Grand Rounds Archive

June 04, 2026 Grand Rounds

Title: Parkinson’s Disease Emergencies: Assessment and Management
This presentation will provide a broad overview of Parkinson’s Disease and what can be expected when these patients present to the Emergency Department. At the end of this presentation, you will be more familiar with initiating management for both common and more rare complications of this disorder and have a greater understanding of the PD resources available in the Calgary zone.

Speaker:  Dr. Tristan Holotnak CCFP-EM PGY-3

Learning Objectives:

• Parkinson’s disease is a common neurodegenerative disorder. Patients experience a broad spectrum of movement, autonomic, and neuropsychiatric symptoms.
• Levodopa is the mainstay of medical therapy for PD. It is important that ED physicians recognize the importance of medication timing for this and other PD medications as well as key medications to avoid.
• Common complications of PD leading to ED visits include falls, dysphagia, aspiration pneumonia, and psychosis. Familiarity with the sequelae and local referral options for these conditions to enhance long term outcomes.
• Rare presentations of PD complications such as Akinetic Crisis benefit from early neurology and ICU consult.
• Local PD patients who have DBS devices implanted or who use Levodopa-Carbidopa Intestinal gel pumps should all have Exceptional Care Plans in Connect Care. Suspected device issues should prompt consultation with the relevant Movement Disorder Clinic RN or Neurologist on call. 

Watch Recording

May 28, 2026 Pediatric Emergency Medicine City-Wide Rounds

Title: Sickle Cell Disease in the Emergency Department

Speaker:  Dr. Julia Madill, PEM Fellow (PGY5)

Learning Objectives:

• Review the epidemiology, pathophysiology, and chronic management of sickle cell disease, with attention to local context.
• Apply an evidence-based approach to the recognition and emergency management of acute complications of sickle cell disease, including key clinical features and investigations.
• Explore opportunities for improving local emergency care pathway for patients with sickle cell disease, including triage protocols, pain management strategies, and multidisciplinary collaboration.

*Note: No recording due to privacy issues

May 21, 2026 Grand Rounds

Speaker: Dr. Tya Marchand 
Title: The Second Shift: Gender and Parenthood in the ER
Gender and parenthood continue to shape career experiences in Emergency Medicine, influencing everything from recruitment and training to advancement, wellness, and retention within the specialty. This presentation explores the structural and cultural barriers faced by women and physician parents in EM, while highlighting opportunities to build more equitable, supportive, and sustainable training and practice environments.
Key Teaching Points:

• Gender bias and traditional workplace structures continue to influence career progression, leadership opportunities, and day-to-day experiences in Emergency Medicine
• Parenthood in EM is associated with unique challenges including scheduling inequities, childcare demands, pregnancy-related workplace concerns, and burnout. Parenthood in EM is associated with unique challenges including scheduling inequities, childcare demands, pregnancy-related workplace concerns, and burnout.
• Supportive policies such as flexible scheduling, parental leave protections, mentorship, and equitable promotion practices improve physician wellness and retention.
• Creating inclusive and psychologically safe workplace cultures benefits not only physicians, but also team dynamics, patient care, and long-term workforce sustainability.
• Advancing equity in EM requires both individual advocacy and system-level change to address persistent structural barriers.

Watch Recording

May 14, 2026 Grand Rounds

Speaker: Dr. Scott Zablotny CCFP–EM PGY-3
Title: Ironing out the Details: Demystifying Iron Infusions in the ED Setting.
Description: This presentation will highlight the existing pathways for the treatment of iron deficiency anemia in Calgary. At the end of this presentation, you will be equipped with more information to decide whether administering an iron infusion in the emergency department is the most appropriate option for your next patient presenting with iron deficiency anemia.
Key Teaching Points:

• Iron deficiency anemia is the most common and widespread nutritional disorder in the world. It increases morbidity and mortality, and is often easily treated.
• Clearly outlined pathways exist in Calgary for both pregnant and non-pregnant patients to guide the management of iron deficiency anemia in the outpatient setting.
• The majority of patients with iron deficiency anemia can be effectively treated with oral iron supplementation.
• The majority of patients in the ED with iron deficiency anemia do not need an iron infusion in the ED, but there are some situations where it would be indicated to do so.
• There are IV iron formulations that are approved by Health Canada such as Monoferric and Ferinject which are superior to Venofer as they can often entirely replete a patient’s iron deficit in one 15-30 minute infusion, however, they are not currently on the AHS Drug Formulary. 

Watch Recording

April 30, 2026 QAER Grand Rounds

Presenter: Dr. Pavneet Singh, MD, MSc, PGY3 Emergency Medicine, Cumming School of Medicine, University of Calgary 
Moderator: Dr. Mike Szava-Kovats, ED Physician & QAER Lead
Title: Evolving Perineal Pain: A Diagnostic Challenge
Description: This case-based review examines a case of a patient with progressive perineal pain across multiple ED encounters. Using a systems lens, we explore how evolving disease, diagnostic uncertainty, and communication across teams influence escalation of care, and identify opportunities to improve recognition and response in time-sensitive conditions.

