by emottawa | Feb 11, 2016 | Grand Round Summaries, Trauma
The principles behind spinal immobilization, including the utilization of backboards and cervical collars was derived from expert opinion in the 1960’s [1-3], and has never been subjected to a randomized controlled trial or high quality...
by emottawa | Feb 4, 2016 | Grand Round Summaries, Resuscitation
Fluids and antibiotics and lactate…. oh my! Sepsis management in the Emergency Department (ED) was revolutionized by the Rivers trial – a relatively small study showing a NNT of 6 with early goal directed therapy (EGDT). It heavily influenced the end-goals of...
by emottawa | Jan 13, 2016 | Cardiology, Grand Round Summaries
Have a crashing Left Ventricular Assist Device (LVAD) patient in your Emergency Department? Need some help? Want to challenge your residents? The following should help you in your bedside assessment and treatment of the critically ill LVAD patient. For a thorough...
by emottawa | Jan 6, 2016 | Grand Round Summaries, Resuscitation
You deftly sweep the tongue aside, slide into the vallecula, lift the epiglottis, and have a great view of the cords. You smoothly pass the tube, secure it, and walk away – a superstar. Meanwhile your nurses wonder “what now?” as your patient begins to wake up pulls...
by emottawa | Dec 18, 2015 | Grand Round Summaries, Toxicology
Acute alcohol intoxication and alcoholism are two separate and unique entities that we see regularly in the emergency department. As ER physicians, our role for the acutely intoxicated patient should focus on ruling out life threatening disease and ensuring their...
by emottawa | Dec 11, 2015 | Grand Round Summaries, Infectious Disease
Cellulitis and erysipelas – collectively referred to as skin and soft tissue infections (SSTIs) – are a seemingly simple entity to manage. Yet the burden of SSTIs and the complexity of this disease process may surprise you! From 1997 to...
by emottawa | Oct 16, 2015 | Grand Round Summaries, Toxicology
This isn’t your parent’s marijuana, thats for sure. As we continue to develop as a species, individuals are continuously attempting to develop newer and greater drug highs. As a result, the toxicologic world is continuously expanding, and in...
by emottawa | Sep 17, 2015 | Grand Round Summaries, Toxicology
The ED patient in acute severe pain can be a challenge to treat. Even when we prescribe opioids appropriately (which is less often than you think), patient contraindications, side effects, and a poor analgesic response may limit their use. There is lots of new...
by emottawa | Aug 27, 2015 | Grand Round Summaries, Hematology
Platelets: too much, too little, don’t work. The approach to platelet emergencies is perhaps a little bit more complicated than that, so we attempt to breakdown a simplified approach to platelets in the Emergency Department (ED). Patients with various disease...
by emottawa | Aug 14, 2015 | Grand Round Summaries, Radiology
Undifferentiated abdominal pain; three words that give every Emergency Physician (EP) the shivers. Plain abdominal X-Ray’s (AXR) are a commonly ordered test in the Emergency Department (ED). Does the AXR play any role in the diagnostic workup of constipation? As CT...
