Editor’s Note: This is part 2 of a 2-part series on homelessness. Check out Part I about the Ottawa Inner City Health Initiative. ‘Ken’ is a 47-year-old unhoused man presenting to the Emergency Department (ED) with severe opioid withdrawal symptoms. After taking his history, you learn that he has been unhoused for the past 2 years and using non-prescribed fentanyl for the past 8 months. His last dose was 28 hours ago. You …
Improving Emergency Care For Individuals Experiencing Homelessness
Editor’s Note: This is part 1 of a 2 part series on patients with homelessness. Stay tuned for Part 2 which will deal with the intersection of homelessness and opiate drug use. A 29-year-old male named Billy presents to your emergency department with a 4-day history of progressive leg tenderness. On exam, you note a poorly demarcated area of erythema on the leg which is warm and tender to the touch, suggestive of …
ABCDE Approach
The ABCDE approach applies to the initial assessment of critically ill patients. For each step, appropriate treatment should be started regardless if there is a definitive diagnosis. Airway1–3 Fatal in minutes. Think of this separately from breathing! Consider what would you do if the airway became threatened, e.g. Have you assessed for predictors of difficult airway management? Assessment Management ● Determine if patient can speak.● Inspect for secretions or foreign bodies.● Check for …
Preprints: What you need to know
View PostA 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 …
Requesting Consults in the Emergency Department
You are halfway through your very first Emergency Medicine shift. You have a 23 year old male patient who appears to be a slam dunk for acute appendicitis – he has symptoms that are consistent with the presentation, pain on palpation at McBurney’s point, a high white count, and CT findings of appendicitis. Your staff is being pulled in a thousand different directions, and asks you if you feel comfortable calling General Surgery …