ED Muskoka Physicians - Living the Dream

Hypertension In The Emergency Department (Pierre Mikhail)

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PECARN Febrile infant tool

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Tylenol Overdose

Hi all,

Attached is the NEW updated and simplified NAC protocol for Tylenol overdoses. Take a little read. I have asked our Nurse leaders at both ER’s to update our protocols too!!


Double Sequence Defibrillation

Posting the summary document on double sequence defibrillation for cases of refractory VF here on EDMuskoka for future reference.

YES our monitors can do this
YES you need 2 monitors with 2 sets of pad placements (see diagram)
YES you push the button at the SAME TIME (really dual simultaneous defibrillation)

you can read more & find a video at http://theresusroom.co.uk/double-sequential-defibrillation
and a 2016 article at https://www.resuscitationjournal.com/article/S0300-9572(16)30398-7/abstract

Double Sequential Defibrillation for Refractory VF

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.

Great Ultrasound Tips from Castlefest

If you’re an ultrasound geek these tips are da bomb

click here

SCAT 5 and concussion statement

Forwarded on behalf of Dr Rich Trenholm to us….


Process Improvements in The Emergency Department

A good read from an Ontario ED

Click Here

Decision fatigue

Hi all,

Really useful summary of points about MD decision fatigue in EM rap this month….

In case you don’t subscribe I’ll post in both ER’s.

I think alot of practice tips that many of us live by and may or may not voice to each other.
The days I try to live by more of these the more I enjoy what I do and feel that I am actually providing good care.

Group hug now.


EDTU X Resuscitation

Hi all,

Mark Mensour brought this info forward for all…
take a look!
Caep new course!

EDTUX Resuscitation 2017 Poster