Emergency Medical Minute

View Top 200 Chart

Back to Rankings Page

Health & Fitness
**Emergency Medical Minute**

Our near daily podcasts move quickly to reflect current events, are inspired by real patient care, and speak to the true nature of what it’s like to work in the Emergency Room or Pre-Hospital Setting. Each medical minute is recorded in a real emergency department, by the emergency physician or clinical pharmacist on duty – the ER is our studio and everything is live.

Latest Episodes:

Podcast 569: The eFAST Exam Jun 08, 2020

Show notes

Contributor: Aaron Lessen, MD

Educational Pearls:.

Focused assessment with Sonography for Trauma (FAST) exam and the extended-FAST (eFAST) are essential components of current trauma care and evaluation
There has been an accumulation of research to provide an estimate of effectiveness of identifying certain injuries with ultrasound:
- For identifying a pneumothorax, the sensitivity ~70% and specificity ~99%.
- For pericardial effusions, sensitivity 90% and specificity ~ 94%.
- For hemoperitoneum, sensitivity ~74% and the specificity ~98%.
While ultrasound is excellent for identifying many injuries, it may not be adequate alone to rule out serious injuries if the clinical suspicion is high based on these pooled studies

References

Netherton S, Milenkovic V, Taylor M, Davis PJ. Diagnostic accuracy of eFAST in the trauma patient: a systematic review and meta-analysis. CJEM. 2019;21(6):727‐738. doi:10.1017/cem.2019.381

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Podcast 568: Shock 'em! Jun 02, 2020

Show notes

Contributor: John Winkler, MD

Educational Pearls:

Unstable ventricular tachycardia (VT) typically manifests with syncope, shortness of breath, diaphoresis and/or chest pain with hemodynamic instability
Electrical cardioversion of unstable ventricular tachycardia is first line treatment
Starting with a higher energy level (or just using the maximum) when performing cardioversion may set you up for better success as many providers feel the first shock has the highest likelihood of success

References

Dresen, W.F. Ferguson, J.D. Ventricular Arrhythmias. Cardiol Clin. 2018 Feb;36(1):129-139. doi: 10.1016/j.ccl.2017.08.007. Epub 2017 Oct 27.

Goyal, A. et al. Synchronized Electrical Cardioversion.StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020-. 2020 Feb 13.

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD

Podcast 567: Mechanical CPR….Not So Fast Jun 01, 2020

Show notes

Contributor: Aaron Lessen, MD

Educational Pearls:

Mechanical CPR (machine assisted compression devices) remains a hot topic of debate in emergency medicine
Machine assisted CPR has been advocated to provide more consistent compressions in cardiac arrest and free up staff for other tasks.
However, multiple studies have shown mechanical CPR provides no significant survival benefit yet increased rates of injury to the chest and abdomen from the devices.
Unless a clear benefit can be found, mechanical CPR devices should not routinely replace traditional CPR in most situations
For prolonged transport as well as resource-limited settings, these devices still may provide the only option for sustained resuscitations

References

Bonnes, J. et al. Manual Cardiopulmonary Resuscitation Versus CPR Including a Mechanical Chest Compression Device in Out-of-Hospital Cardiac Arrest: A Comprehensive Meta-analysis From Randomized and Observational Studies. Ann Emerg Med. 2016 Mar;67(3):349-360.e3. doi: 10.1016/j.annemergmed.2015.09.023. Epub 2015 Nov 19.

Wang, P. Brooks, S. Mechanical Versus Manual Chest Compressions for Cardiac Arrest. Cochrane Database Syst Rev. 2018 Aug 20;8(8):CD007260. doi: 10.1002/14651858.CD007260.pub4.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Selected Audio from 'UnfilterED #7: Russell J. Ledet, Ph.D.' May 31, 2020

Show notes

"Go unafraid! And also know that you got to reach out to the right people and hold on to those people no matter what they look like, no matter what background they come from...Find people who are positive in your life who can help you. If I'm one of those people, reach out to me."

