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Clinical Ultrasonography 101: Where Right Upper Quadrant Scans Go Wrong

In Medical Concepts by Craig Brick0 Comments

The FAST exam helped pave the way for Emergency point of care ultrasound. Compared to many emergency US applications still in their infancy, the FAST exam has been thoroughly studied, widely implemented, and has proven utility. … sorry transcranial US… The FAST has been around since the 1970’s and replaced DPL, it is very sensitive and even more specific. This makes it especially useful as a ‘rule-in’ test allowing expedition of surgery in …

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Tiny Tips: HEART Score – A Tool for Acute Coronary Syndrome

In Medical Concepts, Tiny Tips by Richard Tang0 Comments

Chest Pain? Better check out the HEART (Score)! Chest pain suspected to be of cardiac origin is a common presentation in the first-world Emergency Department, but trying to decide the appropriate level of care of these patients can often be challenging. What if the chest pain is not a straight-forward STEMI that needs to be sent to the cath lab? What do we say when the troponin levels are not high enough to impress …

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TREKK Series | Procedural Sedation

In Guidelines, Medical Concepts by Ashley Lubberdink0 Comments

Cohen is an 8-year old boy (right hand dominant) who fell from the monkey bars and sustained a closed, angulated left distal radius fracture. He is neurovascularly intact and has normal vital signs for his age. He weighs 30kg. He is in a moderate amount of pain despite Tylenol and Advil which was administered in the ED. You note that he will need further pain management, reduction and splinting of his forearm injury …

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Sonography in Hypotension and Cardiac Arrest: The SHoC Consensus Statement

In Knowledge Translation, Medical Concepts by David Lussier0 Comments

Cardiac arrest and hypotension are synonymous with emergency medicine. Over the years, point of care ultrasound (PoCUS) has become an extension of our stethoscope. The recently published consensus statement from the International Federation for Emergency Medicine (IFEM) aims to provide guidance for PoCUS use in these situations, and describes the Sonography in Hypotension and Cardiac Arrest (SHoC Consensus) protocols.1 The guidelines were developed based upon expert consensus formulated using three rounds of a …

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Case Series: Hindsight is always the sharpest – Penetrating trauma

In Case Series, Medical Concepts by James Powell0 Comments

The Case A 17-year-old female was transported to the Emergency Department (ED) by helicopter after a high speed, single vehicle motor vehicle collision. She was found unrestrained by paramedics, with an initial Glasgow Coma Scale of 14, but during extrication she became more agitated and confused. Subsequently she complained of dyspnea and became hypotensive. She was intubated prior to transport for her deteriorating mental status. The patient received 3 litres of crystalloid along …