ED Muskoka Physicians - Living the Dream

psychiatry peds

FYI: Urgent PEDS mental health clinic functioning at RVH and available to all in our LHIN !!
Use as need.

RVH approved for acute peds mental health beds (inpatient) should be open near start of 2018. Construction underway and staffing gearing up now. Just FYI

discharge diagnosis

Feedback again to all…

Please make a formal diagnosis at time of discharge and write it on the chart.

Our coders are struggling.

MVC as the only diagnosis is not enough. MSK is not enough.

I have asked them if they can’t figure out what the discharge diagnosis is to send the chart to your mailbox.

thanks all!!

Dr Brule admits

Morning all,

Dr Bruce did agree to start looking after any patients admitted that he has met and accepted to his practice.
He needs to have met them and accepted them. Being on his list or having called to meet him is not enough.

You can direct patients needing a primary care practitioner to the Algonquin family Health team number and they will register with direct them to Dr Brule ( or others when he is full).
I have directed a few direct to his office and that is okay too.

One number is probably easier to hand out though. Algonquin family Health team 705-787-0846


open shift 1 – 7pm tomorrow Huntsville

Hi all,

Please let me know if you can work any (or all) of 1 – 7 overlap tomorrow in Huntsville!
It will make life better for all.
We had a misunderstanding about funding.
it is funded so lets try and fill it.

Just text or email me direct and I will coordinate coverage.
medevision is stupid right now and won’t let me post it!


new MD in 2018

Hi All,

Just wanted to give a heads up that Dr Nelson Matyasovszky has expressed his formal interest in making Muskoka home after finishing his third year in ER training ( in june 2018). I have met with him a couple times and he has talked to several of you too!!

Many of us know Nelson and I think he wood be a great addition to our ED groups as needed.

He is open to working in either site!

Nelson has already committed to do a family practice locum in the fall of 2018 and so will be here!

Nelson is looking for more shifts next July, august ( maybe 10 to 12 or so a month) then maybe 6 or 7 a month while doing his locum. Then the future awaits!

Nelson is working Huntsville ER this august so please welcome him to town as new med staff peer for next year as you see him!!


CT’s Huntsville


Weekdays …no need to call rad till after 9pm to protocol or get approval for CT’s.
(no longer 3pm)

Evening functions like days now.

Can’t get same for Bracebridge yet as CT tech not onsite…
working on it.


Pediatric patellar osteomyelitis

Hi All,

A diagnosis I have never encountered till recent…and it is rare…
We had one through our ER earlier this year that resulted in a complaint coming to me due to delayed diagnosis.
I am not sure the young boy ( 9 yrs) even had this when he was seen in the ER although he did develop this…
Just another thing to think of!!! Part of resolving the complaint was helping raise awareness of this!

Of course it can be local from an abrasion or injury but often times not…

Hematogenous osteomyelitis of the patella
Gil-Albarova, Jorge; Gómez-Palacio, Victoria Eugenia; Herrera, Antonio

Journal of Pediatric Orthopaedics B: September 2012 – Volume 21 – Issue 5 – p 411–414
doi: 10.1097/BPB.0b013e328348da5b
Author Information
Osteomyelitis is an uncommon infection that is considered to be a childhood disease. Diagnosis is frequently delayed, as it is a very rare condition and also because of its variable presentation. After an accurate diagnosis and treatment, the outcome is favorable in children. We present one case without recent previous infection, antecedent trauma, or penetrating injury, illustrating the difficulties in diagnosis. Nontraumatic osteomyelitis of the patella should be regarded as a rare hematogenous infection. A high index of suspicion should be addressed for early recognition.

blood cultures

Hi all,

Our lab is bursting with blood cultures ( over capacity of our machines actually)!!

Please remember to cancel blood cultures if you don’t need them!
Our sepsis panel is generating alot of cultures (ordered by nursing and MD’s)….!

Just a heads up as they are doing their best to keep up but with considerable expense and extra time by lab staff.

The blood culture main machine is not very old and was bought with a “200 percent capacity” to what was thought to be needed to have a buffer and we are still over that.

just a heads up.


Riita Cronkright

Hi all,

Er nurse Riita in Bracebridge recently lost her husband…

Here is Nancy Andrews email…

Hello all,
I’m sad to let you know that Riitta’s husband Steve passed away this weekend. As most of you know, he had been sick for some time. There will be no service for him for now, but she is considering a celebration of life at a later date. In the mean time, we have started a collection envelope. It will be in the drawer with our personal files. Some ideas for use of the collection are a donation to a butterfly conservation charity, or perhaps, since Riitta appreciates tattoo art, to contribute to a memorial tattoo in Steve’s honour. Any other ideas are welcome.

Nancy Andrews, RN
Clinical Team Lead, ER
Muskoka Algonquin Healthcare
South Muskoka Memorial Hospital
(705) 645-4404
Ext. 3173

Please consider the environment before printing this e-mail message. This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail.

ET stabilizers

We have ET stabilizers…
not all RT’s and staff are using regularly…

They are only $6 each so please use them every time.

We had a case recently that the ET tube was dislodged and patient arrested as this was trying to be fixed.