Can J Emerg Med
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The trainee in difficulty is someone who is either marginal or at risk of failing in his or her clinical performance. Dealing effectively with these learners can pose problems even for seasoned medical educators. This article discusses some of the common mistakes made by educators in dealing with the trainee in difficulty and offers suggestions for a systematic approach. Further, the roles of faculty, including the program director and associate dean's office, and some of the legal issues are described.
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Humidification is a time-honoured therapy for childhood croup (acute laryngotracheobronchitis). Despite a paucity of evidence supporting its use, many physicians, nurses and parents still apply this treatment. Our objective was to summarize available evidence and assess the rationale for the ongoing use of humidity to treat childhood croup. ⋯ There is no strong evidence supporting the use of humidity in the treatment of croup. Although such treatment is still widely used, it is not without risk, and further trials are required to address its efficacy.
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Atenolol, a selective beta(1)-adrenergic antagonist, is commonly used to treat hypertension, ischemic heart disease and cardiac dysrhythmias. Few cases of severe atenolol intoxication have been described, and only one of these reports discussed the use of calcium chloride as a treatment. We present a case of atenolol overdose associated with shock and first-degree heart block, in which administration of calcium chloride led to dramatic improvement after failure of conventional treatment. In addition, we discuss the pharmacokinetics, toxicology and management of beta-blocker overdose, focusing on the possible role of calcium chloride.