Grand Rounds Archive

Feb 24, 2026 PEM City Wide Grand Rounds

Title: The Shadow Side of Quick Thinking: Cognitive Bias in Emergency Medicine
Presenter: Vincent Grant, MD FRCPC
Objectives:

• Identify cognitive biases in the practice of Emergency Medicine
• Recognize how cognitive biases affects patient care, learner feedback & evaluation, and self-assessment
• Apply practical de-biasing strategies to reduce bias in decision making

*Note: No recording due to privacy issues

Feb 19, 2026 Grand Rounds

Speaker: Dr. Jayelle Friesen, MD, MSc, PGY3 Emergency Medicine, Cumming School of Medicine, University of Calgary
Moderator:   Dr. Mike Szava-Kovats, ED Physician & QAER Lead

Title:  Lost in Transition: Handover and Conditional Discharge in a Missed Hip Fracture
Description: This case-based quality review examines a missed hip fracture in the emergency department, highlighting how handover practices and conditional discharge processes intersected to create patient safety vulnerabilities. Through a systems lens, we will explore opportunities to strengthen reliability in transitions of care.
Summary/Teaching points:
- Handover is a High-Risk Clinical Moment: Incomplete synthesis, task-focused sign-out, and unclear ownership can allow diagnostic uncertainty to persist across transitions.
- Automation Changes Risk—It Doesn’t Eliminate It: Order sets, decision supports, and templated processes can introduce new failure modes when they replace, rather than support, clinical reasoning.
- Conditional Discharge Requires Explicit Safety Framing: Discharge contingent on pending results or reassessment must include clear accountability, contingency planning, and patient communication.

*Note: No recording due to privacy issues

Feb 12, 2026 Grand Rounds

Speaker: Dr. Jonathan Wong, PGY5 - Emergency Medicine, Cumming School of Medicine, University of Calgary
Moderator: Dr. Christopher Lipp FRCPC/ABEM, Clinical Lecturer, University of Calgary, Regional Lead – Calgary/Rockies – Climbing Escalade Canada, Fellow of the Academy of Wilderness Medicine - Wilderness Medical Society, Sport and Exercise Medicine Consultant - Orthobiologics and MSK Care: Group23 

Title: Acute Knee Injuries in the ED: Diagnosis, Disposition, and Referral Pathways
Description: This Grand Rounds presents a pragmatic, ED-focused approach to acute traumatic soft tissue knee injuries, with an emphasis on ligamentous, meniscal, and patellofemoral pathology, evidence-based bedside assessment, early management decisions, and Calgary-specific referral pathways.
Summary/Teaching points:     

1. Normal X-rays do not rule out clinically important knee injuries
   Most acute traumatic soft tissue knee injuries—including ACL tears, meniscal tears, patellar instability, and multi-ligament injuries—have normal initial radiographs. ED decision-making should be driven by mechanism, exam findings, and functional deficits rather than imaging alone.
2. A large or rapid effusion after trauma is hemarthrosis until proven otherwise
   This finding should raise concern for ACL or PCL injury, meniscus injury, patellar dislocation, or intra-articular fracture and should prompt a careful ligamentous exam and appropriate imaging—including skyline views, which are frequently omitted.
3. Multi-ligamentous are high-morbidity injuries
   Knee dislocations often self-reduce before ED assessment, masking their severity. Despite normal alignment on exam or X-ray, these injuries carry a high risk of neurovascular complications and require early identification and serial neurovascular exams +/- CTA.
4. Most ligamentous and meniscal injuries do not require immobilization
   Routine use of Zimmer braces in isolated ACL, MCL, LCL, PCL, or meniscal injuries delays recovery and worsens stiffness. Early mobilization and weight bearing as tolerated are preferred.
5. The Locked Knee: Urgent, Not Emergent
   Loss of knee extension due to a suspected bucket-handle meniscal tear or loose body requires timely outpatient evaluation and imaging but should not be forcibly “unlocked” in the ED, including under procedural sedation. Attempted reduction risks iatrogenic chondral injury. 

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Feb 5, 2026 Grand Rounds

Speaker: Dr. Kelle Hurd, Clinical Assistant Professor, General Internal Medicine and Obstetric Internal Medicine, Cumming School of Medicine, University of Calgary
Bio: Dr. Kelle Hurd is a Clinical Assistant Professor in General Internal Medicine and Obstetric Internal Medicine at the University of Calgary. She is a member of the Metis Nation of Alberta and practices in both urban and rural Indigenous communities. She is the Vice-Chair for Indigenous Health for the Department of Medicine at the University of Calgary. She is a medical educator teaching across the UME, PGME, and GIM fellowship programs. Her academic interests include mentorship program development, medical education with a focus on Indigenous cultural safety training and simulation-based curriculum.
Moderator: Dr. Patricia Lee MD FRCPC, Assistant Clinical Professor, Department of Emergency Medicine, University of Calgary 

Title: Reconciliation in Leadership and Clinical Practice
Learning Objectives:
- Understand the history of colonization and its impact on Indigenous communities
- Define reconciliation
- Identify tangible ways to incorporate acts of reconciliation in your workplace and leadership roles 
Summary/Teaching points:     
- Reconciliation is the process of establishing mutual and respectful relationships between non-Indigenous and Indigenous people that requires understanding and acknowledging the impact and harms of colonization, indigenization and active decolonization of structures, policies, and systems. - Reconciliation is everyone’s responsibility regardless of their role in the department. 
- The path to reconciliation in healthcare requires addressing the Truth and Reconciliation Health Calls to Action 18-24 through culturally safe medical care and education, integration of Indigenous science and wellness practices into care, and recruitment and retention of Indigenous excellence in healthcare professions.

