The conversation that extended my career

We all mistakes. It’s better to talk about them.

My heart is pounding. My stomach is in a knot. I can’t think straight.

I made a mistake. Continue reading “The conversation that extended my career”

UTI: More than you ever wanted to know

For this month’s Emergency Medicine Cases, Anton kindly asked me to act as a guest expert on the topic of urinary tract infections. The episode, which I think is fantastic, can be found here. In preparing for the episode, I ended up reading a lot, learning a lot, and taking relatively extensive notes. Although it doesn’t fit with the usual content of First10EM, I decided to share my notes, as I think some people might find them interesting, and they also provide links to all the literature we mention in the podcast. Continue reading “UTI: More than you ever wanted to know”

Chloral Hydrate Toxicity

A guide to the first 10 minutes of resuscitation in chloral hydrate toxicity

Case

#1 A 4 year old girl was prescribed chloral hydrate to be taken at home prior to a procedure by her dentist. After a successful procedure, she was monitored for 1 hour, at which point she was described as tired but rousable and she was discharged home. Three hours later her mother finds her unresponsive and calls 911. Paramedics arrive to find a child in respiratory arrest and quickly package her up for the 5 minute drive to your small community hospital… (Nordt 2014)

#2 Later that evening, a 21 old man is transported from a local bar unresponsive after drinking a beer. The monitor reveals a wide complex tachycardia. There is a faint odor of pears on his breath, which triggers a vague recollection from medical trivia night. You have a nurse talk to his friends, and sure enough, they admit to slipping him a “Micky Finn” as a prank…

Continue reading “Chloral Hydrate Toxicity”

Articles of the Month (March 2017)

A monthly collection of interesting emergency medicine articles appraised to keep your practice informed.

I decided to take a break last month, for the first time in a few years. I imagine some people were hoping I would take I much more extended vacation, but I am sorry to say, you are stuck with me. I might be a little rusty, though, after a month off, so cut me some slack…

As always, the audio version is available on the BroomeDocs podcast (if you can tolerate very poor quality banter that Casey and I produce).
Continue reading “Articles of the Month (March 2017)”

Performance Under Pressure

How well do you perform when the pressure is high? This is one of my favorite emergency medicine topics. Emergency personnel pride themselves on thriving under pressure. Doctors like to think of themselves as perfect, maybe even god-like. Combine the two, and you can imagine the ego of the average emergency physician. But underneath all that bravado, we are all human. We all experience stress, and we all respond to stress in distinctly human ways.

Continue reading “Performance Under Pressure”

The Ottawa heart failure risk scale

A new episode of the SGEM hot off the press just went up. Ken and I spoke to Ian Stiell about his Ottawa heart failure risk scale.

Reference: Stiell et al. Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP. AEM March 2017

Continue reading “The Ottawa heart failure risk scale”

Rapid Review: Ciguatera Poisoning

In the Rapid Review series, I briefly review the key points of a clinical review paper.

The topic: Ciguatera poisoning

The paper: Thompson CA, Jazuli F, Taggart LR, Boggild AK. Ciguatera fish poisoning after Caribbean travel. CMAJ Canadian Medical Association journal. 2016. PMID: 27160878 Continue reading “Rapid Review: Ciguatera Poisoning”