This year, the American Heart Association released the updated 2020 guidelines for cardiopulmonary resuscitation and emergency cardiovascular care; the first major update to the internationally recognized guideline in five years. The American Heart Association (AHA) has updated its Pediatric Basic and Advanced Life Support (PALS) guidelines since their last update in 2010. These new recommendations focus on airway management, emphasizing that pediatric patients with an advanced airway should have a target respiratory rate of …
What to Do in a Resuscitation as a Junior Learner
Background If you’re a medical student interested in emergency medicine, it’s a pretty safe bet that you’re also interested in resuscitation medicine. It’s a defining aspect of the specialty — how to take a sick, undifferentiated patient and simultaneously investigate and treat a potentially very broad differential diagnosis. The challenge is that, as a junior learner, you’ve likely received limited teaching in resuscitation medicine, and what teaching you have received is probably more …
A Junior Learner’s Approach to Dealing with Difficult Situations during Patient Care
Why is this topic important? As a learner, you will inevitably experience “difficult” encounters during patient care. In fact, clerks and junior residents are more likely to label patient encounters as “difficult”.1 These encounters often involve patients that refuse to answer questions, use profanity, demand specific investigations or treatments, and express frustration with wait times. But why is it important for clerks and junior residents to learn how to handle difficult encounters with …
Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES): A Not-So-Rare Cause of Abdominal Pain?
In this article, we will dive into the world of abdominal wall pain – specifically from a condition called Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES) – a diagnosis rarely considered when seeing patients with abdominal pain in the ED. Case Your next patient is Ms. Amanda Cnes, a 34-year-old female with abdominal pain. Before seeing the patient, you have a flip through her chart. She has had numerous ER visits for abdominal pain …
Tiny Tip: “WARM CREAM” as a diagnostic mnemonic for Kawasaki Disease
Kawasaki Disease is typically a self-limiting, medium vessel vasculitis that predominantly affects Asian male children between the ages of 1 to 5.1 One of the major complications from Kawasaki Disease is the development of coronary artery aneurysms. If left untreated, 20-25% of the cases of Kawasaki Disease are associated with coronary artery aneurysms,2 but the risk is reduced to <5% when treated appropriately.3 Thus, it is important to recognize the presentation of Kawasaki …
Subungual Hematomas and Trephination
Case Presentation You are a clinical clerk on your rural family medicine rotation working in the local emergency department. Your preceptor asks you to see a 25-year-old male who presents shortly after having hit his left index finger with a hammer while building a new deck this afternoon. He is otherwise healthy, he is not taking any medications, and he has no known drug allergies. He is right-handed and works as an electrician. …