Procedural sedation is commonly performed in the Emergency Department. It is a critical tool that helps facilitate unpleasant but often necessary procedures that our patients would otherwise not tolerate. However, procedural sedation is also an extraordinarily resource-intensive endeavor. Most often, it requires cardiac monitoring and many interprofessional personnel. Also, despiteRead More →
Conversion Disorder Functional Neurological Disorder is not a diagnosis of exclusion. It is a diagnosis based on positive clinical features. Definitions: Medically Unexplained Physical Symptoms (MUPS) Patient complaints and symptoms for which no medical etiology is identified Somatic Symptom Disorder Somatic symptoms that are distressing to a patient for at least 6Read More →
In the Emergency Department (ED) we’re always thinking about the “ABC’s”. You’ve also probably heard of “DEFG: Don’t Ever Forget Glucose”. This usually refers to hypoglycemia in our critically ill patients—those with decreased level of consciousness, new onset seizures, sepsis, and so on. But what about hyperglycemia? Much ink hasRead More →
Medical Assistance in Dying, or MAiD, was first legalized in Canada in 2016. At first glance, it may have seemed that this legislation, while an important step in Canadian medical care, would have fairly little impact on our practice in the Emergency Department (ED). However, as the ED is theRead More →
Emergency medicine is a diverse specialty. We’ve all had the shift where you go from suturing an elderly woman’s scalp, to managing an anxious patient with chest pain, to running a cardiac arrest as EMS patches in with a trauma. We wear many hats throughout a single shift and it’sRead More →
Let’s start off with a case: 29 year old male, HR: 140, BP: 70/40, Temperature of 39.1. Sounds like straight forward, bread-and-butter emergency medicine doesn’t it? That is, until you look at the past medical history: Single Ventricle Hypoplastic RV Left AV Valve Atresia Large Ventricular Septal Defect Patent FormalRead More →
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 →