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Tiny Tips – Cauda Equina Syndrome

In Medical Concepts, Tiny Tips by Mike Craig2 Comments

Cauda Equina Syndrome (CES) is a collection of signs and symptoms resulting from compression of neural elements at the cauda equina.  Although CES has no universal definition, the most commonly cited clinical presentation involves severe lower back pain, bladder dysfunction, and sensory deficits in the sacral nerve root distribution. Associated symptoms can include radicular leg pain, lower extremity weakness, and erectile dysfunction. A recent review explores this variation in definitions and the diagnostic …

Tiny Tips – Taking a Social History

In Medical Concepts, Tiny Tips by Aaron LeungLeave a Comment

While often overlooked, a patient’s social history can help narrow the differential diagnosis as well as help guide their final disposition. A mnemonic to help with the essential parts of the social history is ETOH SHOTS: Education Level of education of the patient; are they able to understand discharge instructions. Treatment Coverage Does the patient have a drug plan to help cover medication costs, can they afford the medications you are prescribing. Offspring/Supports …

Tiny Tip: HELLP Syndrome

In Tiny Tips by Sarah Luckett-Gatopoulos1 Comment

If you train in a tertiary care center with obstetrical triage, you may not assess many pregnant women beyond the first trimester of pregnancy. However, in community emergency departments without a primary obstetrics triage department, you will often encounter pregnancy-induced hypertension (PIH; systolic pressure 140 mmHg, or diastolic pressure 90 mmHg), a common complication occurring in 7-9% of pregnancies. HELLP syndrome is an important subset of PIH that comes with its own built-in mnemonic …

Tiny Tips: The Ottawa SAH Rule

In Tiny Tips by Brent Thoma2 Comments

This month’s ALiEM Journal Club discussed Perry et al’s 2013 paper Clinical Decision Rules to Rule Out Subarachnoid Hemorrhage for Acute Headache. If you haven’t already, check out the awesome collaborative vodcast featuring ALiEM Editors, Annals of EM Editors and the Authors! If you can’t spare 30 minutes, watch at double speed. I suspect the Ottawa SAH rule may be destined to join the ranks of Stiell et al’s other Canadian exports (the Canadian CT …