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Reporting QI Results Part 1 – Run Charts

In Featured, HiQuiPsby Ahmed TaherLeave a Comment

You are attending your first Quality Committee meeting in your ED. The team is discussing a project they have been working on to decrease unnecessary urine cultures at the urgent care centre associated with the ED. The team has already created a project charter with an appropriate aim statement​1​. They have engaged the appropriate stakeholders and found the best practices for ordering urine cultures in uncomplicated urinary tract infections (UTIs)​2​. The team found …

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Testicular Torsion

In Medical Conceptsby Subhrata VermaLeave a Comment

Case:  18-year-old Arthur comes to the emergency department complaining of sudden onset pain in his testicles that woke him up at 4 am.  Arthur had noticed that part of his testicle appeared swollen when he awoke. This concerned him, since he didn’t remember an injury. He tried applying ice, but after a while of no relief, his parents drove him to the local ED. His pain has increased and is now (at 7 …

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Special HiQuiPs Post – Choosing Wisely Canada and Quality Improvement

In Education & Quality Improvement, HiQuiPsby Ahmed TaherLeave a Comment

Welcome to another HiQuiPs post! This is the first in a series of posts highlighting Choosing Wisely, an international movement that addresses unnecessary tests and treatments, which has spurred many local, national, and international QI initiatives.  In our last post, we discussed variation in the efficiency of medical processes and how this can be attributed to random or non-random (special cause) variation. Variation can be seen throughout different processes in the ED. For …

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Substance use in the ED: Alcohol Use Disorders and the Emergency Department

In Clinical Questions, Medical Conceptsby Gaibrie StephenLeave a Comment

Think back to your last three shifts. Did you see an alcohol related condition? You might even notice a pattern— the same patient, the “regular” who returns time and time again with the same presentation. You may even find yourself writing “discharge home when ambulatory” as you’ve “reached your wits end” and don’t know what to do anymore.  The use of alcohol is common and the emergency department is often where we see …

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Tiny Tips: OSTRICH as a differential for acute monoarthritis

In Tiny Tipsby Fareen Zaver MDLeave a Comment

Acute monoarthritis is a common complaint in the emergency department. The differential for acute monoarthritis is broad. A delay in proper diagnosis and treatment of certain etiologies can result in significant morbidity.​1,2​ The evaluation of a patient with acute monoarthritis should begin with a focused history and physical exam which will guide further laboratory and radiographic studies. With a history of trauma or focal bony pain, radiography can be useful to rule out …

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Case Report: Penetrating Chest Trauma in the Game of Thrones

In Case Series, Medical Conceptsby Will WuLeave a Comment

This is the 4th episode of the Game of Thrones case series examining penetrating chest trauma. Be sure to review Hypothermia and Traumatic Arrest in Game of Thrones, Toxin-Induced Cardiac Arrest in Game of Thrones and Pregnancy and Trauma in Game of Thrones. This post contains spoilers from Game of Thrones Season 8! Patient Presentation and History A 23-year-old female was seen unresponsive with a single penetrating wound to the left anterior chest. …