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Tiny Tips: ICH for ICH – Brain Herniation

In Medical Concepts, Tiny Tips by Amit PersadLeave a Comment

Brain herniation is a catastrophic sequela of increased intracranial pressure (ICP) or local mass effect from intracranial lesions. Different types of brain herniation can occur depending on the location of mass effect and how rapidly this mass effect develops.1 Any mass lesion, including hemorrhage, tumor, vasogenic or cytotoxic edema, trauma or infection can cause herniation. However spontaneous intracerebral hemorrhage (ICH) and traumatic brain injury (TBI) are common causes of herniation in the acute …

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Blood and Clots Series: My patient has a pulmonary embolism. Should I screen them for cancer?

In Blood & Clots, Medical Concepts by Eric TsengLeave a Comment

CanMEDS Roles addressed: Expert, Leader An 83 year old female presents for follow-up after completing 3 months of oral anticoagulant therapy with Rivaroxaban for her unprovoked deep vein thrombosis. She did some research online and heard about a link between venous thrombosis and cancer, and asks why you are not getting a CT scan to rule out malignancy. Should you screen her for cancer? If so, which tests are necessary? What is the …

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Wellness Criteria for P.E. (Practice Enjoyment)

In Infographics by Gerhard DashiLeave a Comment

Editors Note: As part of emergency medicine’s annual wellness week (#iEMWell18), Dr. Gerhard Dashi riffed off of the well known Well’s Criteria for Pulmonary Embolism to create the Wellness Criteria for Practice Enjoyment! Score yourself using our infographic to determine how likely it is that you are enjoying your practice! When to use the Wellness Criteria: The Wellness Criteria risk stratifies residents for P.E. (practice enjoyment) and provides an estimated pre-test probability. The …

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Narrative Medicine and Resilience in Emergency Medicine

In Opinion by Sarah Luckett-GatopoulosLeave a Comment

How do we treat suffering? It’s simple enough to trawl the depths of wisdom collected in Rosen’s. Journal clubs, podcasts, and blogs keep us abreast of the latest updates to evidence-based practice. There is no substitute for the experience gained on clinical shifts. Reading around cases we see in the Emergency Department helps. We may struggle to memorize every list, table, and pathway, but the material itself is pretty straightforward. It’s all laid …

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CAEP FEI | Ice Cream Rounds

In Featured, Featured Education Innovations (FEI) by Samantha Calder-SprackmanLeave a Comment

Mike is a first year resident who just experienced his first case of child abuse. Due to the pressures of the emergency department, he was unable to debrief about the case while on shift. Mike frequently relies on his co-residents to help him process and deal with these difficult cases, but knows others who don’t have that same support network. He wonders if there might be a better way for residents to support …

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Syncope: what (if any) investigations are required?

In Featured, Medical Concepts by Shahbaz SyedLeave a Comment

Syncope is a common problem encountered in the Emergency Department, and yet despite this there are few strong consensus guidelines, and significant practice variation. Here we seek to explore some of the evidence regarding syncope care. The vast majority of literature and recommendations on syncope in this post, are based upon the well patient who has a syncopal event and is now well again. The differential diagnosis in this scenario is actually fairly …