Episode 45: NYGH EM Update Conference 2014
by @ Emergency Medicine Cases
Fri Jun 06 09:09:42 PDT 2014
This past May in Toronto, the largest and, in my opinion, best Canadian EM conference, North York General Hospital's Emergency Medicine Update Conference, attracted 'Captain Cortex' himself, Stuart Swadron, a Toronto native to talk about his approach to vertigo, which highlights how not to miss a posterior circulation stroke. For the seventh year running the EMU conference was proud to have one of the worlds most well known EM educators, Amal Mattu who presented the most important Cardiology Literature from the past year. This podcast includes edited versions of their talks with commentary and summaries.
The post Episode 45: NYGH EM Update Conference 2014 appeared first on Emergency Medicine Cases.
GI Society Receives the BCAB Humanitarian Award
by GIS @ Gastrointestinal Society
Mon Jun 26 09:00:07 PDT 2017
British Columbians will soon be invited to get good advice about their gut at Badgut.org, thanks to a generous airtime donation by the province’s broadcasters. The British Columbia Association of Broadcasters (BCAB) announced its members have chosen the GI (Gastrointestinal) Society and its associated registered charity, the Canadian Society of Intestinal Research, as this year’s [...]
The post GI Society Receives the BCAB Humanitarian Award appeared first on Gastrointestinal Society.
Best Case Ever 24: COPD, Baggging and Vent Settings
by @ Emergency Medicine Cases
Tue May 27 11:16:59 PDT 2014
In anticipation of the Highlights from North York General's Emergency Medicine Update Conference 2014 we have the master educator himself, Dr. Amal Mattu's Best Case ever of a patient who presented with a COPD exacerbation, that we recorded at the conference in Toronto just a couple of weeks ago. Dr. Mattu gives you a string of pearls and pitfalls when it comes to management of COPD, bagging & vent settings that you will never forget. In the upcoming episode Dr. Mattu will review his favorite papers from the cardiology literature of the past year and Dr. Stuart Swadron will give you his approach to the challenges of the patient with vertigo. This will the first of two parts of the highlights from the conference - the largest and best EM conference in Canada.
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Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage
by @ Emergency Medicine Cases Premium
Mon May 09 07:09:22 PDT 2011
In Part 1 of this episode on Headache Pearls & Pitfalls - Migraine Headache & Subarachnoid Hemorrhage, Dr. Anil Chopra and Dr. Stella Yiu discuss the best evidenced-based management of migraine headache in the ED including the use of dexamethasone, dopamine antagonists, the problems with narcotics and the efficacy of 'triptans'. An easy way to remember the worrisome symptoms of headache indicating a serious cause is reviewed followed by a detailed discussion of the pearls, pitfalls and controversies around the work-up of Subarachnoid Hemorrhage (SAH) in light of some exciting recent literature, including the basis for a new Canadian decision rule for SAH.
The post Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage appeared first on Emergency Medicine Cases.
Towards more effective supplement regulation in Canada
Science-Based Pharmacy
I suppose I owe Health Canada some thanks. It was Health Canada’s lackadaisical regulation of dietary supplements and natural health products that turned me from a “shruggie” pha…
Best Case Ever 12: Drugs of Abuse
by @ Emergency Medicine Cases Premium
Sun Oct 07 18:10:44 PDT 2012
As a bonus to Episode 27 on Drugs of Abuse -Stimulants & Opiates, Dr. Margaret Thompson, one of Canada's leading Toxicologists and the medical director of the Ontario Poison Control Centre tells us 2 of her Best Cases Ever about stimulant overdose surprises. In the related Episode, Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....
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Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis
by Anton Helman @ Emergency Medicine Cases
Tue Nov 08 07:40:52 PST 2016
This is EM Cases Journal Jam podcast on a randomized control trial of dilute apple juice vs PediaLyte for mild pediatric gastroenteritis. While IV rehydration is required in cases of severe gastroenteritis (which we rarely see in North America) and oral rehydration with electrolyte maintenance solutions is still the mainstay in treating moderate gastroenteritis, could better-tasting, more cost-effective fluids such as diluted apple juice be just as effective as traditional electrolyte solutions in milder cases? Listen to Dr. Justin Morgenstern (@First10EM) interviewing Dr. Stephen Freedman, the world-renowned pediatric EM researcher who put ondansetron for pediatric gastroenteritis on the map and who was one of our guest experts on our main episode on Pediatric Gastroenteritis, Constipation and Bowel Obstruction, about this practice-changing paper. This is followed by a hilarious rant on the topic from Dr. Anthony Crocco ("Ranthony"), the Division head and medical director of pediatric EM at Hamilton Health Sciences.
The post Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis appeared first on Emergency Medicine Cases.
Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis
by @ Emergency Medicine Cases Premium
Tue Nov 08 07:40:52 PST 2016
This is EM Cases Journal Jam podcast on a randomized control trial of dilute apple juice vs PediaLyte for mild pediatric gastroenteritis. While IV rehydration is required in cases of severe gastroenteritis (which we rarely see in North America) and oral rehydration with electrolyte maintenance solutions is still the mainstay in treating moderate gastroenteritis, could better-tasting, more cost-effective fluids such as diluted apple juice be just as effective as traditional electrolyte solutions in milder cases? Listen to Dr. Justin Morgenstern (@First10EM) interviewing Dr. Stephen Freedman, the world-renowned pediatric EM researcher who put ondansetron for pediatric gastroenteritis on the map and who was one of our guest experts on our main episode on Pediatric Gastroenteritis, Constipation and Bowel Obstruction, about this practice-changing paper. This is followed by a hilarious rant on the topic from Dr. Anthony Crocco ("Ranthony"), the Division head and medical director of pediatric EM at Hamilton Health Sciences.
The post Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis appeared first on Emergency Medicine Cases.
Scotiabank Charity Challenge
by GIS @ Gastrointestinal Society
Thu Apr 13 12:11:27 PDT 2017
The Gastrointestinal Society is thrilled to announce that it will be participating in the 2017 Scotiabank Charity Challenge! The Vancouver races will be happening on June 25, 2017, and the GI Society needs YOUR help to raise funds and awareness for those living with gastrointestinal and liver conditions across Canada. Runners can participate in either [...]
The post Scotiabank Charity Challenge appeared first on Gastrointestinal Society.
Episode 2: Excited Delirium
by Anton Helman @ Emergency Medicine Cases
Tue Mar 09 08:48:48 PST 2010
Dr. Margaret Thompson, Canada's toxicology guru and Dr. Dan Cass review the clinical presentation, precipitating factors and important do's and don'ts in managing patients with Excited Delirium Syndrome to prevent sudden death. They update us on the most current guidelines for Excited Delirium Syndrome and discuss the prevalent theories to explain why many of these patients have cardiac arrests.
Excited Delirium Syndrome has recently been recognized by the American College of Emergency Physicians as a true medical emergency in which, typically, a young obese male, often under the influence of sympathomimetic drugs, becomes acutely delirious and displays super-human strength, tachypnea, profuse sweating and severe agitation. Usually, there is a prolonged and continued struggle with law enforcement despite physical restraints . Severe acidosis, rhabdomyolysis and hyperkalemia ensue, often leading to a sudden bradyasystolic cardiac arrest. Listen to this fascinating episode to find out how you can recognize and treat this important syndrome.
The post Episode 2: Excited Delirium appeared first on Emergency Medicine Cases.
Probiotics and Gastrointestinal Health | Toronto Naturopathic Doctor
Toronto Naturopathic Doctor
Co-Authored by: Sue Plummer, PhD Iveta Garaiova, PhD Marija Pevac-Djukic, MD(Serbia), ND(Canada) Published in The Naturopathic Doctor News and Review For centuries living microorganisms, particularly lactic acid bacteria (producers of lactic acid from sugar), have been used in food…Read more ›
Episode 59b: Amy Plint on the Management of Bronchiolitis
by @ Emergency Medicine Cases
Thu Feb 19 12:19:26 PST 2015
In response to Episode 59 with Dr. Sanjay Mehta and Dr. Dennis Scolnik on the emergency department diagnosis and management of Bronchiolitis, Dr. Amy Plint, one of Canada's most prominent researchers in Bronchiolitis and the Chair of Pediatric Emergency Research Canada, tells her practical approach to choosing medications in the emergency department, the take home message from her landmark 2009 NEJM study on the use of nebulized epinephrine and dexamethasone for treating Bronchiolitis, and the future of Bronchiolitis research.
The post Episode 59b: Amy Plint on the Management of Bronchiolitis appeared first on Emergency Medicine Cases.
IBD Research and Treatment: Canada’s Fame and Shame
by GIS @ Gastrointestinal Society
Tue Sep 12 13:22:05 PDT 2017
Patients, Advocates and The Cameron Institute, issue call for equal access to IBD treatments CAMBRIDGE, ONTARIO (September 12, 2017) – Approximately 233,000 Canadians know how it feels to wake up every day with IBD (Inflammatory Bowel Disease), which includes Crohn’s Disease and Ulcerative Colitis – painful autoimmune disorders which attack the gastrointestinal tract.1,2 A new [...]
The post IBD Research and Treatment: Canada’s Fame and Shame appeared first on Gastrointestinal Society.
Ensuring Probiotic Quality
Natural Medicine Journal
Probiotics are a very significant category of dietary supplements, and integrative practitioners frequently recommend them. Their popularity has fueled significant growth of this segment of natural products. However, as we all know, growth is not always good. In the case of probiotics, this booming growth has introduced a variety of products into the market that span the quality continuum from excellent to harmful. Probiotics are susceptible to specific quality issues, and it behooves the practitioner to know about them.
Best Case Ever 10: Pediatric Syncope
by Anton Helman @ Emergency Medicine Cases
Mon Jul 09 11:28:27 PDT 2012
Pediatric Syncope usually has a benign cause, but may be a warning for sudden death. As a bonus to Episode 25 on ‘Pediatric & Adult Syncope’ with Dr. Eric Letovsky and Dr. Anna Jarvis, 'Canada's mother of Pediatric Emergency Medicine', we have Dr. Jarvis’s Best Case Ever. In the related episode we will cover how to differentiate syncope from seizure, key historical and physical exam clues to determine a cause of syncope, ECG pearls of syncope causing cardiac conditions, from Congenital Prolonged QT Syndrome to Arrhythmogenic Right Ventricular Cardiomyopathy, the value of syncope decision rules such as the ROSE rule and the San Francisco Syncope Rule, the value of ancillary testing, including Holter monitoring, Echocardiograms and Stress Testing and much more......
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Journal Jam 5 One Hour Troponin to Rule Out and In MI
by @ Emergency Medicine Cases
Tue Dec 22 07:15:11 PST 2015
Traditionally we've run at least 2 troponins 6 or 8 hours apart to help rule out MI and recently in algorithms like the HEART score we've combined clinical data with a 2 or 3 hour delta troponin to help rule out MI. The paper we'll be discussing here is a multicentre/multinantional study from the Canadian Medical Association Journal from this year out of Switzerland entitled "Prospective validation of a 1 hour algorithm to rule out and rule in acute myocardial infarction using a high sensitivity cardian troponin T assay" with lead author Tobias Reichlin. It not only looks at whether or not we can rule out MI using a delta troponin at only 1 hour but whether or not we can expedite the ruling in of MI using this protocol.
The post Journal Jam 5 One Hour Troponin to Rule Out and In MI appeared first on Emergency Medicine Cases.
Contact Us
by netclimber @ CNHPR
Tue Feb 03 11:19:52 PST 2015
Information on our location and how to reach us.
The post Contact Us appeared first on CNHPR.
HHP Dimensions of Health: Mental – Resolved to Have a Good Year
by Humarian Health Blogger @ Humarian
Thu Jan 18 04:00:33 PST 2018
A New Year means it’s time for a new podcast! Today is all about goal setting. We all make promises for the New Year, but very few of us actually follow through on our resolutions. Amy tells Dr. B. all about the SMART system that she uses for goal setting, and Dr. B. fires back […]
The post HHP Dimensions of Health: Mental – Resolved to Have a Good Year appeared first on Humarian.
Episode 83 – 5 Critical Care Controversies from SMACC Dublin
by @ Emergency Medicine Cases Premium
Tue Jul 05 07:32:26 PDT 2016
EM Cases Episode 83 - 5 Critical Care Controversies from SMACC Dublin: I had the great opportunity to gather some of the brightest minds in Emergency Medicine and Critical Care from around the world (Mark Forrest from U.K., Chris Nickson from Australia, Chris Hicks from Canada and Scott Weingart from U.S.) at the SMACC Dublin Conference and ask them about 5 Critical Care Controversies and concepts:
How to best prepare your team for a resuscitation
Optimum fluid management in sepsis
Direct vs. video laryngoscopy as first line tool for endotracheal intubation
Early vs. late trauma intubation
Whether or not to attempt a thoracotomy in non-trauma centres
The discussion that ensued was enlightening...
The post Episode 83 – 5 Critical Care Controversies from SMACC Dublin appeared first on Emergency Medicine Cases.
Episode 59b: Amy Plint on the Management of Bronchiolitis
by Anton Helman @ Emergency Medicine Cases
Thu Feb 19 12:19:26 PST 2015
In response to Episode 59 with Dr. Sanjay Mehta and Dr. Dennis Scolnik on the emergency department diagnosis and management of Bronchiolitis, Dr. Amy Plint, one of Canada's most prominent researchers in Bronchiolitis and the Chair of Pediatric Emergency Research Canada, tells her practical approach to choosing medications in the emergency department, the take home message from her landmark 2009 NEJM study on the use of nebulized epinephrine and dexamethasone for treating Bronchiolitis, and the future of Bronchiolitis research.
The post Episode 59b: Amy Plint on the Management of Bronchiolitis appeared first on Emergency Medicine Cases.
Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis
by @ Emergency Medicine Cases
Tue Nov 08 07:40:52 PST 2016
This is EM Cases Journal Jam podcast on a randomized control trial of dilute apple juice vs PediaLyte for mild pediatric gastroenteritis. While IV rehydration is required in cases of severe gastroenteritis (which we rarely see in North America) and oral rehydration with electrolyte maintenance solutions is still the mainstay in treating moderate gastroenteritis, could better-tasting, more cost-effective fluids such as diluted apple juice be just as effective as traditional electrolyte solutions in milder cases? Listen to Dr. Justin Morgenstern (@First10EM) interviewing Dr. Stephen Freedman, the world-renowned pediatric EM researcher who put ondansetron for pediatric gastroenteritis on the map and who was one of our guest experts on our main episode on Pediatric Gastroenteritis, Constipation and Bowel Obstruction, about this practice-changing paper. This is followed by a hilarious rant on the topic from Dr. Anthony Crocco ("Ranthony"), the Division head and medical director of pediatric EM at Hamilton Health Sciences.
The post Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis appeared first on Emergency Medicine Cases.
Episode 45: NYGH EM Update Conference 2014
by Anton Helman @ Emergency Medicine Cases
Fri Jun 06 09:09:42 PDT 2014
This past May in Toronto, the largest and, in my opinion, best Canadian EM conference, North York General Hospital's Emergency Medicine Update Conference, attracted 'Captain Cortex' himself, Stuart Swadron, a Toronto native to talk about his approach to vertigo, which highlights how not to miss a posterior circulation stroke. For the seventh year running the EMU conference was proud to have one of the worlds most well known EM educators, Amal Mattu who presented the most important Cardiology Literature from the past year. This podcast includes edited versions of their talks with commentary and summaries.
The post Episode 45: NYGH EM Update Conference 2014 appeared first on Emergency Medicine Cases.
Becel Gets Trendy with New Avocado-Based Product
by Joanne Somaiya @ Canadian Food Business
Thu Dec 14 12:34:36 PST 2017
By Kelly Townsend Avocado, anyone? Like it or not, the green fruit has dominated as a major food trend the last few years, to the point where avocado toast has became the unexpected mascot of healthy eating everywhere. Recognizing an opportunity, Unilever developed an avocado oil product for its major margarine brand, Becel. “It’s important for …
Best Case Ever 45 – Mike Winters on Cardiac Arrest
by @ Emergency Medicine Cases Premium
Tue May 10 12:50:47 PDT 2016
I had the great pleasure of meeting Dr. Mike Winters on his first ever visit to Canada at North York General's Emergency Medicine Update Conference, where he gave two fantastic presentations. His credentials are impressive: He is the Medical Director of the Emergency Department, Associate Professor in both EM and IM, EM-IM-Critical Care Program co-director and Residency Program Director of EM-IM at the University of Maryland in Baltimore.
Sometimes we are so caught up with the job we need to get done during cardiac arrest that we forget about the important and profound effect that this event has on patients' families. On this Best Case Ever Dr. Winters tells the story of witnessing his grandfather's cardiac arrest, being present in the ED during the resuscitation attempts, and how that experience has coloured his practice. We discuss some pearls on communication with patients' families after death, colour-coded cardiac arrest teams and how to integrate POCUS into cardiac arrest care while minimizing chest compressions.
The post Best Case Ever 45 – Mike Winters on Cardiac Arrest appeared first on Emergency Medicine Cases.
Episode 51 Effective Patient Communication – Managing Difficult Patients
by @ Emergency Medicine Cases
Tue Sep 30 16:47:29 PDT 2014
If you believe that coping with some of the people we deal with in emergency medicine is difficult or impossible, you’re not alone. We all feel this way from time to time. Managing difficult patients can be a challenge to the health care provider and to the entire ED. The hostile aggressive patient, the demanding patient, the know-it-all, the excessively anxious patient, and the incessant complainer, are some of the folks that we need to know how to manage effectively. If we fail to handle these patients appropriately, they may receive suboptimal care, grind patient flow to a halt, and delay care of other patients. If the staff has to deal with a multitude of these patients on a given shift, there’s a sort of swarm-based escalation in frustration and sometimes, unfortunately, a total breakdown of effective patient communication and care.
But don't fret. In this one-of-a-kind podcast on effective patient communication and managing difficult patients, Dr. Walter Himmel, Dr. Jean-Pierre Champagne and RN Ann Shook take us through specific strategies, based on both the medical and non-medical literature, on how we can effectively manage these challenging patients. As a bonus, we address the difficult situation of breaking bad news with a simple mnemonic and discuss tips on how to deliver effective discharge instructions to help improve outcomes once your patient leave the ED.
