Sirens to Scrubs: Subarachnoid Hemorrhage

In Sirens to Scrubs by Michael KruseLeave a Comment

You are dispatched lights and sirens for Jennifer, a 52-year-old female complaining of “the worst headache of my life”. She recalls running on a treadmill then feeling like she had been struck in the back of the head by a clap of thunder. She then proceeded to have a witnessed two-minute episode of syncope. On arrival you find Jennifer coming out of the bathroom where she was just vomiting. As you are getting …

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Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI?

In Blood & Clots, Medical Concepts by Vinai BhagirathLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert Main Messages  P2Y12 inhibition is important for the first 1-6 months after PCI insertion, and may have ongoing benefits up to 12 months or longer.  Addition of anticoagulant to antiplatelet therapy increases the risk of bleeding, but reduces the risk of stroke.  Use of an anticoagulant plus P2Y12 inhibitor is preferable to anticoagulant plus dual …

Blood&Clots Series: Performing non-neuraxial bedside procedures on patients taking anticoagulants

In Blood & Clots, Medical Concepts by Calvin YehLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert Case Description You are assessing a patient in the emergency room who is presenting with a unilateral large pleural effusion that is causing hypoxia and shortness of breath. She needs a thoracentesis but her INR is 3.0 due to the Warfarin she takes for atrial fibrillation. How can this procedure be performed safely? What about …