CJEM Articles: William McCauley

Displaying 1-3 of 3 results

  • Bowel perforation after single-dose activated charcoal
    September 2006 8 5
    Jason P. Green, William McCauley

    Patients presenting to the emergency department (ED) after medication overdose are often given activated charcoal initially for gastrointestinal decontamination. Complications of charcoal are rare, but do occur. The following case describes a patient with pre-existing undiagnosed diverticular disease who developed sigmoid perforation after a single dose of activated charcoal, given without cathartic for a drug overdose. A literature search revealed no other cases of bowel perforation associated with single-dose activated charcoal. This case report discusses adverse effects associated with activated charcoal and the role of cathartics in gastrointestinal decontamination.

  • Attracting top residency candidates: a survey of important program attributes
    November 2005 7 6
    Ian Ball, Jamie A Seabrook, Scott Millington, William McCauley

    Objectives: Emergency medicine (EM) residents work intimately with emergency department staff, and many residents become staff at the institutions that train them. As such, it is in the interest of all training sites to attract the strongest candidates to their programs. The goal of this study was to determine what factors make programs most appealing to EM residency applicants.
    Methods: A survey was developed to assess the relative importance of 20 factors used by EM residency applicants in selecting a Royal College of Physicians and Surgeons of Canada residency program. The survey was piloted on 17 University of Western Ontario EM residency candidates in 2003, and validated on 26 EM residency candidates applying to 8 sites across Canada in 2004.
    Results: The 20 surveyed factors fell into 4 categories. The most important factors were those relating to interactions with the program (4.5 out of 5), followed by factors relating to the program itself (3.5), personal factors (3.4), and lastly, factors relating to the city/province (2.9).
    Conclusions: These data suggest that the most important factors are "interactions with a program" and program characteristics. Both of these are largely within a program's control. By striving to make their curriculum, interview days and medical student electives more appealing a residency program can improve its ability to attract the strongest residency candidates.

  • Tunnelled central venous catheter-induced thrombosis: a rare case of superior vena cava syndrome
    July 2005 7 4
    Sandeep K. Aggarwal, William McCauley

    Thrombotic venous obstruction in patients with a tunnelled central venous catheter is a cause of superior vena cava syndrome that is not routinely encountered by emergency physicians. Diagnosis requires identifying patients at risk (e.g., those under treatment for cancer and those who have a tunnelled central venous catheter), recognizing the signs and symptoms of superior vena cava syndrome, usually dyspnea and dilated neck or thoracic veins, and imaging the venous obstruction using computer tomography or sonography. Management involves anticoagulation and local thrombolytic administration. We report the case of a 28-year-old woman who presented with a 2-day history of face, chest and bilateral arm swelling who had been receiving maintenance chemotherapy for acute lymphoblastic leukemia through a Hickman® catheter. This case demonstrates the need to be vigilant for thrombus formation in patients with long-term, indwelling central venous catheters.