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Core EM – Emergency Medicine Podcast — Government & Organizations
Core EM – Emergency Medicine Podcast

Core EM Emergency Medicine Podcast

Copyright: © Core EM

Latest Episodes:

Episode 137.0 – How to Build a Great Presentation Mar 19, 2018
Show notes

This podcast discusses an 8 step process for building better presentations.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_137_0_Final_Cut.m4a Download 2 Comments
Show Notes

Resources:

P Cubed Presentations

Presentation Zen

Presentation Zen: Simple Ideas on Presentation Design and Delivery

Keynotable

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Episode 136.0 HIV Related Infections in the ED Mar 12, 2018
Show notes

This week we discuss some pearls and pitfalls when caring for HIV+ patients in the ED.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_136_0_Final_Cut.m4a Download One Comment Tags: AIDS, HIV, Infectious Diseases, PCP, TB, Tuberculosis
Show Notes

HIV Associated Infections Based on CD4 Count (cooperhealth.org)

Total Lymphocyte Count = (% lymphocytes x WBC count)/100

TLC 1200 cells/mm³ correlated with CD4 count of < 200 cells/mm³ with a maximal sensitivity of 72.2%, and specificity of 100%

TLC1500 cells/mm³ correlated with CD4 count of 200 – 499 cells/mm³ with a maximal sensitivity of 96.7% and specificity of 100%

TLC 1900 cells/mm³ correlated with CD4 count of ≥ 500 cells/mm³ with a maximal sensitivity of 98.5% and specificity of 100%

Show Notes

REBEL EM: REBEL Cast Episode 1 – Total Lymphocyte Count as a Surrogate Marker for CD4 Count

LITFL: HIV and AIDS

References

Obirikorang C et al. Total Lymphocyte Count as a Surrogate Marker for CD4 Count in Resource-Limited. BMC Infectious Diseases Journal 2012; 12 (128): 1 – 5. PMID: 22676809

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Episode 136.0 HIV Related Infections in the ED Mar 12, 2018
Show notes

This week we discuss some pearls and pitfalls when caring for HIV+ patients in the ED.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_136_0_Final_Cut.m4a Download One Comment Tags: AIDS, HIV, Infectious Diseases, PCP, TB, Tuberculosis
Show Notes

HIV Associated Infections Based on CD4 Count (cooperhealth.org)

Total Lymphocyte Count = (% lymphocytes x WBC count)/100

TLC 1200 cells/mm³ correlated with CD4 count of < 200 cells/mm³ with a maximal sensitivity of 72.2%, and specificity of 100%

TLC1500 cells/mm³ correlated with CD4 count of 200 – 499 cells/mm³ with a maximal sensitivity of 96.7% and specificity of 100%

TLC 1900 cells/mm³ correlated with CD4 count of ≥ 500 cells/mm³ with a maximal sensitivity of 98.5% and specificity of 100%

Show Notes

REBEL EM: REBEL Cast Episode 1 – Total Lymphocyte Count as a Surrogate Marker for CD4 Count

LITFL: HIV and AIDS

References

Obirikorang C et al. Total Lymphocyte Count as a Surrogate Marker for CD4 Count in Resource-Limited. BMC Infectious Diseases Journal 2012; 12 (128): 1 – 5. PMID: 22676809

Read More

Episode 135.0 – Occult Causes of Non-Response to Vasopressors Mar 05, 2018
Show notes

This podcast reviews how clinicians should think about patients who's shock isn't responding to our typical management options.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_135_0_Final_Cut.m4a Download One Comment Tags: Critical Care, Resuscitation, Shock, Vasopressors
Show Notes

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Core EM: Occult Causes of Non-Response to Vasopressors

Emergency Medicine Updates: Hypotension: Differential Diagnosis

EMCrit: Steroids in Septic Shock – PRE-ADRENAL

The Bottom Line: Steroids in Sepsis

EMCrit: RUSH Exam

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Episode 135.0 – Occult Causes of Non-Response to Vasopressors Mar 05, 2018
Show notes

This podcast reviews how clinicians should think about patients who's shock isn't responding to our typical management options.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_135_0_Final_Cut.m4a Download One Comment Tags: Critical Care, Resuscitation, Shock, Vasopressors
Show Notes

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Core EM: Occult Causes of Non-Response to Vasopressors

Emergency Medicine Updates: Hypotension: Differential Diagnosis

EMCrit: Steroids in Septic Shock – PRE-ADRENAL

The Bottom Line: Steroids in Sepsis

EMCrit: RUSH Exam

Read More

Episode 134.0 – Morning Report Pearls III Feb 26, 2018
Show notes

More pearls from our fantastic morning report series.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_134_0_Final_Cut.m4a Download 2 Comments Tags: ALL, Altered Mental Status, Hyperleukocytosis, Hyponatremia, Leukostasis
Show Notes

Take Home Points

1. When seeing patients with AMS, think of the 5 broad categories of pathologies – VS abnormalities, toxic-metabolic, infectious causes, CNS abnormalities and, lastly as a diagnosis of exclusion – psychiatric issues

2. In kids with AMS, think of zebra diagnoses and toxic ingestions and remember that primary psychosis is rare

3. Patients with ALL are susceptible to developing hyperleukocytosis. If the WBC is > 100K, think about getting hematology on the line to initiate chemo induction and leukopheresis

4. Always think about electrolyte disorders, particularly hypoNa in patients with global AMS. Remember to treat severe hypoNa w/ hypertonic saline and, to correct slowly as to avoid ODS

