Yesterday CJEM tweeted out one of their latest article to become open-access: Review of the CATCH study: a clinical decision rule for the use of computed tomography in children with minor head injury. While I understand that they are not able to make all of their articles open-access due to financial considerations, they have made the effort to make those articles published >1 year ago freely available. This article provides an overview and …
Tiny Tips: PERC Rule
The “Tiny Tips” series aims to provide helpful memory aids for remembering difficult to recall exam material for emergency medicine. You can get all of them compiled in an easy-to-review way by downloading the Tiny Tips deck of Boring Cards. This post outlines a mnemonic to help remember the PERC rule (Pulmonary Embolism Rule-out Criteria). PERC is a useful clinical decision rule to help rule-out pulmonary embolism in patients a clinician’s gestalt suggests …
Tiny Tips: START Protocol for Mass Casualty Triage
My residency program discussed the EMS chapters in Rosen’s tonight and went over the START protocol for triage in mass casualty incidents. For the unacquainted, START stands for Simple Triage And Rapid Treatment. This protocol aims to make triage extremely fast and simple to allow first responders to quickly assess large numbers of patients. Triaged patients are clearly marked with colors (black = dead, red = immediate attention, yellow = delayed attention, green = …
Tiny Tips: Altered Mental Status
Altered mental status is a frequent presentation with a very broad differential. Having a solid approach helps provide structure to the workup of a difficult group of patients. IS IT MEAT is a common mnemonic for this presentation and the best one that I have come across (thanks to Nadim Lalani from ermentor.com for teaching it to me and George Farjou for the quick comments to improve it). Not only do the letters have fairly intuitive …
Tiny Tips: The Effects of TCAs
This month I’ve been reading a lot of toxicology. While running through the Antidepressant chapter in Rosen’s I realized that I was definitely going to need help remembering the ridiculous number of pharmacological effects of TCAs. Practical? Not so much. A potentially esoteric exam question? Definitely. This is the first BoringEM “Tiny Tip.” While most of my medical posts are quite long, I think there is some merit to occasionally going over something …
Requesting Consultations using Kessler’s 5-Cs
Bad consults are bad for patients. Consulting colleagues is a critical skill in Emergency Medicine. The success of a good consultation is more than simply getting the consultant to come see the patient. Rather, it’s about getting the best out of your consultant so that ultimately the patient benefits. Poor consultations not only make you look like a dork, they will also have downstream effects on how well your consultations are received for the …