*Note: No recording due to privacy issues

April 23, 2026 Grand Rounds

Topic: Medical Leadership: Can it be the ”X” factor 
“Every Physician is a leader whether they know it or not”
Presenter: Dr. Francois Belanger
Pediatric Emergency Medicine Physician
Time:  April 23, 2026 9:00am
Learning Objectives: 

• What is Medical Leadership?
• Why would someone be interested in Medical Leadership?
• What are the unique skills, competencies and attributes medical leaders ?
• What do medical leaders have to learn?
• What are the development pathways for Medical Leaders?
• How to frame Medical Leadership now and in the future?

*Note: No recording due to privacy issues

April 2, 2026 Grand Rounds

Presenters: Dr. Anne-Marie Brisson, Dr. Shawna Lamond, Dr. Michelle Arnold, Dr. Brooke Miller
Moderator: Dr. Marcie Veitch, MD CCFP-EM        

Title: Lactational Mastitis and Breast Abscess in the ED
Description: You don't want to miss this practice changing presentation that highlights the newly released lactational mastitis and breast abscess pathway for the Calgary Zone.  Our speakers came together to create this pathway to streamline care for patients.  We'll take time to review the revised mastitis protocol as well as give you practical tips to help manage these patients in the ED. 
Summary/Teaching points:
1. Review the revised mastitis protocol (2022)
2. Review management of hyperlactation
- Highlighting need for ice (not warmth) and avoiding massage
3. Review management and new protocol for breast abscesses
- Consider sending a breast milk culture
- Know when to temporize with a bedside aspiration in the ED
4. Be aware of a broader differential/other pathology (ex. Idiopathic Granulomatous Mastitis)
5. Familiarize yourself to the new discharge dot phrases

Watch Recording

March 26, 2026 PEM City Wide Grand Rounds

Presenter: Dr. Dana Stewart

*Note: No recording due to privacy issues

March 19, 2026 Grand Rounds

Speaker:  Dr. Ben Campbell FRCPC – EM PGY-2
Title: Scaling back assumptions: weight and evidence in the ED 
Description: Join us for an examination of the evidence around body habitus and health, and pearls on how emergency care is adjusted (or not) for those who have larger bodies 
Summary/Teaching points:

1. People in larger bodies are on a diverse spectrum with regards to health risk and what they have already been doing to manage that risk. We can’t tell this by looking at someone.
2. Some ED medications and investigation modalities require alternate approaches, but there can be misinformation around this which will be clarified.
3. There are techniques to manage increased risk around airway intervention. 

Watch Recording

March 12, 2026 Grand Rounds

Speaker:  Dr. Cathy Dorrington, MD, FRCPC (EM) 

Title: Blood in the ED: Practical Transfusion Medicine for Emergency Physicians
Description: Emergency physicians frequently initiate transfusion and must make rapid decisions regarding blood product use. This rounds will review evidence-based transfusion thresholds and blood product stewardship, key blood banking and compatibility principles, product-specific considerations, and the transfusion reaction information necessary for risk benefit decisions and informed consent.    
Summary/Teaching points:
- Transfusion has the potential to profoundly decrease morbidity and mortality, but can also cause clinically harmful irreversible immune modulation
- Knowledge regarding blood banking and compatibility can inform our transfusion practice
- Transfusion threshold literature and expert consensus is available to support best practice in blood product utilization
- Having knowledge of the most common transfusion reactions and a universal approach will benefit our patients

Watch Recording

March 6, 2026 Grand Rounds

Speaker:   Dr. Celine Edwards, CCFP-EM PGY03
Moderator: Dr. Andrea Boone, MD, FRCPC (EM/PEM)
Primary Preceptor:  Dr. Jevon Brown, MD, MSc, FRCSC, Director of Calgary Craniofacial Trauma Clinic
Special Guest: Dr. Dave McKenzie, MD, FRCPC (Plastic and Reconstructive Surgery)

Title: In the Face of Trauma: ED Management of Facial Fractures
Description:  Facial fractures are a common emergency presentation, and the outcomes of these injuries have a major impact on patient function. This presentation will review the emergency management of facial fractures, as well as the referral options in Calgary which aim to streamline care and offload the ED.
Summary/Teaching points:

1. Severe craniofacial trauma poses unique challenges to patient stabilization. Although facial fractures sometimes increase the space for laryngoscopy, the loss of bony architecture can obstruct the airway, and life-threatening hemorrhage can occur from internal maxillary artery injury requiring packing, manual reduction, and IR embolization. C-spine injury also occurs frequently in the setting of facial fractures.
2. CT Facial Bones is the imaging modality of choice in all cases of suspected facial fractures, except for isolated nasal fractures which do not require any imaging.
3. Craniofacial fractures requiring emergent surgical consultation include any fracture with CSF leak or pneumocephalus, fractures through the posterior table of the frontal sinus or temporal bone, and orbital fractures complicated by entrapment, ocular compartment syndrome, superior orbital fissure syndrome, and orbital apex syndrome.
4. Evidence supports the delayed outpatient repair of most nonemergent isolated facial fractures, and early disposition of appropriate patients to a facial surgeon (Plastic Surgery or Oral Maxillofacial Surgery in the Calgary Zone) streamlines care.
5. Antibiotics are only recommended in facial fractures which are 1) open; 2) involving the sinuses in a patient with an upper respiratory tract infection or chronic sinusitis; or 3) through a tooth-bearing segment. 

Watch Recording

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. 

Watch Recording

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.

Watch Recording

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.

Watch Recording

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

Watch Recording