In this issue, we collaborated with the CJEM team to create a visual abstract on the article “Outpatient parenteral antibiotic therapy (OPAT) and inpatient treatment strategies for emergency department patients with cellulitis: a cost analysis”.1 Skin and soft tissue infections in the ED almost always equals antibiotic prescription. Depending on severity and patient characteristics, the question is whether oral or intravenous (IV) administration is required, and patients receiving IV antibiotics for these infections …
Managing Agitation in the ED: Part 2 – Restraints, Medical Approach, and Discharge
This post is part two of a two-part series. You may review the previous post here. In the last post, we followed Lucas, a 26 year old male who presented to the ED with bizarre behaviour and aggression. When we left off, he was becoming increasingly agitated and paranoid despite your best efforts in de-escalating the situation. He is beginning to yell at staff and refuses to cooperate with any questioning. Approach to …
Managing Agitation in the ED: Part 1 – Overview and Deescalation Strategies
Lucas is a 26 year old male who presents to the ED by his parents for bizarre behaviour and increasing aggression at home. He has a history of IV drug use but is not forthcoming about which drugs he has used and how recently he has used them. There are two hospital security employees behind him. He is frequently looking behind and around him, and appears dishevelled and unkempt. Lucas appears quite anxious …
Bimanual technique to reduce pediatric inguinal hernia
A 7-week-old male infant named Johnny presents to the Emergency Department with a bulge in his right scrotum that the parents noticed today, worse when he is crying and upset. On exam you notice an inguinal hernia and try to reduce it but are unsuccessful. What technique could you try next? Incarcerated hernias can often be reduced using a bimanual (two-hand) technique and lots of patience. Place the fingers of your non-dominant hand …
Tiny Tips: PETMAC as a mnemonic for the 6 deadly causes of chest pain
An estimated 300,000-500,000 patients present to the emergency department (ED) every year inCanada with complaints of chest pain.1 In USA, the numbers are even more staggering at 8million per year.2 Given its prevalence, having a structured and rapid approach to chest pain isessential. Use the mnemonic PETMAC as an approach to these 6 cannot-miss causes of chestpain in the ED. Just think of your friendly neighbourhood pet, Mac! P: Pulmonary Embolism Classically presents …
PoCUS Previews 03: Intro to the FAST Scan
Welcome back to PoCUS Previews, your illustrated guide to the world of Point of Care Ultrasound (PoCUS)! In the hands of a skilled sonographer, PoCUS can serve as a valuable tool while assessing a patient in trauma. PoCUS can quickly and fairly accurately detect blood loss and signal the presence of internal organ damage. Thus, the Focused Assessment with Sonography in Trauma (FAST) scan is one of the most celebrated uses of PoCUS …