnant female population The rates of venous thromboembolism change throughout pregnancy: Antepartum: 5.4 per 10 000 Peripartum: 7.2 per 10 000 Postpartum: 4.3 per 10 000 This leads to 0.96 deaths per 100 […]
Trust the Process
“Trust the process” – a promise that our assistant Program Director (PD), Jen Leppard, makes on our first day of the EM year. I am new here, and I am nervous. But, as I walk into the ED, this feeling quickly vanishes, as I am reminded of what drew me to Ottawa in the first place – the teaching. Throughout […]