Boring Question: Does this medication cause long QT? (with Bonus: Tiny Tips!)

In Clinical Questions, Tiny Tips by Jatin Kaicker7 Comments

The Clinical Case A 70-year-old female presents to the emergency department with new palpitations and 2 syncopal episodes, witnessed by her son. These episodes have started within the past 10 days. Her past medical history includes diabetes, hypertension, depression, dyslipidemia and atrial fibrillation. She is a long-standing diabetic and is followed by a nephrologist for her diabetic nephropathy. Her medications included: metformin, atorvastatin, aspirin, warfarin and sertraline. She was recently seen in hospital …

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Boring Question: How useful are plain abdominal films for bowel obstruction?

In Clinical Questions by Jatin Kaicker3 Comments

Clinical Scenario An otherwise healthy 65 year old comes into the emergency department with an 8 hour history of abdominal pain. Her last bowel movement was 3 days ago and she’s not sure if she has passed gas.  She endorses nausea but has not vomited. She has not taken her temperature but does not believe she has been febrile. She’s tried Tylenol for analgesia with little relief. She last ate 12 hours ago …

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Boring Question: How does the sensitivity/specificity of lung ultrasound compare to plain films in diagnosing pneumothorax?

In Clinical Questions by Jacob Avila5 Comments

The Case A 74-year-old male with a history of COPD arrived in the emergency department in respiratory distress. On physical examination, the patient was mildly tachypneic and had an oxygen saturation of 93% on a non-rebreather mask. On auscultation, the patient had wheezing and diminished air movement bilaterally. A supine chest radiograph (CXR) was obtained. A short time later, a radiologist called to confirm the presence of a “moderate sized right pneumothorax” (Figure …

Boring Question: Dizzy, need a few HINTS?

In Clinical Questions by Andrew Petrosoniak2 Comments

The dizzy patient. If you haven’t seen a patient with this chief complaint, you either don’t work in an emergency department or you work in an imaginary emergency medicine utopia! Admit it, when you pick up the chart that reads “chief complaint…dizzy”, you look around inconspicuously, slowly replace that chart in the rack… and run quickly become preoccupied with some fascinating task from… oh… somewhere over there! But why? It is not because we …

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Boring Question: How useful are bowel sounds?

In Clinical Questions by Jatin Kaicker5 Comments

This month we launch the first post in a new series entitled “Boring Questions”.  This column will focus on reviewing key literature around common questions that might be asked during a shift.  – Teresa Chan (Managing Editor) Clinical Scenario: A 60-year-old female presented to the emergency department with a 24 hour history of lower abdominal pain. The pain had increased in intensity over the past day and was 7/10 on presentation. She has …

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My Approach to Clearing C-Spines

In Clinical Questions, Medical Concepts by Nadim LalaniLeave a Comment

I gave a talk the other day on clearing C-Spines, with Prezi linked here. As a disclaimer, this is my approach based on my clinical experience and from reading the literature – you should discuss this amongst your colleagues and review the literature to see if you reach the same conclusions.  I would appreciate some comments – peer review if you will. Objectives of the Talk: Apply the Canadian C-Spine Rule and NEXUS criteria …