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 this post, we cover the often seen, but poorly understood entity of Interstitial Lung Disease (ILD). We will focus our discussion on the key features and approaches that the front-line provider needs to know to feel confident managing the newly diagnosed ILD patient, the ILD flare, and the crashingRead 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 →
Comprehensively discussing sepsis in the Emergency Department (ED) in a three-page blog is quite frankly, impossible. You would be hard-pressed to find a disease process that has undergone such dramatic change over the past two decades. Through it all, we still do not have a complete grasp of what sepsisRead More →
As we were preparing for our “Critical Care Week” here at the EM Ottawa Blog, I was thinking I should definitely tap into the knowledge of an ICU physician whom I know very well. That physician is also my awesome wife, Dr. Erin Rosenberg. She’s been a staff intensivist atRead More →