James (Jamie) Powell

156 posts

James (Jamie) Powell

James (Jamie) Powell

@JamesPowellMD

Doctor - FRCPC Emergency Medicine @KelownaEM | Teacher - Clinical Educator Fellow @UBCMedCHES | Views are my own.

AB, Canada Katılım Eylül 2013
222 Takip Edilen256 Takipçiler
James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
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
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
Patient presents with unilateral "black spot in right eye" and floaters. No flashes or pain. Thought I would POCUS just in case... #POCUS #MedEd
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
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!
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
@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
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Wende Gibbs
Wende Gibbs@WendeNGibbs·
@JamesPowellMD Wow, risks nearly zero. Seems like benefit would outweigh. Especially for such a serious condition.
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
@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?
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
@WendeNGibbs Good question. Patient didn't want it because of the risks of worsening headache, and small risks associated with the procedure.
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Wende Gibbs
Wende Gibbs@WendeNGibbs·
@JamesPowellMD Why would you have to “push” for the LP? Is there a downside to doing it?
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James (Jamie) Powell retweetledi
Kelowna EM Residency
Kelowna EM Residency@KelownaEM·
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
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
As an ED doctor, "I put that (stuff) on everything!" 😆
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James (Jamie) Powell
James (Jamie) Powell@JamesPowellMD·
Diagnosis? Patient presented with crushing chest pain, ST elevation and a positive troponin. Coronary arteries were clean! #MedEd
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