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 →
In this post, we discuss the pharmacology, myths, and a myriad of roles for Ketamine in the ED; including analgesia, sedation, agitation, alcohol withdrawal, and suicidal ideation. Part I: Pharmacokinetics and pharmacodynamics of ketamine Produced in 1970s, structurally related to PCP Use declined with: advent of propofol, increasing documented casesRead More →
Do you often get the components of scapholunate instability mixed up? Do you find this a tough one to teach to residents? Dr. Hendin has you covered – here she provides an great graphic to fully explain the Mayfield classification (scapholunate instability).Read More →
Methodology Score: 3.5/5 Usefulness Score: 4/5 Babl FE, et al. Lancet. 2017 Jun 17;389(10087):2393-2402. Question and Methods: This prospective observational study sought to externally validate and subsequently compare the relative performance of the PECARN, CATCH, and CHALICE paediatric head injury CDRs. Findings: The validation cohort demonstrated a sensitivity of 100%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 →
In this post, we will review several recent updates related to pre-hospital medicine. Specifically, we will: Review the role of tranexamic acid (TXA) in pre-hospital trauma Discuss the use of ketamine in Excited Delirium Examine the new Ottawa ROSC bypass protocol and new modifications to the Trauma bypass protocol forRead 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 →
Methodology Score: 3/5 Usefulness Score: 3/5 Nazerian P, et al. Circulation. 2018 Jan 16;137(3):250-258. Editorial – Biomarker-Assisted Diagnosis of Acute Aortic Dissection. Question: The ADvISED trial was an International Multicenter prospective observational study of a novel diagnostic strategy that integrated the Aortic Dissection Detection Risk Score (ADD-RS) and D-Dimer in an ED population to rule outRead More →