Last year, I started keeping track of the books I was reading, mostly to help prevent me from bringing a handful of books on vacation only to find out that I have already read them all. Reading back through the list was a nice “year in review” exercise for me. […]
Rants & Ramblings
50 posts
By now, I think everyone has heard of the test threshold. It is most often discussed in the context of the workup for pulmonary embolism. (I think it is an important concept that we probably need to employ more widely in emergency medicine, but that is the topic of a […]
You can’t interpret the results of a test without knowing the pretest probability. I am sure we have all heard the same lecture about screening tests. I am sure that we have all been surprised by the strange numbers that result from applying seemingly excellent tests in low risk populations. […]
When the dye starts, it might feel like you are peeing your pants. Don’t worry, you won’t actually pee. It’s just a side effect of the dye.” During my time in New Zealand, I have heard that speech far too many times. (The consequence of a strange rule that requires […]
We spend a lot of time talking about making the emergency department experience better for children, and we probably still have a long way to go. The emergency department is an inherently scary place, to which we add a series of painful tests and procedures. No one visits the emergency […]
I walk into the room and see a 3 year old screaming in pain. It’s 3 am and her ear hurts. She couldn’t sleep. I ask her father what he has been using at home for pain. He pulls out a box and my heart sinks. Another parent duped by […]
My approach to status epilepticus is somewhat more aggressive than commonly taught algorithms. It is summarized (overly simply) as “benzo → benzo → propofol”. There have been a number of concerns raised with this strategy recently on twitter. This post outlines the reasoning (and limited evidence) behind my seizure algorithm.
Last week, I discussed the reasons that I believe that tramadol is a bad drug that shouldn’t be prescribed. This week, I will tackle a similarly bad drug: codeine. The argument is essentially the same. Tramadol may be moderately worse, because of the added SNRI effects, but the variable effects […]
I have never prescribed tramadol. I was taught that, for a variety of reasons, it’s an awful drug. In Canada, everyone seemed to agree. But then I moved to New Zealand.