The post Episode 51 Effective Patient Communication – Managing Difficult Patients appeared first on Emergency Medicine Cases.
Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions
by Anton Helman @ Emergency Medicine Cases
Tue Mar 29 12:30:54 PDT 2016
This is EM Cases Journal Jam Podcast 6 - Outpatient Topical Anesthetics for Corneal Abrasions.
I’ve been told countless times by ophthalmologists and other colleagues NEVER to prescribe topical anesthetics for corneal abrasion patients, with the reason being largely theoretical - that tetracaine and the like will inhibit re-epithelialization and therefore delay epithelial healing as well as decrease corneal sensation, resulting in corneal ulcers. With prolonged use of outpatient topical anesthetics for corneal abrasions, corneal opacification could develop leading to decreased vision.
Now this might be true for the tetracaine abuser who pours the stuff in their eye for weeks on end, but when we look at the literature for toxic effects of using topical anesthetics in the short term, there is no evidence for any clinically important detrimental outcomes. Should we ignore the dogma and use tetracaine anyway? Is there evidence that the use of topical anesthetics after corneal abrasions is safe and effective for pain control without adverse effects or delayed epithelial healing?
To discuss the paper "The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review" by Drs. Swaminathan, Otterness, Milne and Rezaie published in the Journal of Emergency Medicine in 2015, we have EM Cases’ Justin Morgenstern, a Toronto-based EM Doc, EBM enthusiast as well as the brains behind the First10EM blog and Salim Rezaie, Clinical Assistant Professor of EM and Internal Medicine at University of Texas Health Science Center at San Antonio as well as the Creator & Founder of the R.E.B.E.L. EM blog and REBELCast podcast.
In this Journal Jam podcast, Dr. Morgenstern and Dr. Rezaie also discuss a simple approach to critically appraising a systematic review article, how to handle consultants who might not be aware of the literature and/or give you a hard time about your decisions and much more...
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Marijuana Stocks Newsletter – February 13, 2018
by Steven M @ What's Hempening
Tue Feb 13 06:35:49 PST 2018
One of Canada’s Top 4 marijuana Stocks To Watch Will Georgia Decriminalize Marijuana Possession? Why is this Marijuana Stock Considered a “Game-Changer”? Texas Opens Frist MMJ Dispensary Canadian Marijuana Stocks Gain Popularity Abroad Blue Line Protection Group, Inc.(BLPG) and Hypur Bring “Hypur Vault”… GT Biopharma Inc. (GTBP) Announces Dr. Jeffrey Miller, Renowned NK Cell… CannTrust […]
The post Marijuana Stocks Newsletter – February 13, 2018 appeared first on What's Hempening.
Episode 63 – Pediatric DKA
by @ Emergency Medicine Cases
Tue Apr 28 16:20:51 PDT 2015
Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases’ partners who’s mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering - why was DKA singled out in this needs assessment?
It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment - cerebral edema being the big bad one.
The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum ketones are in the diagnosis of DKA, how to assess the severity of DKA to guide management, how to avoid the dreaded cerebral edema that all too often complicates DKA, how to best adjust fluids and insulin during treatment, which kids can go home, which kids can go to the floor and which kids need to be transferred to a Pediatric ICU.
The post Episode 63 – Pediatric DKA appeared first on Emergency Medicine Cases.
Episode 77 Fever in the Returning Traveler
by @ Emergency Medicine Cases Premium
Mon Feb 29 21:19:53 PST 2016
In this EM Cases episode with Dr. Nazanin Meshkat, multinational ED doc and Dr. Matthew Muller, infectious disease specialist, we discuss the most common tropical disease killers that we see in patients who present with Fever in the Returning Traveler. Every year an increasing number of people travel abroad, and travelers to tropical destinations are often immunologically naïve to the regions they’re going to. It’s very common for travelers to get sick. In fact, about 2/3 of travelers get sick while they’re traveling or soon after their return, and somewhere between 3 and 19% of travelers to developing countries will develop a fever.
Imported diseases, like Malaria, Dengue, Ebola, and Zyka can be acquired abroad and brought back to your ED in unsuspecting individuals. This is serious stuff - you might be surprised to learn that Malaria is responsible for more morbidity and mortality worldwide than any other illness.
According to a study in CJEM most emergency physicians have minimal or no specific training in tropical diseases and emergency physicians indicated an unacceptably low level of comfort when faced with patients with tropical disease symptoms. In fact, 40% of the cases were incorrectly diagnosed or managed. And Canadian ED docs aren’t the only ones who’s skill isn’t stellar in this department - a similar 2006 study of UK physicians showed a 78% misdiagnosis rate. This misdiagnosis rate isn’t wholly because of lack of knowledge – it almost certainly also has to do with the vague presentations and huge amount of overlap between so many tropical disease.
You might be thinking that it’s impossible to learn all the thousands of details of the dozens of different tropical diseases - true. However, in the ED, while we don’t need to know every detail of every tropical disease, and don’t necessarily need to make the exact diagnosis right away, we do need to have a rational, organized approach to diagnosing and managing fever in the returning traveler, so that we can identify some of the more common serious illnesses like Malaria, Dengue and Typhoid fever, and start timely treatment in the ED.
The post Episode 77 Fever in the Returning Traveler appeared first on Emergency Medicine Cases.
WTBS 6 Measuring Quality – The Value of Health Care Metrics
by Dr. Howard Ovens @ Emergency Medicine Cases
Mon Feb 29 08:48:04 PST 2016
A New York Times article titled “How Measurement Fails Doctors and Teachers” went viral on social media in January and caused a lot of chatter in medical circles. Its author, a professor of medicine at the University of California, gave voice to a wide sense of frustration, and while I understand that feeling and think it’s justified, I don’t agree with labelling measurement as the culprit. As I expressed in my first WTBS blog post, “Why Recording Time to Initial Assessment is Worthwhile,” I believe my job as an administrator is to make the job of my staff easier, and measurements can help us maintain standards of care and understand where gaps in the system may exist—when such data are collected and used appropriately.
In this guest blog, Dr. Lucas Chartier, an emergency physician in Toronto with a background in quality improvement, expands on the subject of how we’ve gone off course in our zeal for measurement and helps us try to find the path back to our intended goals.
The post WTBS 6 Measuring Quality – The Value of Health Care Metrics appeared first on Emergency Medicine Cases.
HHP – Dr. Towle: Ways to Keep Your Pet Healthy in 2018
by Humarian Health Blogger @ Humarian
Wed Jan 31 12:30:33 PST 2018
On this week’s show, we welcome back our favorite veterinarian, Dr. Julie Towle, to talk about some of the things pet owners can do to help their pets stay healthier in 2018. Dr. Towle talks about wet food vs. dry food, core exercises for dogs, mental and environmental enrichment for dogs and cats, the importance […]
The post HHP – Dr. Towle: Ways to Keep Your Pet Healthy in 2018 appeared first on Humarian.
Updates in the natural health products ingredients database (NHPID) January 2015
by netclimber @ CNHPR
Sat Jan 31 11:03:47 PST 2015
The post Updates in the natural health products ingredients database (NHPID) January 2015 appeared first on CNHPR.
Episode 71 ACLS Guidelines 2015 – Cardiac Arrest Controversies Part 1
by @ Emergency Medicine Cases
Wed Oct 21 13:58:51 PDT 2015
A lot has changed over the years when it comes to managing the adult in cardiac arrest. As a result, survival rates after cardiac arrest have risen steadily over the last decade. With the release of the 2015 American Heart Association ACLS Guidelines 2015 online on Oct 16th, while there aren’t a lot a big changes, there are many small but important changes we need to be aware of, and there still remains a lot of controversy. In light of knowing how to provide optimal cardio-cerebral resuscitation and improving patient outcomes, in this episode we’ll ask two Canadian co-authors of The Guidelines, Dr. Laurie Morrison and Dr. Steve Lin some of the most practice-changing and controversial questions.
The post Episode 71 ACLS Guidelines 2015 – Cardiac Arrest Controversies Part 1 appeared first on Emergency Medicine Cases.
Coupon Database
True Couponing
COUPONS!! We've put together an easy searchable database of all UNexpired coupons so you will never go to the store for something you need empty handed!
Setting the table for a homegrown value-added food sector
by Joanne Somaiya @ Canadian Food Business
Tue Feb 06 09:56:41 PST 2018
As foreign food processors pull out of Canada, taking jobs with them, it’s essential to the economy that we fill the gap By Sylvain Charlebois, Senior Fellow, Atlantic Institute for Market Studies The bloodbath in foreign-owned, large-scale food manufacturing in Canada continues. Canadian value-added food producers need to fill the gap. In the past few …
New Herbal Smoking Brands Emerge As Canada Moves Toward Legalization
What's Hempening
New Herbal Smoking Brands Emerge As Canada Moves Toward Legalization
Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales
by @ Emergency Medicine Cases Premium
Tue Dec 30 15:00:40 PST 2014
There are hundreds of clinical decision rules and risk scales published in the medical literature, some more widely adopted than others. Ian Stiell, the father of clinical decision rules, shares with us his views and experiences gained from co-creating some of the most influential CDRs and risk scales to date. He explains the criteria for developing a CDR, the steps to developing a valid CDR, how best to apply CDRs and risk scales to clinical practice, and the hot-off the-press new Ottawa COPD Risk Score and Ottawa Heart Failure Risk Score for helping you with disposition decisions. It turns out that in Canada, we discharge about two thirds of the acute decompensated heart failure patients that we see in the ED, while the US almost all patients with decompensated heart failure are admitted to hospital. Dr. Stiell's new risk scores may help physicians in Canada make safer disposition decisions while help physicians in the US avoid unnecessary admissions.
The post Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales appeared first on Emergency Medicine Cases.
One of Canada’s Top 4 marijuana Stocks To Watch
by Steven M @ What's Hempening
Tue Feb 13 07:38:50 PST 2018
One of Canada’s Top 4 marijuana Stocks To Watch Will Georgia Decriminalize Marijuana Possession? Why is this Marijuana Stock Considered a “Game-Changer”? Texas Opens Frist MMJ Dispensary Canadian Marijuana Stocks Gain Popularity Abroad CannTrust Holdings Inc. (CNTTF) Receives Sales License from Health Canada for… mCig, Inc. (MCIG) Provides Update on Obitx Spin-Off and Other Corporate… […]
The post One of Canada’s Top 4 marijuana Stocks To Watch appeared first on What's Hempening.
Happy Canada Day!
by thrive360 @ thrive360
Fri Jun 30 03:22:57 PDT 2017
By Zannat Reza, MHSc RD Happy Canada Day!!! Have an amazingly delicious long weekend featuring red and white-themed recipes. With local strawberries in season, how about these Strawberry Cardamom Scones? I created this recipe for Canadian Lentils, so yes, there are lentils in these scones...
The post Happy Canada Day! appeared first on thrive360.
Best Case Ever 23: The Effect of Medical Insurance on ED Care
by Anton Helman @ Emergency Medicine Cases
Mon May 19 14:59:48 PDT 2014
EM Cases brings you Canada's brightest minds in Emergency Medicine. Dr. Stuart Swadron, EM:RAP's 'Captain Cortex' in fact went to medical school at the University of Toronto and practiced in British Columbia before he headed down to Los Angeles to complete his Emergency Medicine Residency and become the residency program director at USC. So he is just the man to tell us his Best Case Ever about The Effect of Medical Insurance on ED Care and highlight some of the differences between the U.S. and Canadian health care systems. This is in anticipation of our upcoming EM Cases episode on North York General's 'Highlights of the Emergency Medicine Update Conference 2014', Canada's largest and best EM Conference where Dr. Swadron spoke eloquently about his approach to Vertigo in the ED including the value of the HINTS exam. In this upcoming episode we will also have Dr. Amal Mattu talking about the most important Cardiology Literature from the past year. We would love to hear your opinion on how the Canadian and U.S. health care systems could be changed to help improve patient care in our emergency departments. Please post your comments below.
The post Best Case Ever 23: The Effect of Medical Insurance on ED Care appeared first on Emergency Medicine Cases.
Journal Jam 7 – Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial
by @ Emergency Medicine Cases
Tue Jul 26 16:07:52 PDT 2016
Journal Jam 7 - Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial.
In our most popular EM Cases episode to date - ACLS Guidelines Cardiac Arrest Controversies, we boldly stated, that there has never been an antiarrhythmic medication that has shown any long term survival benefit in cardiac arrest. The use of medications in cardiac arrest has been one of those things that we all do, but that we know the evidence isn’t great for. Yet Amiodarone is still in the newest AHA adult cardiac arrest algorithm for ventricular fibrillation or pulseless ventricular tachycarida – 300mg IV after the 3rd shock with the option to give it again at 150mg after that. Anti-arrhythmics have been shown in previous RCTs to increase the rate of return of spontaneous circulation and even increased survival to hospital admission, however none of them have been able to show a decrease in mortality or a favourable neurological outcome at hospital discharge. In other words, there has never been shown a long term survival or functional benefit - which is a bit disconcerting.
But now, we have a recent large randomized, controlled trial that shines some new light on the role of anti-arrythmics in cardiac arrest - The ALPS trial: Amiodarone vs Lidocaine vs placebo in out of hospital cardiac arrest. In this Journal Jam podcast, Justin Morgenstern and Anton Helman interview two authors of the ALPS trial, Dr. Laurie Morrison a world-renowned researcher in cardiac arrest and Dr. Paul Dorian, a cardiac electrophysiologist and one of Canada's leading authorities on arrhythmias about what we should take away from the ALPS trial. It turns out, it's not so simple. We also discuss the value of dual shock therapy for shock resistant ventricular fibrillation and the future of cardiac arrest care.
The post Journal Jam 7 – Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial appeared first on Emergency Medicine Cases.
Best Case Ever 23: The Effect of Medical Insurance on ED Care
by @ Emergency Medicine Cases Premium
Mon May 19 14:59:48 PDT 2014
EM Cases brings you Canada's brightest minds in Emergency Medicine. Dr. Stuart Swadron, EM:RAP's 'Captain Cortex' in fact went to medical school at the University of Toronto and practiced in British Columbia before he headed down to Los Angeles to complete his Emergency Medicine Residency and become the residency program director at USC. So he is just the man to tell us his Best Case Ever about The Effect of Medical Insurance on ED Care and highlight some of the differences between the U.S. and Canadian health care systems. This is in anticipation of our upcoming EM Cases episode on North York General's 'Highlights of the Emergency Medicine Update Conference 2014', Canada's largest and best EM Conference where Dr. Swadron spoke eloquently about his approach to Vertigo in the ED including the value of the HINTS exam. In this upcoming episode we will also have Dr. Amal Mattu talking about the most important Cardiology Literature from the past year. We would love to hear your opinion on how the Canadian and U.S. health care systems could be changed to help improve patient care in our emergency departments. Please post your comments below.
The post Best Case Ever 23: The Effect of Medical Insurance on ED Care appeared first on Emergency Medicine Cases.
Episode 41: Hypertensive Emergencies
by @ Emergency Medicine Cases
Mon Mar 24 08:31:09 PDT 2014
In this episode on Hypertensive Emergencies, Dr. Joel Yaphe, EM residency program director at the University of Toronto & Dr. Clare Atzema, one of Canada's leading cardiovascular EM researchers will discuss the controversies of how to manage patients who present to the ED with high blood pressure and evidence of end organ damage related to the high blood pressure. Hypertensive emergencies are a grab bag of diagnoses that all need to be treated differently. Hypertensive Encephalopathy, Aortic Dissection, Acute Pulmonary Edema, Pre-eclampsia & Eclampsia, Acute Renal Failure, Subarachnoid Hemorrhage and Intracranial Hemorrhage all need individualized blood pressure management.
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Product Licensing
by netclimber @ CNHPR
Thu Feb 05 16:23:17 PST 2015
The post Product Licensing appeared first on CNHPR.
Best Case Ever 10: Pediatric Syncope
by @ Emergency Medicine Cases Premium
Mon Jul 09 11:28:27 PDT 2012
Pediatric Syncope usually has a benign cause, but may be a warning for sudden death. As a bonus to Episode 25 on ‘Pediatric & Adult Syncope’ with Dr. Eric Letovsky and Dr. Anna Jarvis, 'Canada's mother of Pediatric Emergency Medicine', we have Dr. Jarvis’s Best Case Ever. In the related episode we will cover how to differentiate syncope from seizure, key historical and physical exam clues to determine a cause of syncope, ECG pearls of syncope causing cardiac conditions, from Congenital Prolonged QT Syndrome to Arrhythmogenic Right Ventricular Cardiomyopathy, the value of syncope decision rules such as the ROSE rule and the San Francisco Syncope Rule, the value of ancillary testing, including Holter monitoring, Echocardiograms and Stress Testing and much more......
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[wpfilebase tag=file id=387 tpl=emc-mp3 /]
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Best Case Ever 23: The Effect of Medical Insurance on ED Care
by @ Emergency Medicine Cases
Mon May 19 14:59:48 PDT 2014
EM Cases brings you Canada's brightest minds in Emergency Medicine. Dr. Stuart Swadron, EM:RAP's 'Captain Cortex' in fact went to medical school at the University of Toronto and practiced in British Columbia before he headed down to Los Angeles to complete his Emergency Medicine Residency and become the residency program director at USC. So he is just the man to tell us his Best Case Ever about The Effect of Medical Insurance on ED Care and highlight some of the differences between the U.S. and Canadian health care systems. This is in anticipation of our upcoming EM Cases episode on North York General's 'Highlights of the Emergency Medicine Update Conference 2014', Canada's largest and best EM Conference where Dr. Swadron spoke eloquently about his approach to Vertigo in the ED including the value of the HINTS exam. In this upcoming episode we will also have Dr. Amal Mattu talking about the most important Cardiology Literature from the past year. We would love to hear your opinion on how the Canadian and U.S. health care systems could be changed to help improve patient care in our emergency departments. Please post your comments below.
The post Best Case Ever 23: The Effect of Medical Insurance on ED Care appeared first on Emergency Medicine Cases.
