Syncope makes up approximately 1% of acute care visits in Canadian emergency departments and is a common symptom for a wide range of underlying etiologies.1 Identifying any serious underlying condition for syncope and disposition planning is the main area of focus in the emergency department. In addition to a comprehensive history and physical, the 12-lead ECG is a part of the initial evaluation in any patient presenting with syncope. The mnemonic, WOBBLER can …
Tiny Tip: HOUSE as a discharge guide for marginalized patients that incorporates the social determinants of health
Emergency Departments are often the primary source of healthcare for marginalized patients with substance use disorders and precarious housing1. As such, we have unique opportunities to intervene and initiate change. While many screening tools exist to identify substance use disorders, the novel H.O.U.S.E. mnemonic is the first to cover high yield items to be discussed with patients prior to discharge2. It can be used as an easy to remember tool to ensure that …
Tiny Tips: Causes of Atrial Fibrillation
Atrial fibrillation is the most common arrhythmia encountered and managed in the emergency department.1,2 In addition to ensuring hemodynamic stability and subsequent management of the arrhythmia, the emergency physician must identify and treat potential underlying causes. Atrial fibrillation itself may be a sequela of an underlying life-threatening disease process such as pulmonary embolism or sepsis. In some instances, treatment of the underlying cause may lead to the resolution of the arrhythmia.1 It is …
Tiny Tips: Pediatric Airway Anatomy Considerations
Intubation in children is an uncommon but high-risk procedure in the emergency department.1 The incidence of adverse events during intubation is high, particularly desaturation and hypotension.1 Thus, pediatric airway management is an important and lifesaving skill. The pediatric airway has significant anatomical differences from an adult. To remember these variations, consider the mnemonic “CHILD”. How is it different? How do we change management? Cricoid2 Narrowest portion of airway. Risk of subglottic stenosis. …
Tiny Tip: “WARM CREAM” as a diagnostic mnemonic for Kawasaki Disease
Kawasaki Disease is typically a self-limiting, medium vessel vasculitis that predominantly affects Asian male children between the ages of 1 to 5.1 One of the major complications from Kawasaki Disease is the development of coronary artery aneurysms. If left untreated, 20-25% of the cases of Kawasaki Disease are associated with coronary artery aneurysms,2 but the risk is reduced to <5% when treated appropriately.3 Thus, it is important to recognize the presentation of Kawasaki …
Tiny Tips: OSTRICH as a differential for acute monoarthritis
Acute monoarthritis is a common complaint in the emergency department. The differential for acute monoarthritis is broad. A delay in proper diagnosis and treatment of certain etiologies can result in significant morbidity.1,2 The evaluation of a patient with acute monoarthritis should begin with a focused history and physical exam which will guide further laboratory and radiographic studies. With a history of trauma or focal bony pain, radiography can be useful to rule out …