While virtual care has been used in several provinces for decades (1), during the COVID pandemic the use of these models of care increased. Virtual care may be structured in different ways, with differing access points and staffing structures (2). In this article, we focus on the model of the in-person emergency department staffed with nurses with a virtual emergency physician. Some emergency departments have made the difficult decision to close or reduce open hours as …
See (N)one, Do One, Teach One: Barriers in Teaching Cricothyrotomy
“Can’t Intubate, Can’t Ventilate” – a fearsome phrase for all airway providers that necessitates an equally fright-inducing procedure. Cricothyrotomy is an emergency procedure where an incision is made through the cricothyroid membrane and a tube is inserted for ventilation. Although there are percutaneous techniques, this article will discuss surgical techniques which have been shown to produce more favourable success, complication rates of the procedure, as well as address some common fears associated with …
How can artificial intelligence advance emergency medicine? A look at the current state
Nearly two years have passed since OpenAI unveiled ChatGPT, propelling artificial intelligence’s (AI) capabilities into the public spotlight and sparking a technological race to incorporate AI into virtually every field – from computer operating systems, to film writing, to ordering food at the drive-through. Beyond the excitement, large AI models have important pitfalls to pay attention to. Most importantly, the quality of its outputs is directly linked to the quality of its training …
FIRE SAFE: What are the indications for intubation in inhalational injuries?
Inhalational injuries occur as a complication of approximately one-third of burns and may lead to significant morbidity and mortality if not correctly managed.1 Inhalational injury to the upper airway can occur as a result of direct thermal injury, leading to airway swelling and necessitating the need for early intubation for airway protection.2 Inhalational injuries can also damage the lower airways due to exposure to smoke and other chemicals. Respiratory distress may be further …
An Approach to Undifferentiated Shock and Hypotension
Background Shock is a state of cellular and tissue hypoxia caused by reduced oxygen delivery or increased oxygen consumption. We tend to use the patients systolic blood pressure (SBP) as our main diagnostic test for shock as it is readily available and simple to assess. Therefore, patients with a SBP of 90 mmHg or less are considered to be in shock until proven otherwise. Caution should be noted for special populations such as pediatrics, geriatrics or hypertensive patients who have …
Recognizing and Managing Liver Failure in the ED
Donna is a 48-year-old female brought by EMS to your community ED after her roommates noticed her behaving erratically at home. They report she has been vomiting and become increasingly confused over the past 24 hours, now complaining of right upper quadrant discomfort. She was recently discharged from the hospital a week ago following an uncomplicated ankle ORIF. Donna’s roommates tell you she is otherwise healthy, but does consume two to three glasses …