CBD Oil (Hemp Oil) – Benefits, Side Effects, & Why It Is Legal
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 13:23:56 PST 2018
CBD Oil: What Is It? CBD stands for cannabidiol, one of the many cannabinoid compounds found in most strains of Cannabis sativa, also known as marijuana.1 Cannabinoids are compounds that react with specific receptors found throughout the human body. Unlike tetrahydrocannabinol (THC), another popular cannabinoid, CBD oil doesn’t have psychoactive properties.1 This means consuming it […]
The post CBD Oil (Hemp Oil) – Benefits, Side Effects, & Why It Is Legal appeared first on Better Health Organization.
Best Case Ever 45 – Mike Winters on Cardiac Arrest
by Anton Helman @ Emergency Medicine Cases
Tue May 10 12:50:47 PDT 2016
I had the great pleasure of meeting Dr. Mike Winters on his first ever visit to Canada at North York General's Emergency Medicine Update Conference, where he gave two fantastic presentations. His credentials are impressive: He is the Medical Director of the Emergency Department, Associate Professor in both EM and IM, EM-IM-Critical Care Program co-director and Residency Program Director of EM-IM at the University of Maryland in Baltimore.
Sometimes we are so caught up with the job we need to get done during cardiac arrest that we forget about the important and profound effect that this event has on patients' families. On this Best Case Ever Dr. Winters tells the story of witnessing his grandfather's cardiac arrest, being present in the ED during the resuscitation attempts, and how that experience has coloured his practice. We discuss some pearls on communication with patients' families after death, colour-coded cardiac arrest teams and how to integrate POCUS into cardiac arrest care while minimizing chest compressions.
The post Best Case Ever 45 – Mike Winters on Cardiac Arrest appeared first on Emergency Medicine Cases.
Coronary Artery Disease Overview
by Humarian Health Blogger @ Humarian
Mon Feb 05 12:29:13 PST 2018
It’s American Heart Month! That means it’s time for us to draw attention to our hearts and what we can do to keep them beating strong. Heart health is a big concern for Americans, as heart disease is the leading cause of death for men and women in the United States with more than 700,000 […]
The post Coronary Artery Disease Overview appeared first on Humarian.
Top 14 Serious Candida Symptoms: Rash, Yeast Infection, Esophagitis & More
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 13:54:08 PST 2018
Candida is a fungal infection caused from an overgrowth of Candida yeast. In most cases, the strain known as Candida albicans is responsible. Candida Symptoms Generally, there are two categories of candida symptoms: overall and location-specific. The candida symptoms list includes:2,3,4,5,6,7 Skin rash Fatigue Esophagitis White patches on the tongue, throat, inner cheeks or mouth […]
The post Top 14 Serious Candida Symptoms: Rash, Yeast Infection, Esophagitis & More appeared first on Better Health Organization.
Episode 51 Effective Patient Communication – Managing Difficult Patients
by Anton Helman @ Emergency Medicine Cases
Tue Sep 30 16:47:29 PDT 2014
If you believe that coping with some of the people we deal with in emergency medicine is difficult or impossible, you’re not alone. We all feel this way from time to time. Managing difficult patients can be a challenge to the health care provider and to the entire ED. The hostile aggressive patient, the demanding patient, the know-it-all, the excessively anxious patient, and the incessant complainer, are some of the folks that we need to know how to manage effectively. If we fail to handle these patients appropriately, they may receive suboptimal care, grind patient flow to a halt, and delay care of other patients. If the staff has to deal with a multitude of these patients on a given shift, there’s a sort of swarm-based escalation in frustration and sometimes, unfortunately, a total breakdown of effective patient communication and care.
But don't fret. In this one-of-a-kind podcast on effective patient communication and managing difficult patients, Dr. Walter Himmel, Dr. Jean-Pierre Champagne and RN Ann Shook take us through specific strategies, based on both the medical and non-medical literature, on how we can effectively manage these challenging patients. As a bonus, we address the difficult situation of breaking bad news with a simple mnemonic and discuss tips on how to deliver effective discharge instructions to help improve outcomes once your patient leave the ED.
The post Episode 51 Effective Patient Communication – Managing Difficult Patients appeared first on Emergency Medicine Cases.
Leyla Weighs In: Five ways to stay healthy during cold and flu season
by Leyla Muedin MS, RD, CDN @ Article – DR. RONALD HOFFMAN
Fri Jan 19 16:41:46 PST 2018
Besides regular hand washing, which can reduce your chances of getting the flu by 50 percent according to the CDC, here are some other things you can do to keep your immune system optimal: 1) Take a probiotic, and eat probiotic foods...read more
Best Case Ever 37 Neonatal Lazy Feeder
by @ Emergency Medicine Cases Premium
Tue Jun 16 13:06:23 PDT 2015
On this EM Cases Best Case Ever Dr. Anthony Crocco, the Head and the Division Head of Pediatric EM at McMaster University and Medical Director of Pediatric Emergency Medicine at Hamilton Health Sciences Hosptial, discusses an approach to the neonatal lazy feeder and why we should abandon the use of codeine in pediatrics as well as in breastfeeding mothers. The approach to the neonatal lazy feeder should be considered as an approach to altered level of awareness with a wide differential diagnosis, and there is one question that should always be asked of the neontal lazy feeder....
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Watch this space…
by Jason Hawrelak @ Probiotic Advisor
Sun Mar 08 20:05:48 PDT 2015
The post Watch this space… appeared first on Probiotic Advisor.
Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales
by Anton Helman @ Emergency Medicine Cases
Tue Dec 30 15:00:40 PST 2014
There are hundreds of clinical decision rules and risk scales published in the medical literature, some more widely adopted than others. Ian Stiell, the father of clinical decision rules, shares with us his views and experiences gained from co-creating some of the most influential CDRs and risk scales to date. He explains the criteria for developing a CDR, the steps to developing a valid CDR, how best to apply CDRs and risk scales to clinical practice, and the hot-off the-press new Ottawa COPD Risk Score and Ottawa Heart Failure Risk Score for helping you with disposition decisions. It turns out that in Canada, we discharge about two thirds of the acute decompensated heart failure patients that we see in the ED, while the US almost all patients with decompensated heart failure are admitted to hospital. Dr. Stiell's new risk scores may help physicians in Canada make safer disposition decisions while help physicians in the US avoid unnecessary admissions.
The post Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales appeared first on Emergency Medicine Cases.
Episode 69 Obesity Emergency Management
by @ Emergency Medicine Cases Premium
Tue Sep 08 11:11:44 PDT 2015
Current estimates of the prevalence of obesity are that a quarter of adult Canadians and one third of Americans are considered obese with approximately 3% being morbidly obese. With the proportion of patients with a BMI>30 growing every year, you’re likely to manage at least one obese patient on every ED shift. Obese patients are at high risk of developing a host of medical complications including diabetes, hypertension, coronary artery disease, peripheral vascular disease, biliary disease, sleep apnea, cardiomyopathy, pulmonary embolism and depression, and are less likely compared to non-obese adults to receive timely care in the ED.
Not only are these patients at higher risk for morbidity and mortality, but obesity emergency management is complicated by the patient’s altered cardiopulmonary physiology and drug metabolism. This can make their acute management much more challenging and dangerous. To help us gain a deeper understanding of the challenges of managing obese patients and elucidate a number of important differences as well as practical approaches to obesity emergency management, we welcome Dr. Andrew Sloas, the founder and creator of the fantastic pediatric EM podcast PEM ED, Dr. Richard Levitan, a world-famous airway management educator and innovator and Dr. David Barbic a prominent Canadian researcher in obesity in emergency medicine from University of British Columbia....
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Should you try a “natural alternative” before medication?
by Scott @ Science-Based Pharmacy
Sun Jul 17 07:22:34 PDT 2016
The idea of taking medication can be frightening. And as consumers and patients that want to make our own informed health decisions, it’s understandable and even appropriate to question our physicians when they recommend drug treatments. We need to understand the rationale for any medication that’s recommended or prescribed, the benefits of therapy, the side … Continue reading Should you try a “natural alternative” before medication?
Episode 83 – 5 Critical Care Controversies from SMACC Dublin
by @ Emergency Medicine Cases
Tue Jul 05 07:32:26 PDT 2016
EM Cases Episode 83 - 5 Critical Care Controversies from SMACC Dublin: I had the great opportunity to gather some of the brightest minds in Emergency Medicine and Critical Care from around the world (Mark Forrest from U.K., Chris Nickson from Australia, Chris Hicks from Canada and Scott Weingart from U.S.) at the SMACC Dublin Conference and ask them about 5 Critical Care Controversies and concepts:
How to best prepare your team for a resuscitation
Optimum fluid management in sepsis
Direct vs. video laryngoscopy as first line tool for endotracheal intubation
Early vs. late trauma intubation
Whether or not to attempt a thoracotomy in non-trauma centres
The discussion that ensued was enlightening...
The post Episode 83 – 5 Critical Care Controversies from SMACC Dublin appeared first on Emergency Medicine Cases.
Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction
by Anton Helman @ Emergency Medicine Cases
Fri Jan 06 17:04:26 PST 2012
In Part 2 of this pediatric abdominal pain Episode - Pediatric Gastroenteritis, Constipation & Bowel Obstruction, Dr. Anna Jarvis, Canada's "mother of pediatric emergency medicine" and Dr. Stephen Freedman, one of Canada's pre-eminent researchers in pediatric GI emergencies, discuss the assessment, work-up and treatment of pediatric gastroenteritis, with particular attention to gastroenteritis & acute abdomen mimics, how best to assess hydration status, the nuances of the use of ondansetron and the prose and cons of various rehydration methods. A detailed discussion of the most common and lethal causes of acute abdomen bowel obstruction in pediatrics follows, including intussesception and midgut volvulus. Finally, the differential diagnosis and best management of the most common cause of pediatric abdominal pain, constipation, is reviewed.
The post Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction appeared first on Emergency Medicine Cases.
Adam Gibson
by netclimber @ CNHPR
Mon Mar 09 12:03:20 PDT 2015
Adam Gibson, the Director General of the Natural and Non-prescription Health Products Directorate leaves his position as of January 16, 2015. His replacement has not yet been announced.
The post Adam Gibson appeared first on CNHPR.
Episode 18 Part 2: More Point of Care Ultrasound
by Anton Helman @ Emergency Medicine Cases
Tue Nov 08 07:25:25 PST 2011
In Part 2 of this Episode on Emergency Ultrasound or Point of Care Ultrasound (POCUS) Dr. Fischer, Dr. Hannam, Dr. Chenkin & Dr. Hall, Canada's EM ultrasound gurus discuss how POCUS can help our decision-making in the pediatric patient with a limp, in the patient with necrotizing fasciitis, in the pregnant patient with vaginal bleeding and in the common and challenging elderly patient with undifferentiated abdominal pain. They cover POCUS indications from urinary retention to appendicitis and debate the utility of these indications. This is followed by a debate on how best to educate ourselves and the EM community in POCUS and how best to designs quality assurance programs so that point of care ultrasound (POCUS) becomes an accepted tool across the entire medical community.
The post Episode 18 Part 2: More Point of Care Ultrasound appeared first on Emergency Medicine Cases.
The Probiotic Advisor Advantage - Probiotic Advisor
Probiotic Advisor
Probiotic Advisor will revolutionize your use of probiotics. When you prescribe natural medicines, such as vitamins, minerals, or herbal medicines, you don’t make the assumption that because vitamins C, B12, A and D are all vitamins they are, therefore, used in the same way. Or that zinc, iron, and magnesium are all minerals that can … Continue reading The Probiotic Advisor Advantage →
Candida Albicans: Test for Overgrowth, Treatment Options, & Die Off
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 11:29:04 PST 2018
Candida Albicans What is Candida? In biological terms, Candida is a genus of single-celled fungi in the yeast family. However, the frequently used candida definition often refers to the overgrowth of Candida, most often the Candida albicans species.3 The proper Candida pronunciation is \ˈkan-də-də\ or CAN-de-duh.9 What is Candida albicans? – Candida albicans (C. albicans) […]
The post Candida Albicans: Test for Overgrowth, Treatment Options, & Die Off appeared first on Better Health Organization.
Episode 73 Emergency Management of Pediatric Seizures
by @ Emergency Medicine Cases Premium
Tue Dec 01 09:11:15 PST 2015
Pediatric seizures are common. So common that about 5% of all children will have a seizure by the time they’re 16 years old. If any of you have been parents of a child who suddenly starts seizing, you’ll know intimately how terrifying it can be.
While most of the kids who present to the ED with a seizure will end up being diagnosed with a benign simple febrile seizure, some kids will suffer from complex febrile seizures, requiring some more thought, work-up and management, while others will have afebrile seizures which are a whole other kettle of fish. We need to know how to differentiate these entities, how to work-them up and how to manage them in the ED. At the other end of the spectrum of disease there is status epilepticus – a true emergency with a scary mortality rate - where you need to act fast and know your algorithms like the back of your hand. This topic was chosen based on a nation-wide needs assessment study conducted by TREKK (Translating Emergency Knowledge for Kids), a collaborator with EM Cases.
With the help of two of Canada’s Pediatric Emergency Medicine seizure experts hand picked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we’ll give you the all the tools you need to approach the child who presents to the ED with seizure with the utmost confidence.
The post Episode 73 Emergency Management of Pediatric Seizures appeared first on Emergency Medicine Cases.
Episode 2: Excited Delirium
by @ Emergency Medicine Cases Premium
Tue Mar 09 08:48:48 PST 2010
Dr. Margaret Thompson, Canada's toxicology guru and Dr. Dan Cass review the clinical presentation, precipitating factors and important do's and don'ts in managing patients with Excited Delirium Syndrome to prevent sudden death. They update us on the most current guidelines for Excited Delirium Syndrome and discuss the prevalent theories to explain why many of these patients have cardiac arrests.
Excited Delirium Syndrome has recently been recognized by the American College of Emergency Physicians as a true medical emergency in which, typically, a young obese male, often under the influence of sympathomimetic drugs, becomes acutely delirious and displays super-human strength, tachypnea, profuse sweating and severe agitation. Usually, there is a prolonged and continued struggle with law enforcement despite physical restraints . Severe acidosis, rhabdomyolysis and hyperkalemia ensue, often leading to a sudden bradyasystolic cardiac arrest. Listen to this fascinating episode to find out how you can recognize and treat this important syndrome.
The post Episode 2: Excited Delirium appeared first on Emergency Medicine Cases.
Episode 18 Part 2: More Point of Care Ultrasound
by @ Emergency Medicine Cases
Tue Nov 08 07:25:25 PST 2011
In Part 2 of this Episode on Emergency Ultrasound or Point of Care Ultrasound (POCUS) Dr. Fischer, Dr. Hannam, Dr. Chenkin & Dr. Hall, Canada's EM ultrasound gurus discuss how POCUS can help our decision-making in the pediatric patient with a limp, in the patient with necrotizing fasciitis, in the pregnant patient with vaginal bleeding and in the common and challenging elderly patient with undifferentiated abdominal pain. They cover POCUS indications from urinary retention to appendicitis and debate the utility of these indications. This is followed by a debate on how best to educate ourselves and the EM community in POCUS and how best to designs quality assurance programs so that point of care ultrasound (POCUS) becomes an accepted tool across the entire medical community.
The post Episode 18 Part 2: More Point of Care Ultrasound appeared first on Emergency Medicine Cases.
Episode 45: NYGH EM Update Conference 2014
by @ Emergency Medicine Cases Premium
Fri Jun 06 09:09:42 PDT 2014
This past May in Toronto, the largest and, in my opinion, best Canadian EM conference, North York General Hospital's Emergency Medicine Update Conference, attracted 'Captain Cortex' himself, Stuart Swadron, a Toronto native to talk about his approach to vertigo, which highlights how not to miss a posterior circulation stroke. For the seventh year running the EMU conference was proud to have one of the worlds most well known EM educators, Amal Mattu who presented the most important Cardiology Literature from the past year. This podcast includes edited versions of their talks with commentary and summaries.
The post Episode 45: NYGH EM Update Conference 2014 appeared first on Emergency Medicine Cases.
NPN Number, Natural Health Products and NPN Search | Supplement Analyst
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WTBS 4 – Emergency Physician Speed: How Fast is Fast Enough?
by Dr. Howard Ovens @ Emergency Medicine Cases
Tue Sep 22 12:50:09 PDT 2015
Racing legend Mario Andretti famously said, “If everything seems under control, you’re just not going fast enough.” He was talking about cars, but to many beleaguered emergency physicians trying to keep up with the patient queue, emergency medicine often seems this way. This guest blog on emergency physician productivity began as a question to our national association, the Canadian Association of Emergency Physicians (CAEP): Are there any national standards with respect to emergency physician productivity, i.e., expected number of patients assessed per hour? The question was referred to the CAEP Public Affairs Committee and triggered a lively email discussion among our members....
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Episode 27: Drugs of Abuse – Stimulants and Opiates
by @ Emergency Medicine Cases
Mon Oct 15 13:47:15 PDT 2012
Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....
The post Episode 27: Drugs of Abuse – Stimulants and Opiates appeared first on Emergency Medicine Cases.
Best Case Ever 17: Geriatric Emergency Medicine
by Anton Helman @ Emergency Medicine Cases
Tue Jul 02 08:54:19 PDT 2013
As a bonus to Episode 34 on Geriatric Emergency Medicine, Dr. Don Melady, one of Canada's leading educators in Geriatric EM, tells us about his Best Case Ever in which a simple fall turns out to be a multi-facited complicated case with a simple solution.
In the related Episode 34 on Geriatric Emergency Medicine Dr. Melady and Dr. Jacques Lee cover an approach to geriatric Delirium, managing agitation, indications for CT head in the delirious older person, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, key drug interactions, pain management, atypical ACS and pearls in Geriatric abdominal pain presentations.
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Episode 59b: Amy Plint on the Management of Bronchiolitis
by @ Emergency Medicine Cases Premium
Thu Feb 19 12:19:26 PST 2015
In response to Episode 59 with Dr. Sanjay Mehta and Dr. Dennis Scolnik on the emergency department diagnosis and management of Bronchiolitis, Dr. Amy Plint, one of Canada's most prominent researchers in Bronchiolitis and the Chair of Pediatric Emergency Research Canada, tells her practical approach to choosing medications in the emergency department, the take home message from her landmark 2009 NEJM study on the use of nebulized epinephrine and dexamethasone for treating Bronchiolitis, and the future of Bronchiolitis research.
