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Boring Question: What is the role of xanthochromia in ruling out SAH?

In Clinical Questions by Patrick Bafuma6 Comments

The Case Your first patient of the shift is a 19-year-old male with “the worst headache ever.” His mother states she’s quite worried because he “never gets headaches.”  He had some slight nuchal rigidity, but is afebrile.  And as such, you arranged a non-contrast CT Head, which was found to have a normal without signs of intracranial hemorrhage.  Now, 12 hours after onset of his headache, and after discussing the risk and benefits …

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Boring Question | Are wound closure strips an acceptable alternative to tissue-adhesives?

In Clinical Questions by Patrick Bafuma1 Comment

Your next patient is a seven-year-old boy with a 3 cm linear laceration to his calf that he sustained sliding into second base during his little league baseball game. The patient was seen 3 months ago for a facial laceration that was repaired with sutures according to his mother. She reports he was very uncomfortable with the stitches last time, and would like to know “if there is some other way to do …

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Boring Question | Does this pediatric patient require a hard cast ?

In Clinical Questions by Patrick Bafuma2 Comments

It is a typical day in Fast Track, and you have a 8 year old who fell off their skateboard with a distal radius fracture that is commonly referred to as a “Buckle fracture” (AKA torus fracture). The child is very upset and concerned about having their arm splinted / casted given that they plan on spending a lot of time in a swimming pool this summer. You wonder, does this patient require …

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Boring Question: Does my patient require admission for IV antibiotic administration?

In Clinical Questions by Patrick Bafuma8 Comments

We have all had a patient or two request admission for intravenous antibiotics. Usually, the argument is that IV administration is better because it ‘gets into the blood more quickly’. In fact, many of us have made that argument ourselves, or heard it from our peers. But, what if I told you that many of your favourite antibiotics have similar pharmacokinetic properties regardless of the route of administration? What if I also showed …