A recent clinical practice article in the NEJM(1) on Transient Ischaemic Attack (TIA) gave a nice summary of this topic. Current guidelines that are good reference sources on stroke and TIA management include: American Heart Association and the American Stroke Association (AHA–ASA),(2) NICE,(3) and the European Stroke Organization(4) Definition of TIA The new definition of…

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Hanging is one of the topics that comes up every now and then on an exam and infrequently into the emergency department. What are the key points? 2 Types of Hangings Suspension: rope tied around the neck and the person suspended so that the ligatures tighten. These are the most common forms of hanging presentation…

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This is a review of the updated guidelines on Diagnosis and Management of DVT and PE, which were released in March 2020 by the National Institute for Health and Care Excellence(NICE). They now incorporate the use of age adjusted D-dimers and the PERC(Pulmonary Embolism Rule-Out Criteria). They cover the management of different causes of thromboembolism…

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We all remember MacGyver. He’d had a toothpick and a piece of thread and voila, he’s create a rocket launcher out of it. Far-fetched and fun. Well there are a lot of very clever and inventive Critical Care docs out there, who have invented a lot of stuff, primarily for treating the hypoxic covid-19 patient.…

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Here is a quick review of how we are approaching  intubation of potential COVID-19 patients at our hospital.  Please develop your own strategy and base it on your resources. The evidence for a lot of what is done is consensus-based. There is a lot of material coming out. Here is a quick summary. A new paper…

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I have a lot of questions. Here are some answers and a few resources for you. This is all uncharted territory. We have some evidence from SARS and  other instances that we can use, but I don’t think that anyone really knows all the answers. We have Government Health services guidelines, which we all should be using…

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The fitting and use of personal protective equipment is so important to limit infection spread. We aren’t always the best at it.  Sometimes we are too embarrassed to ask how to do it properly and we certainly can’t practice with every team member in the hospital, especially at times of greatest need, such as pandemics,…

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