Optho Burr
The Optho Burr is finally back at Midtown — stored in the EENT cupboard once again.
Revised N-AC Protocol
FYI our Tylenol overdose powerplan is being updated to include the latest recommendations from poison control and should go live as of April 1st.
I'll share more info as it becomes available. Read the Ontario Poison Centre announcement →
New NIH Scoring Tool
PDFs are attached outlining the changes:
MR Indications for Stroke Patients
FYI, mainly an issue for the MRP during a stroke admission, but sharing for awareness. Dr Teleg suggests MRI as part of the routine stroke workup with the following urgency:
Urgent brain MRI requests (< 12–24 hours)
- Indicate rationale of urgency — i.e. decision-making on diagnosis or treatment is dependent on brain MRI findings (e.g. query for amyloid; restart anticoagulation query; mimic — multiple sclerosis, needs solumedrol right away).
- Communicate with Radiology Team (MRI staff and on-call staff) re: urgency.
Brain MRI as part of Stroke Work-up
- Canadian Stroke Best Practices recommends brain MRI within 7 days of admission for higher diagnostic yield.
- Canadian Stroke Best Practices recommends brain MRI for suspected posterior circulation stroke syndromes and mimics of other neurological conditions.
- Admitting Stroke Physician/Hospitalist can adjust the requested time in the Cerner Order (e.g. if admitted on February 25, 2026, order the brain MRI on this day, with time to be done for February 27, 2026 AM).
- Indicate and be concise in the requisition of what is being looked for in the brain MRI study (e.g. "right-sided weakness, query pontine stroke"; or "acute confusion with right-sided weakness, query for CAA, white matter disease").
Rationale of Brain MRI as part of Stroke Work-up
- Ascertains the vascular ischemic territory involved (anterior and posterior circulations).
- Able to differentiate chronic and old, covert/silent strokes versus new ischemia.
- Able to determine the timing of the acute cerebrovascular event (DWI hyperintensity will appear for 7 days on brain MR).
- Brain MRI is utilized in the investigation of Cerebral Amyloid Angiopathy.
- Brain MRI able to differentiate stroke versus mimics (infection, demyelinating, structural).
GIMRAC Wait Times
GIMRAC wait times have gone down significantly — internists are able to see patients within 1–2 weeks at most. Urgent referrals are now able to be seen within 24–48 hours.