Evidence-Based Medicine

Next time you’re irrigating a wound, reach for the tap

by Andrew Worster, MD, MSc on August 31, 2008

In the ED, NS is the solution of choice for cleaning wounds. It’s sterile, isotonic, innocuous, readily available and, as far as any of us knows, probably relatively inexpensive.

Antibiotics may not be necessary after I&D of cutaneous abscess, even for MRSA

by Suneel Upadhye, MD, MSc on August 31, 2008

The Setup:

You’re working in a busy suburban ED when a patient presents with an abscess of the forearm that’s been growing for three days. The patient denies any IV drug use, significant comorbidities, or prior abscesses. You determine that the patient has an uncomplicated (no overlying cellulitis) 4cm abscess that would benefit from I&D, which is completed with irrigation and gauze packing. The patient asks you if you think they need antibiotics…

Perform an LP and analyze the results to dx bacterial meningitis

by Rawle A. Seupaul, MD on July 31, 2008

Test Your Knowledge Which of the following maneuvers decreases post-LP headaches?
A. Bedrest
B. Reduced number of attempts
C. Smaller gauge atraumatic needles
D. IV fluids
E. Patient positioning
F. Clinician experience
G. All of the above

How to Treat Bell’s Palsy

by Andrew Worster, MD, MSc on May 31, 2008

Corticosteroids, Antivirals, Both or Neither?

Using Research in Real Time

by Rupinder Sahsi, BSc, MD on April 30, 2008

I was recently questioned by one of our residents as to whether there is sound evidence that crystalloids were better than colloid solutions in trauma resuscitation. I said, “yes, of course.”

EBM: The ABCD2 decision rule

by John Crossley, MD & Christopher Carpenter, MD on February 29, 2008

Should this patient with a TIA be admitted for work-up or can they be safely sent home?

The Obese Patient: Abnormal ECGs

by Ademola Adewale, MD & Christopher Carpenter, MD on December 31, 2007

Abnormal ECGs in the morbidly obese

Can you spot the obesity-related normal ECG variants?

Introduction to Knowledge Translation

by Chris Carpenter, MD, MSc and Rupinder Sahsi, MD on December 31, 2007

Knowledge translation is the science of moving evidence to action. If EPs continue to lag behind in adopting evidence-based best practices, special interests will do it for us.

Canadian Head CT Rule

by Christopher Carpenter, MD, MSc on November 30, 2007

Should US physicians use the Canadian head CT rule?

Are the standards of care in Canada and the U.S. different with regard to ordering CT scans for minor head trauma? Does practicing defensive medicine ignore evidence-based best practice or is it just our American reality.

YES

“Use the rule to cut costs and radiation without litigation exposure.”

by Christopher R. Carpenter, MD, MSc.

“A miss is a miss. Juries don’t care if you’re saving cost!”

by Kevin Klauer, DO

Study says: Skip the rectal exam

by Daniel Handel, MD, MPH on September 30, 2007

Spare your next patient the discomfort of the DRE unless there is obvious indication.

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