What a headache: Updates on Migraine Management
Migraine headaches are not a benign disease – they have a significant impact on quality of life, ability to function, and pose a considerable economic and societal burden. Prevalence tends to peak during peoples’ period of highest productivity. According to the World Health Organization’s (WHO) update on Global Burden of Disease (2004), a severe migraine is considered to be as disabling […]
Let’s talk about some drugs
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, think about how you are going to treat it. Thought about […]
Anxiety, Depression and Everything in Between
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 helpful for these patients, or we end up consulting psychiatry for […]
Pulmonary Embolism in Pregnancy: Diagnostic Dilemmas
Epidemiology of pulmonary embolism in pregnancy The rate of pulmonary embolism (PE) in pregnancy is 5.4 per 10 000 pregnancies. This is 5x the risk of the general non-pregnant female population The rates of venous thromboembolism change throughout pregnancy: Antepartum: 5.4 per 10 000 Peripartum: 7.2 per 10 000 Postpartum: 4.3 per 10 000 This leads to 0.96 deaths per 100 […]
Learning during COVID-19
During the COVID-19 pandemic, one of the challenges facing residents is continuing to receive high-quality learning during their training. Difficulties such as transitioning to a virtual platform, protecting residents from certain aerosol-generating procedures, and decreased patient volumes make it challenging for learners compared to the pre-COVID era. Here, we explore some strategies to help ensure that residents are progressing along […]
Solid Organ Donation from the Emergency Department – Missed Donor Opportunities
In this post, we aim to highlight the perspectives of family, physicians, the emergency department and pre-hospital medicine in regards to organ donation. Types of Organ Tissue Donation There are 2 main types of deceased organ donation including neurologic determination of death and donation after circulatory determination of death. Neurologic determination of death includes a very strict set of criteria […]
End-of-life care in the ED related to COVID-19
Hot off the press from CJEM; End-of-life care in the Emergency Department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19).
Guidelines for Emergency Airway Management of COVID-19
Guiding Principles Suspected SARS-COV-2 patients showing signs of hypoxemic respiratory failure should be intubated proactively, as early as possible. Signs may include FiO2 requirement > 50%, clinical signs of respiratory fatigue despite supplemental oxygen, or hemodynamic instability. Do not wait for rapid deterioration to act! Such unstable respiratory failure patients in the ED – whether under the care of Emergency […]
You’re a doctor, Harry! Welcome to residency
It’s July 1st. A brand new gaggle (gaggle: a flock of geese when not in flight) of residents has started at the hospital. The beginning of residency is a pretty stressful time, especially when the last few months of med school were on zoom. This year is certainly a little extra special. The end of med school is supposed to […]