Tactical Medicine News Blog

Dr. Paul Miller, emergency physician and head of a palliative care unit at McMaster Univeristy tells the story of his Best Case Ever on End of Life Care. He shows us that clear consultant communication can make the difference between end of life care that takes into account patients' wishes and values and end of life care that fails. The upcoming episode on End of Life Care and Palliative Care in Emergency Medicine with Dr. Miller, Dr. Howard Ovens and Dr. Shona McLachlan will elucidate some strategies to manage some of the most challenging situations in Emergency Medicine such as critically ill patients with 'Full Code' status who have no chance of meaningful survival, and cancer patients near the end of life who have false hopes of a cure and request aggressive medical management over aggressive palliative care. We review the most important treatment options for symptom management for the dying patient including pain, dyspnea and terminal delirium and much more... The post Best Case Ever 40 End of Life Care & Consultant Communication appeared first on Emergency Medicine Cases.

Racing legend Mario Andretti famously said, “If everything seems under control, you’re just not going fast enough.” He was talking about cars, but to many beleaguered emergency physicians trying to keep up with the patient queue, emergency medicine often seems this way. This guest blog on emergency physician productivity began as a question to our national association, the Canadian Association of Emergency Physicians (CAEP): Are there any national standards with respect to emergency physician productivity, i.e., expected number of patients assessed per hour? The question was referred to the CAEP Public Affairs Committee and triggered a lively email discussion among our members.... The post WTBS 4 – Emergency Physician Speed: How Fast is Fast Enough? appeared first on Emergency Medicine Cases.

Racing legend Mario Andretti famously said, “If everything seems under control, you’re just not going fast enough.” He was talking about cars, but to many beleaguered emergency physicians trying to keep up with the patient queue, emergency medicine often seems this way. This guest blog on emergency physician productivity began as a question to our national association, the Canadian Association of Emergency Physicians (CAEP): Are there any national standards with respect to emergency physician productivity, i.e., expected number of patients assessed per hour? The question was referred to the CAEP Public Affairs Committee and triggered a lively email discussion among our members.... The post WTBS 4 – Emergency Physician Speed: How Fast is Fast Enough? appeared first on Emergency Medicine Cases.

Racing legend Mario Andretti famously said, “If everything seems under control, you’re just not going fast enough.” He was talking about cars, but to many beleaguered emergency physicians trying to keep up with the patient queue, emergency medicine often seems this way. This guest blog on emergency physician productivity began as a question to our national association, the Canadian Association of Emergency Physicians (CAEP): Are there any national standards with respect to emergency physician productivity, i.e., expected number of patients assessed per hour? The question was referred to the CAEP Public Affairs Committee and triggered a lively email discussion among our members.... The post WTBS 4 – Emergency Physician Speed: How Fast is Fast Enough? appeared first on Emergency Medicine Cases.

Background: Some of the major take home points from the sepsis trilogy of studies recently published (ProCESS, ARISE, and ProMISe) was that early identification of patients with sepsis, early intravenous fluids, and timely, appropriate broad-spectrum antibiotics is key to decreasing morbidity and mortality. In 2006 a study by Kumar et al [3] showed a 7.6% increase in mortality in patients with sepsis for every hour of delay after the onset of shock, but this finding has not been reproduced. In fact, the results of timing of antibiotic administration on outcomes have been all over the map. Regardless, the Surviving Sepsis Campaign still has very specific recommendations regarding the timing of antibiotics. And even more painful is that metrics for the quality of care of patients with severe sepsis and septic shock are now recognizing these recommendations as core measures.