A 64 year old woman presents to the emergency department with dyspnea. On exam she is mildly tachypneic, has an oxygen saturation of 94% on 2L nasal prongs, and bilateral crackles to auscultation. You suspect acute heart failure and wonder about the role of lung ultrasound as you await her chest x-ray. Clinical question: What is the sensitivity and specificity of lung PoCUS compared to chest radiograph for diagnosis of acute decompensated …
CJEM Visual Abstract: IV Prostaglandin to Reduce Digital Amputations in Frostbite
In this issue, we collaborated with the CJEM team to create a visual abstract on the article “Effectiveness of intravenous prostaglandin to reduce digital amputations from frostbite: an observational study”.1 When we are dealing with frostbite in the ED, traditionally, management is focused on re-warming (of both an extremity, or simply the entire patient!). Depending on severity and patient characteristics, the question is whether or not amputation is required to debride necrotic tissues …
Clinical Question: Can stable patients presenting to the emergency department with blunt abdominal trauma be managed safely without a CT scan?
You are working in a rural Emergency Department (ED). You assess a 25-year-old male patient who crashed his car into a tree. Vitals are normal and GCS is 15. Airway is patent and protected. There is bilateral chest rise, no abdominal tenderness or seatbelt sign. Pelvis is stable, and you notice some swelling over his right wrist. What is Blunt Abdominal Trauma? Blunt abdominal trauma is an injury to the abdomen without an …
The Many Paths to Emergency Medicine in Canada
What is an emergency medicine doctor? The answer likely differs between a major academic centre and a rural hospital. Perhaps the simplest definition is any physician who staffs an emergency department (ED). When it comes to training, emergency medicine (EM) certainly holds the title of most heterogeneous specialty in Canada. While some physicians complete a five-year residency in EM and are Royal College certified, others complete a one-year EM fellowship after two years …
Call for Junior Editors, Class of 2022-23!
We are pleased to announce that CanadiEM is now accepting applications for our Junior Editor program! If you are interested in learning more about Free Open Access Medical Education (FOAM) or becoming part of our virtual community of practice,1 this program is for you. The application deadline is October 31, 2022. We are currently looking for applications for our blogs, infographics, newsletter, and social media teams. What are Junior Editors? The role of …
ABCDE Approach
The ABCDE approach applies to the initial assessment of critically ill patients. For each step, appropriate treatment should be started regardless if there is a definitive diagnosis. Airway1–3 Fatal in minutes. Think of this separately from breathing! Consider what would you do if the airway became threatened, e.g. Have you assessed for predictors of difficult airway management? Assessment Management ● Determine if patient can speak.● Inspect for secretions or foreign bodies.● Check for …