The vast majority of burns that present to the ED can be managed as outpatients1,2, usually by the patient’s family doctor, but many emergency physicians do not feel comfortable with burn management. Burn management often follows the preferences and experiences of plastic surgeons, so the overarching caveat for everything belowRead More →
Consider world champion tennis player Roger Federer. He represents one of the most successful professional athletes of our time. To what does he owe his success? While he undoubtedly possesses a remarkable amount of motivation, dedication, and athleticism, there is another factor to consider. He has a coach. In fact,Read More →
Chest pain is a common presenting complaint to Emergency Departments (ED) worldwide. Massive resource investment is required to differentiate benign from sinister causes of chest pain, and for the treatment, referral, and risk stratification of chest pain patients. A cardiac etiology of chest pain is found in roughly 15% ofRead More →
TCCC (Tactical combat casualty care) outlines the priorities of care for casualties in combat applications Nearly 90% of combat fatalities occur before reaching a medical treatment facility Prehospital phase is the focus of efforts to reduce deaths in combat TCCC Working Group includes trauma surgeons, EM physicians, internists, family physicians,Read More →
Most clinicians are familiar with and utilize the Glasgow Coma Scale (GCS) on a daily basis, but many are not aware of the updates and additions to the score that were made in 2014 and 2018, respectively. Clarifications in the wording of the scale attempt to increase the ease ofRead More →
Patients who receive solid organ or stem cell transplants are complex, but we see them frequently in the Emergency Department! This review summarizes the physiology of transplant and a few of the key issues to be aware of in these patients. Transplant by the numbers Locally, in Ottawa, there areRead More →
In this post, we will review the anatomy, essential history, and common presentations of tracheostomy patients in the ED, including obstruction, decannulation, bleeding, tracheal stenosis, and infection. Anatomy of a tracheostomy tube Outer cannula Sits directly in the tracheal stoma Proximal end designed to allow tube to be easily securedRead More →
Methodology: 3.5/5 Usefulness: 4/5 Albers GW, et al. N Engl J Med. 2018 Jan 24. Journal Club Bottom Line Question/Methods: This was a multicentre, prospective, randomized, open label, blinded outcome trial comparing thrombectomy + medical therapy vs medical therapy alone in patients with delayed presentation (6-16 hours) of proximal MCARead More →
Urgent care presents a specific set of challenging clinical questions for the emergency physician. Often, seemingly mundane presentations will leave us questioning whether or not we have managed a case appropriately. Our decision-making can be highly influenced by the long lasting effects of dogma, clinical anecdotes, or historical studies ofRead More →
Sickle Cell Disease (SCD) is a complex medical entity, associated with significant morbidity and mortality. Patients with SCD suffer from acute and chronic pain, along with a seemingly endless list of additional complications (from hemolysis and sequestration, to aplastic crises and acute chest syndrome). The associated morbidity of SCD isRead More →