Sudden cardiac arrest represents a significant cause of morbidity and mortality worldwide. Over 356,000 out-of-hospital cardiac arrests (OHCA) occur annually in the United States, with resuscitative efforts extending into the Emergency Department (ED) for many of these patients. Prognosis remains dismal, with death occurring in 92%. Background WhileRead More →
Journal Club Summary Methodology: 3/5 Usefulness: 3.5/5 Annane D, et al. N Engl J Med. 2018 Mar 1;378(9):809-818. Editorial: A Role for Hydrocortisone Therapy in Septic Shock? Question and Methods: Large multi-center, double-blinded, randomized-controlled trial comparing effects of steroids (fludrocortisone + hydrocortisone) to placebo on 90-day mortality of ICU patientsRead More →
Mechanical CPR is a technology whereby a machine performs chest compressions in place of a human provider. These devices are becoming increasingly prevalent in the prehospital and in-hospital arenas, and it is inevitable that healthcare providers will interact with them in some capacity. Given the variable evidence in the literature,Read More →
Hemorrhage is the leading cause of preventable death on the battlefield. Damage Control Resuscitation (DCR) works synergistically with Damage Control Surgery (DCS) and prioritizes non-surgical interventions that reduce morbidity and mortality due to trauma and hemorrhage. DCR aims to restore homeostasis and prevent or mitigate tissue hypoxia and coagulopathy. ThisRead More →
We’re familiar with sodium bicarbonate as a simple buffer solution, which has been utilized for a myriad of medical indications backed up by physiologic rationale and occasional moderate-quality evidence. It comes in two forms; vials (typically for infusions) and pre-filled syringes (pushed in cardiac arrest). There have been on-an-off shortagesRead More →
In this post, we will aim to review the literature looking at identifying clinical and historical features that can help differentiate stroke mimics from strokes. We will also discuss the safety of the administration of IV tPA to misdiagnosed stroke mimics. This post will not focus on the recent developmentsRead More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Jabre P, et al. JAMA. 2018 Feb 27;319(8):779-787. Question and Methods: This was a multicenter randomized trial comparing bag valve mask ventilation with endotracheal intubation performed by emergency physicians in 2043 patients with out-of-hospital cardiac arrest in France and Belgium Findings: Their primary outcome ofRead More →
Non-purulent skin and soft tissue infections (SSTIs; i.e. cellulitis or erysipelas) account for up to 3% of all emergency department (ED) visits. Once the diagnosis of a non-purulent SSTI is made, the emergency physician must select the appropriate antibiotic agent, dose, duration and route (oral or intravenous (IV)). Current guidelinesRead More →
Syncope constitutes 1% of Emergency Department (ED) visits, and approximately 10% of these patients will have serious underlying conditions causing syncope (arrhythmia, MI, serious structural heart disease, pulmonary embolism, subarachnoid or severe hemorrhage). Alarmingly, half to one-third of these serious conditions will not be identified during ED evaluation. We previously derived theRead More →
In 2018, CAEP endorsed the creation of a Wellness Committee, led by Drs. Roderick Lim (chair), Sara Gray (vice-chair), Louise Rang (communications), Lisa Fischer (secretary), Jada Fitzpatrick (resident representative). To conclude the Canadian EM Wellness Week, the executive of the committee has put together some reflections on the importance ofRead More →