James (Jamie) Powell

Got asked last minute to do an interview. Turned out to be a "little" (National) live video news segment! See what you think. cbc.ca/player/play/19…

Finishing my last exam ever feels like going outside for the first time again! #RoyalCollegeExams #PGwhy5 #AwaitingResults

Make sure you read the EPA first! People tend to inappropriately low score an TD-stage resident (2/5 since recognized but they didn't fully manage a patient) and high score a C-stage resident (5/5 since they passed the ETT, but they didn't fully resuscitate the patient) #MedEd

Patient presents with unilateral "black spot in right eye" and floaters. No flashes or pain. Thought I would POCUS just in case... #POCUS #MedEd

@qappas No MRI, sorry

Thunderclap headache with negative CT- head. Patient ineligible for Ottawa SAH rules due to known aneurism, and presented more than 24 hours after so required further workup. CT-A showed unchanged aneurism with no active bleed. Who would push for the LP? Here's what I found!

@chholland I've never thought of that...

@JamesPowellMD Keep in mind that SAH on subsequent imaging can be the result of the LP, particularly in a cortical distribution

@WendeNGibbs Even with good technique, 10-30% get post LP headache (up-to-date), which was the patients main concern. Although its a significant number, with a high risk history I agree that benefit outweighs the risk and we should recommend and 'push' for an LP

@JamesPowellMD Wow, risks nearly zero. Seems like benefit would outweigh. Especially for such a serious condition.

@mikegcraig Good point! Do you know of any rules or guidelines for AVM bleed rule out? What RBC cut off would you use in tube 4?

@WendeNGibbs Good question. Patient didn't want it because of the risks of worsening headache, and small risks associated with the procedure.

@JamesPowellMD Why would you have to “push” for the LP? Is there a downside to doing it?

@emergmedottawa @EMO_Daddy @tingdan @baylis_jared

All six years of the @KelownaEM residents in the same photo (including past grads @tingdan and @baylis_jared). Can’t wait until March 3rd to see who’ll join the picture next year @CaRMS_CA @BCEmergMedNtwrk @EMResUBC

Big thank you to Dr Scott Martyna for taking our Emerg residents to his Oral/Maxillofacial surgery clinic for an afternoon of emergency dentistry pearls and facial/dental blocks! @361Joules @EMResUBC

@DrKateJMiller @LessIsMoreMed @drpdhillon I don't know! A friend braught it back from SRPC conference in Halifax. Love it.

As an ED doctor, "I put that (stuff) on everything!" 😆

I'm on the website, so it must be official! @ubcMedCHES ches.med.ubc.ca/james-powell/

So thankful for my Kelowna Family @KelownaEM @361Joules @KClarkEM

@ResusTonight Ya! Nice. Thank you Allan.

@JamesPowellMD Takotsubo? Great case Jamie. Hope you're doing well! -Allan, the nurse from Vancouver

Diagnosis? Patient presented with crushing chest pain, ST elevation and a positive troponin. Coronary arteries were clean! #MedEd