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 […]

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 […]

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 […]

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. […]

Part II: COVID-19, making sense of the numbers

In the current age of the COVID pandemic, we find ourselves inundated with headlines and millions of daily social media posts on COVID-19. For the frontline healthcare worker, the massive amount of online information can be overwhelming, and for the general public, it often feels as though they are being plunged into anxiety and panic. The goal of these articles […]

Nurse-Led ACLS

What is nurse-led ACLS (Advanced Cardiac Life Support)? A resuscitation model where a nurse takes on a leadership role coordinating and running the ACLS algorithm as part of the overall resuscitation effort. Nursing leadership has always played an integral role in hospital resuscitations, however, it has traditionally been in an unofficial capacity. Nurse-led ACLS is a concept that has been […]