CRACKCast & Physicians as Humans on CanadiEM

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**CRACKCast & Physicians as Humans on CanadiEM**

CanadiEM aims to improve emergency care in Canada by building an online community of practice for healthcare practitioners and providing them with high quality, freely available educational resources. The CanadiEM Podcast brings you cutting edge clinical topics on the National Rounds Series and delves into the struggles that doctors face on the Physicians as Humans Series.

Latest Episodes:

CRACKCast E067 - Sexual Assault Mar 20, 2017

Show notes

This episode covers Chapter 67 of Rosen's Emergency Medicine. Its a heavy topic, but important to get right.

What precautions should be taken prior to engaging in potential sexual abuse cases?

What information can be useful in determining the location and likelihood of injury in sexual assault?

What is the prevalence of mental illness in sexual assault patients? Which populations are found to have a higher proportion of mental illness? What effect does mental illness have on the severity of the attack?

What factors make genital injury more likely to be observed? Less likely?

What are the risks of STI's after sexual assault?

What are appropriate treatments for STI prophylaxis in cases of suspected sexual abuse/assault?

What resources exist to help medical providers and any victims of sexual abuse?

What differences should be considered with male victims of sexual assault?

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Thank-you to Dr. Sampsel for her assistance with this episode!

E066 - Child Maltreatment Mar 13, 2017

Show notes

CRACKCast E065 - Forensic Medicine Mar 06, 2017

Show notes

This episode covers Chapter 65 of Rosen's Emergency Medicine. Its a big intro into the next few chapters covering forensic medicine in the emergency department. Tighten up those boot straps, this stuff is heavy!

What are some pearls and pitfalls for ER physicians when dealing with Forensic Emergency Medicine?
What are proper terms used to describe wound injury patterns?
What's the anatomy of a cartridge (bullet)? What are the types and important aspects of wound ballistics?
What signs would you see for the various ranges of fire of a bullet?
What are common red flags to alert you to the possibility of domestic violence? What risk factors make domestic violence more common?
Describe the different types of blunt force pattern injuries and the pathophysiology of how they occur. Do the same for sharp force and thermal wounds.
What does the Health Insurance Portability and Accountability Act permit a physician to disclose to the investigating law enforcement officer?

CRACKCast E064 - Chemical Injury Feb 27, 2017

Show notes

This episode covers Chapter 64 of Rosen's Emergency Medicine. Worried about what to do with those patient's coming in with their skin melting off from a chemical exposure? We've got you covered.

1) Describe the difference between Alkali and Acid injuries

2) Describe a HAZMAT response on scene

3) Describe the decontamination of an individual

4) List PPE for first responders or caregivers

Wisecracks

-Name two acids that cause damage through liquefactive necrosis -List Chemical Agents used in Warfare / Terrorism -What chemicals should you NOT irrigate with water?

CRACKCast E063 - Thermal Burns Feb 20, 2017

Show notes

This episode of CRACKCast covers Rosen's Chapter 63, Thermal Burns. These patients are often the sickest in the department and many are on their way to the ICU. There are life-saving interventions that are begun in the emergency department with significant impacts on morbidity and mortality, and many are discussed in this episode.

Signposts:

List zones of burns
List 6 indications for intubation in the burn patient
List and describe 2 formulas for fluid resuscitation
Describe depth classification for burn injuries
List indicators of upper airway and lower airway burns
What is the Rule of 9's and how is it modified in pediatrics
List criteria for transfer to burn unit
Describe basic burn dressing management
List 5 burn prevention strategies

Wisecracks:

What are the indications for an escharotomy
What are the primary considerations in mechanical ventilation of burn patients

CRACKCast E062 - Venomous Animal Injuries Feb 13, 2017

Show notes

This episode covers Chapter 62 of Rosen's Emergency Medicine. Does leaving the comfort of your warm, safe bed scare you? After this chapter, it might...

