Critical Care 2 – Myasthenic Crisis

This is the second case in a series looking at critical care medicine. Patients under the care of the critical care team may develop delayed complications of their illness or injuries. These cases can help individuals and teams prepare to identify and manage these patients who become newly, and sometimes unexpectedly, unstable. This case comes … Continue reading Critical Care 2 – Myasthenic Crisis

Critical Care 1 – Subarachnoid Hemorrhage

This is the first case in a series looking at critical care medicine. Patients under the care of the critical care team may develop delayed complications of their illness or injuries. This patient with a spontaneous subarachnoid hemorrhage develops progressive hydrocephalus with need for hyperosmotic therapy and airway management.

PEA Arrest and Breaking Bad News

A 70 year old man who had an unwitnessed cardiac arrest is brought to the ED via EMS from his local Tennis Club. Despite multiple rounds of appropriate resuscitative measures, the patient does not gain return of spontaneous circulation (ROSC). Learners will need to discuss the termination of resuscitation with team members and communicate with the patient’s wife.

Geriatric Case 6: Elder Abuse

This is the sixth and final case in a six-part mini-series focusing on the management of geriatric patients in the ED. This series of cases was written by Drs. Rebecca Shaw, Nemat Alsaba, and Victoria Brazil. Dr. Rebecca Shaw is an emergency physician currently working as a medical education fellow within the Emergency Department of … Continue reading Geriatric Case 6: Elder Abuse

Geriatric Case 4: End of Life Care

An 89-year-old patient is brought in to the ED by ambulance from their nursing home. Staff found her unresponsive and hypotensive at morning handover. She had been treated for UTI by her family physician over the last few days. Participants identify severe sepsis and realize that critical care interventions may be inappropriate. This should prompt a goals of care discussion including potential for initiating end-of-life care.

Geriatric Case 1: Delirium

An 81-year-old (wo)man is brought to the ED by her/his friend as she/he is confused and agitated. In the ED, her/his confusion worsens. Initially she/he is fidgety but as the case progresses she/he becomes more agitated and confused. She/he will be fairly uncooperative, moving around and not able to follow many commands. The participants should be looking for a source of infection and evidence of any recent trauma.  They are expected to use both non-pharmacological and safe pharmacological options in order to control the situation, ensure patient safety, and facilitate investigations.