In this interview, Dr. Thara Kumar and Dr. Hans Rosenberg tell us about take-home naloxone kits used for opioid overdose. They discuss how to use them, where to get them, how they work, and more. They offer practical guidance to physicians in Canada and also include tips for the general public.
Dr. Thara Kumar is an emergency medicine resident in her fifth and final year of training at the University of Ottawa, with a Global Health Certificate from Johns Hopkins University. Dr. Hans Rosenberg an emergency physician at the Ottawa Hospital and an assistant professor in the Faculty of Medicine at the University of Ottawa. Together, they co-authored a practice article published in CMAJ called "Five things to know about...Take-home naloxone."
Max Deschner is a medical student at the University of Ottawa
Maaike de Vriesis an epidemiologist & PhD candidate at the University of Toronto
Jonathan Gravel is an epidemiologist & resident physician at the University of Toronto
Pain is one of the most common reasons patients present to emergency departments and primary care clinics, as well as a common complaint among patients treated by subspecialty services. Physicians will agree that treating pain is vital. Yet despite grossly inadequate training in pain management – physicians are expected to offer multimodal pain management (including pharmacological, non-pharmacological and behavioural therapies). All too often, patients with acute or chronic pain also do not have a complete understanding of what options should be available to them and how to access them. Needless to say, an informed and bidirectional discussion between providers and patients about pain management before an opioid prescription is written is an all too rare occurrence. ...continue reading →
In the last two weeks I’ve attended three very different scientific conferences on behalf of the CMAJ Group. In fact you couldn’t get more different than the 33rd International Conference on Pharmacoepidemiology and Therapeutic Risk Management (ICPE - all Big Data and massive record linkage aimed at finding out more about the benefits and harms of medicines and devices) and the 5th Canadian Conference on Physician Health (mainly focusing on the major problem of physician burnout and what we should do about it). And yet the same study was mentioned by plenary speakers at both conferences to support the same message: that physicians are overburdened by administrative and data-capture demands. Across four medical specialties, “for every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day,” ...continue reading →
In March 1996, I was a healthy, fit 50-year-old man enjoying life with a young family. A month later, I was in an induced coma fighting for my life against acute septic shock accompanied by severe adult respiratory distress syndrome (ARDS) and multi-joint and -organ dysfunction which frequently accompanies sepsis. My sepsis was brought on by Group A Streptococcus (Strep A) in my bloodstream which compromised almost all my joints.
My trajectory which led to acute sepsis is not unusual. On Day 1, I had a very severe, but short-lived, bout of extremely high fever (40.5 degrees Celsius), followed by excruciating hip pain the following day.
By Day 3, the hip pain had become unbearable. That evening, we called my family doctor’s on-call service and a doctor came to the house at midnight. The physician felt my condition was osteoarthritis and prescribed anti-inflammatories.
On Day 4, my wife became so concerned that she called a doctor who was a family friend. ...continue reading →