*Note: No recording due to privacy issues

Jan 29, 2026 Grand Rounds

Speaker: Paul Brandt - Founder and CEO of #NotInMyCity and Co-Chair Alberta Center to Combat Trafficking in Persons (The AC)
Title: #NotInMyCity : Emergency Medicine’s role in recognizing and responding to Human Trafficking
Description:    In this Grand Rounds presentation, Paul Brandt, Founder and CEO of #NotInMyCity, explores the critical role of emergency medicine in recognizing and responding to human trafficking, sharing statistics, survivor stories, and actionable strategies to empower healthcare providers in identifying victims and fostering collaborative interventions.

1. Challenge Biases and Stereotypes: Human trafficking victims don’t fit a single profile—anyone can be affected, regardless of appearance, age, gender, or background; unlearning misconceptions is key to effective identification in ER settings.
2. Leverage Healthcare Access for Intervention: 88% of victims seek healthcare while trafficked, making ERs a frontline opportunity; focus on relational approaches to build trust without judgment, treating patients as people to encourage disclosure and support.
3. Incorporate Evidence-Based Tools and Protocols: Use frameworks like HEAL Trafficking’s PEARR Tool and screening pilots (e.g., Recognizing & Responding to Child Exploitation in Healthcare) to standardize responses, address system gaps, and improve outcomes.
4. Acknowledge Emotional Toll and Promote Collaboration: Recognizing trafficking can be stressful for providers—emphasize collective action across healthcare, law enforcement, and NGOs to share resources, reduce burnout, and end exploitation through initiatives like #NotInMyCity’s working groups.

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Jan 22, 2026 Grand Rounds

Speaker: Dr. Alexandra St-Onge-St-Hilaire, Pediatric Emergency Medicine Physician
Title: Beyond closed loop communication: what underpins effective teamwork?
Summary/Teaching Points:

1. Explain how team culture and psychological safety influence team performance.
2. Recognize mitigated speech as a barrier to effective communication, and apply strategies to promote clear, direct communication for patient safety.
3. Apply practical strategies to build effective teamwork during clinical shifts.

*Note: No recording due to privacy issues

Jan 15, 2026 Grand Rounds

Speaker 1: Dr. Taranveer Toor, MD, CCFP-EM Resident Physician (PGY-3)
Title:  Necrotizing Fasciitis: Lessons from Guidelines and Local Outcomes
Description: This presentation examines necrotizing fasciitis through the lens of established guidelines and local outcome data, with a focus on practical, practice-changing insights for emergency physicians working at FMC, PLC, RGH, and SHC. 
Summary/Teaching Points:
- Necrotizing fasciitis is difficult to diagnose early: The gold standard for diagnosis and treatment is operative exploration, and early surgical consultation is critical when clinical concern exists.
- Imaging and laboratory tests are adjuncts: These may support the diagnosis but should never delay surgical consultation or operative evaluation when concern is high.
- Empiric antibiotics should be broad and initiated early: Piperacillin-tazobactam, vancomycin, and clindamycin provide coverage for polymicrobial infection and toxin suppression. 
- Early source control saves lives: Aim for operative intervention within 12 hours when necrotizing infection is suspected.
- When in doubt, escalate: A critically ill patient with a rapidly progressive or ischemic-appearing infection should be treated as necrotizing fasciitis until proven otherwise.

Speaker 2: Research Update: Dr. Andrew McRae, Associate Professor Emergency Medicine, and Community Health Sciences
Title: Femoral nerve blocks for hip fractures, Cardiac POCUS for heart failure, and chest pain.
Description:    Dr. McRae will review results from a recent trial, including patients recruited at Rockyview General Hospital, showing that ED regional anesthesia for hip fractures reduces risk of in-hospital delirium. He will also discuss upcoming and ongoing ED-based research studies.

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Jan 8, 2026 Grand Rounds

Speaker: Dr. Philip Bialek, CD, MD, CCFP, PGY3 - CCFP EM
Moderator: Dr. Scott Lucyk, MD, FRCPC, DABEM, Emergency Physician, Medical Toxicologist, Clinical Associate Professor, Poison and Drug Information Service (PADIS), Alberta Health Services - Calgary Zone
Title: From Fields to Battlefields: Organophosphate Poisoning and Beyond
Description: Organophosphate and Carbamate poisonings are high consequence, low frequency events. Moving past organophosphates, in an increasingly unstable world, chemical weapons have been used in recent years to carry out assassinations with dire consequences for the public. This presentation will review the toxicology of these chemicals and provide easy to remember strategies for assessing, stabilizing, and providing ongoing treatment to patients with organophosphate or nerve agent poisoning. 
Summary:
A.) Decontamination : AABCDE’s
- Airway
- Antidotes
- Breathing
- Circulation
- Disability
- Exposure
B.) Early treatment with antidotes and benzodiazepines is key.
C.) Antidotes:
- Atropine, 2mg, IV  - initial dose with serial dose doubling Q5mins. Target atropinization (no secretions/quiet chest and HR>80 BPM)
- Pralidoxime, 2g, IV loading dose
- Midazolam, 5mg, IV
D.) Early Airway capture: dual suction, dual set up, DAM activation. Avoid Succinylcholine, use 2mg/kg of rocuronium

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