You’re on a night shift in the ED and receive a patch about a 75-year-old female with altered LOC. EMS reports an empty bottle of doxepin was found in her home. The patient is tachycardic and hypotensive, and on arrival has a GCS of around 12. You quickly look up the class of medication that doxepin belongs to, and realize it’s a TCA. What do you need to worry about in this patient, …
Tiny Tips: Causes of Atrial Fibrillation
Atrial fibrillation is the most common arrhythmia encountered and managed in the emergency department.1,2 In addition to ensuring hemodynamic stability and subsequent management of the arrhythmia, the emergency physician must identify and treat potential underlying causes. Atrial fibrillation itself may be a sequela of an underlying life-threatening disease process such as pulmonary embolism or sepsis. In some instances, treatment of the underlying cause may lead to the resolution of the arrhythmia.1 It is …
FrontlineEM Primer: Human Trafficking
Management It is important to remember that our job as physicians is to determine if someone is at risk of being trafficked and then to facilitate connections to an interdisciplinary team and resources. It is not our responsibility to determine if someone meets the legal definition of trafficking and use only this as a measure of whether or not treatment and interventions are required. Step 1: Identification of Red Flags The following list …
Identifying a Trafficked Patient in the Emergency Room
Editor’s Note: February 22 is National Human Trafficking Awareness Day. Today, CanadiEM is featuring a pair of posts with important takes on this issue. A young woman presents to the emergency department with pelvic pain. She’s accompanied by her boyfriend who insists he come into the exam room and tries to provide the history for the patient, stating that she doesn’t remember things well. The patient makes poor eye contact and defers questions …
The AHA 2020 “Top 10 Changes” Project: CPR & ECC Guidelines Infographic Series
Cardiac Arrest: What Is It All About? Cardiac arrest is one of the most polarizing things we face in Emergency Medicine. The reality of its morbidity and mortality really juxtaposes the moment of joy where you ~finally~ get that pulse back! Thanks to the efforts of organizations like the American Heart Association (AHA) and the Heart & Stroke Foundation of Canada (HSFC), ongoing research into resuscitation and the ACLS algorithm continue to improve …
PEM Pearls 03: Non Accidental Trauma pt. 2
Welcome back to PEM Pearls: the CanadiEM Infographic Series focused on providing approaches and high-yield pearls for important pediatric EM topics! This is part 2 of our 2 part Non-Accidental Trauma posts. Today we will be discussing the workup, investigations, and management for potential non-accidental trauma cases.1 There are a variety of goals of care that emergency physicians should perform when managing a potential non-accidental trauma case. In short, remember to treat, record, …