The Status on Status: Management of Status Epilepticus
Status epilepticus (SE) is considered one of the most common neurological emergencies with an estimated incidence of 20 cases/100,000 people worldwide. Just the facts The distribution is bimodal, peaking in patients <1 and >60 years old. In children, the cause is predominantly from febrile illnesses, with or without infection, and in adults it is largely secondary to acute damage from […]
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 […]
Complications of Assisted Reproductive Technology
Assisted reproductive technology (ART) is an evolving field with many therapies that have a common goal: to maximize the chance of pregnancy while minimizing the risk of multiple gestations. As the Canadian infertility rate approaches 15%, the use of ART is steadily increasing (1). In fact, 1-4% of all newborns in industrialized nations are conceived with assisted reproductive technology (2). […]
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 […]
Braving the Electrical Storm in the ED
This post takes a deep dive into the pathophysiology, presentation and management of electrical storm in the emergency department. The management focuses on patients with implantable cardioverter-defibrillators receiving multiple shocks, patients with polymorphic ventricular tachycardia and refractory ventricular fibrillation. Electrical storm (ES) has varying definitions in the literature depending on whether or not the patient has an ICD (an implantable […]
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 […]
Sepsis and Septic Shock
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 resuscitation(1,2). This definition of septic shock highlights the importance of factoring in both macrocirculatory (blood pressure) and microcirculatory markers (lactate) when treating patients. […]
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 […]