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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 …

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Navigating Patient Handovers

In All Posts, Education & Quality Improvement by Richard TangLeave a Comment

06:50AM: You are heading towards the tail end of your night shift, swamped with traumas, resuscitations, and overall high volumes of patients. You look forward to heading back to the warm embrace of your bed. However, before you can leave, you run your list again with your supervising physician and realize that there are still a few patients that will likely need to be handed over to the morning shift physician. The incoming …

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The RULES of Patient Reassessments

In Education & Quality Improvement by Arthur WelsherLeave a Comment

You have seen the patient, collected a thorough history of pertinent positives and negatives, completed a comprehensive physical, generated a differential diagnosis, presented the case to your attending and ordered all the appropriate investigations. The next step in providing the best care in the emergency department is reassessing, reassessing, and reassessing. The Emergency Department is unique in that there is minimal continuity of care. Once the patient is discharged from the department you …

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HiQuiPs: Quality Improvement in the time of COVID-19

In Education & Quality Improvement, HiQuiPs by Ahmed TaherLeave a Comment

You are attending your monthly ED staff meeting where the main topic of discussion is the COVID-19 pandemic. Recent events around the world have compelled your hospital to make changes to better prepare for the expected increase in local respiratory cases. The ED staff meeting has a debrief about some changes that will be happening including personal protective equipment use changes, new COVID-19 swab testing, ED triage and flow changes and many other …

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Debrief while it’s HOT

In Education & Quality Improvement, Featured by Priyank BhatnagarLeave a Comment

A 72 year old male is brought into the resuscitation room with respiratory distress. He has had two days of fever, cough, fatigue and shortness of breath with a known COVID-19 positive case in his household. His past medical history includes well-controlled hypertension and diabetes. His oxygen saturation on 6L nasal prongs is 88% and it is clear he is working hard to breathe. Intubation for oxygenation is apparent and you prepare your …

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Approach to Pain Management in the ED

In Education & Quality Improvement, Medical Concepts by Jana BalakumaranLeave a Comment

Pain is one of the most common concerns of patients presenting to the ED. Achieving excellent analgesia while minimizing side effects is an important and nuanced skill to develop. The goal of emergency pain management is not to completely eradicate pain but rather, reduce pain to an acceptable level allowing for safe discharge/return to daily activities, or to bridge until inpatient care can be arranged​1,2​. There are a number of principles of pain …