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EM Quick Hits 62 Optimizing RSI Medication Timing, ED Boarding of Older Patients, Prolonged Tourniquet Use, Rural Peer Support Programs, ECG Reciprocal Changes, Nutrition Tips for Shift Workers
Manage episode 463572630 series 1252124
Content provided by Dr. Anton Helman. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Dr. Anton Helman or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://ro.player.fm/legal.
On this month's EM Quick Hits podcast: Anand Swaminathan on optimizing RSI medication timing, Brittany Ellis on ED boarding challenges in older patients and solutions to ED crowding and flow, Dave Jerome on managing prolonged tourniquet application, Nour Khatib and Phil Gillick on a rural peer support case, Jesse McLaren on ECG reciprocal changes in acute coronary occlusion, and Melody Ng on practical nutrition tips for shift workers...
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501 episoade
Manage episode 463572630 series 1252124
Content provided by Dr. Anton Helman. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Dr. Anton Helman or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://ro.player.fm/legal.
On this month's EM Quick Hits podcast: Anand Swaminathan on optimizing RSI medication timing, Brittany Ellis on ED boarding challenges in older patients and solutions to ED crowding and flow, Dave Jerome on managing prolonged tourniquet application, Nour Khatib and Phil Gillick on a rural peer support case, Jesse McLaren on ECG reciprocal changes in acute coronary occlusion, and Melody Ng on practical nutrition tips for shift workers...
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501 episoade
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Emergency Medicine Cases
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1 Ep 202 Eating Disorders: Common, Commonly Missed, Mismanaged and Misunderstood 1:27:43
1:27:43
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Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Only one in 246 patients who screen positive for an eating disorder at triage have a chief complaint suggesting it. These patients don’t always fit the stereotype—many appear “healthy,” have normal BMI, or present with vague GI, cardiac, or neurological symptoms. Missing the diagnosis has important consequences. The earlier an eating disorder is identified and the earlier that appropriate treatment is initiated the better the long term outcomes. In this episode, with the expertise of Dr. Samantha Martin and Dr. Jennifer Tomlin, we’ll break down the essential clinical clues, screening questions, red flags, and subtle exam findings that can help Emergency Physicians diagnose eating disorders early and initiate treatment to decrease mortality and long term morbidity in these young patients. Eating disorders need to be thought of as both a psychiatric condition and medical condition to optimize the pick up rate and appropriate management. Missing or mismanaging eating disorders in the ED means missing an opportunity to save a life and prevent long term morbidity... Please consider a donation to EM Cases to ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 EM Quick Hits 62 Optimizing RSI Medication Timing, ED Boarding of Older Patients, Prolonged Tourniquet Use, Rural Peer Support Programs, ECG Reciprocal Changes, Nutrition Tips for Shift Workers 1:26:10
1:26:10
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On this month's EM Quick Hits podcast: Anand Swaminathan on optimizing RSI medication timing, Brittany Ellis on ED boarding challenges in older patients and solutions to ED crowding and flow, Dave Jerome on managing prolonged tourniquet application, Nour Khatib and Phil Gillick on a rural peer support case, Jesse McLaren on ECG reciprocal changes in acute coronary occlusion, and Melody Ng on practical nutrition tips for shift workers...…
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Emergency Medicine Cases
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1 Ep 201 How EM Experts Think Part 2: Data Gathering, Diagnostic and Treatment Decision Making, Test Ordering and Interpretation, Documentation, Emotional Resilience 1:23:26
1:23:26
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In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine? How can we best streamline thorough data gathering for each case so that we don't miss key data points? How do the master EM clinicians perform an efficient and targeted history and physical exam? How can the concept of heuristic cycling help you avoid outdated or faulty thinking? How can we document our clinical encounter in a way that considers a differential diagnosis that prioritizes dangerous conditions and improve our thinking around cases? How can we use the 2-10% rule for pre-test probabilities and the concept of preferred error to guide our decision making for tests and treatments in the ED? What strategies can we use to avoid anchoring bias and keep your mind open to all possibilities? What’s the role of shared decision-making when navigating diagnostic uncertainty? How does understanding the vigilance pendulum help us assess our risk tolerance better? How can post-shift decision journaling, conducting pre-mortems and meditation improve our decision making and boost our emotional resilience on shift? and many more...The accompanying blog An EM Expert Mindset - A Female Perspective is recommended reading with this podcast https://emergencymedicinecases.com/the-em-expert-mindset-a-female-perspective/ Please consider a small donation to EM Cases to ensure ongoing high quality FOAMed: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 How EM Experts Think: Strategies for Pre-Shift, Arrival Ritual, Staying Focused, Managing Interruptions, Cognitive Load & Negative Emotions, Resuscitation Mindset, Post-Resuscitation Recovery 1:22:15
1:22:15
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Which elements of your current pre-shift preparation contribute most to your mental clarity and performance, and what new practices might further optimize your readiness? With interruptions shown to increase task errors and decision fatigue, how can you strike a balance between being approachable to colleagues and safeguarding your focus for patient care? When confronted with a particularly challenging or emotionally charged case, what strategies have you found most effective for maintaining professionalism and clear decision-making under pressure? How often do you debrief after high-stakes scenarios, and what impact has debriefing—whether formal or informal—had on your team’s learning, emotional recovery, and future preparedness? What strategies do you use to foster open communication and ensure all team members feel empowered to provide input during high-stakes situations? How do you mentally and emotionally shift from managing a critical resuscitation to treating lower-acuity patients without compromising your focus or energy? When faced with a complex case where diagnostic clarity is elusive, how do you prioritize your next steps while maintaining confidence in your decision-making process? How can apps, personalized workflows, or EMR tools be better utilized to minimize cognitive load and enhance clinical decision-making during shifts? These are just some of the questions we pose in this 2-part podcast series on How the Experts Think with Dr. Reuben Strayer, Dr. Scott Weingart and Dr. Mike Betzner...The accompanying blog An EM Expert Mindset - A Female Perspective is recommended reading with this podcast https://emergencymedicinecases.com/the-em-expert-mindset-a-female-perspective/ Please consider a donation to ensure EM Cases continues to provide you high quality Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 EM Quick Hits 61 TEE in Cardiac Arrest, Nebulized Ketamine, Cellulitis Update, SQ Insulin for DKA, Medicolegal DDx Documentation Tips 59:53
