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Tiny Tips – Approach to Diabetic Ketoacidosis

In Medical Concepts, Tiny Tips by Larissa Hattin0 Comments

Don’t Know Anything about Diabetic Ketoacidosis (DKA)? In Canada, 5 000 – 10 000 patients are admitted to the hospital with diabetic ketoacidosis (DKA) each year.1 Most of these patients will initially present to the Emergency Department.  The initial assessment and management of these patients in the ED is crucial, as 50% of DKA deaths occur in the first 48-72hrs.2  Managing DKA can be overwhelming for learners; interpreting blood gases, thinking about electrolyte and fluid …

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Tiny Tips – Taking a Social History

In Medical Concepts, Tiny Tips by Aaron Leung0 Comments

While often overlooked, a patient’s social history can help narrow the differential diagnosis as well as help guide their final disposition. A mnemonic to help with the essential parts of the social history is ETOH SHOTS: Education Level of education of the patient; are they able to understand discharge instructions. Treatment Coverage Does the patient have a drug plan to help cover medication costs, can they afford the medications you are prescribing. Offspring/Supports …

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Tiny Tips: Canadian CT Head Rule

In Medical Concepts, Tiny Tips by Omar Anjum0 Comments

“But Doc, I didn’t hit my head THAT hard” Computed tomography (CT) scans are frequently performed after a head injury to rule out acute intracranial findings. However, most Emergency Department patients with a head injury have no acute CT findings. The Canadian CT Head Rule (CCHR) was developed to help clinicians determine when to order a CT image for patients with minor head injury.1 In 2010, a multi-centre prospective trial implemented the CCHR and …

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Tiny Tips: History taking in a returning traveler

In Medical Concepts, Tiny Tips by Anali Maneshi0 Comments

Following a trip abroad, up to 8% of travelers will present for medical attention1. Many of these complaints are mild, but some are life-threatening. A detailed travel history and history of the presenting illness are essential in identifying serious illnesses and preventing over-investigation of more common non-dangerous infectious complaints (i.e. URTI’s). An easy mnemonic to help you remember key aspects of the travel history is TRAVEL: T – Time of onset The timing of …

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Tiny Tip: The Ottawa Ankle and Foot Rules – To Image or Not to Image

In Medical Concepts, Tiny Tips by Maeghan Fu0 Comments

Ankle and foot injuries are common presentations to the Emergency Department, and it can often be difficult to know whether imaging is required. In 1992, Dr. Ian Stiell and his colleagues developed The Ottawa Ankle Rules 12 to facilitate this decision. The Ottawa ankle and foot rules are highly sensitive and widely used as a tool to reduce unnecessary imaging in Emergency Departments.