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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 …

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Clinical question: Is the Bier Block safe and effective analgesia in the ED?

In Clinical Questions, Medical Concepts by Anali Maneshi0 Comments

A 12-year-old healthy male fell while learning how to use his hoverboard. An X-ray done in the ER shows a displaced distal radius fracture, amenable to reduction and non-surgical management. While discussing the reduction technique, his parents request analgesia with as little sedation as possible because they don’t want him “put to sleep.” You recall reading about a type of regional anaesthesia for the upper extremities but do not know the effectiveness and …

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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 …