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Sepsis and Septic Shock

Sepsis and Septic Shock

by Garrick Mok, Pascale King | May 7, 2020 | Critical Care, Featured, Grand Round Summaries, Infectious Disease, Resuscitation

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...
Hypothermia Part 2: Prognostication and Protocols

Hypothermia Part 2: Prognostication and Protocols

by Mark McKinney, Shahbaz Syed | Mar 12, 2020 | Featured, Grand Round Summaries, Resuscitation, Trauma

Here we present part two on our series on hypothermia. For more on the assessment, resuscitation, and management of the hypothermic patient, see part one. Prognostication of cardiac arrest in hypothermia Indicators of cardiac arrest before cooling (Brown 2012) Major...
Hypothermia: Keeping your cool when it gets cold

Hypothermia: Keeping your cool when it gets cold

by Mark McKinney, Shahbaz Syed | Mar 5, 2020 | Featured, Grand Round Summaries, Resuscitation, Trauma

Hypothermia results in slightly over one hundred deaths per year in Canada; typically as a result of primary hypothermia, frostbite and other cold exposure injuries (Toronto Public Health, 2014). In the United States, this is estimated at 1500 deaths annually...
Community Paramedicine: Behind the Scenes

Community Paramedicine: Behind the Scenes

by Jessica McCallum, Pascale King | Feb 20, 2020 | Featured, Geriatrics, Grand Round Summaries, Medical Education, Pre-Hospital, Quality Improvement

What is Community Paramedicine? The international round table on community paramedicine provides the following definition: “…a model of care whereby paramedics apply their training and skills in non-traditional community-based environments outside of the usual...
Emerging Updates in Septic Shock

Emerging Updates in Septic Shock

by Shannon Fernando, Kate O'Connell | Jan 30, 2020 | Critical Care, Grand Round Summaries, Resuscitation

In September 2018, Dr. Bram Rochwerg and I wrote a blog post on the treatment of patients with sepsis and septic shock. Much of this was based on the 2016 Surviving Sepsis Campaign (SSc) Clinical Practice Guidelines [1]. However, in a little over a year, significant...
Management of PEA: in need of resuscitation?

Management of PEA: in need of resuscitation?

by Bo Zheng, Alex Coutin | Jan 16, 2020 | Airway, cardiac arrest, Critical Care, Featured, Grand Round Summaries, Resuscitation

What is pulseless electric activity (PEA)? Pulseless electrical activity is diagnosed based on a patient having an organized, non-shockable rhythm and no palpable pulse.  However, PEA is not always a cardiac arrest state.  In many cases, patients with PEA have...
Borderline Personality Disorder – Part 2

Borderline Personality Disorder – Part 2

by Daniel Beamish, Pascale King | Dec 19, 2019 | Featured, Grand Round Summaries, mental health, psychiatry

This post is a continuation of Borderline Personality Disorder – Part 1. In this second post, Dr. Beamish discusses the management of BPD in the emergency department and shares some valuable resources. Borderline Personality Disorder – Part 2 Case 2 A 22...
Borderline Personality Disorder – Part 1

Borderline Personality Disorder – Part 1

by Daniel Beamish, Pascale King | Dec 12, 2019 | Grand Round Summaries, mental health, psychiatry

Borderline Personality Disorder (BPD) is a personality disorder that describes the emotional dysregulation, impulsivity, recurrent self-harm and suicidal behaviour experienced by many individuals. People suffering from this personality disorder frequently live chaotic...
E-cigarette and Vaping Associated Lung Injury (EVALI)

E-cigarette and Vaping Associated Lung Injury (EVALI)

by Harrison Carmichael, Pascale King | Nov 28, 2019 | Featured, Grand Round Summaries, Respirology, Toxicology

You may have seen the headlines; E-cigarette and Vaping Associated Lung Injury (EVALI) represent a new disease process that is potentially life-threatening. Emergency Physicians will inevitably be exposed to EVALI as front line health care providers. Here, we will...
We Need to Talk: Communicating with patients

We Need to Talk: Communicating with patients

by Erica Lee, Kate O'Connell | Nov 21, 2019 | Featured, Grand Round Summaries, Patient Advocacy

During your medical training, how many times did someone watch you talk to a real patient? What about explaining their diagnosis? Or how to take their medications? Have you had a conversation with a patient and felt that you weren’t “speaking the same language”? Good...
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