CASE PRESENTATION Johnny English, a 42-year-old previously healthy male, presents to the ER with a 3-hour history of pain and swelling localized to the scrotum. He is systemically well and denies lower urinary tract or gastrointestinal symptoms. Upon further questioning, Johnny tells a bizarre story about saving the world by chasing a traitorous MI7 agent through the Swiss Alps and then fighting him to the death. English explains that during their fight he …
Blood & Clots Series: What is the role of convalescent plasma for treating COVID-19?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert, scholar, advocate Case Description A 45-year-old patient is diagnosed with COVID-19 and is receiving supportive care on the inpatient medicine ward. It is early in her clinical course and she continues to require supplemental oxygen via nasal prongs, but remains in stable condition with mild shortness of breath and intermittent fevers. One day while in …
Blood & Clots Series: Subsegmental PE – To Treat or Not To Treat?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical expert, scholar Main Messages Improved technology has led to an increase in the detection of subsegmental PE (SSPE) An algorithmic approach can help identify patients who will benefit from anticoagulation: generally those with concomitant DVTs and patients with additional risk factors for progression There is clinical equipoise regarding the decision to anticoagulate in this case, and …
How to Read Patient Monitors
It’s your first day as a clerk in the Emergency Department and your staff has asked you to see an 80 year old patient with known COPD presenting with increasing shortness of breath. He reminds you to check the patient monitor when you go in there to look for any abnormalities and to record a new set of vitals on the chart. Patient monitors can be overwhelming early in your training when you’re …
Sirens to Scrubs: Thermal Burns
You are dispatched to Jack, a 3-year-old with a burn. When you arrive, you’re told by Jack’s frantic mother that she turned her head for a second in the kitchen and Jack pulled a pot of boiling water off the counter, spilling hot water on his left arm and upper chest. Jack is crying in pain. Jack’s mother asks what his treatment will be and whether this will leave a permanent scar. You’re …
Use of Anticoagulation in Patients with COVID-19 Infection
Introduction The novel coronavirus, known as COVID-19, was originally reported in a cluster of pneumonia cases in Wuhan (China) near the end of 20191. Over the next 6 months, COVID-19 has emerged as the world’s newest pandemic disease with over 7 million cases worldwide1. The clinical presentation of COVID-19 is broad and classically involves fever, cough, dyspnea, malaise, and bilateral infiltrates on chest imaging. Less typical symptoms including diarrhea, myalgia, confusion, anosmia, and …