EM Rounds - Nov 16, 2022

Great AHD overall!
00:00:00 The Anonymous Emergentologist
00:39:07 Validity of Direct Fundoscopy
01:04:38 Break
01:22:00 Professional Liability of Physicians in Quebec
02:18:11 Radial Torus Fractures and the Force Trial
The Anonymous Emergentologist with Dr. Jerrald Dankoff
Take Home Points:
1) Anonymity is often associated with a negative connotation.
2) The patients to who you gave your contact rarely overuse it.
3) There are specific caveats and special cases for which giving your personal contact may not apply.
Validity of Direct Fundoscopy with Dr. Paola Moresoli
Take Home Points:
1) Indications for fundoscopic exam are neuro deficit, visual disturbance, headache, elevated ICP and severe HTN.
2) Direct fundoscopy is challenging and emergency physicians perform poorly at it.
3) If your question is papilloedema, use ultrasound.
4) If you are concerned, use panoptic, photography with NMOF or call Ophtalmology.
Professional Liability of Physicians in Quebec with Dr. Mathieu Groulx
Take Home Points:
1) Professional liability imports the principles of ordinary civil liability.
2) Physicians have an obligation of means, and their conduct must be assessed against the conduct of a prudent and diligent doctor placed in the same circumstances
3) Courts may only make a finding of fault where a violation of universally accepted rules of medicine has occurred
Radial Torus Fractures and the Force Trial with Dr Miriam Ghaly
Take Home Points:
1) X-rays should be scrutinized for other fracture patterns (greenstick, SHII)
2) Patients may be discharged home with the offer of a soft bandage if a buckle fracture is diagnosed.
3) No clinical follow-up OR repeat x-ray is routinely indicated.