The post Episode 59b: Amy Plint on the Management of Bronchiolitis appeared first on Emergency Medicine Cases.
Best Case Ever 37 Neonatal Lazy Feeder
by Anton Helman @ Emergency Medicine Cases
Tue Jun 16 13:06:23 PDT 2015
On this EM Cases Best Case Ever Dr. Anthony Crocco, the Head and the Division Head of Pediatric EM at McMaster University and Medical Director of Pediatric Emergency Medicine at Hamilton Health Sciences Hosptial, discusses an approach to the neonatal lazy feeder and why we should abandon the use of codeine in pediatrics as well as in breastfeeding mothers. The approach to the neonatal lazy feeder should be considered as an approach to altered level of awareness with a wide differential diagnosis, and there is one question that should always be asked of the neontal lazy feeder....
The post Best Case Ever 37 Neonatal Lazy Feeder appeared first on Emergency Medicine Cases.
Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage
by @ Emergency Medicine Cases
Mon May 09 07:09:22 PDT 2011
In Part 1 of this episode on Headache Pearls & Pitfalls - Migraine Headache & Subarachnoid Hemorrhage, Dr. Anil Chopra and Dr. Stella Yiu discuss the best evidenced-based management of migraine headache in the ED including the use of dexamethasone, dopamine antagonists, the problems with narcotics and the efficacy of 'triptans'. An easy way to remember the worrisome symptoms of headache indicating a serious cause is reviewed followed by a detailed discussion of the pearls, pitfalls and controversies around the work-up of Subarachnoid Hemorrhage (SAH) in light of some exciting recent literature, including the basis for a new Canadian decision rule for SAH.
The post Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage appeared first on Emergency Medicine Cases.
Episode 73 Emergency Management of Pediatric Seizures
by Anton Helman @ Emergency Medicine Cases
Tue Dec 01 09:11:15 PST 2015
Pediatric seizures are common. So common that about 5% of all children will have a seizure by the time they’re 16 years old. If any of you have been parents of a child who suddenly starts seizing, you’ll know intimately how terrifying it can be.
While most of the kids who present to the ED with a seizure will end up being diagnosed with a benign simple febrile seizure, some kids will suffer from complex febrile seizures, requiring some more thought, work-up and management, while others will have afebrile seizures which are a whole other kettle of fish. We need to know how to differentiate these entities, how to work-them up and how to manage them in the ED. At the other end of the spectrum of disease there is status epilepticus – a true emergency with a scary mortality rate - where you need to act fast and know your algorithms like the back of your hand. This topic was chosen based on a nation-wide needs assessment study conducted by TREKK (Translating Emergency Knowledge for Kids), a collaborator with EM Cases.
With the help of two of Canada’s Pediatric Emergency Medicine seizure experts hand picked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we’ll give you the all the tools you need to approach the child who presents to the ED with seizure with the utmost confidence.
The post Episode 73 Emergency Management of Pediatric Seizures appeared first on Emergency Medicine Cases.
Episode 49 Effective Patient Communication, Patient Centered Care and Patient Satisfaction
by @ Emergency Medicine Cases
Mon Aug 11 15:24:25 PDT 2014
If you believe that coping with some of the people we deal with in emergency medicine is difficult or impossible, you’re not alone. We all feel this way from time to time. We all work in stressful environments where it may feel as though we have too little time for effective patient communication, patient centered care and patient satisfaction. You and your patients may often have mismatched views of what’s important. You may have a specific medical agenda and they might have a very different agenda.
Then there’s the difficult patient – we all know who these people are – the hostile aggressive patient, the demanding patient, the know-it-all, the excessively anxious patient, and the incessant complainer, among others. If we don’t know how to handle these patients appropriately, they may receive suboptimal care, grind patient flow to a halt, and delay care of other patients. And of course, if the staff has to deal with a multitude of these patients on a given shift, there’s a sort of swarm-based escalation in frustration and sometimes, unfortunately, a total breakdown of effective care. These frustrations don’t only come out when we’re presented with multiple sequential difficult patients, but for some of us, the more we practice, the more we become desensitized to the needs of all of our patients and their families and, we run the risk of destroying the doctor-patient relationship, as well as making most of our patient interactions frustrating, unsatisfying, – even detrimental to our health and the outcomes of our patients.
How you communicate in the ED can improve patient outcomes and enhance job satisfaction, yet there is little education on patient centered care for EM practitioners. After listening to this episode, it is my hope that what you learn from the literature and from expert opinion,and then apply to the way you communicate with your patients, will effectively make you a happier health care professional.
Dr.Walter Himmel, Dr. Jean Pierre Champagne and RN Ann Shook guide us in this round table discussion on effective patient communication, patient centered care and patient satisfaction – this has evolved my practice into what I perceive as a higher level of personal satisfaction as well as patient care….I hope it will do the same for you.
The post Episode 49 Effective Patient Communication, Patient Centered Care and Patient Satisfaction appeared first on Emergency Medicine Cases.
2017 Survey Report: Clostridium difficile Infection
by GIS @ Gastrointestinal Society
Wed Jan 17 10:09:47 PST 2018
The GI Society represents Canadians living with gastrointestinal diseases and disorders, including those who have experienced Clostridium difficile infection (CDI), and the devastating digestive symptoms that occur from this infection. We offer patient education on a wide array of GI conditions, in text and video formats, including a video on the development, symptoms, and treatments [...]
The post 2017 Survey Report: <em>Clostridium difficile</em> Infection appeared first on Gastrointestinal Society.
L. helveticus - A common probiotic strain - Humarian
Humarian
L. helveticus is a probiotic bacterium that has been gaining popularity as a health-promoting culture in probiotic and nutraceutic food products.
Best Case Ever 51 – Anticoagulants and GI Bleed with Walter Himmel
by @ Emergency Medicine Cases Premium
Tue Nov 08 07:18:56 PST 2016
In anticipation of Episode 88 and 89: DOACs Use, Misuse and Reversal with the president of Thrombosis Canada and world renowned thrombosis researcher Dr. Jim Douketis, internist and thrombosis expert Dr. Benjamin Bell and 'The Walking Encyclopedia of EM' Dr. Walter Himmel, we have Dr. Himmel telling us the story of his Best Case Ever on anticoagulants and GI bleed. He discusses the most important contraindication to DOACs, the importance of not only attempting to reverse the effects of anticoagulants in a bleeding patient but managing the bleed itself as well as more great pearls. In the upcoming episodes we'll run through 6 cases and cover the clinical use of DOACs, how they work, safety, indications, contraindications, management of minor, moderate and severe bleeding, the new DOAC reversal agents, management of DVT with DOAC anticoagulants, stroke prevention in atrial fibrillation with DOACs and much more...
The post Best Case Ever 51 – Anticoagulants and GI Bleed with Walter Himmel appeared first on Emergency Medicine Cases.
NEW HEALTH CANADA REGULATIONS CAME INTO EFFECT TODAY - Stalco
Stalco
Doing business in Canada just got a step harder for Natural Health Products: are you prepared? Today, December 1st, 2013, Health Canada imposed a new set of regulations on Natural Health Products that are sold in the Canadian Marketplace. Those new rules make it especially onerous for any companies who are in violation of the...Read More
Episode 51 Effective Patient Communication – Managing Difficult Patients
by @ Emergency Medicine Cases Premium
Tue Sep 30 16:47:29 PDT 2014
If you believe that coping with some of the people we deal with in emergency medicine is difficult or impossible, you’re not alone. We all feel this way from time to time. Managing difficult patients can be a challenge to the health care provider and to the entire ED. The hostile aggressive patient, the demanding patient, the know-it-all, the excessively anxious patient, and the incessant complainer, are some of the folks that we need to know how to manage effectively. If we fail to handle these patients appropriately, they may receive suboptimal care, grind patient flow to a halt, and delay care of other patients. If the staff has to deal with a multitude of these patients on a given shift, there’s a sort of swarm-based escalation in frustration and sometimes, unfortunately, a total breakdown of effective patient communication and care.
But don't fret. In this one-of-a-kind podcast on effective patient communication and managing difficult patients, Dr. Walter Himmel, Dr. Jean-Pierre Champagne and RN Ann Shook take us through specific strategies, based on both the medical and non-medical literature, on how we can effectively manage these challenging patients. As a bonus, we address the difficult situation of breaking bad news with a simple mnemonic and discuss tips on how to deliver effective discharge instructions to help improve outcomes once your patient leave the ED.
The post Episode 51 Effective Patient Communication – Managing Difficult Patients appeared first on Emergency Medicine Cases.
Episode 70 End of Life Care in Emergency Medicine
by @ Emergency Medicine Cases
Tue Sep 29 09:37:44 PDT 2015
Most of us in North America live in cultures that almost never talk about death and dying. And medical progress has led the way to a shift in the culture of dying, in which death has been medicalized. While most people wish to die at home, every decade has seen an increase in the proportion of deaths that occur in hospital. Death is often seen as a failure to keep people alive rather than a natural dignified end to life. This is at odds with what a lot of people actually want at the end of their lives: 70% of hospitalized Canadian elderly say they prefer comfort measures as apposed to life-prolonging treatment, yet as many as ⅔ of these patients are admitted to ICUs.
Quality End of Life Care in Emergency Medicine is not widely taught. Most of us are not well prepared for death in our EDs – and we should be. There’s no second chance when it comes to a bad death like there is if you screw up a central line placement, so you need the skills to do it right the first time.
To recognize when comfort measures and compassion are what will be best for our patients, is just as important as knowing when to intervene and treat aggressively in a resuscitation. Emergency physicians should be able to recognize not only the symptoms and patterns that are common in the last hours to days of life, but also understand the various trajectories over months or years toward death, if they’re going to provide the high quality end of life care that patients deserve.
So, with the help of Dr. Howard Ovens, a veteran emergency physician with over 25 years of experience who speaks at national conferences on End of Life Care in Emergency Medicine, Dr. Paul Miller, an emergency physician who also runs a palliative care unit at McMaster University and Dr. Shona MacLachlan who led the palliative care stream at the CAEP conference in Edmonton this past June, we'll help you learn the skills you need to assess dying patients appropriately, communicate with their families effectively, manage end of life symptoms with confidence and much more...
The post Episode 70 End of Life Care in Emergency Medicine appeared first on Emergency Medicine Cases.
Probiotics and prebiotics in pregnancy
BabyCenter Canada
Find out whether probiotics and prebiotics are safe in pregnancy.
Journal Jam 2: Small Bore Chest Tube and Outpatient Management of Pneumothorax
by @ Emergency Medicine Cases
Tue Dec 09 07:25:09 PST 2014
It makes sense that the treatment of primary spnontaneous pneumothorax would lend itself well to outpatient management, since patients are usually young and otherwise healthy, and the mortality and morbidity from these air leaks are really very low. Most patients would rather be managed as an outpatient rather than admitted to hospital and sending these patients home would probably end up saving the system resources and money. In this month's Journal Jam Podcast on small bore chest tube and outpatient management of pneumothorax, the highlighted article that Anton Helman and Teresa Chan discuss is Voison et al. on the “Ambulatory Management of Large Spontaneous Pneumothorax With Pigtail Catheters.” We hear from Michelle Lin, Seth Trueger, Heather Murray and the lead author himself, Stephan Jouneau. Questions posed include: In what ways is the use of small bore catheters with Heimlich valves for spontaneous pneumothorax better than needle aspiration? Is it necessary to repeat a CXR after placement of the catheter? Who should follow up these patients after they are discharged from the hospital? How can we minimize kinking and dislodgement of the catheter? and many more.....
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Journal Jam 5 One Hour Troponin to Rule Out and In MI
by @ Emergency Medicine Cases Premium
Tue Dec 22 07:15:11 PST 2015
Traditionally we've run at least 2 troponins 6 or 8 hours apart to help rule out MI and recently in algorithms like the HEART score we've combined clinical data with a 2 or 3 hour delta troponin to help rule out MI. The paper we'll be discussing here is a multicentre/multinantional study from the Canadian Medical Association Journal from this year out of Switzerland entitled "Prospective validation of a 1 hour algorithm to rule out and rule in acute myocardial infarction using a high sensitivity cardian troponin T assay" with lead author Tobias Reichlin. It not only looks at whether or not we can rule out MI using a delta troponin at only 1 hour but whether or not we can expedite the ruling in of MI using this protocol.
The post Journal Jam 5 One Hour Troponin to Rule Out and In MI appeared first on Emergency Medicine Cases.
BCE 65 Intimate Partner Violence – A Silent Epidemic
by @ Emergency Medicine Cases
Tue Jan 23 13:57:55 PST 2018
I was taken aback when I came across the statistic that approximately every 6 days a woman in Canada is killed by her intimate partner. Victims of intimate partner violence and domestic violence that we see in the ED typically involve an abuse story of repeated escalating violence over time that ends up in a crisis situation. The woman is often financially dependent on her abuser and has no one to turn to for help. In one of her worst cases ever from Janus General, Dr. Meeta Patel and I discuss the notions that Emergency providers have a unique opportunity to identify patients who are victims of intimate partner violence; that we should begin by thinking of how we can screen every woman of childbearing age about intimate partner violence in a private, safe and respectful way. We describe the quick Partner Violence Screen and finally how to offer supportive, empowering statements and connect your patients with resources like assaulted women’s helpline and shelters in your community...
The post BCE 65 Intimate Partner Violence – A Silent Epidemic appeared first on Emergency Medicine Cases.
Canadian natural health product registration current regulations
CNHPR
NNHPD latest additions and significant updates.
Episode 27: Drugs of Abuse – Stimulants and Opiates
by Anton Helman @ Emergency Medicine Cases
Mon Oct 15 13:47:15 PDT 2012
Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....
The post Episode 27: Drugs of Abuse – Stimulants and Opiates appeared first on Emergency Medicine Cases.
Episode 77 Fever in the Returning Traveler
by Anton Helman @ Emergency Medicine Cases
Mon Feb 29 21:19:53 PST 2016
In this EM Cases episode with Dr. Nazanin Meshkat, multinational ED doc and Dr. Matthew Muller, infectious disease specialist, we discuss the most common tropical disease killers that we see in patients who present with Fever in the Returning Traveler. Every year an increasing number of people travel abroad, and travelers to tropical destinations are often immunologically naïve to the regions they’re going to. It’s very common for travelers to get sick. In fact, about 2/3 of travelers get sick while they’re traveling or soon after their return, and somewhere between 3 and 19% of travelers to developing countries will develop a fever.
Imported diseases, like Malaria, Dengue, Ebola, and Zyka can be acquired abroad and brought back to your ED in unsuspecting individuals. This is serious stuff - you might be surprised to learn that Malaria is responsible for more morbidity and mortality worldwide than any other illness.
According to a study in CJEM most emergency physicians have minimal or no specific training in tropical diseases and emergency physicians indicated an unacceptably low level of comfort when faced with patients with tropical disease symptoms. In fact, 40% of the cases were incorrectly diagnosed or managed. And Canadian ED docs aren’t the only ones who’s skill isn’t stellar in this department - a similar 2006 study of UK physicians showed a 78% misdiagnosis rate. This misdiagnosis rate isn’t wholly because of lack of knowledge – it almost certainly also has to do with the vague presentations and huge amount of overlap between so many tropical disease.
You might be thinking that it’s impossible to learn all the thousands of details of the dozens of different tropical diseases - true. However, in the ED, while we don’t need to know every detail of every tropical disease, and don’t necessarily need to make the exact diagnosis right away, we do need to have a rational, organized approach to diagnosing and managing fever in the returning traveler, so that we can identify some of the more common serious illnesses like Malaria, Dengue and Typhoid fever, and start timely treatment in the ED.
The post Episode 77 Fever in the Returning Traveler appeared first on Emergency Medicine Cases.
Canadian Marijuana Stocks Gain Popularity Abroad
What's Hempening
Canadian Marijuana Stocks Gain Popularity Abroad6 Marijuana Stocks That Trade On The NYSEThe Latest Update From Jeff Sessions2 Recent Marijuana Stock AcquisitionsIs Georgia Next State To Vote On Legalization?CannTrust Holdings Inc. (CNTTF) Receives Sales
Episode 52: Commonly Missed Uncommon Orthopedic Injuries
by Anton Helman @ Emergency Medicine Cases
Mon Oct 13 12:14:26 PDT 2014
We rarely discuss medico-legal issues on EM Cases because it misguides us a bit from good patient centered care – which is what emergency medicine is really all about.
Nonetheless, missed orthopedic injuries are the most common reason for an emergency doc to be sued in Canada. This is partly because missed orthopedic injuries are far more common than missed MIs for example, but it’s also because it’s easy to miss certain orthopedic injuries – especially the ones that aren’t super common. And orthopedics is difficult to learn and remember for the EM practitioner as there are so many injuries to remember.
And so, you guessed it – on this episode we’re going to run through some key not-so-common, easy to miss orthopedic injuries, some of which I, personally had to learn about the hard way, if you know what I mean.
After listening to this episode, try some cognitive forcing strategies – for every patient with a FOOSH that you see, look for and document a DRUJ injury. Wait, hold on….I don’t wanna give it all away at the top of the post.
Let’s hear what EM doc and sports medicine guru Ivy Cheng, and the orthopedic surgeon who everyone at North York General turns to when they need help with a difficult ortho case, Hossein Medhian, have to say about Commonly Missed Uncommon Orthopedic Injuries.
The post Episode 52: Commonly Missed Uncommon Orthopedic Injuries appeared first on Emergency Medicine Cases.
Journal Jam 7 – Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial
by Justin Morgenstern @ Emergency Medicine Cases
Tue Jul 26 16:07:52 PDT 2016
Journal Jam 7 - Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial.
In our most popular EM Cases episode to date - ACLS Guidelines Cardiac Arrest Controversies, we boldly stated, that there has never been an antiarrhythmic medication that has shown any long term survival benefit in cardiac arrest. The use of medications in cardiac arrest has been one of those things that we all do, but that we know the evidence isn’t great for. Yet Amiodarone is still in the newest AHA adult cardiac arrest algorithm for ventricular fibrillation or pulseless ventricular tachycarida – 300mg IV after the 3rd shock with the option to give it again at 150mg after that. Anti-arrhythmics have been shown in previous RCTs to increase the rate of return of spontaneous circulation and even increased survival to hospital admission, however none of them have been able to show a decrease in mortality or a favourable neurological outcome at hospital discharge. In other words, there has never been shown a long term survival or functional benefit - which is a bit disconcerting.
