Patients with complaints of acute headache comprise 4% of emergency department visits.1 Most headaches presenting to the ED are primary headaches such as migraines, however, important secondary causes, such as hemorrhage, cannot be missed.2. A recent CrackCast outlined an excellent approach to headache red flags. The HEADACHe mnemonic can help you remember these red flags3! History describing the worst headache of life or a headache that is different than usual Exertion as a trigger for …
Tiny Tips: Approach to Abnormal Uterine Bleeding
Whether the patient is an expecting mother, a post-menopausal woman, or a young adolescent, abnormal uterine bleeding is distressing for the patient, and often overwhelming for learners. Consider the ‘CAUSES OF bLOOD’ to better tailor your investigations and management. Cancer Abruption Urogenital infections (PID, endometritis, salpingitis) Severe menorrhagia Ectopic pregnancy Spontaneous abortion Ovarian cyst rupture Fibroid (Leiomyoma) b… Location of placenta- placenta previa Ovarian torsion Onset after delivery – Post-Partum Hemorrhage Drugs – …
Tiny Tip: Is this a ‘CASE’ of an elbow fracture?
An elbow fracture is a common pediatric injury in emergency medicine. These fractures present challenges in diagnosis due to the maturing skeletal anatomy and the subtlety of these injuries.1 Plain radiographs are adequate to detect elbow fractures in most cases and a systematic approach can help learners diagnose these pathologies.2,3 An approach to reading elbow radiographs: After confirming patient identification and appropriate radiographic view, a mnemonic to help guide your approach to elbow …
Tiny Tips – Cauda Equina Syndrome
Cauda Equina Syndrome (CES) is a collection of signs and symptoms resulting from compression of neural elements at the cauda equina. Although CES has no universal definition, the most commonly cited clinical presentation involves severe lower back pain, bladder dysfunction, and sensory deficits in the sacral nerve root distribution. Associated symptoms can include radicular leg pain, lower extremity weakness, and erectile dysfunction. A recent review explores this variation in definitions and the diagnostic …
Tiny Tips: HEART Score – A Tool for Acute Coronary Syndrome
Chest Pain? Better check out the HEART (Score)! Chest pain suspected to be of cardiac origin is a common presentation in the first-world Emergency Department, but trying to decide the appropriate level of care of these patients can often be challenging. What if the chest pain is not a straight-forward STEMI that needs to be sent to the cath lab? What do we say when the troponin levels are not high enough to impress …
Tiny Tips – Approach to Diabetic Ketoacidosis
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 …