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LITFL: HSV Encephalitis

EM Cases: Episode 60 – Emergency Management of Hyponatremia

Core EM: Severe Hyponatremia

Core EM: Episode 58: Hyponatremia

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Episode 133.0 – Initial Trauma Assessment Feb 19, 2018
Show notes

This week we dive in to the initial trauma assessment.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_133_0_Final_Cut.m4a Download Leave a Comment Tags: ABCDEs, Trauma
Show Notes

Take Home Points

Development of a systematic approach is essential to rapidly assessing the wide diversity of trauma patients and minimizes missed injures

Prepare with whatever information is available before the patient arrives and remember to get a good handoff from the pre-hospital team

Complete the primary survey (ABCDEs) and address immediate life threats

Round out your assessment with a good medical history and remember to complete a comprehensive head-to-toe exam

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Shlamovitz GZ, et al. Poor test characteristics for the digital rectal examination in trauma patients. Ann Emerg Med. 2007;50(1):25-33, 33.e1. PMID: 17391807

ER Cast: Gunshot to the Groin with Kenji Inaba

EM:RAP: Do We Still Need The C-Collar?

YouTube: Death of the Dinosaur: Debunking Trauma Myths by Dr. S.V. Mahadevan

REBEL EM: Is ATLS wrong about palpable blood pressure estimates?

Life in the Fast Lane: Digital rectal exam (DRE) in trauma

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Episode 132.0 – Air Embolism Feb 12, 2018
Show notes

This week we dive into the rare but potentially fatal, and difficult to diagnose, air embolism.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_132_0_Final_Cut.m4a Download 2 Comments Tags: Air Embolism, Central Lines, Hyperbaric Oxygen
Show Notes

Take Home Points

Air embolism is a rare but potentially fatal complication of central line placement and some surgical procedures and of course of as the result of barotrauma.

Recognizing the signs and symptoms of air embolism can be tricky because it will look like any other ischemic process. Consider air embolism if you have a patient that rapidly decompensates after placement of a central line, the most likely culprit for those of us in the ED.

Treatment should focus on supportive cares. Give supplemental O2, IV fluids and hemodynamic support and consider hyperbarics and cardiopulmonary bypass for the super sick patient.

Show Notes

Core EM: Air Embolism

Blanc et al. Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med. 2002; 28(5): 559-63. PMID 12029402

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Episode 131.0 – Spontaneous Bacterial Peritonitis (SBP) Feb 05, 2018
Show notes

This week we explore the presentation, diagnosis and management of SBP.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_131_0_Final_Cut.m4a Download Leave a Comment Tags: Gastroenterology, Infectious Diseases, SBP
Show Notes

Take Home Points

SBP is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis

An ascites PMN count > 250 cells/mm³ is diagnostic of SBP but treatment should be considered in any patient with ascites and abdominal pain or fever

Treatment of SBP is with a 3rd generation cephalosporin with the addition of albumin infusion in any patient meeting AASLD criteria (Cr > 1.0 mg/dL, BUN > 30 mg/dL or Total bilirubin > 4 mg/dL)

Read More

Oyama LC: Disorders of the liver and biliary tract, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 90: p 1186-1205.

REBEL EM: Spontaneous Bacterial Peritonitis

EMRAP: C3 Live Paracentesis Video

LITFL: Spontaneous Bacterial Peritonitis

SinaiEM: SBP Pearls

REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)?

Core EM: Episode 123.0 – Paracentesis Journal Update

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Episode 130.0 – Morning Report Pearls II Jan 29, 2018
Show notes

Another set of high-yield pearls coming out of our morning report conferences.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_130_0_Final_Cut.m4a Download Leave a Comment Tags: Babesiosis, Carbon Monoxide, Doxycycline, Myasthenia Gravis, Tick-Borne Illnesses
Show Notes

Take Home Points

Non-specific viral syndromes are usually just that, a viral syndrome but, be cautious as a number of more serious ailments can present similarly. This includes tick borne illnesses, acute HIV and carbon monoxide

Doxycycline is safe in kids. The dental staining seen with tetracycline is specific to that drug, not the class. If doxy is the best drug for the disease, use it.

Lots of meds can lead to a myasthenia gravis exacerbation. Carefully review meds before prescribing for interactions

Read More

CDC: Research on Doxycycline and Tooth Staining

Core EM: Episode 96.0 – Carbon Monoxide Poisoning

Sinai EM: Succinycholine in Myasthenia Gravis

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Episode 129.0 – Toxic Alcohols Jan 22, 2018
Show notes

We welcome Meghan Spyres back to the podcast to discuss toxic alcohol ingestion diagnosis and management.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_129_0_Final_Cut.m4a Download Leave a Comment Tags: Ethylene Glycol, Fomepizole, Methanol, Toxic Alcohols, Toxicology
Show Notes

Take Home Points

Suspect a toxic alcohol in any patient with a large osmol gap or a large anion gap metabolic acidosis and consider treating these patients empirically.

Fomepizole is the critical antidote for toxic alcohol ingestions but, patients are likely going to require dialysis as well.

Call your local poison control center if you suspect a toxic alcohol ingestion to help guide management.

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LITFL: Toxic Alcohol Ingestion

ER Cast: Mind the Gap: Anion Gap Acidosis

FOAMCast: Episode 43 – Alcohols

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Episode 128.0 – Hip Dislocations Jan 15, 2018
Show notes

This week, we sit down with Billy Goldberg - senior faculty at NYU/Bellevue, to discuss some nuances of hip dislocation management.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_128_0_Final_Cut.m4a Download Leave a Comment Tags: Orthopedics, Trauma
Show Notes

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Core EM: Hip Dislocation

OrthoBullets: Hip Dislocation

EMin5: Hip Dislocation

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