But now, we have a recent large randomized, controlled trial that shines some new light on the role of anti-arrythmics in cardiac arrest - The ALPS trial: Amiodarone vs Lidocaine vs placebo in out of hospital cardiac arrest. In this Journal Jam podcast, Justin Morgenstern and Anton Helman interview two authors of the ALPS trial, Dr. Laurie Morrison a world-renowned researcher in cardiac arrest and Dr. Paul Dorian, a cardiac electrophysiologist and one of Canada's leading authorities on arrhythmias about what we should take away from the ALPS trial. It turns out, it's not so simple. We also discuss the value of dual shock therapy for shock resistant ventricular fibrillation and the future of cardiac arrest care.
The post Journal Jam 7 – Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial appeared first on Emergency Medicine Cases.
Episode 73 Emergency Management of Pediatric Seizures
by @ Emergency Medicine Cases
Tue Dec 01 09:11:15 PST 2015
Pediatric seizures are common. So common that about 5% of all children will have a seizure by the time they’re 16 years old. If any of you have been parents of a child who suddenly starts seizing, you’ll know intimately how terrifying it can be.
While most of the kids who present to the ED with a seizure will end up being diagnosed with a benign simple febrile seizure, some kids will suffer from complex febrile seizures, requiring some more thought, work-up and management, while others will have afebrile seizures which are a whole other kettle of fish. We need to know how to differentiate these entities, how to work-them up and how to manage them in the ED. At the other end of the spectrum of disease there is status epilepticus – a true emergency with a scary mortality rate - where you need to act fast and know your algorithms like the back of your hand. This topic was chosen based on a nation-wide needs assessment study conducted by TREKK (Translating Emergency Knowledge for Kids), a collaborator with EM Cases.
With the help of two of Canada’s Pediatric Emergency Medicine seizure experts hand picked by TREKK, Dr. Lawrence Richer and Dr. Angelo Mikrogianakis, we’ll give you the all the tools you need to approach the child who presents to the ED with seizure with the utmost confidence.
The post Episode 73 Emergency Management of Pediatric Seizures appeared first on Emergency Medicine Cases.
Episode 41: Hypertensive Emergencies
by @ Emergency Medicine Cases Premium
Mon Mar 24 08:31:09 PDT 2014
In this episode on Hypertensive Emergencies, Dr. Joel Yaphe, EM residency program director at the University of Toronto & Dr. Clare Atzema, one of Canada's leading cardiovascular EM researchers will discuss the controversies of how to manage patients who present to the ED with high blood pressure and evidence of end organ damage related to the high blood pressure. Hypertensive emergencies are a grab bag of diagnoses that all need to be treated differently. Hypertensive Encephalopathy, Aortic Dissection, Acute Pulmonary Edema, Pre-eclampsia & Eclampsia, Acute Renal Failure, Subarachnoid Hemorrhage and Intracranial Hemorrhage all need individualized blood pressure management.
The post Episode 41: Hypertensive Emergencies appeared first on Emergency Medicine Cases.
Dream Water Launches Beauty Shot
by Press Release @ BevNET.com
Mon Feb 12 08:30:02 PST 2018
Dream Water is now incorporating healthy hair, skin, nail & collagen support with the launch of its’ easy to take, great tasting Dream Water Beauty shot.
Journal Jam 7 – Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial
by @ Emergency Medicine Cases Premium
Tue Jul 26 16:07:52 PDT 2016
Journal Jam 7 - Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial.
In our most popular EM Cases episode to date - ACLS Guidelines Cardiac Arrest Controversies, we boldly stated, that there has never been an antiarrhythmic medication that has shown any long term survival benefit in cardiac arrest. The use of medications in cardiac arrest has been one of those things that we all do, but that we know the evidence isn’t great for. Yet Amiodarone is still in the newest AHA adult cardiac arrest algorithm for ventricular fibrillation or pulseless ventricular tachycarida – 300mg IV after the 3rd shock with the option to give it again at 150mg after that. Anti-arrhythmics have been shown in previous RCTs to increase the rate of return of spontaneous circulation and even increased survival to hospital admission, however none of them have been able to show a decrease in mortality or a favourable neurological outcome at hospital discharge. In other words, there has never been shown a long term survival or functional benefit - which is a bit disconcerting.
But now, we have a recent large randomized, controlled trial that shines some new light on the role of anti-arrythmics in cardiac arrest - The ALPS trial: Amiodarone vs Lidocaine vs placebo in out of hospital cardiac arrest. In this Journal Jam podcast, Justin Morgenstern and Anton Helman interview two authors of the ALPS trial, Dr. Laurie Morrison a world-renowned researcher in cardiac arrest and Dr. Paul Dorian, a cardiac electrophysiologist and one of Canada's leading authorities on arrhythmias about what we should take away from the ALPS trial. It turns out, it's not so simple. We also discuss the value of dual shock therapy for shock resistant ventricular fibrillation and the future of cardiac arrest care.
The post Journal Jam 7 – Amiodarone vs Lidocaine vs Placebo in Cardiac Arrest: The ALPS Trial appeared first on Emergency Medicine Cases.
Best Case Ever 24: COPD, Baggging and Vent Settings
by @ Emergency Medicine Cases Premium
Tue May 27 11:16:59 PDT 2014
In anticipation of the Highlights from North York General's Emergency Medicine Update Conference 2014 we have the master educator himself, Dr. Amal Mattu's Best Case ever of a patient who presented with a COPD exacerbation, that we recorded at the conference in Toronto just a couple of weeks ago. Dr. Mattu gives you a string of pearls and pitfalls when it comes to management of COPD, bagging & vent settings that you will never forget. In the upcoming episode Dr. Mattu will review his favorite papers from the cardiology literature of the past year and Dr. Stuart Swadron will give you his approach to the challenges of the patient with vertigo. This will the first of two parts of the highlights from the conference - the largest and best EM conference in Canada.
The post Best Case Ever 24: COPD, Baggging and Vent Settings appeared first on Emergency Medicine Cases.
Statins for everyone?
by Scott @ Science-Based Pharmacy
Sun Apr 10 05:19:55 PDT 2016
Preventing a disease, before it occurs, seems intuitively obvious. But when it comes to taking medicine to prevent a disease before it occurs, people tend to be much less comfortable. Not only are there the concerns about the “medicalization” of healthy people, there are good questions about benefits, risks (like side effects), and costs. Cardiovascular … Continue reading Statins for everyone?
Episode 52: Commonly Missed Uncommon Orthopedic Injuries
by @ Emergency Medicine Cases
Mon Oct 13 12:14:26 PDT 2014
We rarely discuss medico-legal issues on EM Cases because it misguides us a bit from good patient centered care – which is what emergency medicine is really all about.
Nonetheless, missed orthopedic injuries are the most common reason for an emergency doc to be sued in Canada. This is partly because missed orthopedic injuries are far more common than missed MIs for example, but it’s also because it’s easy to miss certain orthopedic injuries – especially the ones that aren’t super common. And orthopedics is difficult to learn and remember for the EM practitioner as there are so many injuries to remember.
And so, you guessed it – on this episode we’re going to run through some key not-so-common, easy to miss orthopedic injuries, some of which I, personally had to learn about the hard way, if you know what I mean.
After listening to this episode, try some cognitive forcing strategies – for every patient with a FOOSH that you see, look for and document a DRUJ injury. Wait, hold on….I don’t wanna give it all away at the top of the post.
Let’s hear what EM doc and sports medicine guru Ivy Cheng, and the orthopedic surgeon who everyone at North York General turns to when they need help with a difficult ortho case, Hossein Medhian, have to say about Commonly Missed Uncommon Orthopedic Injuries.
The post Episode 52: Commonly Missed Uncommon Orthopedic Injuries appeared first on Emergency Medicine Cases.
Probiotics in the NICU: a ‘how-to’ guide
Neonatal Research
I have had several communications from people interested in starting the use of probiotics in their nurseries. There are often roadblocks, and some reluctance from either infection control, or phar…
Best Case Ever 51 – Anticoagulants and GI Bleed with Walter Himmel
by @ Emergency Medicine Cases
Tue Nov 08 07:18:56 PST 2016
In anticipation of Episode 88 and 89: DOACs Use, Misuse and Reversal with the president of Thrombosis Canada and world renowned thrombosis researcher Dr. Jim Douketis, internist and thrombosis expert Dr. Benjamin Bell and 'The Walking Encyclopedia of EM' Dr. Walter Himmel, we have Dr. Himmel telling us the story of his Best Case Ever on anticoagulants and GI bleed. He discusses the most important contraindication to DOACs, the importance of not only attempting to reverse the effects of anticoagulants in a bleeding patient but managing the bleed itself as well as more great pearls. In the upcoming episodes we'll run through 6 cases and cover the clinical use of DOACs, how they work, safety, indications, contraindications, management of minor, moderate and severe bleeding, the new DOAC reversal agents, management of DVT with DOAC anticoagulants, stroke prevention in atrial fibrillation with DOACs and much more...
The post Best Case Ever 51 – Anticoagulants and GI Bleed with Walter Himmel appeared first on Emergency Medicine Cases.
Running Clinic
by GIS @ Gastrointestinal Society
Thu May 25 14:37:09 PDT 2017
Have you been diagnosed with Crohn's disease or ulcerative colitis? Do you want to get into running but don’t want to train alone? Would you like a reason to get outside and become healthier and more physically active? If so, the Gastrointestinal Society’s brand-new running clinic for people with active Crohn's disease or ulcerative colitis [...]
The post Running Clinic appeared first on Gastrointestinal Society.
Alkaline Diet Plan: Can these high alkaline foods prevent cancer?
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 09:11:26 PST 2018
Alkaline Diet What is an alkaline diet? – The alkaline diet, which is also known as the acid alkaline diet (or alkaline ash diet) is based on the theory that minerals found in various types of food can affect the pH balance of your body.2 The alkaline diet plan includes fresh vegetables, fruit, nuts and […]
The post Alkaline Diet Plan: Can these high alkaline foods prevent cancer? appeared first on Better Health Organization.
BCE 65 Intimate Partner Violence – A Silent Epidemic
by @ Emergency Medicine Cases Premium
Tue Jan 23 13:57:55 PST 2018
I was taken aback when I came across the statistic that approximately every 6 days a woman in Canada is killed by her intimate partner. Victims of intimate partner violence and domestic violence that we see in the ED typically involve an abuse story of repeated escalating violence over time that ends up in a crisis situation. The woman is often financially dependent on her abuser and has no one to turn to for help. In one of her worst cases ever from Janus General, Dr. Meeta Patel and I discuss the notions that Emergency providers have a unique opportunity to identify patients who are victims of intimate partner violence; that we should begin by thinking of how we can screen every woman of childbearing age about intimate partner violence in a private, safe and respectful way. We describe the quick Partner Violence Screen and finally how to offer supportive, empowering statements and connect your patients with resources like assaulted women’s helpline and shelters in your community...
The post BCE 65 Intimate Partner Violence – A Silent Epidemic appeared first on Emergency Medicine Cases.
Episode 67 Pediatric Pain Management
by @ Emergency Medicine Cases
Tue Jul 07 13:39:13 PDT 2015
Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
The post Episode 67 Pediatric Pain Management appeared first on Emergency Medicine Cases.
Episode 63 – Pediatric DKA
by Anton Helman @ Emergency Medicine Cases
Tue Apr 28 16:20:51 PDT 2015
Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases’ partners who’s mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering - why was DKA singled out in this needs assessment?
It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment - cerebral edema being the big bad one.
The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum ketones are in the diagnosis of DKA, how to assess the severity of DKA to guide management, how to avoid the dreaded cerebral edema that all too often complicates DKA, how to best adjust fluids and insulin during treatment, which kids can go home, which kids can go to the floor and which kids need to be transferred to a Pediatric ICU.
The post Episode 63 – Pediatric DKA appeared first on Emergency Medicine Cases.
Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage
by Anton Helman @ Emergency Medicine Cases
Mon May 09 07:09:22 PDT 2011
In Part 1 of this episode on Headache Pearls & Pitfalls - Migraine Headache & Subarachnoid Hemorrhage, Dr. Anil Chopra and Dr. Stella Yiu discuss the best evidenced-based management of migraine headache in the ED including the use of dexamethasone, dopamine antagonists, the problems with narcotics and the efficacy of 'triptans'. An easy way to remember the worrisome symptoms of headache indicating a serious cause is reviewed followed by a detailed discussion of the pearls, pitfalls and controversies around the work-up of Subarachnoid Hemorrhage (SAH) in light of some exciting recent literature, including the basis for a new Canadian decision rule for SAH.
The post Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage appeared first on Emergency Medicine Cases.
Is a profit-first philosophy in retail pharmacy compromising working conditions and patient care?
by Scott @ Science-Based Pharmacy
Sun Apr 24 12:23:09 PDT 2016
The tension between the “business of pharmacy” and the professional responsibilities of pharmacists, as health care professionals, has always been present in retail (“community”) pharmacy practice. For much of the past several decades, pharmacies have generally been owned by pharmacists, elevating pharmacy ethics and professional responsibilities to the level of the owner. But the era of … Continue reading Is a profit-first philosophy in retail pharmacy compromising working conditions and patient care?
Episode 34: Geriatric Emergency Medicine
by Anton Helman @ Emergency Medicine Cases
Mon Jul 08 08:07:17 PDT 2013
In this episode Dr. Don Melady, Canada's leading educator in Geriatric Emergency Medicine (Geri-EM) & Dr. Jaques Lee, one of Canada's leading researchers in Geri-EM, discuss the common yet challenging Geriatric Emergencies: a practical approach to geriatric Delirium, best practice for managing agitation and pain in the older patient, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, atypical presentations of common life threatening emergencies including ACS and surgical abdomen, key drug interactions in the geriatric patient and more..
The post Episode 34: Geriatric Emergency Medicine appeared first on Emergency Medicine Cases.
Episode 2: Excited Delirium
by @ Emergency Medicine Cases
Tue Mar 09 08:48:48 PST 2010
Dr. Margaret Thompson, Canada's toxicology guru and Dr. Dan Cass review the clinical presentation, precipitating factors and important do's and don'ts in managing patients with Excited Delirium Syndrome to prevent sudden death. They update us on the most current guidelines for Excited Delirium Syndrome and discuss the prevalent theories to explain why many of these patients have cardiac arrests.
Excited Delirium Syndrome has recently been recognized by the American College of Emergency Physicians as a true medical emergency in which, typically, a young obese male, often under the influence of sympathomimetic drugs, becomes acutely delirious and displays super-human strength, tachypnea, profuse sweating and severe agitation. Usually, there is a prolonged and continued struggle with law enforcement despite physical restraints . Severe acidosis, rhabdomyolysis and hyperkalemia ensue, often leading to a sudden bradyasystolic cardiac arrest. Listen to this fascinating episode to find out how you can recognize and treat this important syndrome.
The post Episode 2: Excited Delirium appeared first on Emergency Medicine Cases.
Exploring Public Trust in Food and Farming
by Joanne Somaiya @ Canadian Food Business
Mon Sep 11 08:30:24 PDT 2017
By: Cayley Humphreys CCFI Public Trust Summit From the farm and ranch right through to Canada’s largest food service companies, interest in public trust in the food system continues to grow. In efforts to satisfy consumers concerns, a unique mix of thought leaders of all ages across supply chains, governments, industries and academia will come …
Caring for your Gut while Travelling Abroad | Gastrointestinal Society
Gastrointestinal Society
There are several infectious illnesses a traveller could experience, especially while visiting developing regions where health and sanitation conditions are different from North American standards. This article will focus on three conditions that affect the digestive system: travellers’ diarrhea, hepatitis A, and hepatitis B. Travellers’ Diarrhea Travellers’ diarrhea (TD) afflicts 20-50% of people travelling …
Best Case Ever 51 – Anticoagulants and GI Bleed with Walter Himmel
by Anton Helman @ Emergency Medicine Cases
Tue Nov 08 07:18:56 PST 2016
In anticipation of Episode 88 and 89: DOACs Use, Misuse and Reversal with the president of Thrombosis Canada and world renowned thrombosis researcher Dr. Jim Douketis, internist and thrombosis expert Dr. Benjamin Bell and 'The Walking Encyclopedia of EM' Dr. Walter Himmel, we have Dr. Himmel telling us the story of his Best Case Ever on anticoagulants and GI bleed. He discusses the most important contraindication to DOACs, the importance of not only attempting to reverse the effects of anticoagulants in a bleeding patient but managing the bleed itself as well as more great pearls. In the upcoming episodes we'll run through 6 cases and cover the clinical use of DOACs, how they work, safety, indications, contraindications, management of minor, moderate and severe bleeding, the new DOAC reversal agents, management of DVT with DOAC anticoagulants, stroke prevention in atrial fibrillation with DOACs and much more...
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Episode 70 End of Life Care in Emergency Medicine
by Anton Helman @ Emergency Medicine Cases
Tue Sep 29 09:37:44 PDT 2015
Most of us in North America live in cultures that almost never talk about death and dying. And medical progress has led the way to a shift in the culture of dying, in which death has been medicalized. While most people wish to die at home, every decade has seen an increase in the proportion of deaths that occur in hospital. Death is often seen as a failure to keep people alive rather than a natural dignified end to life. This is at odds with what a lot of people actually want at the end of their lives: 70% of hospitalized Canadian elderly say they prefer comfort measures as apposed to life-prolonging treatment, yet as many as ⅔ of these patients are admitted to ICUs.
Quality End of Life Care in Emergency Medicine is not widely taught. Most of us are not well prepared for death in our EDs – and we should be. There’s no second chance when it comes to a bad death like there is if you screw up a central line placement, so you need the skills to do it right the first time.
To recognize when comfort measures and compassion are what will be best for our patients, is just as important as knowing when to intervene and treat aggressively in a resuscitation. Emergency physicians should be able to recognize not only the symptoms and patterns that are common in the last hours to days of life, but also understand the various trajectories over months or years toward death, if they’re going to provide the high quality end of life care that patients deserve.
