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 …
“Rock Paper Scissors”: A Mnemonic for Testing Peripheral Nerve Motor Functions of the Hand
Upper extremity injuries are one of the common reasons for visits to the emergency department. A quick physical exam, including both motor and sensory exam of the hand, can help triage the severity and urgency for referral to upper extremity specialists. When assessing the distal peripheral nerve motor functions of the hand, try using this mnemonic: “Rock, Paper, Scissors”. The combinations of movements by muscles innervated by the three peripheral nerves make up …
Tiny Tips: STEMI? Don’t forget your PAILS!
Reading ECGs is a bread and butter emergency medicine skill. At busy centres a triage nurse may hand you tens of them to glance at per shift. It can be a mindless, monotonous task, but your brain needs to know where to look. So, when you identify legitimate ST elevation and you are concerned about a STEMI, where are those reciprocal changes found again? Think of PAILS! This mnemonic identifies that ST segment …