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Tiny Tip: Anaphylaxis Treatment

In Medical Concepts, Tiny Tips by Taft MicksLeave a Comment

Anaphylaxis is a common presentation to the emergency department requiring rapid treatment as death can occur within minutes. From 1986 – 2011, in Ontario, Canada alone there were 82 deaths from anaphylaxis (1). Epinephrine 0.5mg IM (1:1000) is the first line treatment for anaphylaxis and the only lifesaving treatment (2). The other medications are for symptomatic control or can help prevent the biphasic reaction anywhere from 8-72 hours from the initial reaction. For …

Tiny Tips: Epinephrine Dosage

In Medical Concepts, Tiny Tips by Taft MicksLeave a Comment

Epinephrine is a commonly used medication in the emergency department for the management of anaphylaxis and cardiac arrest. Administering this drug can be confusing as the dosage and concentration are different for each indication. The “allergy epi” 1:1000 concentration is 10 times more concentrated than the “cardiac epi”. The “allergy epi” is delivered IM while the “cardiac epi” is delivered IV. This difference leads to an increased risk of error as the incorrect …

Tiny Tips: weakness MADE NICER

In Tiny Tips by Anali ManeshiLeave a Comment

Editor’s Note: This is a great mnemonic developed by two Canadian medical students Anali Maneshi and Matthew Cherian. This tool serves as a framework for an approach to a common ED presentation. If you have a tiny tip for us please consider sending it along by following our author instructions here.  Geriatric patients make up 20% of all visits to Canadian EDs (1). General weakness, which can have a large differential, is a common …

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Tiny Tip: Banning Factor Xa – How to remember NOACs

In Tiny Tips by Teresa ChanLeave a Comment

There has been an increase in novel oral anticoagulants (NOACs), which often thought of by many as the non-warfarin anticoagulants. Within this group there are two subclasses: Factor IIa (thrombin) inhibitors Factor Xa inhibitors One of our @MacEmerg PGY3 residents, Laura Morrison (no relation to esteemed resuscitation Canadian researcher Laurie Morrison) recently told me about a quick and dirty tip to remember what class each of the NOACs belongs to… and thereby helping you …

Tiny Tips | SVNCOPE for Syncope

In Tiny Tips by Jared PatyLeave a Comment

Syncope is common presenting complaint in the emergency department. Over 40% of adults will experience a syncopal episode, and syncope accounts for approximately 1% of all ED visits (1). Because syncope can result from a variety of etiologies, both life-threatening and benign, the syncopal patient is diagnostically challenging and can be especially daunting for learners. A consistent framework helps learners avoid missing a potentially serious underlying problem. The SVNCOPE mnemonic is a useful …

Tiny Tip: HINTS exam to determine INFARCT

In Tiny Tips by Andrew Petrosoniak1 Comment

I recently wrote a post about the utility of the HINTS exam for patients who present with persistent vertigo known as acute vestibular syndrome (AVS). The available evidence suggests that this bedside exam is highly effective to help differentiate peripheral from central causes. And in one study, it may even be better than an MRI in the first 48hrs [1]! Finally, the answer to all of your vertiginous problems in the emergency department…except …