BEEM Cases 3 – Acute Respiratory Failure: NIPPV & POCUS

Shortness of breath is a very common chief complaint in the emergency department, but despite our familiarity with this symptom, management is not always straightforward. The differential diagnosis is extensive, including the common cardiorespiratory conditions, but extending to toxicologic, hematologic, neuromuscular, metabolic, and psychiatric causes. Over the past decade, we have seen the widespread adoption of new technologies to help us manage these patients. This post will look at some new evidence on two of those technologies: noninvasive positive pressure ventilation (NIPPV) and ultrasound (POCUS). We will answer 3 questions based on 3 systematic reviews using the BEEM critical appraisal framework...

Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales

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.

Best Case Ever 24: COPD, Baggging and Vent Settings

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.