So, with the help of Dr. Howard Ovens, a veteran emergency physician with over 25 years of experience who speaks at national conferences on End of Life Care in Emergency Medicine, Dr. Paul Miller, an emergency physician who also runs a palliative care unit at McMaster University and Dr. Shona MacLachlan who led the palliative care stream at the CAEP conference in Edmonton this past June, we'll help you learn the skills you need to assess dying patients appropriately, communicate with their families effectively, manage end of life symptoms with confidence and much more...
The post Episode 70 End of Life Care in Emergency Medicine appeared first on Emergency Medicine Cases.
Probiotics and Gastrointestinal Health
by Marija Pevac-Djukic @ Toronto Naturopathic Doctor
Fri Jan 15 07:04:49 PST 2010
Co-Authored by: Sue Plummer, PhD Iveta Garaiova, PhD Marija Pevac-Djukic, MD(Serbia), ND(Canada) Published in The Naturopathic Doctor News and Review For centuries living microorganisms, particularly lactic acid bacteria (producers of lactic acid from sugar), have been used in food…
The post Probiotics and Gastrointestinal Health appeared first on Toronto Naturopathic Doctor.
Is the way to a (wo)man’s heart through his(her) stomach?
by Dr. Ronald Hoffman @ Article – DR. RONALD HOFFMAN
Fri Feb 02 14:57:03 PST 2018
Earlier this week, I spoke at NYU Langone Medical Center as part of their Heart Health Lecture Series. The subject was “Fostering a Healthy Microbiome for Cardiovascular Health.” Along with Dr. Lea Ann Chen, a gastroenterologist who is doing research on...read more
Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions
by @ Emergency Medicine Cases
Tue Mar 29 12:30:54 PDT 2016
This is EM Cases Journal Jam Podcast 6 - Outpatient Topical Anesthetics for Corneal Abrasions.
I’ve been told countless times by ophthalmologists and other colleagues NEVER to prescribe topical anesthetics for corneal abrasion patients, with the reason being largely theoretical - that tetracaine and the like will inhibit re-epithelialization and therefore delay epithelial healing as well as decrease corneal sensation, resulting in corneal ulcers. With prolonged use of outpatient topical anesthetics for corneal abrasions, corneal opacification could develop leading to decreased vision.
Now this might be true for the tetracaine abuser who pours the stuff in their eye for weeks on end, but when we look at the literature for toxic effects of using topical anesthetics in the short term, there is no evidence for any clinically important detrimental outcomes. Should we ignore the dogma and use tetracaine anyway? Is there evidence that the use of topical anesthetics after corneal abrasions is safe and effective for pain control without adverse effects or delayed epithelial healing?
To discuss the paper "The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review" by Drs. Swaminathan, Otterness, Milne and Rezaie published in the Journal of Emergency Medicine in 2015, we have EM Cases’ Justin Morgenstern, a Toronto-based EM Doc, EBM enthusiast as well as the brains behind the First10EM blog and Salim Rezaie, Clinical Assistant Professor of EM and Internal Medicine at University of Texas Health Science Center at San Antonio as well as the Creator & Founder of the R.E.B.E.L. EM blog and REBELCast podcast.
In this Journal Jam podcast, Dr. Morgenstern and Dr. Rezaie also discuss a simple approach to critically appraising a systematic review article, how to handle consultants who might not be aware of the literature and/or give you a hard time about your decisions and much more...
The post Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions appeared first on Emergency Medicine Cases.
Canada Joins U.S. in Food-Safety Modernization ~ Licensing of Food Importers
by cnhpradmin @ CNHPR
Mon Mar 09 12:02:35 PDT 2015
This act is significant in that it represents the first major changes to food legislation in decades, similar to the Food Safety Modernization Act in the United States. Changes aren’t expected overnight. The Canadian Food Inspection Agency (CFIA) said current legislation and regulations will remain in effect until it publicizes…
The post Canada Joins U.S. in Food-Safety Modernization ~ Licensing of Food Importers appeared first on CNHPR.
Episode 67 Pediatric Pain Management
by @ Emergency Medicine Cases Premium
Tue Jul 07 13:39:13 PDT 2015
Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
The post Episode 67 Pediatric Pain Management appeared first on Emergency Medicine Cases.
Best Case Ever 37 Neonatal Lazy Feeder
by @ Emergency Medicine Cases
Tue Jun 16 13:06:23 PDT 2015
On this EM Cases Best Case Ever Dr. Anthony Crocco, the Head and the Division Head of Pediatric EM at McMaster University and Medical Director of Pediatric Emergency Medicine at Hamilton Health Sciences Hosptial, discusses an approach to the neonatal lazy feeder and why we should abandon the use of codeine in pediatrics as well as in breastfeeding mothers. The approach to the neonatal lazy feeder should be considered as an approach to altered level of awareness with a wide differential diagnosis, and there is one question that should always be asked of the neontal lazy feeder....
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Episode 77 Fever in the Returning Traveler
by @ Emergency Medicine Cases
Mon Feb 29 21:19:53 PST 2016
In this EM Cases episode with Dr. Nazanin Meshkat, multinational ED doc and Dr. Matthew Muller, infectious disease specialist, we discuss the most common tropical disease killers that we see in patients who present with Fever in the Returning Traveler. Every year an increasing number of people travel abroad, and travelers to tropical destinations are often immunologically naïve to the regions they’re going to. It’s very common for travelers to get sick. In fact, about 2/3 of travelers get sick while they’re traveling or soon after their return, and somewhere between 3 and 19% of travelers to developing countries will develop a fever.
Imported diseases, like Malaria, Dengue, Ebola, and Zyka can be acquired abroad and brought back to your ED in unsuspecting individuals. This is serious stuff - you might be surprised to learn that Malaria is responsible for more morbidity and mortality worldwide than any other illness.
According to a study in CJEM most emergency physicians have minimal or no specific training in tropical diseases and emergency physicians indicated an unacceptably low level of comfort when faced with patients with tropical disease symptoms. In fact, 40% of the cases were incorrectly diagnosed or managed. And Canadian ED docs aren’t the only ones who’s skill isn’t stellar in this department - a similar 2006 study of UK physicians showed a 78% misdiagnosis rate. This misdiagnosis rate isn’t wholly because of lack of knowledge – it almost certainly also has to do with the vague presentations and huge amount of overlap between so many tropical disease.
You might be thinking that it’s impossible to learn all the thousands of details of the dozens of different tropical diseases - true. However, in the ED, while we don’t need to know every detail of every tropical disease, and don’t necessarily need to make the exact diagnosis right away, we do need to have a rational, organized approach to diagnosing and managing fever in the returning traveler, so that we can identify some of the more common serious illnesses like Malaria, Dengue and Typhoid fever, and start timely treatment in the ED.
The post Episode 77 Fever in the Returning Traveler appeared first on Emergency Medicine Cases.
Best Case Ever 45 – Mike Winters on Cardiac Arrest
by @ Emergency Medicine Cases
Tue May 10 12:50:47 PDT 2016
I had the great pleasure of meeting Dr. Mike Winters on his first ever visit to Canada at North York General's Emergency Medicine Update Conference, where he gave two fantastic presentations. His credentials are impressive: He is the Medical Director of the Emergency Department, Associate Professor in both EM and IM, EM-IM-Critical Care Program co-director and Residency Program Director of EM-IM at the University of Maryland in Baltimore.
Sometimes we are so caught up with the job we need to get done during cardiac arrest that we forget about the important and profound effect that this event has on patients' families. On this Best Case Ever Dr. Winters tells the story of witnessing his grandfather's cardiac arrest, being present in the ED during the resuscitation attempts, and how that experience has coloured his practice. We discuss some pearls on communication with patients' families after death, colour-coded cardiac arrest teams and how to integrate POCUS into cardiac arrest care while minimizing chest compressions.
The post Best Case Ever 45 – Mike Winters on Cardiac Arrest appeared first on Emergency Medicine Cases.
Best Case Ever 17: Geriatric Emergency Medicine
by @ Emergency Medicine Cases
Tue Jul 02 08:54:19 PDT 2013
As a bonus to Episode 34 on Geriatric Emergency Medicine, Dr. Don Melady, one of Canada's leading educators in Geriatric EM, tells us about his Best Case Ever in which a simple fall turns out to be a multi-facited complicated case with a simple solution.
In the related Episode 34 on Geriatric Emergency Medicine Dr. Melady and Dr. Jacques Lee cover an approach to geriatric Delirium, managing agitation, indications for CT head in the delirious older person, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, key drug interactions, pain management, atypical ACS and pearls in Geriatric abdominal pain presentations.
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Best Case Ever 24: COPD, Baggging and Vent Settings
by Anton Helman @ Emergency Medicine Cases
Tue May 27 11:16:59 PDT 2014
In anticipation of the Highlights from North York General's Emergency Medicine Update Conference 2014 we have the master educator himself, Dr. Amal Mattu's Best Case ever of a patient who presented with a COPD exacerbation, that we recorded at the conference in Toronto just a couple of weeks ago. Dr. Mattu gives you a string of pearls and pitfalls when it comes to management of COPD, bagging & vent settings that you will never forget. In the upcoming episode Dr. Mattu will review his favorite papers from the cardiology literature of the past year and Dr. Stuart Swadron will give you his approach to the challenges of the patient with vertigo. This will the first of two parts of the highlights from the conference - the largest and best EM conference in Canada.
The post Best Case Ever 24: COPD, Baggging and Vent Settings appeared first on Emergency Medicine Cases.
Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue
by @ Emergency Medicine Cases Premium
Mon Aug 28 10:04:51 PDT 2017
In anticipation of EM Cases Main Episode 100 on Disaster Medicine with Laurie Mazurik, David Kollek and Joshua Bezanson, Dr. Mazurik tells of her experience as a disaster medicine leader with keeping health care workers safe during the SARS era. If you were faced with a patient with suspected Ebola or drug resistant TB or any other biohazard patient who required intubation, would you know how to handle the situation so that you and your colleagues were safe...
The post Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue appeared first on Emergency Medicine Cases.
Probiotics: Five Things You Need to Know - thrive360
thrive360
True or false – all yogurts contain probiotics. False! I was recently invited by Danone Canada to attend a session on probiotics hosted by Dietitians of Canada. I should say that I’ve done work for Danone in the past (not specifically on DanActive, its probiotic drink), and they are not currently an active client. The speaker, Natasha Haskey, MSc RD works for the Saskatoon Health Region and stated no
Fall Detoxification: Therapeutic Recommendations to Support and Maintain a Health Immune System
by Marija Pevac-Djukic @ Toronto Naturopathic Doctor
Mon Aug 05 13:38:58 PDT 2013
Teleconference Presented by Marija Pevac-Djukic MD(Europe) ND Wednesday, September 11, 2013 5 PM – 6:30 PM PST | 8:00 PM – 9:30 PM EST **For practitioners only** An ounce of prevention is worth a pound of cure. While the emunctories…
The post Fall Detoxification: Therapeutic Recommendations to Support and Maintain a Health Immune System appeared first on Toronto Naturopathic Doctor.
Episode 71 ACLS Guidelines 2015 – Cardiac Arrest Controversies Part 1
by @ Emergency Medicine Cases Premium
Wed Oct 21 13:58:51 PDT 2015
A lot has changed over the years when it comes to managing the adult in cardiac arrest. As a result, survival rates after cardiac arrest have risen steadily over the last decade. With the release of the 2015 American Heart Association ACLS Guidelines 2015 online on Oct 16th, while there aren’t a lot a big changes, there are many small but important changes we need to be aware of, and there still remains a lot of controversy. In light of knowing how to provide optimal cardio-cerebral resuscitation and improving patient outcomes, in this episode we’ll ask two Canadian co-authors of The Guidelines, Dr. Laurie Morrison and Dr. Steve Lin some of the most practice-changing and controversial questions.
The post Episode 71 ACLS Guidelines 2015 – Cardiac Arrest Controversies Part 1 appeared first on Emergency Medicine Cases.
Episode 69 Obesity Emergency Management
by @ Emergency Medicine Cases
Tue Sep 08 11:11:44 PDT 2015
Current estimates of the prevalence of obesity are that a quarter of adult Canadians and one third of Americans are considered obese with approximately 3% being morbidly obese. With the proportion of patients with a BMI>30 growing every year, you’re likely to manage at least one obese patient on every ED shift. Obese patients are at high risk of developing a host of medical complications including diabetes, hypertension, coronary artery disease, peripheral vascular disease, biliary disease, sleep apnea, cardiomyopathy, pulmonary embolism and depression, and are less likely compared to non-obese adults to receive timely care in the ED.
Not only are these patients at higher risk for morbidity and mortality, but obesity emergency management is complicated by the patient’s altered cardiopulmonary physiology and drug metabolism. This can make their acute management much more challenging and dangerous. To help us gain a deeper understanding of the challenges of managing obese patients and elucidate a number of important differences as well as practical approaches to obesity emergency management, we welcome Dr. Andrew Sloas, the founder and creator of the fantastic pediatric EM podcast PEM ED, Dr. Richard Levitan, a world-famous airway management educator and innovator and Dr. David Barbic a prominent Canadian researcher in obesity in emergency medicine from University of British Columbia....
The post Episode 69 Obesity Emergency Management appeared first on Emergency Medicine Cases.
Episode 83 – 5 Critical Care Controversies from SMACC Dublin
by Anton Helman @ Emergency Medicine Cases
Tue Jul 05 07:32:26 PDT 2016
EM Cases Episode 83 - 5 Critical Care Controversies from SMACC Dublin: I had the great opportunity to gather some of the brightest minds in Emergency Medicine and Critical Care from around the world (Mark Forrest from U.K., Chris Nickson from Australia, Chris Hicks from Canada and Scott Weingart from U.S.) at the SMACC Dublin Conference and ask them about 5 Critical Care Controversies and concepts:
How to best prepare your team for a resuscitation
Optimum fluid management in sepsis
Direct vs. video laryngoscopy as first line tool for endotracheal intubation
Early vs. late trauma intubation
Whether or not to attempt a thoracotomy in non-trauma centres
The discussion that ensued was enlightening...
The post Episode 83 – 5 Critical Care Controversies from SMACC Dublin appeared first on Emergency Medicine Cases.
5 Things You Can Do to Keep your Pet Healthy in 2018
by Humarian Health Blogger @ Humarian
Tue Jan 23 04:00:07 PST 2018
The basics for keeping a healthy pet may seem obvious, but “best practices” change at a frightening rate nowadays. It can be difficult to keep up with the constant onslaught of new information and even more difficult to separate the good advice from the bad. We caught up with our resident veterinarian, Dr. Julie Towle, […]
The post 5 Things You Can Do to Keep your Pet Healthy in 2018 appeared first on Humarian.
Episode 69 Obesity Emergency Management
by Anton Helman @ Emergency Medicine Cases
Tue Sep 08 11:11:44 PDT 2015
Current estimates of the prevalence of obesity are that a quarter of adult Canadians and one third of Americans are considered obese with approximately 3% being morbidly obese. With the proportion of patients with a BMI>30 growing every year, you’re likely to manage at least one obese patient on every ED shift. Obese patients are at high risk of developing a host of medical complications including diabetes, hypertension, coronary artery disease, peripheral vascular disease, biliary disease, sleep apnea, cardiomyopathy, pulmonary embolism and depression, and are less likely compared to non-obese adults to receive timely care in the ED.
Not only are these patients at higher risk for morbidity and mortality, but obesity emergency management is complicated by the patient’s altered cardiopulmonary physiology and drug metabolism. This can make their acute management much more challenging and dangerous. To help us gain a deeper understanding of the challenges of managing obese patients and elucidate a number of important differences as well as practical approaches to obesity emergency management, we welcome Dr. Andrew Sloas, the founder and creator of the fantastic pediatric EM podcast PEM ED, Dr. Richard Levitan, a world-famous airway management educator and innovator and Dr. David Barbic a prominent Canadian researcher in obesity in emergency medicine from University of British Columbia....
The post Episode 69 Obesity Emergency Management appeared first on Emergency Medicine Cases.
Cannabis Oil – Is Cannabis Oil Legal? Medical Uses, Cancer & More
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 10:11:10 PST 2018
What Is Cannabis Oil? Often referred to as marijuana, Cannabis sativa is a naturally occurring plant variety with active compounds.1,9 While over 400 chemicals have been identified in the plant, the two of interest to most people are tetrahydrocannabinol (THC) and cannabidiol (CBD). In simple terms, THC has psychoactive properties that influence the central nervous […]
The post Cannabis Oil – Is Cannabis Oil Legal? Medical Uses, Cancer & More appeared first on Better Health Organization.
Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction
by @ Emergency Medicine Cases
Fri Jan 06 17:04:26 PST 2012
In Part 2 of this pediatric abdominal pain Episode - Pediatric Gastroenteritis, Constipation & Bowel Obstruction, Dr. Anna Jarvis, Canada's "mother of pediatric emergency medicine" and Dr. Stephen Freedman, one of Canada's pre-eminent researchers in pediatric GI emergencies, discuss the assessment, work-up and treatment of pediatric gastroenteritis, with particular attention to gastroenteritis & acute abdomen mimics, how best to assess hydration status, the nuances of the use of ondansetron and the prose and cons of various rehydration methods. A detailed discussion of the most common and lethal causes of acute abdomen bowel obstruction in pediatrics follows, including intussesception and midgut volvulus. Finally, the differential diagnosis and best management of the most common cause of pediatric abdominal pain, constipation, is reviewed.
The post Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction appeared first on Emergency Medicine Cases.
Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions
by @ Emergency Medicine Cases Premium
Tue Mar 29 12:30:54 PDT 2016
This is EM Cases Journal Jam Podcast 6 - Outpatient Topical Anesthetics for Corneal Abrasions.
I’ve been told countless times by ophthalmologists and other colleagues NEVER to prescribe topical anesthetics for corneal abrasion patients, with the reason being largely theoretical - that tetracaine and the like will inhibit re-epithelialization and therefore delay epithelial healing as well as decrease corneal sensation, resulting in corneal ulcers. With prolonged use of outpatient topical anesthetics for corneal abrasions, corneal opacification could develop leading to decreased vision.
Now this might be true for the tetracaine abuser who pours the stuff in their eye for weeks on end, but when we look at the literature for toxic effects of using topical anesthetics in the short term, there is no evidence for any clinically important detrimental outcomes. Should we ignore the dogma and use tetracaine anyway? Is there evidence that the use of topical anesthetics after corneal abrasions is safe and effective for pain control without adverse effects or delayed epithelial healing?
