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Isolated distal DVT – Diagnosis and Management

In Clinical Questions by David Wonnacott3 Comments

Case: A 51-year-old woman presents to the ED with the chief complaint of left leg swelling. She recently underwent bunion correction surgery to her left foot 7 weeks ago, and her cast was removed one week ago. Over the last day or two she has had significantly increased leg swelling and more recently reports some dull pain described as” heaviness” to the affected leg. The patient denies chest pain, shortness of breath, or …

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Mechanical Heart: a basic approach to LVADs in the ED

In Medical Concepts by Jared Baylis0 Comments

You may be wondering; why do we need another post on left ventricular assist devices ( LVADs ) when there are already several phenomenal articles out there in the #FOAMed universe? There are two reasons for this. First, to my knowledge, there has not yet been a #FOAMed article regarding community emergency department (ED) management of LVAD related complications. LVADs are surgically placed in tertiary care, academic centres with specialized LVAD teams. However, …

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Tiny Tips – Approach to Diabetic Ketoacidosis

In Medical Concepts, Tiny Tips by Larissa Hattin0 Comments

Don’t Know Anything about Diabetic Ketoacidosis (DKA)? In Canada, 5 000 – 10 000 patients are admitted to the hospital with diabetic ketoacidosis (DKA) each year.1 Most of these patients will initially present to the Emergency Department.  The initial assessment and management of these patients in the ED is crucial, as 50% of DKA deaths occur in the first 48-72hrs.2  Managing DKA can be overwhelming for learners; interpreting blood gases, thinking about electrolyte and fluid …

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TREKK Series | Diabetic Ketoacidosis

In Guidelines, Medical Concepts by Ashley Lubberdink2 Comments

Mark is a 7-year old boy who was brought into the ED by his mom who noticed he has been more fatigued than usual over the past day. Three days ago, he had rhinorrhea and a cough, and since then has been complaining of generalized abdominal pain, nausea, 2 episodes of nonbloody, nonbilious emesis today, and increased thirst. He is otherwise healthy, takes no medications, has no allergies, has up to date immunizations …

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Tiny Tips – Taking a Social History

In Medical Concepts, Tiny Tips by Aaron Leung0 Comments

While often overlooked, a patient’s social history can help narrow the differential diagnosis as well as help guide their final disposition. A mnemonic to help with the essential parts of the social history is ETOH SHOTS: Education Level of education of the patient; are they able to understand discharge instructions. Treatment Coverage Does the patient have a drug plan to help cover medication costs, can they afford the medications you are prescribing. Offspring/Supports …