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Tiny Tips: The COWS Scale

In Tiny Tips, TipsForEMExams by Isabelle GrayLeave a Comment

As the opiate crisis continues to escalate, emergency departments are seeing higher numbers of patients with complaints and complications related to opiate use disorder. There is strong evidence for opiate agonist treatment in preventing opiate related deaths. Additionally, Suboxone (buprenorphine-naloxone) is the recommended first line treatment.​1​ Suboxone Treatment For a full Suboxone start, a patient is required to be in moderate withdrawal, meaning a Clinical Opiate Withdrawal Scale (COWS) score of greater than …

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Miracles from Heaven Case Report: Small Bowel Obstruction

In Medical Concepts by Tessa LadnerLeave a Comment

Earlier in the day, five-year-old Annabel had a regular morning and afternoon. She attended a birthday party and seemed to be herself, laughing with her friends and running around. At 0200 and Annabel calls for her mom, crying and clutching her stomach. Her mom rushes into her daughter’s room and finds Annabel in significant pain. Annabel is rushed to the hospital at 0400. At triage, she is in significant discomfort, crying, and tachycardic. …

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Clinical Question – How Do I Approach Agitation and Aggression in Children with Autism Spectrum Disorder in the Emergency Department?

In Clinical Questions by Devika SinghLeave a Comment

A 7-year-old boy with autism spectrum disorder presents to the emergency department (ED) with upper respiratory infection symptoms. He starts becoming agitated as you try to auscultate his lungs and aggressively comes towards you. You are unsure of the best method to approach this situation. Research has demonstrated that almost one third of children with autism spectrum disorder (ASD) who present to the emergency department had negative experiences or unwanted outcomes.​1,2​ Children with …

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Clinical Question: When should patients be allowed to eat in the Emergency Department?

In Clinical Questions by David ZhengLeave a Comment

You have just finished seeing a 12-year-old boy who fell off the monkey bars about an hour ago. He has an obvious deformity to his right elbow and you suspect a displaced fracture that will require reduction. You would like to use procedural sedation to facilitate the reduction, but an empty granola bar wrapper stops you in your tracks. “We missed dinner rushing here and he couldn’t resist,” his mom says. Staring at …

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The CCEDRRN COVID Mortality Score

In Infographics by Corinne HohlLeave a Comment

Emergency Departments see critically ill patients with COVID-19. Families and care providers often have to make immediate management decisions about whether or not to intubate hypoxic patients. That decision has substantial downstream implications for patients and the health system. For patients a course of mechanical ventilation is commonly prolonged (average 13 days), and fraught with long-term sequelae, and often does not prevent death. Intubation takes patients’ ability to eat, speak and communicate with …

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PoCUS Previews 01: Intro to PoCUS

In All Posts, Featured, Infographics by Revathi NairLeave a Comment

Welcome to PoCUS Previews; CanadiEM’s newest infographic series!  Ultrasound (US) is an imaging modality that uses high frequency soundwaves and their reflection to produce real time images of various structures within the human body. In Emergency Medicine, small portable US machines can be used to gain an abundance of clinical insight that can ultimately aid in diagnosis. However, generating and interpreting these images can be quite challenging. PoCUS Previews aims to simplify Point …