To discuss the paper "The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review" by Drs. Swaminathan, Otterness, Milne and Rezaie published in the Journal of Emergency Medicine in 2015, we have EM Cases’ Justin Morgenstern, a Toronto-based EM Doc, EBM enthusiast as well as the brains behind the First10EM blog and Salim Rezaie, Clinical Assistant Professor of EM and Internal Medicine at University of Texas Health Science Center at San Antonio as well as the Creator & Founder of the R.E.B.E.L. EM blog and REBELCast podcast.
In this Journal Jam podcast, Dr. Morgenstern and Dr. Rezaie also discuss a simple approach to critically appraising a systematic review article, how to handle consultants who might not be aware of the literature and/or give you a hard time about your decisions and much more...
The post Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions appeared first on Emergency Medicine Cases.
Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue
by Anton Helman @ Emergency Medicine Cases
Mon Aug 28 10:04:51 PDT 2017
In anticipation of EM Cases Main Episode 100 on Disaster Medicine with Laurie Mazurik, David Kollek and Joshua Bezanson, Dr. Mazurik tells of her experience as a disaster medicine leader with keeping health care workers safe during the SARS era. If you were faced with a patient with suspected Ebola or drug resistant TB or any other biohazard patient who required intubation, would you know how to handle the situation so that you and your colleagues were safe...
The post Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue appeared first on Emergency Medicine Cases.
Ganeden Continues Canadian Expansion with New Health Canada Approvals - BevNET.com
BevNET.com
As a result of recent regulatory work, Ganeden has made advancements for the usage of its patented and shelf-stable probiotic strain, GanedenBC30 (Bacillus coagulans GBI-30 6086), in Canada.
Episode 49 Effective Patient Communication, Patient Centered Care and Patient Satisfaction
by @ Emergency Medicine Cases Premium
Mon Aug 11 15:24:25 PDT 2014
If you believe that coping with some of the people we deal with in emergency medicine is difficult or impossible, you’re not alone. We all feel this way from time to time. We all work in stressful environments where it may feel as though we have too little time for effective patient communication, patient centered care and patient satisfaction. You and your patients may often have mismatched views of what’s important. You may have a specific medical agenda and they might have a very different agenda.
Then there’s the difficult patient – we all know who these people are – the hostile aggressive patient, the demanding patient, the know-it-all, the excessively anxious patient, and the incessant complainer, among others. If we don’t know how to handle these patients appropriately, they may receive suboptimal care, grind patient flow to a halt, and delay care of other patients. And of course, if the staff has to deal with a multitude of these patients on a given shift, there’s a sort of swarm-based escalation in frustration and sometimes, unfortunately, a total breakdown of effective care. These frustrations don’t only come out when we’re presented with multiple sequential difficult patients, but for some of us, the more we practice, the more we become desensitized to the needs of all of our patients and their families and, we run the risk of destroying the doctor-patient relationship, as well as making most of our patient interactions frustrating, unsatisfying, – even detrimental to our health and the outcomes of our patients.
How you communicate in the ED can improve patient outcomes and enhance job satisfaction, yet there is little education on patient centered care for EM practitioners. After listening to this episode, it is my hope that what you learn from the literature and from expert opinion,and then apply to the way you communicate with your patients, will effectively make you a happier health care professional.
Dr.Walter Himmel, Dr. Jean Pierre Champagne and RN Ann Shook guide us in this round table discussion on effective patient communication, patient centered care and patient satisfaction – this has evolved my practice into what I perceive as a higher level of personal satisfaction as well as patient care….I hope it will do the same for you.
The post Episode 49 Effective Patient Communication, Patient Centered Care and Patient Satisfaction appeared first on Emergency Medicine Cases.
Episode 49 Effective Patient Communication, Patient Centered Care and Patient Satisfaction
by Anton Helman @ Emergency Medicine Cases
Mon Aug 11 15:24:25 PDT 2014
If you believe that coping with some of the people we deal with in emergency medicine is difficult or impossible, you’re not alone. We all feel this way from time to time. We all work in stressful environments where it may feel as though we have too little time for effective patient communication, patient centered care and patient satisfaction. You and your patients may often have mismatched views of what’s important. You may have a specific medical agenda and they might have a very different agenda.
Then there’s the difficult patient – we all know who these people are – the hostile aggressive patient, the demanding patient, the know-it-all, the excessively anxious patient, and the incessant complainer, among others. If we don’t know how to handle these patients appropriately, they may receive suboptimal care, grind patient flow to a halt, and delay care of other patients. And of course, if the staff has to deal with a multitude of these patients on a given shift, there’s a sort of swarm-based escalation in frustration and sometimes, unfortunately, a total breakdown of effective care. These frustrations don’t only come out when we’re presented with multiple sequential difficult patients, but for some of us, the more we practice, the more we become desensitized to the needs of all of our patients and their families and, we run the risk of destroying the doctor-patient relationship, as well as making most of our patient interactions frustrating, unsatisfying, – even detrimental to our health and the outcomes of our patients.
How you communicate in the ED can improve patient outcomes and enhance job satisfaction, yet there is little education on patient centered care for EM practitioners. After listening to this episode, it is my hope that what you learn from the literature and from expert opinion,and then apply to the way you communicate with your patients, will effectively make you a happier health care professional.
Dr.Walter Himmel, Dr. Jean Pierre Champagne and RN Ann Shook guide us in this round table discussion on effective patient communication, patient centered care and patient satisfaction – this has evolved my practice into what I perceive as a higher level of personal satisfaction as well as patient care….I hope it will do the same for you.
The post Episode 49 Effective Patient Communication, Patient Centered Care and Patient Satisfaction appeared first on Emergency Medicine Cases.
Blue Line Protection Group, Inc.(BLPG) and Hypur Bring “Hypur Vault” Cash Vaulting Solution to Nevada
by Steven M @ What's Hempening
Tue Feb 13 05:34:56 PST 2018
One of Canada’s Top 4 marijuana Stocks To Watch Will Georgia Decriminalize Marijuana Possession? Why is this Marijuana Stock Considered a “Game-Changer”? Texas Opens Frist MMJ Dispensary Canadian Marijuana Stocks Gain Popularity Abroad Blue Line Protection Group, Inc.(BLPG) and Hypur Bring “Hypur Vault”… GT Biopharma Inc. (GTBP) Announces Dr. Jeffrey Miller, Renowned NK Cell… CannTrust […]
The post Blue Line Protection Group, Inc.(BLPG) and Hypur Bring “Hypur Vault” Cash Vaulting Solution to Nevada appeared first on What's Hempening.
Episode 70 End of Life Care in Emergency Medicine
by @ Emergency Medicine Cases Premium
Tue Sep 29 09:37:44 PDT 2015
Most of us in North America live in cultures that almost never talk about death and dying. And medical progress has led the way to a shift in the culture of dying, in which death has been medicalized. While most people wish to die at home, every decade has seen an increase in the proportion of deaths that occur in hospital. Death is often seen as a failure to keep people alive rather than a natural dignified end to life. This is at odds with what a lot of people actually want at the end of their lives: 70% of hospitalized Canadian elderly say they prefer comfort measures as apposed to life-prolonging treatment, yet as many as ⅔ of these patients are admitted to ICUs.
Quality End of Life Care in Emergency Medicine is not widely taught. Most of us are not well prepared for death in our EDs – and we should be. There’s no second chance when it comes to a bad death like there is if you screw up a central line placement, so you need the skills to do it right the first time.
To recognize when comfort measures and compassion are what will be best for our patients, is just as important as knowing when to intervene and treat aggressively in a resuscitation. Emergency physicians should be able to recognize not only the symptoms and patterns that are common in the last hours to days of life, but also understand the various trajectories over months or years toward death, if they’re going to provide the high quality end of life care that patients deserve.
So, with the help of Dr. Howard Ovens, a veteran emergency physician with over 25 years of experience who speaks at national conferences on End of Life Care in Emergency Medicine, Dr. Paul Miller, an emergency physician who also runs a palliative care unit at McMaster University and Dr. Shona MacLachlan who led the palliative care stream at the CAEP conference in Edmonton this past June, we'll help you learn the skills you need to assess dying patients appropriately, communicate with their families effectively, manage end of life symptoms with confidence and much more...
The post Episode 70 End of Life Care in Emergency Medicine appeared first on Emergency Medicine Cases.
Spread the Mustard
by thrive360 @ thrive360
Thu Jul 20 13:30:29 PDT 2017
by Zannat Reza, MHSc RD Did you know that two-thirds of all the mustard traded in the world is grown in Canada? And that farmers in Saskatchewan grow about 75% of Canada’s mustard crop. Who knew Canada was such a power in the spice world?...
The post Spread the Mustard appeared first on thrive360.
How to love apples with a savoury twist
by thrive360 @ thrive360
Wed Sep 13 13:19:11 PDT 2017
by Zannat Reza, MHSc RD When cooking with apples we often think sweet desserts, but getting creative with this Canadian staple can lend an unexpected twist to savoury recipes as well. My colleague, Anna Richardson, developed a series of delicious recipes. Dig into an apple...
The post How to love apples with a savoury twist appeared first on thrive360.
Episode 46 – Social Media and Emergency Medicine Learning
by @ Emergency Medicine Cases
Tue Jun 24 08:58:15 PDT 2014
In early June of this year I caught up with Dr. Rob Rogers of iTeach EM and The Teaching Course, Dr. Ken Milne of The Skeptics Guide to EM and Dr. Brent Thoma of Academic Life in EM and Boring EM at the Canadian Association of Emergency Medicine Conference in Ottawa to chat about the evolution of Social Media & Emergency Medicine Learning. In this podcast, we discuss how Social Media can enhance your career, tips on how to get the most out of FOAMed without getting overwhelmed by the volume of material, swarm-based medicine, tacit knowledge sharing, the flipped classroom, the use of FOAMed in emergency medicine training curricula, how Twitter, Google+, Google Hangout and Google Glass have changed the face of medical education, and much more.
The post Episode 46 – Social Media and Emergency Medicine Learning appeared first on Emergency Medicine Cases.
Best Case Ever 12: Drugs of Abuse
by Anton Helman @ Emergency Medicine Cases
Sun Oct 07 18:10:44 PDT 2012
As a bonus to Episode 27 on Drugs of Abuse -Stimulants & Opiates, Dr. Margaret Thompson, one of Canada's leading Toxicologists and the medical director of the Ontario Poison Control Centre tells us 2 of her Best Cases Ever about stimulant overdose surprises. In the related Episode, Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....
[wpfilebase tag=file id=396 tpl=emc-play /]
[wpfilebase tag=file id=397 tpl=emc-mp3 /]
The post Best Case Ever 12: Drugs of Abuse appeared first on Emergency Medicine Cases.
Episode 34: Geriatric Emergency Medicine
by @ Emergency Medicine Cases Premium
Mon Jul 08 08:07:17 PDT 2013
In this episode Dr. Don Melady, Canada's leading educator in Geriatric Emergency Medicine (Geri-EM) & Dr. Jaques Lee, one of Canada's leading researchers in Geri-EM, discuss the common yet challenging Geriatric Emergencies: a practical approach to geriatric Delirium, best practice for managing agitation and pain in the older patient, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, atypical presentations of common life threatening emergencies including ACS and surgical abdomen, key drug interactions in the geriatric patient and more..
The post Episode 34: Geriatric Emergency Medicine appeared first on Emergency Medicine Cases.
Top 6 Black Mold Symptoms & How to Prevent Black Mold Exposure
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 10:38:29 PST 2018
What is Black Mold Most people have heard of black mold, but are you aware of the dangers and side effects related to this fungus? Also known as Stachybotrys chartarum, black mold is most often found in damp building materials, and can be prevalent in older and humid homes. The term ‘black mold’ can be […]
The post Top 6 Black Mold Symptoms & How to Prevent Black Mold Exposure appeared first on Better Health Organization.
Complete Guide to Cupping Therapy: Types, Benefits & Side Effects
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 17 09:41:54 PST 2018
Cupping: What is it? Cupping is an ancient medicinal practice that dates as early as 3000 B.C., and has made a recent resurgence in the alternative health industry. Cupping was traditionally practiced by Middle Eastern, Greek, and Chinese cultures for thousands of years before becoming popular in Europe and in North America. Historically, cupping was […]
The post Complete Guide to Cupping Therapy: Types, Benefits & Side Effects appeared first on Better Health Organization.
BCE 65 Intimate Partner Violence – A Silent Epidemic
by Anton Helman @ Emergency Medicine Cases
Tue Jan 23 13:57:55 PST 2018
I was taken aback when I came across the statistic that approximately every 6 days a woman in Canada is killed by her intimate partner. Victims of intimate partner violence and domestic violence that we see in the ED typically involve an abuse story of repeated escalating violence over time that ends up in a crisis situation. The woman is often financially dependent on her abuser and has no one to turn to for help. In one of her worst cases ever from Janus General, Dr. Meeta Patel and I discuss the notions that Emergency providers have a unique opportunity to identify patients who are victims of intimate partner violence; that we should begin by thinking of how we can screen every woman of childbearing age about intimate partner violence in a private, safe and respectful way. We describe the quick Partner Violence Screen and finally how to offer supportive, empowering statements and connect your patients with resources like assaulted women’s helpline and shelters in your community...
The post BCE 65 Intimate Partner Violence – A Silent Epidemic appeared first on Emergency Medicine Cases.
Mintel Report Highlights Canada’s Conservative Spending Habits
by Joanne Somaiya @ Canadian Food Business
Fri Jun 16 06:00:23 PDT 2017
Mintel has released the finding of its annual poll of Canadian spending habits, and financial concerns and values
Episode 27: Drugs of Abuse – Stimulants and Opiates
by @ Emergency Medicine Cases Premium
Mon Oct 15 13:47:15 PDT 2012
Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....
The post Episode 27: Drugs of Abuse – Stimulants and Opiates appeared first on Emergency Medicine Cases.
Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue
by @ Emergency Medicine Cases
Mon Aug 28 10:04:51 PDT 2017
In anticipation of EM Cases Main Episode 100 on Disaster Medicine with Laurie Mazurik, David Kollek and Joshua Bezanson, Dr. Mazurik tells of her experience as a disaster medicine leader with keeping health care workers safe during the SARS era. If you were faced with a patient with suspected Ebola or drug resistant TB or any other biohazard patient who required intubation, would you know how to handle the situation so that you and your colleagues were safe...
The post Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue appeared first on Emergency Medicine Cases.
Episode 52: Commonly Missed Uncommon Orthopedic Injuries
by @ Emergency Medicine Cases Premium
Mon Oct 13 12:14:26 PDT 2014
We rarely discuss medico-legal issues on EM Cases because it misguides us a bit from good patient centered care – which is what emergency medicine is really all about.
Nonetheless, missed orthopedic injuries are the most common reason for an emergency doc to be sued in Canada. This is partly because missed orthopedic injuries are far more common than missed MIs for example, but it’s also because it’s easy to miss certain orthopedic injuries – especially the ones that aren’t super common. And orthopedics is difficult to learn and remember for the EM practitioner as there are so many injuries to remember.
And so, you guessed it – on this episode we’re going to run through some key not-so-common, easy to miss orthopedic injuries, some of which I, personally had to learn about the hard way, if you know what I mean.
After listening to this episode, try some cognitive forcing strategies – for every patient with a FOOSH that you see, look for and document a DRUJ injury. Wait, hold on….I don’t wanna give it all away at the top of the post.
Let’s hear what EM doc and sports medicine guru Ivy Cheng, and the orthopedic surgeon who everyone at North York General turns to when they need help with a difficult ortho case, Hossein Medhian, have to say about Commonly Missed Uncommon Orthopedic Injuries.
The post Episode 52: Commonly Missed Uncommon Orthopedic Injuries appeared first on Emergency Medicine Cases.
Colon Hydrotherapy – Colonic Weight Loss, Safety, Benefits, & Cost
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 17 10:28:21 PST 2018
Colon Hydrotherapy Colon hydrotherapy, also known as colon irrigation, or a colonic, is an alternative medical therapy, which has grown in popularity over the past decade. Colon hydrotherapy stems from the ancient concept of autointoxication, which suggests that fecal matter can poison the body from the inside.1 So, what is colon hydrotherapy, and what kind […]
The post Colon Hydrotherapy – Colonic Weight Loss, Safety, Benefits, & Cost appeared first on Better Health Organization.
Probiotic products in Canada with clinical evidence: What can gastroenterologists recommend?
PubMed Central (PMC)
Probiotics, defined as ‘live microorganisms, which when administered in adequate amounts, confer a health benefit on the host’, are finally becoming an option for gastroenterologists in Canada, after being available for many years in Japan, ...
Episode 34: Geriatric Emergency Medicine
by @ Emergency Medicine Cases
Mon Jul 08 08:07:17 PDT 2013
In this episode Dr. Don Melady, Canada's leading educator in Geriatric Emergency Medicine (Geri-EM) & Dr. Jaques Lee, one of Canada's leading researchers in Geri-EM, discuss the common yet challenging Geriatric Emergencies: a practical approach to geriatric Delirium, best practice for managing agitation and pain in the older patient, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, atypical presentations of common life threatening emergencies including ACS and surgical abdomen, key drug interactions in the geriatric patient and more..
The post Episode 34: Geriatric Emergency Medicine appeared first on Emergency Medicine Cases.
Avocado Nutrition & Calories: How to Pick The Perfect Avocado
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 10:14:59 PST 2018
Avocado The avocado is a fruit, which grows on trees native to Mexico, Central, and South America. The first avocado tree came to the United States in 1871, and gained popularity with Americans. By 1950 there were more than 25 different types of avocados available in California.1 Avocados have thick, dark green and purple, textured […]
The post Avocado Nutrition & Calories: How to Pick The Perfect Avocado appeared first on Better Health Organization.
Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales
by @ Emergency Medicine Cases
Tue Dec 30 15:00:40 PST 2014
There are hundreds of clinical decision rules and risk scales published in the medical literature, some more widely adopted than others. Ian Stiell, the father of clinical decision rules, shares with us his views and experiences gained from co-creating some of the most influential CDRs and risk scales to date. He explains the criteria for developing a CDR, the steps to developing a valid CDR, how best to apply CDRs and risk scales to clinical practice, and the hot-off the-press new Ottawa COPD Risk Score and Ottawa Heart Failure Risk Score for helping you with disposition decisions. It turns out that in Canada, we discharge about two thirds of the acute decompensated heart failure patients that we see in the ED, while the US almost all patients with decompensated heart failure are admitted to hospital. Dr. Stiell's new risk scores may help physicians in Canada make safer disposition decisions while help physicians in the US avoid unnecessary admissions.
The post Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales appeared first on Emergency Medicine Cases.
Episode 41: Hypertensive Emergencies
by Anton Helman @ Emergency Medicine Cases
Mon Mar 24 08:31:09 PDT 2014
In this episode on Hypertensive Emergencies, Dr. Joel Yaphe, EM residency program director at the University of Toronto & Dr. Clare Atzema, one of Canada's leading cardiovascular EM researchers will discuss the controversies of how to manage patients who present to the ED with high blood pressure and evidence of end organ damage related to the high blood pressure. Hypertensive emergencies are a grab bag of diagnoses that all need to be treated differently. Hypertensive Encephalopathy, Aortic Dissection, Acute Pulmonary Edema, Pre-eclampsia & Eclampsia, Acute Renal Failure, Subarachnoid Hemorrhage and Intracranial Hemorrhage all need individualized blood pressure management.
The post Episode 41: Hypertensive Emergencies appeared first on Emergency Medicine Cases.
Best Case Ever 12: Drugs of Abuse
by @ Emergency Medicine Cases
Sun Oct 07 18:10:44 PDT 2012
As a bonus to Episode 27 on Drugs of Abuse -Stimulants & Opiates, Dr. Margaret Thompson, one of Canada's leading Toxicologists and the medical director of the Ontario Poison Control Centre tells us 2 of her Best Cases Ever about stimulant overdose surprises. In the related Episode, Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....
[wpfilebase tag=file id=396 tpl=emc-play /]
[wpfilebase tag=file id=397 tpl=emc-mp3 /]
The post Best Case Ever 12: Drugs of Abuse appeared first on Emergency Medicine Cases.
Connectivity and Digitalization in Food Production
by Joanne Somaiya @ Canadian Food Business
Thu Dec 14 12:23:15 PST 2017
How Canadian food manufacturers will benefit from digitalization By Markus Brettschneider From automotive and aerospace, many industries have been using digitalization technologies, such as automation and robotics, for many years. This goes hand in hand with the idea of the Industrial Internet of Things (IIoT), where connectivity of devices opens up new possibilities to improve production. …
Pet Dental Health
by Humarian Health Blogger @ Humarian
Mon Feb 12 13:00:07 PST 2018
Have you ever noticed that many dogs have bad breath? Of course you have, but I’ll bet you didn’t know that bad breath could be a sign of a serious dental health risk. In fact, nearly 70% of cats and dogs have gingivitis by the age of 3! Even worse, this gingivitis can lead to […]
The post Pet Dental Health appeared first on Humarian.
Stopping Bread from Turning Stale
by Joanne Somaiya @ Canadian Food Business
Thu Dec 14 12:03:31 PST 2017
Bread consumption has steadily declined in Canada over the last decade but growing diversity in the bread aisle is encouraging younger consumers to stay in the category By Chris Brockman Canadians are unequivocally eating less bread. According to Mintel, based on data from Statistics Canada and the Economist Intelligence Unit, per capita consumption of bread has …
Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction
by @ Emergency Medicine Cases Premium
Fri Jan 06 17:04:26 PST 2012
In Part 2 of this pediatric abdominal pain Episode - Pediatric Gastroenteritis, Constipation & Bowel Obstruction, Dr. Anna Jarvis, Canada's "mother of pediatric emergency medicine" and Dr. Stephen Freedman, one of Canada's pre-eminent researchers in pediatric GI emergencies, discuss the assessment, work-up and treatment of pediatric gastroenteritis, with particular attention to gastroenteritis & acute abdomen mimics, how best to assess hydration status, the nuances of the use of ondansetron and the prose and cons of various rehydration methods. A detailed discussion of the most common and lethal causes of acute abdomen bowel obstruction in pediatrics follows, including intussesception and midgut volvulus. Finally, the differential diagnosis and best management of the most common cause of pediatric abdominal pain, constipation, is reviewed.
The post Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction appeared first on Emergency Medicine Cases.
Best Case Ever 10: Pediatric Syncope
by @ Emergency Medicine Cases
Mon Jul 09 11:28:27 PDT 2012
Pediatric Syncope usually has a benign cause, but may be a warning for sudden death. As a bonus to Episode 25 on ‘Pediatric & Adult Syncope’ with Dr. Eric Letovsky and Dr. Anna Jarvis, 'Canada's mother of Pediatric Emergency Medicine', we have Dr. Jarvis’s Best Case Ever. In the related episode we will cover how to differentiate syncope from seizure, key historical and physical exam clues to determine a cause of syncope, ECG pearls of syncope causing cardiac conditions, from Congenital Prolonged QT Syndrome to Arrhythmogenic Right Ventricular Cardiomyopathy, the value of syncope decision rules such as the ROSE rule and the San Francisco Syncope Rule, the value of ancillary testing, including Holter monitoring, Echocardiograms and Stress Testing and much more......
[wpfilebase tag=file id=386 tpl=emc-play /]
[wpfilebase tag=file id=387 tpl=emc-mp3 /]
The post Best Case Ever 10: Pediatric Syncope appeared first on Emergency Medicine Cases.
Hello world!
by admin @ Probiotics Database
Thu Dec 09 09:42:22 PST 2010
Welcome to WordPress. This is your first post. Edit or delete it, then start blogging!
The post Hello world! appeared first on Probiotics Database.
Journal Jam 2: Small Bore Chest Tube and Outpatient Management of Pneumothorax
by Anton Helman @ Emergency Medicine Cases
Tue Dec 09 07:25:09 PST 2014
It makes sense that the treatment of primary spnontaneous pneumothorax would lend itself well to outpatient management, since patients are usually young and otherwise healthy, and the mortality and morbidity from these air leaks are really very low. Most patients would rather be managed as an outpatient rather than admitted to hospital and sending these patients home would probably end up saving the system resources and money. In this month's Journal Jam Podcast on small bore chest tube and outpatient management of pneumothorax, the highlighted article that Anton Helman and Teresa Chan discuss is Voison et al. on the “Ambulatory Management of Large Spontaneous Pneumothorax With Pigtail Catheters.” We hear from Michelle Lin, Seth Trueger, Heather Murray and the lead author himself, Stephan Jouneau. Questions posed include: In what ways is the use of small bore catheters with Heimlich valves for spontaneous pneumothorax better than needle aspiration? Is it necessary to repeat a CXR after placement of the catheter? Who should follow up these patients after they are discharged from the hospital? How can we minimize kinking and dislodgement of the catheter? and many more.....
[wpfilebase tag=file id=523 tpl=emc-play /]
[wpfilebase tag=file id=524 tpl=emc-mp3 /]
The post Journal Jam 2: Small Bore Chest Tube and Outpatient Management of Pneumothorax appeared first on Emergency Medicine Cases.
Episode 67 Pediatric Pain Management
by Anton Helman @ Emergency Medicine Cases
Tue Jul 07 13:39:13 PDT 2015
Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.
The post Episode 67 Pediatric Pain Management appeared first on Emergency Medicine Cases.
Episode 71 ACLS Guidelines 2015 – Cardiac Arrest Controversies Part 1
by Anton Helman @ Emergency Medicine Cases
Wed Oct 21 13:58:51 PDT 2015
A lot has changed over the years when it comes to managing the adult in cardiac arrest. As a result, survival rates after cardiac arrest have risen steadily over the last decade. With the release of the 2015 American Heart Association ACLS Guidelines 2015 online on Oct 16th, while there aren’t a lot a big changes, there are many small but important changes we need to be aware of, and there still remains a lot of controversy. In light of knowing how to provide optimal cardio-cerebral resuscitation and improving patient outcomes, in this episode we’ll ask two Canadian co-authors of The Guidelines, Dr. Laurie Morrison and Dr. Steve Lin some of the most practice-changing and controversial questions.
The post Episode 71 ACLS Guidelines 2015 – Cardiac Arrest Controversies Part 1 appeared first on Emergency Medicine Cases.
Health Equity, Trust and Data Collection in the Emergency Department
by Dr. Howard Ovens @ Emergency Medicine Cases
Tue Aug 18 08:28:03 PDT 2015
I view the emergency department as a safe refuge, a modern-day secular sanctuary. We are the one health-care service that never turns anyone away; we provide shelter to the homeless on cold winter nights, safety for battered women, and food for the hungry. I have always felt this “sanctuary” role was part of the core mission of the ED, one with a great potential for improving lives, or at least providing comfort.
The post Health Equity, Trust and Data Collection in the Emergency Department appeared first on Emergency Medicine Cases.
Journal Jam 5 One Hour Troponin to Rule Out and In MI
by Anton Helman @ Emergency Medicine Cases
Tue Dec 22 07:15:11 PST 2015
Traditionally we've run at least 2 troponins 6 or 8 hours apart to help rule out MI and recently in algorithms like the HEART score we've combined clinical data with a 2 or 3 hour delta troponin to help rule out MI. The paper we'll be discussing here is a multicentre/multinantional study from the Canadian Medical Association Journal from this year out of Switzerland entitled "Prospective validation of a 1 hour algorithm to rule out and rule in acute myocardial infarction using a high sensitivity cardian troponin T assay" with lead author Tobias Reichlin. It not only looks at whether or not we can rule out MI using a delta troponin at only 1 hour but whether or not we can expedite the ruling in of MI using this protocol.
The post Journal Jam 5 One Hour Troponin to Rule Out and In MI appeared first on Emergency Medicine Cases.
Towards more effective supplement regulation in Canada
by Scott @ Science-Based Pharmacy
Sun Sep 25 18:42:25 PDT 2016
I suppose I owe Health Canada some thanks. It was Health Canada’s lackadaisical regulation of dietary supplements and natural health products that turned me from a “shruggie” pharmacist into one that started advocating, publicly, for putting consumers’ interests ahead of those of supplement manufacturers. While health regulations are seemingly created to protect consumers, Health Canada … Continue reading Towards more effective supplement regulation in Canada
Forty Creek Entrusts Fans to Choose 2018 Limited Edition Blend
by Press Release @ BevNET.com
Mon Feb 12 10:00:34 PST 2018
Award-winning whisky brand, Forty Creek, is once again putting flavour first as it seeks input from Canadian taste buds across the country to determine their next limited edition release.
Bayside Distributors Finds Focus In Healthy Beverages
by Martín Caballero @ BevNET.com
Mon Feb 12 14:46:51 PST 2018
Bayside Distributors, which currently services around 1,100 accounts in Massachusetts and Rhode Island with a focus on independent gourmet, natural and specialty stores, has followed the pivot in food and beverage towards trends like clean label, plant-based and reduced sugar.
Probiotics might save lives in low-resource countries
by keithbarrington @ Neonatal Research
Mon Feb 05 13:12:01 PST 2018
After several years of preliminary investigations, a huge RCT has been published from India (Panigrahi P, et al. A randomized synbiotic trial to prevent sepsis among infants in rural India. Nature. 2017;548:407.) which enrolled babies over 2 kg birth weight … Continue reading
Phillips Colon Health Review - Probiotics Database
Probiotics Database
Amazon.com Rating: Visit manufacturer webpage: http://www.phillipsrelief.com Phillip’s Colon Health is available at: What is Phillip’s Colon Health? Phillip’s Colon Health contains 3 probiotic strains in a capsule. Other Features Capsules are easily dissolved by the digestive juices of the stomach. Unprotected capsules will expose the probiotics inside to stomach acid. Phillip’s Colon Health does not have …
Episode 46 – Social Media and Emergency Medicine Learning
by Anton Helman @ Emergency Medicine Cases
Tue Jun 24 08:58:15 PDT 2014
In early June of this year I caught up with Dr. Rob Rogers of iTeach EM and The Teaching Course, Dr. Ken Milne of The Skeptics Guide to EM and Dr. Brent Thoma of Academic Life in EM and Boring EM at the Canadian Association of Emergency Medicine Conference in Ottawa to chat about the evolution of Social Media & Emergency Medicine Learning. In this podcast, we discuss how Social Media can enhance your career, tips on how to get the most out of FOAMed without getting overwhelmed by the volume of material, swarm-based medicine, tacit knowledge sharing, the flipped classroom, the use of FOAMed in emergency medicine training curricula, how Twitter, Google+, Google Hangout and Google Glass have changed the face of medical education, and much more.
The post Episode 46 – Social Media and Emergency Medicine Learning appeared first on Emergency Medicine Cases.
Journal Jam 2: Small Bore Chest Tube and Outpatient Management of Pneumothorax
by @ Emergency Medicine Cases Premium
Tue Dec 09 07:25:09 PST 2014
It makes sense that the treatment of primary spnontaneous pneumothorax would lend itself well to outpatient management, since patients are usually young and otherwise healthy, and the mortality and morbidity from these air leaks are really very low. Most patients would rather be managed as an outpatient rather than admitted to hospital and sending these patients home would probably end up saving the system resources and money. In this month's Journal Jam Podcast on small bore chest tube and outpatient management of pneumothorax, the highlighted article that Anton Helman and Teresa Chan discuss is Voison et al. on the “Ambulatory Management of Large Spontaneous Pneumothorax With Pigtail Catheters.” We hear from Michelle Lin, Seth Trueger, Heather Murray and the lead author himself, Stephan Jouneau. Questions posed include: In what ways is the use of small bore catheters with Heimlich valves for spontaneous pneumothorax better than needle aspiration? Is it necessary to repeat a CXR after placement of the catheter? Who should follow up these patients after they are discharged from the hospital? How can we minimize kinking and dislodgement of the catheter? and many more.....
[wpfilebase tag=file id=523 tpl=emc-play /]
[wpfilebase tag=file id=524 tpl=emc-mp3 /]
The post Journal Jam 2: Small Bore Chest Tube and Outpatient Management of Pneumothorax appeared first on Emergency Medicine Cases.
Episode 18 Part 2: More Point of Care Ultrasound
by @ Emergency Medicine Cases Premium
Tue Nov 08 07:25:25 PST 2011
In Part 2 of this Episode on Emergency Ultrasound or Point of Care Ultrasound (POCUS) Dr. Fischer, Dr. Hannam, Dr. Chenkin & Dr. Hall, Canada's EM ultrasound gurus discuss how POCUS can help our decision-making in the pediatric patient with a limp, in the patient with necrotizing fasciitis, in the pregnant patient with vaginal bleeding and in the common and challenging elderly patient with undifferentiated abdominal pain. They cover POCUS indications from urinary retention to appendicitis and debate the utility of these indications. This is followed by a debate on how best to educate ourselves and the EM community in POCUS and how best to designs quality assurance programs so that point of care ultrasound (POCUS) becomes an accepted tool across the entire medical community.
The post Episode 18 Part 2: More Point of Care Ultrasound appeared first on Emergency Medicine Cases.
Parsley (Flat Leaf & Curly) – Top 12 Benefits, Nutrition, & Uses
by Better Health Organization Research Team @ Better Health Organization
Wed Jan 10 10:57:14 PST 2018
Parsley What is parsley and where is parsley from? Parsley is a type of flowering plant from the family of Apiaceae. It is native to central Mediterranean countries including Greece, Portugal, Spain, Italy, Malta, Morocco, Tunisia and Algeria. The parsley definition as stated by the Oxford English Dictionary classifies it as a “biennial plant with […]
The post Parsley (Flat Leaf & Curly) – Top 12 Benefits, Nutrition, & Uses appeared first on Better Health Organization.
Best Case Ever 17: Geriatric Emergency Medicine
by @ Emergency Medicine Cases Premium
Tue Jul 02 08:54:19 PDT 2013
As a bonus to Episode 34 on Geriatric Emergency Medicine, Dr. Don Melady, one of Canada's leading educators in Geriatric EM, tells us about his Best Case Ever in which a simple fall turns out to be a multi-facited complicated case with a simple solution.
In the related Episode 34 on Geriatric Emergency Medicine Dr. Melady and Dr. Jacques Lee cover an approach to geriatric Delirium, managing agitation, indications for CT head in the delirious older person, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, key drug interactions, pain management, atypical ACS and pearls in Geriatric abdominal pain presentations.
The post Best Case Ever 17: Geriatric Emergency Medicine appeared first on Emergency Medicine Cases.
Episode 46 – Social Media and Emergency Medicine Learning
by @ Emergency Medicine Cases Premium
Tue Jun 24 08:58:15 PDT 2014
In early June of this year I caught up with Dr. Rob Rogers of iTeach EM and The Teaching Course, Dr. Ken Milne of The Skeptics Guide to EM and Dr. Brent Thoma of Academic Life in EM and Boring EM at the Canadian Association of Emergency Medicine Conference in Ottawa to chat about the evolution of Social Media & Emergency Medicine Learning. In this podcast, we discuss how Social Media can enhance your career, tips on how to get the most out of FOAMed without getting overwhelmed by the volume of material, swarm-based medicine, tacit knowledge sharing, the flipped classroom, the use of FOAMed in emergency medicine training curricula, how Twitter, Google+, Google Hangout and Google Glass have changed the face of medical education, and much more.
The post Episode 46 – Social Media and Emergency Medicine Learning appeared first on Emergency Medicine Cases.
Episode 63 – Pediatric DKA
by @ Emergency Medicine Cases Premium
Tue Apr 28 16:20:51 PDT 2015
Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases’ partners who’s mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering - why was DKA singled out in this needs assessment?
It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment - cerebral edema being the big bad one.
The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum ketones are in the diagnosis of DKA, how to assess the severity of DKA to guide management, how to avoid the dreaded cerebral edema that all too often complicates DKA, how to best adjust fluids and insulin during treatment, which kids can go home, which kids can go to the floor and which kids need to be transferred to a Pediatric ICU.
The post Episode 63 – Pediatric DKA appeared first on Emergency Medicine Cases.
Probiotic yogurt benefits vary, study finds
CBC News
Canadian consumers daunted by shelves of yogurt in a wide array of styles at the grocery store should keep in mind not all probiotic products are created equal.