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Sirens to Scrubs: Wolff-Parkinson-White Syndrome

In Medical Concepts, Sirens to Scrubs by Paula Sneath1 Comment

You are dispatched to Jasmine, a 31yo patient, for palpitations. On arrival, you find her clinically stable in a narrow-complex, regular tachycardia at a rate of 180bpm. As you begin to coach her through vagal maneuvers and reach for your adenosine she advises you ‘I have something called Wolff-Parkinson-White – does that change anything?’ You think maybe it does, but you’re not sure. About Sirens to Scrubs Sirens to Scrubs was created with …

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Tiny Tips: STEMI? Don’t forget your PAILS!

In Medical Concepts, Tiny Tips by Thomas WinterLeave a Comment

Reading ECGs is a bread and butter emergency medicine skill. At busy centres a triage nurse may hand you tens of them to glance at per shift. It can be a mindless, monotonous task, but your brain needs to know where to look. So, when you identify legitimate ST elevation and you are concerned about a STEMI, where are those reciprocal changes found again? Think of PAILS! This mnemonic identifies that ST segment …

Blood & Clots Series: What are the risks of reversing anticoagulation?

In Blood & Clots, Medical Concepts by Andrew ShihLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert, Communicator Case Description You are working a shift in your local emergency department and an 89-year-old female is brought in with a 2-day history of melena stool.  The patient has a history of atrial fibrillation and uncontrolled hypertension despite being on an ACE-inhibitor. Her initial bloodwork shows a hemoglobin of 102 g/L (no baseline provided), …

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Blood & Clots Series: Is Fecal Occult Blood Testing helpful in deciding whether it’s safe to prescribe anticoagulants?

In Blood & Clots, Medical Concepts by Eric TsengLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert, Leader Case Description You have just diagnosed a 55-year-old male with an acute proximal deep vein thrombosis in the emergency department. The event was unprovoked, and he has symptoms of leg swelling and pain. He is otherwise healthy and takes no regular medications. He has no symptoms suggestive of PE, and his blood pressure and oxygen …

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Tiny Tip: “STAB” as a Tool for Diagnosing Occipital Neuralgia

In Medical Concepts, Tiny Tips by Vivian TamLeave a Comment

Approaching the complaint Occipital neuralgia is a headache disorder characterized by shooting neuropathic pain secondary to greater or lesser occipital nerve pathology. The diagnosis should be considered in a patient presenting with the following: Unilateral or bilateral pain originating at the skull base Sharp, shooting, lancinating, or burning pain that radiates forward along the dermatomes supplied by the greater or lesser occipital nerves Paroxysmal pain lasting seconds to minutes Dysesthesia or allodynia over …