Emergency Medicine Cases

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Ep 135 Commonly Missed or Mismanaged Shoulder Injuries – Approach and Glenohumeral Dislocations Feb 11, 2020

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Dr. Arun Sayal and Dr. Dale Dantzer answer questions such as: How do we know we have adequate shoulder x-ray views? How can we best remember the differential diagnosis of an orthopedic extremity emergency with a normal x-ray? What is the quickest and best way to test neurologic status of patients with shoulder injuries? Why is axillary view of the shoulder so valuable? What is the biggest myth when it comes to the mechanism of injury for posterior glenohumeral shoulder dislocations? What physical exam maneuvers increase suspicion for posterior glenohumeral dislocation? What are the subtle findings on x-ray we should look for in patients with suspected posterior glenohumeral dislocation? What is the preferred first line reduction technique for posterior shoulder dislocation? What are the most common and consequential pitfalls in the management of anterior shoulder dislocations? and many more...

Preparation for Emergency Infectious Outbreak in your ED – Coronavirus Feb 11, 2020

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The current outbreak of the novel respiratory pathogen Coronavirus is an opportunity to remind ourselves of how to properly and adequately prepare for an emergency outbreak in our EDs. Although the mortality rate in patients with Coronavirus in this outbreak is less than 1% (which pales in comparison to Ebola or SARS), historically these types of outbreaks have occured every 5-6 years (SARS 2003, HINI 2009, Ebola 2014, Coronavirus 2020), so they are somewhat predictable and we should know how to prepare for them in our EDs. In this special edition EM Cases podcast Dr. Megan Landes, a Global Health expert, researcher and EM educator runs us through how to best practically prepare our EDs for an outbreak like Coronavirus...

JJ 16 Heparin for ACS and STEMI Jan 28, 2020

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Does heparin - LMWH or unfractionated heparin - benefit the patient with a pretty good story for angina with a bump in their troponin and some ST depression in the lateral leads? We’re expected to routinely give heparin for all these NSTEMI and unstable angina patients with any ischemic changes seen on the ECG, right? And for STEMI too. But should we?....

EM Quick Hits 12 AFib Early vs Delayed Cardioversion, Snake Bites, Ovarian Torsion Myths, Crystal Meth, Aortic Dissection, Severe Asthma Meds Jan 14, 2020

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In this EM Quick Hits podcast we have Paul Dorion on immediate cardioversion vs rate control/delayed cardioversion for atrial fibrillation, Justin Morgenstern & Justin Hensley on emergency management of snake bites, Brit Long on reliability of clinical features in the diagnosis of ovarian torsion, Michelle Klaiman on emergency management of crystal methamphetamine use disorder, Hans Rosenberg & Rob Ohle on workup of suspected aortic dissection, and Anand Swaminathan on epinephrine and magnesium sulphate in severe asthma...

Ep 134 Shift Preparation: Pre-gaming with Rob Orman Dec 31, 2019

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The question is: how do we best mentally and physically prepare for an ED shift? Dr. Rob Orman, master educator and fellow podcaster joins Anton to discuss a few options...

Ep 133 Emergency Management of Status Epilepticus Dec 17, 2019

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Among the presentations seen in the ED, few command the same respect as status epilepticus. It is, in itself, both a diagnostic dilemma and, at times, a therapeutic nightmare. There’s a reason it’s the very first domino to fall in the dreaded sequence “seizure, coma, death”. Status epilepticus can be nuanced to manage. Sure, most seizures self-abort or love an IV dose of lorazepam, but ask anyone who’s been down the propofol route, and they’re not likely to have forgotten the time they stared down a patient who just...would...not....stop...

EM Quick Hits 11 Blunt Cerebrovascular Injury, Physostigmine, TEE in Cardiac Arrest, Understanding Nystagmus, Subtle Inferior MI, Choicebo Dec 03, 2019

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In this EM Quick Hits podcast we have Emily Austin on physostigmine for anticholinergic toxidrome, Walter Himmel on understanding nystagmus to differentiate central vs peripheral causes of vertigo, Rob Devins on the role of transesophageal echocardiogram in cardiac arrest, Jesse MacLaren on nuances in inferior MI ECG changes and aVL, Andrew Petrosoniak on a practical approach to blunt cerebrovascular injury and Reuben Strayer on choicebo...

Ep 132 Emergency Approach to Resolved Seizures Nov 19, 2019

Show notes

What is the essential list of immediate life threats with specific antidotes that we must know for the ED patient with a seizure? What are the key elements for distinguishing a true seizure from syncope? From Psychogenic Non-Epileptic Seizure (PNES)? From TIA? From migraine? How do you distinguish Todd's Paralysis from TIA or stroke? What are indications for lactate and troponins in patients who present with a seizure? Do all patients with first time unprovoked seizures require anti-seizure medication in the ED? What is the preferred anti-seizure medication and route for ED loading for the patient with a first time seizure? Which patients who present with seizure require a CT head in the ED? What are indications and ideal timing for EEG for patient who present to the ED with seizure? and many more...

EM Quick Hits 10 – TXA CRASH-3, CJEM Cellulitis, Double Defib, Serratus Anterior Block, PARC score, Toxic Shock Syndrome Nov 05, 2019

Show notes

Sarah Reid on pediatric appendicitis risk calculator, Sheldon Cheskes & Mark Ramzy on double defibrillation for refractory ventricular fibrillation, Hans Rosenberg & Krishan Yadav on cellulitis clinical pearls, Anand Swaminathan on serratus anterior block, Brit Long on recognition of toxic shock syndrome, Justin Morgenstern on tranexamic acid in head injury and CRASH-3...

Ep 131 PEA Arrest, PseudoPEA and PREM – With Simard and Weingart Oct 22, 2019

Show notes

Rob Simard of POCUS Cases fame and Scott Weingart go beyond ACLS and guide you through the complex world of PEA. We discuss that the palpation technique is poor at determining whether or not a patient has a pulse, that the POCUS pulse is more accurate and as rapid compared to the palpation technique at determining whether or not a patient has a pulse, the difference between true PEA arrest, PseudoPEA and PREM, why epinephrine may be harmful in PEA, Weingart's chain of survival approach from PEA arrest to ROSC, four tools to help differentiate true PEA arrest from PseudoPEA, how to prevent long pauses in chest compressions using POCUS, EM Cases PEA arrest and PseudoPEA suggested dynamic algorithm, vasopressor choices in PseudoPEA, whether the "QRS wide vs narrow width" approach to PEA arrest underlying cause is useful or not and much more...

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