59:53
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On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips...…
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Emergency Medicine Cases
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1 Ep 199 Trauma Airway and Airway Trauma 1:44:20
1:44:20
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In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma? Dr. George Kovacs and Dr. Andrew Petroniak answer this and other questions such as: how should we re-sequence the trauma resuscitation depending on immediate life-threats? When is immediate vs delayed intubation recommended? How useful are the Zones of the neck in penetrating neck trauma? What is the optimal dosing of airway medications in the sick trauma patient? How should we modify our airway strategy for the severely head injured patient and/or agitated patient? When should we consider ketamine facilitated fiberoptic intubation in the trauma patient? and many more... Please consider a donation to EM Cases to ensure ongoing Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 EM Quick Hits 60 Post-Tonsillectomy Hemorrhage, Post-CABG Infections, Bougie Tips, Pelvic Fracture Bleeds, Debriefing: Why, When & How 52:10
52:10
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On this month's EM Quick Hits podcast: Kevin Wasko on post-tonsillectomy hemorrhage management, Brit Long on assessment and management of post-CABG surgical incision infections, Anand Swaminathan on evidence, pitfalls and tips on using Bougies, Leah Flannigan on when to suspect vascular injury in patients with low energy mechanism pelvic fractures, Andrew Petrosoniak on debriefing after cases: why, when and how... Do you learn a lot from EM Cases? Please consider a donation to ensure EM Cases continues to provide you high quality Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 Ep 198 Understanding and Improving Culture in Emergency Medicine: Key Insights 1:28:32
1:28:32
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In this EM Cases podcast Anton chats with Dr. Peter Brindley and Dr. Leon Byker who have a deep interest in the Culture of Medicine to explore what culture in medicine is, why culture is so important, and then drive home 10 strategies to improving the culture in our departments emphasizing the importance of human connection, empathy, open communication, and a willingness to learn from mistakes in creating a positive and fulfilling work environment, so that we love our work, we love our department, we love taking care of our patients and our patients have better outcomes... Support EM Cases and Free Open Access Medical Education by making a donation now: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 EM Quick Hits 59 Traumatic Coronary Artery Dissection, Proper Use of Insulin, Mesenteric Ischemia, Exercise Associated Hyponatremia, AI for OMI 58:46
58:46
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On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 Ep 197 Acute Heart Failure Risk Stratification and Disposition 1:14:44
1:14:44
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We over-admit low risk acute heart failure patients and under-admit high risk heart failure patients. In this podcast we discuss the diagnostic accuracy of various clinical features, lab tests and imaging modalities for acute heart failure, the 3 validated risk stratification tools and a simple approach to PoCUS for the diagnosis and prognostication of acute heart failure in the ED to improve our diagnostic accuracy and disposition decisions for patients with acute heart failure... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma 1:11:42
1:11:42
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In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 Ep 196 Pediatric Meningitis Recognition, Workup and Management 1:28:57
1:28:57
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In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages? How does one differentiate between meningitis and retropharyngeal abscess on physical exam? How do the Canadian and American guidelines on work up of well-appearing febrile infants compare when to it comes to indications for lumbar puncture? Which patients with suspected meningitis require imaging prior to lumbar puncture? How do we best interpret the various CSF tests to help distinguish between viral and bacterial meningitis? What are the indications and timing of administering dexamethasone in the pediatric patient with suspected meningitis? and many more.... EM Cases is Free Open Access; please consider a donation to help ensure that EM Cases remains Free Open Access on our donation page https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments 58:03
58:03
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In this month's EM Quick Hits podcast: Megan Landes on the importance of diagnosing HIV in the ED, Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion, Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient, Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis, Matt Poyner on the most lucrative side-gig, DIY investing. To support EM Cases, please consider a donation here: https://emergencymedicinecases.com/donation/…
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Emergency Medicine Cases
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1 Ep 195 Management of Subarachnoid Hemorrhage 48:33
48:33
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Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr. Katie Lin and Dr. Jeff Perry we answer questions such as: what are the 4 critical priorities in the initial stabilization of the patient with a suspected massive subarachnoid hemorrhage? When is a CT plus CTA of the head indicated up front in the management of patients with suspected subarachnoid hemorrhage? What is the evidence for oral nimodipine in improving outcomes in patients with subarachnoid hemorrhage and how does it work? What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage? What are the simplest and best prognostic tools available for spontaneous subarachnoid hemorrhage to help counsel families and patients? and more...…
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Emergency Medicine Cases
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1 Ep 194 Subarachnoid Hemorrhage – Recognition, Workup and Diagnosis Deep Dive 1:21:50
1:21:50
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Anton is joined by the world's leading EM researcher in subarachnoid hemorrhage diagnosis Dr. Jeff Perry and EM-Stroke team clinician Dr. Katie Lin for a deep dive into why we still miss this life-threatening diagnosis, the key clinical clues, proper use of decision tools, indications for CT, indications for CTA, indications for LP and CSF interpretation for the sometimes elusive diagnosis of subarachnoid hemorrhage... Help support EM Cases by making a donation: https://emergencymedicinecases.com/donation/…
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