Sign Post:

List the 4 families of venomous snakes.
Describe phenotypic characteristics of Pit-Vipers
Describe phenotypic characteristics of coral snakes?
List the grades of pit viper envenomation and indicate therapy?
Describe a black-widow spider and expected management goals?
Describe a brown recluse spider and expected management goals
List 3 classes of venomous marine injuries, and describe key principles of management for each?

WiseCrack:

What does expert opinion suggest to avoid anaphylaxis in non-recombinant antivenin administration?
What is the most toxic, per weight, venom?
What are the general phenotypic features of poisonous snakes in North America?

CRACKCast E061 - Mammalian Bites Feb 06, 2017

Show notes

This episode covers Chapter 61 of Rosen's Emergency Medicine. Know anything about mammalian bites...? Yeah, neither did we until we read this chapter. Lots of juicy clinical pearls.

List 5 pathogens responsible for infection from Dog bite
List 4 risk factors for overwhelming sepsis from dog bite
What first line antibiotic is a good choice for cat and dog bites?
What species are known to cause infection with Pasteurella multocida?
What are the risk factors for infection with animal bites?
Describe the treatment of Monkey Bites?
When is anti-viral prophylaxis NOT indicated for a monkey bite
1. What is the duration of therapy of antiviral prophylaxis?
Describe the recommendations for wound closure and antibiotics in bite cases

Wisecracks:

What about seal bites?
What about rabies in BC?
Waterhouse-Friderichsen syndrome & capnocytophagia-related Gangrene sepsis - what are they?

CRACKCast E060 - Foreign Bodies Jan 30, 2017

Show notes

This episode of CRACKCast covers Rosen's Chapter 60, Foreign Bodies. This episode covers an approach to foreign bodies, including location specific tips, complications and safe removal in the ED.

Describe your approach to Ocular FB
What is Seidel Sign?
List indirect signs of FB on Xray
List complications of ear FB
Describe the process of anesthesia of the ear and preparation for FB removal
Describe 5 techniques for removal of FB from ear
Describe the management of TM perforation secondary to FB
Describe 5 techniques for removal of FB from nose
Describe a step-wise approach to pediatric FB airway obstruction
List 7 symptoms of Esophageal FB
List 8 complications of esophageal FB
List 4 complications specific to button battery ingestions
List indications for removal of esophageal FBs
List 4 removal techniques of esophageal FB
List 5 techniques for management of food bolus and their mechanism of action
List the criteria for continued expectant management for intestinal FB
Describe the stepwise management of a Rectal FB

Wisecracks:

What is the safe dose of topical anesthetics?
How do you test the radiolucency of an object?
What is a Cafe Coronary? What is Penetration Syndrome?
Differentiate Body stuffing from Body Packing

Physicians as Humans Podcast E03: Making Space for Depression Jan 27, 2017

Show notes

In the third episode of the Physicians as Humans project, I corresponded with a Canadian emergency physician who sent me her personal account of depression. The result is this beautiful, thoughtful story that she has graciously allowed me to read for the podcast.

This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact velmurug@ualberta.ca.

Music for Episode 02 (All songs have been modified for the project)

ambient by strange day. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
Cease by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
I Dunno by Grapes. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
Lost Within by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
Moon by LEMMiNO. Music provided by Music for Creators under a Creative Commons Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 license.
Tomorrow by Bensound
Laws of Movement by The Passion HiFi. www.thepassionhifi.com

CRACKCast E059 - Wound Management Principles Jan 23, 2017

Show notes

This episode of CRACKCast covers Rosen's Chapter 59, Wound Management Principles. This episode covers the nitty-gritty details of wound management and what you need to know to get that perfect wound closure!

Questions:

1) List risk factors for wound infection2) List the 5 stages of wound healing3) List toxic doses of local anesthetics4) 3 types of wound closure?5) List advantages of and contraindications of tissue adhesives6) List indications for tetanus immune prophylaxis7) List 5 specific wound care instructions8) List 7 situations where antibiotic prophylaxis is indicated in wound management

WiseCracks:

Evidence guided tips for scar healing?

How to decrease pain of anaesthetic injection?

Where can I find a concise guide to Suture material use?