Can’t Miss Diagnoses Epidural hematoma Subdural hematoma Acute on Chronic Subdural Hematoma Other Intracranial Hemorrhage (ICH) Basilar Skull Fracture Le fort Fractures of midface (I, II, III) Early COVID-19 may present with mild and subtle symptoms (headache, myalgias) make sure you consider this when receiving a trauma patient. See “Headache” section for more on other benign causes of headaches. History Trauma/head injury history – AMPLE – Allergies, Medications, PMHx, Last oral intake, Exposures …
CanadiEM Frontline Primer – Trauma – Primary Survey
Can’t Miss Diagnoses Multisystem Trauma REMEMBER: Trauma violates the Occam’s Razor approach to diagnosis. Unlike multiple-choice questions, multi-system trauma patients require a methodical approach from head to toe. A basic approach will be the classic Advanced Trauma Life Support (ATLS) approach. ALSO REMEMBER: Early COVID-19 may present with mild and subtle symptoms (headache, myalgia, etc.) make sure you consider this when receiving a trauma patient. There is enough community spread that trauma patients …
CanadiEM Frontline Primer – Skin and Soft Tissue Infections
Introduction Skin and soft tissue infections are a common chief complaint and continue to be an increasingly common chief complaint in the emergency department.1–4 Abscess and cellulitis are the two most common conditions encountered, but it is important to have a high clinical index of suspicion for some of the true cutaneous emergencies. Currently, there are no cases of COVID-19 with ONLY cutaneous symptoms. Make sure to complete a good review of systems …
CanadiEM Frontline Primer – Lower Leg Swelling
Can’t Miss Diagnoses Unilateral Acute DVT (proximal, isolated distal) Arterial Occlusion Cellulitis MSK Septic Joint Bursitis Fracture Ruptured Baker’s Cyst Compartment Syndrome Superficial Thrombophlebitis Necrotizing Fasciitis HematomaMyositis Bilateral Acute Bilateral DVT Cellulitis CHF Exacerbation Constrictive Pericarditis AKI Nephrotic Syndrome IVC Thrombosis Medication Adverse Event Preeclampsia Considerations in the age of COVID-19 for your safety: Many individuals with COVID-19 can present entirely asymptomatically, without cough or fever. If the rate of COVID-19 is high …
CanadiEM Frontline Primer – Early Pregnancy – First Trimester Bleeding
Can’t Miss Diagnoses First Trimester Bleeding: Miscarriage (formerly known as spontaneous abortion) Ectopic pregnancy Infection Cervical/vaginal lesions Trauma Coagulopathy Points to focus upon Hx: Last Menstrual Cycle Determine if patient has been on fertility treatments, which will elevate their risk of heterotopic pregnancy (a concurrent intrauterine AND ectopic pregnancies) to roughly 1:200 (much more common than normal rates which are closer to 1:10,000). Prenatal care & screening, prenatal vitamins Screen for other first …
CanadiEM Frontline Primer – MSK – Joint Pain
Can’t Miss Diagnoses Septic Arthritis Trauma Also, assess overlying soft tissues for infections which can also be very life-threatening (e.g. Necrotizing Fasciitis). Open Joint Prosthetic Joint Infection MIMICS Gout Rheumatoid arthritis Osteoarthritis Hemarthrosis Dislocations DDx for Monoarticular Arthritis O – OsteoarthritisS – Septic arthritisT – Tumor in nearby bone / TraumaR – Rheumatic & autoimmune diseaseI – Intra-articular pathologyC – Crystal arthropathy (Gout, pseudogout)H – Hemarthrosis More details here! DDx for Prosthetic Joint …