EMOttawa - Emergency Medicine Ottawa

The Zika Virus exploded onto the international health scene in the last several months. It was first discovered in humans in 1951 and remained limited to Africa and Asia until the first major outbreak in Micronesia in 2007. Since then the virus has continued to evolve and spread from the Pacific Islands and French Polynesia to the main major outbreak in South America in early 2015 and finally to the US in January 2016.

Pediatric endotracheal intubation is an uncommon procedure in the Emergency Department (ED); even in high volume tertiary pediatric centres the incidence has been reported at 8-10/10,000 patients. While infrequent, pediatric airway management is an essential and life-saving skill that all ER physicians must be prepared for.  Much of the knowledge and skill set from the adult world is applicable here, however there are several important differences that are unique to the pediatric population.

For many of us in Emergency Medicine, PTSD is something we don’t really think about.We might pause before using ketamine for sedation in a war veteran, or seek psychological support for victims of sexual assault, but it is not a topic that we usually discuss or associate with.It certainly isn’t something that we feel threatens us and our careers.

However studies using standardized and validated tools have shown a point prevalence of PTSD in German [1] and Belgian [2] emergency physicians, Dutch hospital physicians [3] and Vancouver ED staff [4] to be approximately 15%.By comparison, the lifetime prevalence of PTSD in the Canadian population is approximately 2.4% [5] so a point prevalence of 15% is extremely high.

Though initially surprising, these numbers start to make sense when we think about the types of cases that emergency physicians handle regularly:pediatric injuries and arrests, sexual assaults, graphic traumas, failed resuscitations.We are exposed daily to things that would sca…