Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?

There is no patient emergency more important than protecting health care workers during a pandemic.

A previously healthy 42-year-old male developed a fever and cough shortly after returning to Canada from overseas. Initially, he had mild upper respiratory tract infection symptoms and a cough. He was aware of the coronavirus disease-2019 (COVID-19) and the advisory to self-isolate and did so; however, he developed increasing respiratory distress over several days and called 911. On arrival at the emergency department (ED), his heart rate was 130 beats/min, respiratory rate 32 per/min, and oxygenation saturation 82% on room air. As per emergency medical services (EMS) protocol, they placed him on nasal prongs under a surgical mask at 5 L/min and his oxygen saturation improved to 86%.

The World Health Organization declared the novel coronavirus disease 2019 (COVID-19) to be a pandemic on March 11, 2020, and, currently, there are over 10,000 confirmed cases in Canada, with this number expected to grow exponentially. There has been widespread interest in the use of point-of-care ultrasound (POCUS) in the management of patients with suspected COVID-19. The CAEP Emergency Ultrasound Committee has developed recommendations on the use of POCUS in these patients, with an emphasis on machine infection control measures.

A 65-year-old female smoker complains of dizziness and mild headache. While at the local pharmacy buying acetaminophen, she decides to check her blood pressure to see if it could be “causing her symptoms.” Her initial measurement is 220/96 mm Hg. In consultation with the on-duty pharmacist she is instructed to immediately attend the emergency department (ED) for management of her hypertension.

Even before starting your evening shift you know it's going to be busy. Ambulances are lined up in front of the hospital, and the charge nurse already seems stressed out. The senior Emergency Medicine (EM) resident is standing in the physician office, ready to start her shift as well. You have worked with her a few times during this rotation. She is competent, you trust in her management plans for all her individual patients. Together you both review the patient tracker: a variety of patient presentations ready to be seen, plus an additional 20 patients in the waiting room. Negotiating the learning objective for the shift, the resident indicates that she would like to work on more efficiently managing patient flow and the administration of the emergency department (ED). But…isn't that a skill you just learn from experience? You wonder what evidence-informed strategies might exist for training her for this next step.

A 43-year-old female presents to the emergency department (ED) after she woke up with the sensation that the room was spinning and vomited three times at home. She continues to have significant vertigo when she presents to the ED 4 hours later. Her symptoms are worsened by head movement. She has noticed some unsteadiness but is able to walk unaided. When you examine her, she has left-beating horizontal nystagmus with a slight rotatory component to the left.