Vital signs are amongst the first pieces of patient information available to you in the acute setting. They play a role in many of the decisions we make in emergency medicine. Unfortunately, vital signs can be influenced by a number of factors and there are many situations in which vital signs are less than reliable. Abnormal vital signs can be an indicator of an underlying pathology, a variant due to medication, or a …
Urine Testing and UTIs in the Older ED Patient
View PostRequesting 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 …
Case Report: Johnny English’s Blunt Scrotal Trauma
CASE PRESENTATION Johnny English, a 42-year-old previously healthy male, presents to the ER with a 3-hour history of pain and swelling localized to the scrotum. He is systemically well and denies lower urinary tract or gastrointestinal symptoms. Upon further questioning, Johnny tells a bizarre story about saving the world by chasing a traitorous MI7 agent through the Swiss Alps and then fighting him to the death. English explains that during their fight he …
Blood & Clots Series: What is the role of convalescent plasma for treating COVID-19?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert, scholar, advocate Case Description A 45-year-old patient is diagnosed with COVID-19 and is receiving supportive care on the inpatient medicine ward. It is early in her clinical course and she continues to require supplemental oxygen via nasal prongs, but remains in stable condition with mild shortness of breath and intermittent fevers. One day while in …
Blood & Clots Series: Subsegmental PE – To Treat or Not To Treat?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert, scholar Main Messages Improved technology has led to an increase in the detection of subsegmental PE (SSPE) An algorithmic approach can help identify patients who will benefit from anticoagulation: generally those with concomitant DVTs and patients with additional risk factors for progression There is clinical equipoise regarding the decision to anticoagulate in this case, and …