Emergency Medical Minute

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**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 #303: Lazarus Effect Mar 09, 2018

Show notes

Author: Dylan Luyten, M.D.

Educational Pearls

The Lazarus phenomenon is the delayed return of spontaneous circulation after cessation of CPR.
A prospective study in Finland found 5 out of 840 patients where CPR was attempted in the setting of cardiac arrest experienced the Lazarus effect (about 0.6%).
3 of these patients died on scene, and the other 2 died in the hospital at 1.5 and 26 hours respectively.
Ultimately, the Lazarus effect is rare, but it does occur and providers and family members should be aware that signs such as gasping or twitching may be seen after cardiac arrest, but the prognosis is still dismal.

References

Kuisma, M, et al. (September 2017) "Delayed return of spontaneous circulation (the Lazarus phenomenon) after cessation of out-of-hospital cardiopulmonary resuscitation". Resuscitation. 118: 107-111

Podcast #302: Flu Mar 07, 2018

Show notes

Author: Jared Scott, M.D.

Educational Pearls

Flu is widespread throughout the US (through Jan 20th 2018).
All age groups have seen surge in hospitalizations, but 65 + age group has seen the largest surge in hospitalizations due to flu.
New recommendations for treating with Tamiflu! Treat the following high-risk groups at any stage of illness: Children under age 2, Adults 65 and older, patients with comorbidities such as chronic lung disease, heart disease, blood disorders, kidney disorders, liver disorders, neurological disorders, immunosuppressed, pregnant women, American Indians, extreme obesity, women under 19 on long-term aspirin, and nursing home residents.

References:

https://www.cdc.gov/flu/about/disease/high_risk.htm

https://www.cdc.gov/flu/weekly/summary.htm

Podcast #301: Biliary Pathology Mar 05, 2018

Show notes

Author: Don Stader, M.D.

Educational Pearls

Common pathologies include cholecystitis, choledocholithiasis, and in concerningly ascending cholangitis.
Cholecystitis is obstruction at the cystic duct leading to inflammation of gallbladder wall, while choledocholithiasis is a distal obstruction of the biliary tree, and ascending cholangitis is an ascending infection of the biliary tree secondary to obstruction.
Risk factors for Cholecystitis are the 5 F's (Fat, Forty, Female, Fertile, Family Hx).
Classic symptoms seen in ascending cholangitis are Charcot's Triad of fever, RUQ pain, and jaundice, or Reynold's pentad which is more severe and has the addition ofaltered mental status and hypotension.
Porcelain gallbladder is a radiographic finding showing calcification of the gallbladder that is associated with cancer of the gallbladder.

References:

Kimura Y, Takada T, Kawarada Y, et al. (2007). "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg.

Strasberg, SM (26 June 2008). "Clinical practice. Acute calculous cholecystitis". The New England Journal of Medicine. 358 (26): 2804–11.

Opioid Safety Summit: Admiral Winnefeld's Strategy to Wage War on the Opioid Epidemic Feb 27, 2018

Show notes

Since the tragic overdose of his son, Admiral Winnefeld has developed an intriguing strategy on how to combat the Opioid Epidemic.

Dreamland in Denver Part VI: "Dreamland" Feb 16, 2018

Show notes

Sam Quinones, American journalist and author of the critically acclaimed book, Dreamland: The True Tale of America's Opiate Epidemic, shares the story of how he discovered the truth about the Opiate Epidemic.

Dreamland in Denver Part V: "Tales from a Harm Reductionist" Feb 16, 2018

Show notes

Lisa Raville, executive director of The Harm Reduction Action Center in Denver, shares tales from her perspective as a Harm Reductionist.

Dreamland in Denver Part IV: "Doing Harm: Medicine's Role in Creating the Opioid Crisis." Feb 16, 2018

Show notes

Emergency Medical Minute's very own Donald Stader, MD explains Medicine's contribution to the catastrophe that is the Opioid Epidemic.

Dreamland in Denver Part III: "Opioid Mythbusters: 10 Fallacies that Fueled the Opiate Crisis" Feb 16, 2018

Show notes

Dr. Robert Valuck, director of the Colorado Consortium, presents 10 fallacies that have fueled the Opioid Epidemic.

Dreamland in Denver Part II: "Why Calling it 'the Opioid Epidemic' Misses the Point Feb 16, 2018

Show notes

The Honorable Alby Zweig shares his impactful first-hand experience with addiction, recovery and triumph.

Dreamland in Denver Part I: "No Family is S.A.F.E. ...Yet" Feb 16, 2018

Show notes

Admiral James Winnefeld and Mary Winnefeld speak publicly for the first time about the tragic overdose of their son, Jonathon, and how 'No Family is S.A.F.E...yet'.

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