Russell J. Ledet hails from Lake Charles, Louisiana. After serving in the U.S. Navy, he attended Southern University and A&M College for his undergraduate degrees in biology and chemistry. Afterwards, he went on to complete his Ph.D. in molecular oncology at New York University. He is currently a second-year MD-MBA student at Tulane University School of Medicine and A.B. Freeman School of Business. He is the co-founder and president of 'The 15 White Coats', a non profit organization focused on helping people of color get into medical school and improving the cultural literacy of our learning spaces.

The 15 White Coats website:

https://www.the15whitecoats.org/

Get in touch with Russell:

E-Mail: Russell.ledet@gmail.com

Twitter: @theguywithyes

Instagram: @maleahandmahlinasbaba

UnfilterED #7: Russell J. Ledet, Ph.D. May 27, 2020

Show notes

In this very special episode of UnfilterED, Russell speaks candidly about his childhood, the challenges that made him the man he is today and his plans for the future, including The 15 White Coats' goal to put an individual of color through medical school debt-free.

Time Stamps:

1:53 - Russell's Introduction

6:50 How have you learned from your experiences and where you came from?

9:30 - Entrepreneurship at a young age

14:15 - Russell's Faith

16:20 - Joining the Navy

20:30 - Role Models

32:40 - Visiting the Whitney Plantation and the origin of The 15 White Coats

44:40 - The future of The 15 White Coats

53:00 - What is your take home message for a young person of color listening to this interview?

The 15 White Coats website:

https://www.the15whitecoats.org/

Get in touch with Russell:

E-Mail: Russell.ledet@gmail.com

Twitter: @theguywithyes

Instagram: @maleahandmahlinasbaba

Intro Music:

Backbay Lounge Kevin MacLeod (incompetech.com)

Licensed under Creative Commons: By Attribution 3.0 License

http://creativecommons.org/licenses/by/3.0/

Podcast 566: The Cholera Pandemic May 26, 2020

Show notes

Contributor: Jared Scott, MD

Educational Pearls:

Cholera has been responsible for 6 previous global pandemics and currently the world is in the seventh pandemic of cholera, ongoing since 1961.
Cholera originated in the Ganges Delta of India and spread worldwide but largely is unseen in the US and other developed countries due to water sanitation
Cholera is a bacterial illness that is water borne and causes severe diarrhea
Estimates say that there are 1.3-4 million cases annually and up to 143,000 people die each year from Cholera.
Treatment is largely supportive and can be done with oral rehydration therapy consisting of water, salt, and sugar.
There are three oral vaccinations for Cholera but unfortunately are not widely available
Cholera has been responsible for ushering in public health initiatives. Most famously when John Snow was able to isolate a single water source causing Cholera infections in London and by shutting it off eradicated the bacteria

References

"Cholera." World Health Organization, World Health Organization, 17 Jan. 2019, https://www.who.int/news-room/fact-sheets/detail/cholera

Clemens JD, Nair GB, Ahmed T, Qadri F, Holmgren J. Cholera. Lancet. 2017;390(10101):1539‐1549. doi:10.1016/S0140-6736(17)30559-7

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Podcast 565: Cesarean Scar Pregnancies May 25, 2020

Show notes

Contributor: Nick Hatch, MD

Educational Pearls:

A cesarean scar ectopic pregnancy occurs when the pregnancy implants along the scar tissue deep in the myometrium from a prior cesarean surgery, felt to be precipitated by a small fissure or fistula residual in the scar
Diagnosis can be challenging and ultrasound may not clearly show this type of ectopic pregnancy
MRI has been successfully used for diagnosis as well
Various treatment options exist including medical and surgical management but if left untreated, cesarean ectopic pregnancies are life threatening

References

Gonzalez N, Tulandi T. Cesarean Scar Pregnancy: A Systematic Review. J Minim Invasive Gynecol. 2017;24(5):731‐738. doi:10.1016/j.jmig.2017.02.020

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

COVID-19 Digest: The Possible Link Between Severe COVID-19 and Low Vitamin D Levels (Recorded 5/21/20) May 22, 2020

Show notes

Host: Elizabeth Esty, MD.

At this point, with so many of the studies we've digested exploring correlations, associations, observational studies and anecdotal reports and speculation, we could subtitle the show: what we don't know about COVID. And so, today, we'll look at what we don't know about Vitamin D and COVID. There have been a number of studies and a fair amount of media coverage in recent weeks that look at a possible link between low Vitamin D levels and severity of COVID.

