Journal Club Summary: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al N Engl J Med. 2018 Jul 18. Editorial: Testing Epinephrine for Out-of-Hospital Cardiac Arrest. Callaway CW, et al. N Engl J Med. 2018 Jul 18. Question and Methods: Multicenter, randomized,Read More →
When we are caring for a septic patient in the ED, we know that aggressive care with early antibiotics and ensuring adequate preload saves lives. But what do we do when we aren’t sure if more fluid will help any longer? How can we finesse our fluid management in theRead More →
Journal Club Summary Methodology: 3.5/5 Usefulness: 3.5/5 Moore HB, et al. Lancet. 2018 Jul 28;392(10144):283-291. Editorial: No gains with plasma-first resuscitation in urban settings? Question and Methods: Use of prehospital plasma in patients with hemorrhagic shock before arrival at an urban level 1 trauma center.Read More →
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 →