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A “Friends” Case Report – Joey’s Urolithiasis

In Case Series, Featured by Anna BlackLeave a Comment

Presentation Joey Tribbiani, a previously healthy 28-year-old male, presents to the ED with left-sided flank pain. In the past 12 hours, he has had four 20-minute episodes of sudden onset, severe left flank pain radiating to the groin. During these episodes he was unable to find a comfortable position. He felt nauseous and had one episode of emesis. He denies hematuria and any lower urinary tract, gastrointestinal, or respiratory symptoms. He reports no …

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Disposition Decisions: What do we need to consider and why?

In All Posts, Education & Quality Improvement by Rob WoodsLeave a Comment

Being able to think patients through to their final disposition can be a challenging skill at the clerkship level. However, a good clinician should start thinking about a patient’s disposition as soon as they pick up the chart. Before you take a patient’s history, look at the triage note and start to think through your differential diagnosis, diagnostic workup, therapeutic management, and disposition plan. What are the “most common” and “cannot miss” diagnoses …

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“Help us help you” – Soliciting Feedback in the ED

In All Posts, Education & Quality Improvement, Mentorship by Arthur WelsherLeave a Comment

We’ve all heard the adage that practice makes perfect and to become an expert you must complete 10 000 hours of deliberate practice​1​. This involves motivated, goal oriented, purposeful practice with periodic feedback. Feedback is critical to allow for growth from where you currently are as a clinical clerk to where you want to be as future practicing physician​2​. Even with extensive deliberate practice, you will plateau without guidance and identification of areas …

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Identification of Emergency Department Patients for Referral to Rapid-Access Addiction Services

In Infographics, Knowledge Translation by Samuel WilsonLeave a Comment

This month, CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine that looks at substance-related ED presentations and the need for direct referral to a rapid-access addiction services. Recent national data shows that substance-related emergency department visits are rapidly increasing.​1​ Despite this finding, previous studies show that many EDs do not have referral protocols for rapid-access addiction services.​2​ A prospective cohort study was conducted by Hann et al. to better characterize substance-related …

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Approach to Caring for Homeless Patients in the ED during the COVID-19 Pandemic

In Education & Quality Improvement, Featured by Claire BodkinLeave a Comment

Introduction It’s a cliche that holds true now more than ever – the emergency department really is the front door to the medical system. Despite many health and social services shuttering or moving to virtual care during the COVID-19 pandemic, the emergency department remains open 24/7. Our EDs are still committed to seeing anyone who shows up, in communities of all sizes from coast-to-coast. And while we try to keep people at home …