Is first pass success without hypoxemia increased with the use of apneic oxygenation during rapid sequence intubation in the emergency department? As part of the MVP infographic series, this post reviews an article by Sakles et al. looking at apneic oxygenation in rapid sequence intubation (RSI). Previous studies have shown that multiple intubation attempts during RSI are associated with an increase in adverse events such as hypoxemia, hypotension, and cardiac arrest1–6. Thus, it …
ThromboPhonia E02, Re-starting Anti-Coagulation After Intracranial Hemorrhage
View PostCanadiEM MVP Infographic Series – CRASH-2 Trial
CanadiEM MVP Infographic Series – CRASH-2 Trial As part of the MVP infographics series, this article features the CRASH-2 Trial that evaluated the use of tranexamic acid (TXA) in trauma patients with significant hemorrhage. Previous to this study, a significant amount of evidence existed in support of the use of TXA in patients undergoing elective surgery to prevent bleeding. The homeostatic mechanisms responsible for hemorrhage in trauma patients and those undergoing elective surgery …
“Rock Paper Scissors”: A Mnemonic for Testing Peripheral Nerve Motor Functions of the Hand
Upper extremity injuries are one of the common reasons for visits to the emergency department. A quick physical exam, including both motor and sensory exam of the hand, can help triage the severity and urgency for referral to upper extremity specialists. When assessing the distal peripheral nerve motor functions of the hand, try using this mnemonic: “Rock, Paper, Scissors”. Peripheral Nerve Muscles Innervated Movement Mnemonics Median1 Flexor Digitorum Superficialis Finger Flexion Rock …
CanadiEM MVP Infographic Series – A Study to Develop Clinical Decision Rules for the Use of Radiography in Acute Ankle Injuries
This post will highlight a study by Stiell et. al (1992) in which the authors successfully developed highly sensitive clinical decision rules to detect significant ankle and foot fractures on radiography.1 At the time of this study, the authors noted that there were no widely accepted guidelines for the use of radiography in ankle injuries.2,3 Ankle radiographic series were the second most commonly performed musculoskeletal exam in the emergency department despite the incidence …
Sirens to Scrubs: Fever-Phobia
You’re transporting Milly, a 68y/o healthy woman to the hospital with a fever of 38.9C with a productive cough. As you offload her she asks for a blanket, so you ask your student to get her one while you start your paperwork. Your student, Vincent, later tells you that he was taught at school not to give blankets to febrile patients and asks you about your reasoning for giving one to Milly. About …