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 …
HiQuiPs: Quality Improvement in the time of COVID-19
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 …
Debrief while it’s HOT
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 …
Approach to Pain Management in the ED
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 arranged1,2. There are a number of principles of pain …