It has been a slower than usual night shift, and you have just led a resuscitation for a COVID-19 patient in your ED. Your ED has experienced several policy changes in recent weeks, from new standards for the use of personal protective equipment to policies for mitigating risk during aerosol-generating medical procedures to guidelines on how to best communicate between resuscitation and support teams. You wonder how your department can implement multiple changes …
How to Read and Make Statistical Process Charts – Part 1
You are attending your monthly ED business meeting. There has been a recent effort to decrease the time it takes a patient to be transferred to the imaging department for a STAT CT scan. The project team has concluded the first two PDSA cycles after wide stakeholder engagement, and a root cause analysis. Two interventions were carried out: one, redesigning the process for patient pick up and transport, and two, a new expedited …
Case Report: Airway Management of Penetrating Neck Trauma in the Game of Thrones
Patient Presentation On a cold winter’s day in Winterfell, a middle-aged man by the name of Lord Baelish was stood in front of the Northern and Vale lords to answer for his crimes. His cunning and deceitful nature nature has finally led to his demise. After taking back the North from Lord Ramsay Bolton, Lady Sansa Stark was prepared to punish Lord Baelish for years of lies, betrayals, and murders. Lady Arya of …
Priapism Case Report: Robert De Niro’s Hard Situation in “Little Fockers”.
CASE PRESENTATION: Jack Byrnes, a 62-year-old Caucasian male, presented to the ER with a persistent, painful, 8-hour erection following the off-label use of Sustengo, a novel PDE5 inhibitor. Jack reports that he found a box of Sustengo samples among his son-in-law’s belongings and decided to try one. When his son-in-law discovered what had happened, he urged Jack to go to the ER. Jack refused and insisted that his son-in-law, a nurse, manage the …
How to Present a Case in the Emergency Department
Presenting a case in the ED is important for a number of reasons. Not only does better communication result in better patient care, but it’s also a great learning opportunity and your chance as a clerk to impress your attending. Presenting a case well conveys your level of knowledge and understanding to an attending, which allows them to accurately assess and teach to your weaknesses. It also illustrates that you can create a …
Blood & Clots Series: When should I worry about a PE in a patient with COVID-19 and how do I make the diagnosis?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert, Health Advocate Case Description A patient is admitted to the internal medicine ward and after 5 days of clinical stability, she develops respiratory failure and is admitted to ICU. After 72 hours of mechanical ventilation her D-Dimer is increasing, and she develops worsening oxygenation. When should one suspect PE in COVID-19, and how to establish …