Methodology: 2.5/5 Usefulness: 3/5 Daley JI, et al. Acad Emerg Med 26 (11), 1211-1220 Nov 2019 Questions and methods: In patients with abnormal vital signs, what is the sensitivity of FOCUS for the diagnosis of PE? Prospective, multicenter, observational study. Findings: 136 patients with pendingRead More →
Methodology: 3/5 Usefulness: 2.5/5 Gaydos CA et al. Ann Emerg Med. 2019 Jul;74(1):36-44. doi: 10.1016/j.annemergmed.2018.09.012. Epub 2018 Nov 2. Question and Methods: RCT of women receiving pelvic testing for CT/NG comparing standard of care test (NAAT) vs. POC test (GeneXpert). Treatment was at the discretion ofRead More →
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 newbornsRead More →
Methodology: 3/5 Usefulness: 3/5 Twerenbold R, et al. J Am Coll Cardiol. 2019 Jul 30;74(4):483-494. Editorial: Evaluating Suspected Acute MI in the Emergency Department: What Is and What Should Never Be. Question and Methods: Prospective international study of the impact on management and patient safety using theRead More →
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, thinkRead More →
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 helpfulRead More →
This post takes a deep dive into the pathophysiology, presentation and management of electrical storm in the emergency department. The management focuses on patients with implantable cardioverter-defibrillators receiving multiple shocks, patients with polymorphic ventricular tachycardia and refractory ventricular fibrillation. Electrical storm (ES) has varying definitions in the literature depending onRead More →
The Surviving Sepsis Guidelines define sepsis as a “life-threatening organ dysfunction caused by a dysregulated host response to an infection”. Septic shock is further defined as sepsis with hypotension (MAP ≤65) and/or lactate ≥2.0 despite adequate fluid resuscitation(1,2). This definition of septic shock highlights the importance of factoring in bothRead More →
Methodology: 3/5 Usefulness: 3/5 Butler CC, et al. Lancet. 2020 Jan 4;395(10217):42-52. Editorial: Neuraminidase inhibitors for influenza-like illness in primary care. Question and Methods: This was a pragmatic randomised controlled trial of 3266 patients, where patients were randomised to either usual care or usual care with oseltamivir. Findings: Symptom durationRead More →
Fear, while on a mission (see below for a French translation). It was not that long ago, my husband was strapped on a missile (on purpose) at the Baikonur Cosmodrome in Kazakhstan. I sat in the dirt at 17:21, on the bare Kazak Steppes, eyes focused on the Soyuz RocketRead More →