Archive for category: Clinical

Is it Time to Start Using the HEART Pathway in the Emergency Department?

30 Apr
April 30, 2015

There are approximately 8 to 10 million patients complaining of chest pain coming to Emergency Departments (EDs) in the United States annually. In the US, we use a very liberal testing strategy in order to avoid acute coronary syndrome (ACS) in patients presenting with chest pain. This results in over 50% of ED patients with […]

Hands-On Defibrillation: If the Glove Fits…You Must Acquit!

27 Apr
April 27, 2015

We’ve had some heated debates on the topic of hands-on defibrillation (HOD) for the past few years. We all know the most important time to avoid a pause during CPR is the perishock pause (). We also know that despite lots of safety data (, ) and safe experience doing HOD (, Johnson) there are still concerns […]

Skin Anesthesia: Lidocaine vs Bupivacaine +/- Epinephrine

23 Apr
April 23, 2015

  When selecting a local anesthetic agent for skin wounds I have historically been taught to use lidocaine to provide a faster onset, and to use bupivacaine for a longer duration of action. It can be time consuming to find 0.5% Bupivacaine with epinephrine and 2% Lidocaine with Epinephrine to produce a final mixture of […]

April 2015 “Skeptical Edition” REBELCast

20 Apr
April 20, 2015

Welcome back to a special edition, or should I say “skeptical edition” of REBELCast. We have started to do something new by inviting guests onto the show to discuss papers in the literature they find interesting.  This month I had the pleasure of working with Ken Milne, an emergency room physician in Canada. Today, Ken and […]

Accelerated Diagnostic Protocol for Chest Pain Not Useful in a US Population?

16 Apr
April 16, 2015

There are approximately 8 to 10 million patients coming to Emergency Departments (EDs) in the United States annually. In the US, we use a very liberal testing strategy in order to avoid acute coronary syndrome (ACS) in patients presenting with chest pain. This results in over 50% of ED patients with acute chest pain receiving […]

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