View Post

When and how to treat hyponatremia in the ED

In Clinical Questions, Medical Concepts by Andrei SmarandacheLeave a Comment

Electrolyte imbalances like hyponatremia can be the cause of a variety of vague complaints. At the same time, patients may present with electrolyte abnormalities that are asymptomatic and are incidental findings on bloodwork. Here’s an approach to deciding when and how to treat hyponatremia in the emergency department. We also thank Drs. Joel Topf (@kidney_boy) and Dr. John Neary (@jddneary) for their valuable input on this article! The Case Marjorie, an 83-year-old female, …

View Post

CAEP FEI | The Nightmares Course at Queen’s University

In Education & Quality Improvement, Featured, Featured Education Innovations (FEI) by Andrew HallLeave a Comment

Lilly is a first year resident who is called by the floor nurse about an elderly gentleman who is “feeling unwell”. She walks into the room and notices he is wheezing and appears short of breath. Lilly starts feeling extremely anxious and is unsure of what she should do before rushing to find her staff. She wishes there was a course that would allow her to be exposed to these situations and become …

View Post

Case Report: Pregnancy and Trauma in the Game of Thrones

In Case Series, Medical Concepts by Will WuLeave a Comment

This is the 3rd Episode of the Game of Thrones Case Series. Be sure to also review Hypothermia and Traumatic Arrest in the Game of Thrones and Toxin-Induced Cardiac Arrest in Game of Thrones. Patient Presentation and History During the wedding of Edmure and Roslin, a young pregnant woman of unknown gestational age was found unresponsive with multiple abdominal stab wounds on the floor of the great hall at The Twins. Lord Frey allegedly planned …

View Post

Shocked? Hands On Defibrillation

In Medical Concepts by Sean McIntoshLeave a Comment

High quality chest compressions and defibrillation are two of the most meaningful interventions in a cardiac arrest1. If you have taken Advanced Cardiac Life Support (ACLS), you’ve heard the mantra “I’m clear, you’re clear, everybody’s clear.”1 During delivery of a shock, valuable seconds of chest compressions are lost. This pause in chest compression translates to a decrease in coronary perfusion pressure, one of the largest predictors of return of spontaneous circulation (ROSC).2 After chest compressions resume, …

View Post

Dr. Google isn’t the colleague you’d like it to be

In Featured, Opinion by Shahbaz SyedLeave a Comment

“Well, I looked up my symptoms on Google, and it said I was having a heart attack”, we’ve all had this patient interaction before. We live in an era where information is so freely and easily accessible. The danger comes in determining the intrinsic accuracy of data. An recent study has suggested that researching symptoms online is more likely to make one feel worse, and less informed. While this is of no surprise to …

View Post

Blood and Clots Series: Does my complex patient have DIC?

In Blood & Clots, Medical Concepts by Andrew ShihLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert Case Description You are seeing a 56M in your critical care suite who has just arrived as a transfer from a peripheral hospital.  The patient has had a recent diagnosis of acute leukemia and was given chemotherapy and a recent stem cell transplant 20 days ago at this hospital.  When he started getting sicker, they requested …