Blood & Clots Series: How do you stop warfarin for surgery?

In Blood & Clots, Medical Concepts by Kerstin de WitLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert, Scholar Case Description You are assessing a 76 year old lady who takes warfarin for stroke prevention because she had a mechanical aortic valve replacement 4 years ago. She was at the preoperative clinic this morning because she will have a knee replacement surgery in a weeks time. The anesthesiologist said they would  like to …

Sirens to Scrubs: Subarachnoid Hemorrhage

In Sirens to Scrubs by Michael KruseLeave a Comment

You are dispatched lights and sirens for Jennifer, a 52-year-old female complaining of “the worst headache of my life”. She recalls running on a treadmill then feeling like she had been struck in the back of the head by a clap of thunder. She then proceeded to have a witnessed two-minute episode of syncope. On arrival you find Jennifer coming out of the bathroom where she was just vomiting. As you are getting …

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HiQuiPs: Patient Safety in the ED Part 2 – Key Concepts in the Systems-Based Patient Safety Paradigm

In Education & Quality Improvement, HiQuiPs by Ryan TamLeave a Comment

You are working a busy shift in your local ED, which has a paper-based system for documentation and orders. You have seen two patients with the first name ‘Ben’, and two patients with the last name ‘Chen’. As you are reflecting on this, you realize that the last order you placed for one of the ‘Bens’ was placed on the wrong patient chart. You quickly grab the chart, put a line through the …