Current Academic Projects/Activity

NORSE (New Onset Refractory Status Epilepticus)

Advocacy/Clinical Care Guidance/Research - NORSEINSTITUTE.ORG

I am a member of the Advisory Board at the NORSE Institute. We are a group of individuals spanning families, physicians (Pediatric & Adult Neurology, Neurocritical Care) dedicated to raising awareness for NORSE. We are building a foundation where other providers are able to diagnose, treat, and seek consultation from expert and expert-centers when managing NORSE patients. In addition, we have developed a registry for these pateints and soon their families. Our goal is to raise awareness of NORSE and associated conditions and to work toward a cure.

“Vision of the NORSE Institute: TO FIND AN EFFECTIVE TREATMENT FOR NORSE

Effective treatment for this rare and poorly understood disorder is currently elusive. Finding it requires new thinking from multiple medical disciplines and integration of these ideas and research. We hope to stimulate this thinking and explore both the conceptual boundaries of NORSE as well as the practical boundaries of NORSE treatment: long-term critical care, ICU and epilepsy coordination, palliative care, and immune treatments.”

Medical Education – torontocriticalcare.org - Sr Resident and Fellow education in the intensive care unit at University of Toronto

Based on positive reception and uptake by users at Western and the increasing utilization of mobile devices for content consumption in medical education (and life in general!), we developed the Educational portal for the Interdepartmental Division of Critical Care at the University of Toronto. This website is being used for ICU Sr residents and clinical fellows for educational use and organization by the program.

Extubation Pathway – extubate.ecriticalcare.org

There are many excellent airway management strategies, checklists, and guidelines. The same cannot be said about extubation pathways and preparedness for acute extubation failure in general medical/surgical ICUs. I am working with Dr. John Fuller at Western University where we have developed and evidence-informed extubation pathway that can be utilized by Respiratory Therapists to assist in safe extubation practices. We are studying extubation safety pre- and post- pathway introduction to assess its impact on aspects of patient safety.

Medical Education – [eCriticalCare.org] - Junior/off-service resident education in the intensive care unit at Western University

For a full description of this project, please see eCriticalCare.org (see Education and ICU Boot Camp). The ICU rotation for junior and off-service residents can be challenging in many ways. These include: ICU as a complex environment with multiple teams and multi-modal monitoring, there are competing schedules (call,vacation,teaching schedules), there are different knowledge gaps and starting points for the residents, and there is significant anxiety associated with managing acute situations and procedures. We developed ICU Boot Camp as a course and mobile-platform using Google Classroom for students so that they can start their rotation ready to start taking care of critically-ill patients.

Future Directions

Areas of interest:

  • Stroke and quality of care/improvement in stroke pathways; specifically peri-tPA and EVT and how they interact with critical care systems.
  • status epileptius, refractory SE, NORSE
  • Delirium in the ICU, EEG to study mechanisms of delirium in the ICU, including occult seizure activity.
  • Interface between computational solutions and medical challenges in caring for acute medically-ill and critically-ill patients. My specific interest, based on my PhD work, is time-series analysis and utilizing both linear and nonlinear tools to analyze physiologic signals for classifying and predicting disease processes.

If you are a Principle Investigator and seek collaboration please do not hesitate to contact me.