Tiny Tips: Approach to the Alarming Ventilator

In Tiny Tips by Brent Thoma4 Comments

The December edition of EM:RAP had a great segment with Haney Mallemat and Stuart Swadron that went over five “Critical Care Quickies.” One of them presented an approach to an alarming ventilator that really caught my eye. The classic mnemonic that I was taught for this situation was Differential for the Alarming Ventilator: DOPE(S) D – Dislodged tube O – Obstructed tube (mucous plug, blood, kink) P – Pneumothorax E – Equipment failure (ventilator, …

Tiny Tips: Seizures and STATUS EPILEPsy

In Tiny Tips by Teresa Chan1 Comment

Seizure is a common presenting complaint in the Emergency Department.  According to one study seizure related presentations amount to about 1% of all ED visits. In that same study, status epilepticus accounted for around 6% of those patients presenting with seizures  And that was in 2000. Since then, then the definition of status epilepticus has changed.  In 2008, the Neurocritical Care Society introduced a new definition for Status Epilepticus. Status Epilepticus is now defined as: 5 minutes …

Tiny Tips: The CATCH Rule

In Tiny Tips by Brent Thoma2 Comments

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 …

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Tiny Tips: PERC Rule

In Medical Concepts, Tiny Tips by Brent Thoma7 Comments

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 …

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Tiny Tips: START Protocol for Mass Casualty Triage

In Medical Concepts, Tiny Tips by Brent ThomaLeave a Comment

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 = …