Standing on the corner, minding my own business in the ER

Novel Management of PEA Arrest (Calgary EM Journal Club)

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ACLS management of PEA arrest is traditionally done using CPR, epinephrine and running through the H’s and T’s. Unfortunately, the H’s and T’s can be difficult to recall in a stressful situation, and furthermore, they do not approach cardiac arrest in a physiologic manner. We recently reviewed the following paper that uses a novel approach to […]

Empiric antibiotics after cardiac arrest?

The July 2014 EM:RAP Paper Chase reviewed a paper claiming 38% of OHCA (Out of Hospital Cardiac Arrest) patients are bacteremic, and thus we should routinely give antibiotics to post-arrest patients. We reviewed this paper at the Calgary Journal Club recently and unfortunately, the authors conclusions are more leap of faith than anything else. This single […]

The Negative or Inconclusive Ultrasound in Appendicitis – Can a CDR help?

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The September edition of journal club featured two articles focused on the diagnosis of appendicitis.  These articles each highlight some critical EBM points, which is why I’m breaking them apart into separate posts. This post will only focus on the first article, which examined a potential clinical decision rule for the management of patients with […]

SOCMOB joins REBELEM

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Hi all, I’m excited to report that I’ve joined the group over at REBELEM.com (Rezaie’s Evidence Based Evaluation of Literature in Emergency Medicine) and my first post on the use of Colchicine for treatment of pericarditis is now up. For those of you who don’t follow REBEL:EM, what are you waiting for?  With Salim Rezaie […]

Novel therapies for Anterior Epistaxis (Calgary EM Journal Club)

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Epistaxis can be managed in many ways, from a simple squeeze of the nose to stuffing it with a tampon, and everything in between.  Today we’ll look at two novel methods of managing anterior epistaxis, one of which has become my go to for the moderate, non-anticoagulated bleeder.  Both of these techniques obviate the need […]

Paraspinous Cervical Block for Headache

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Previously we have discussed the use of propofol for migraine headache (part 1, part 2).  In this post, we’ll look at another headache treatment that can be added to your armamentarium, the paraspinous cervical block. There are many standard cocktails for headache management in the ED, but unfortunately, many of these require an IV, fluids, […]

SOCMOB How To: Using the Ventilator for DSI with Dave Lendrum

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Hi all, Today we have a guest post from Dr. David Lendrum, an ER physician at the Foothills Hospital in Calgary.  Dave is a super brilliant doc, and this post will outline how to perform BIPAP using a ventilator, as opposed to bringing an extra BIPAP machine into an already crowded resus area.  This is […]

Evidence Based Management of Acute Heart Failure: Forget LMNOP, think POND!

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Case: Imagine you are an attending ED physician supervising a learner. A 72 year old female presents to the ED with cough and shortness of breath worsening over a week.  She has a history of Afib, previous MI, diabetes and dyslipidemia.  She has recently been non-compliant with her meds and has been taking some ketorolac […]

NSAIDs Part 3: Gastrointestinal Side Effects and Toxicity

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In part 1 of our discussion on NSAIDs, we discussed the equal efficacy of various NSAIDs, while in part 2, we looked at the concept of an analgesic ceiling effect when using NSAIDs. Congrats to all of those who identified the ceiling in part 2 as the Chihuly work at the Bellagio in Las Vegas.  […]

NSAIDs part 2: The Ceiling Effect

Sorry readers.  I’ve been slacking off on vacation in NYC, eating too much and blogging about food more than medicine.  Tonight at dinner with Mr. EMCrit, Scott called me out a bit for insufficient content.  Also, one of my readers has some rounds coming up soon, and needs to talk NSAIDs.  With that in mind, […]