Vitamin D plays a role in both adaptive and innate immunity, which we discussed at some length in our episode on the BCG vaccine and COVID. Macrophages starved for Vitamin D can't produce peroxide to kill microbes, and some of the toll-like receptors crucial to innate immunity that recognize pathogen molecules don't work right without Vitamin D. Finally, Vitamin D modulates the immune response, preventing release of too many cytokines.

The potential for Vitamin D to play a role in preventing severe COVID-19 seems plausible, but what does the science say?

Research By: Elizabeth Esty and Nathan Novotny.

Sound Editing By: Nathan Novotny.

References:

[1] Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al., editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011. 3, Overview of Vitamin D. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56061/

[2] Helming L, Böse J, Ehrchen J, et al. 1α,25-dihydroxyvitamin D3 is a potent suppressor of interferon γ–mediated macrophage activation. Blood. 2005;106(13):4351-4358. doi:10.1182/blood-2005-03-1029

[3] Parva NR, Tadepalli S, Singh P, et al. Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus. 10(6). doi:10.7759/cureus.2741

[4] Sizar O, Khare S, Goyal A, Bansal P, Givler A. Vitamin D Deficiency. In: StatPearls. StatPearls Publishing; 2020. Accessed May 21, 2020. http://www.ncbi.nlm.nih.gov/books/NBK532266/

[5] Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. Published online May 6, 2020. doi:10.1007/s40520-020-01570-8

[6] Vitamin D and Inflammation – Potential Implications for Severity of Covid-19 – Irish Medical Journal. Accessed May 21, 2020. http://imj.ie/vitamin-d-and-inflammation-potential-implications-for-severity-of-covid-19/

[7] Raharusun P, Priambada S, Budiarti C, Agung E, Budi C. Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study. Social Science Research Network; 2020. doi:10.2139/ssrn.3585561

[8] The Center for Evidence Based Medicine. Vitamin D: A rapid review of the evidence for treatment or prevention in COVID-19. CEBM. Accessed May 21, 2020. https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-the-evidence-for-treatment-or-prevention-in-covid-19/

[9] Hastie CE, Mackay DF, Ho F, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):561-565. doi:10.1016/j.dsx.2020.04.050

On the Streets #5: Trauma during COVID-19 May 20, 2020

Show notes

Jordan sits down to discuss trauma with Dr. Kaysie Banton, the Trauma Services Medical Director at Level 1 Trauma Center Swedish Medical Center in Englewood, Colorado. In this laid back interview, Dr. Banton discusses how the COVID-19 has affected trauma volumes at Swedish. While trauma as an aggregate hasn't decreased, the types of trauma for the time of year have shifted as well as the acuity of injuries that present. This episode focuses on how public opinion surrounding the pandemic has shifted the way patients seek care, how delays to seeking care changes her role as a trauma surgeon and what is being done at hospitals to emphasize the safety of patients amidst COVID. Jordan and Dr. Banton talk about how EMS can shift their interview and examinations with this type of behavior in mind. As people delay their care for fear of contracting COVID-19, traumatic injuries that might only require a day or two in the hospital are worsening while untreated and progress to stages that are unnecessary. Dr. Banton leaves medical practitioners with a call to action to educate the public about the benefits of seeking medical care as one normally would outside the pandemic to avoid the worsening of an injury.

Podcast 564: Cardiac Ischemia Management Update May 19, 2020

Show notes

Contributor: Nick Tsipis, MD

Educational Pearls:

Recent randomized controlled trial compared early intervention (PCI/CABG) to medical management for those diagnosed with moderate to severe cardiac ischemia on stress testing
Primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest
Secondary outcome was death from cardiovascular causes or myocardial infarction.
The study reported that patients who had more aggressive invasive procedures early on in treatment had a 2% increase in poor outcomes in the immediate period after intervention (6 months) but long term had a 2% decrease in poor outcomes.
Overall the mortality was essentially identical between the two groups

References

1) Maron, D.J., et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020 Apr 9;382(15):1395-1407. doi: 10.1056/NEJMoa1915922. Epub 2020 Mar 30.

Our TOPPODCAST Picks

Follow Us

Stay Connected

Related Podcasts

Links

Stay Connected