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 …
Identifying presentations of opioid poisoning as an opportunity for meaningful intervention
A 24-year-old woman is brought to the emergency department (ED) after being discovered with a decreased level of consciousness in a local mall bathroom. Two doses of intranasal naloxone were administered on-site by bystanders. After receiving naloxone, her LOC improved, though she was still mildly sedated upon arrival to the ED. After 1-2 hours in the ED, she is alert and reported using 0.5g of smoked fentanyl prior to the episode. You learn …
Spot the diagnosis! The case of woman lying in bed.
This piece by Robert Tennant Cooper, commissioned in 1912, depicts a young woman lying in bed on a balcony. An ominous figure lurks by her bedside with an hourglass. Without the figure, the scene appears almost calm and peaceful with a beautiful landscape beyond the balcony. Observe the piece to come up with a potential diagnosis for the woman lying in bed. What might the woman lying in bed be suffering from? The …
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 …
Emergency Medicine as Social Emergency Medicine
A conversation about social emergency medicine would have sounded incredibly dry before I became a medical student and a mother living through a global pandemic. Now, as I contemplate my own future, as well as the reality of Canadian families navigating complex challenges facing our health and livelihoods, the conversation feels deeply personal. I often wonder how I will practice differently in the future because of what my mentors and teachers are learning …