Munsif Bhimani

Publications (5)3.55 Total impact

• Article: Diagnostic approach to pulmonary embolism in a rural emergency department.

  Mike Ballantine, Munsif Bhimani, W Ken Milne
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  ABSTRACT: Pulmonary embolism (PE) is a serious condition with mortality estimates of up to 10%. We sought to investigate the diagnosis of PE, time to access imaging and diagnostic utility of each modality in a rural emergency department (Ed). We completed a retrospective chart review to determine the investigations performed and treatments initiated in the management of suspected PE in a rural hospital. A total of 47 charts from a 5-year period were reviewed. Of these, 83.0% indicated a D-dimer test was ordered, and 31.9% and 40.4% indicated either ventilation-perfusion (V/Q) or computed tomography (CT) were ordered during the ED visit. Computed tomography diagnosed 11 of the 12 instances of confirmed PE. Mean time to patients undergoing V/Q or CT was 1.58 and 1.59 days, respectively. Low-molecular-weight heparin was started in 83.0% of patients. In this ED there may be over reliance on the D-dimer test, irrespective of Wells score. Access to V/Q and CT were similar to that of an urban centre. Empiric anticoagulation was started in most patients.
  Canadian journal of rural medicine: the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale: le journal officiel de la Societe de medecine rurale du Canada 01/2012; 17(1):17-20.
• Article: Neck injury at a rural emergency department: perils, pitfalls and management considerations.

  Audra Smallfield, Terry Evans, Munsif Bhimani
  Canadian journal of rural medicine: the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale: le journal officiel de la Societe de medecine rurale du Canada 01/2010; 15(3):120-2.
• Article: EM training - The authors respond.

  Munsif Bhimani, Gordon Dickie, Shelley McLeod, Daniel Kim
  CJEM: Canadian journal of emergency medical care = JCMU: journal canadien de soins medicaux d'urgence 06/2008; 10(3):196-7. · 1.18 Impact Factor
• Article: Ramsay Hunt syndrome presenting as simple otitis externa.

  Daniel Kim, Munsif Bhimani
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  ABSTRACT: Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection occurs in the geniculate ganglion, causing otalgia, auricular vesicles and peripheral facial paralysis. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. We report the case of a patient who was diagnosed with simple otitis externa after presenting to the emergency department (ED) with a 3-day history of right-sided otalgia. Her condition subsequently evolved to include right-sided auricular vesicles and right-sided facial weakness. She presented to the ED again after 2 days and was correctly diagnosed with Ramsay Hunt syndrome. We describe the clinical presentation, diagnostic findings and management of this uncommon but important entity.
  CJEM: Canadian journal of emergency medical care = JCMU: journal canadien de soins medicaux d'urgence 06/2008; 10(3):247-50. · 1.18 Impact Factor
• Article: Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments.

  Munsif Bhimani, Gordon Dickie, Shelley McLeod, Daniel Kim
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  ABSTRACT: We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions.
  CJEM: Canadian journal of emergency medical care = JCMU: journal canadien de soins medicaux d'urgence 12/2007; 9(6):449-52. · 1.18 Impact Factor