TamingtheSRU

Latest Episodes:

CTs in SAH - Does Time Even Matter Feb 02, 2023

Show notes

In this podcast, Dr. Justin Milligan covers a recently published retrospective review that could inform our future practice. We all rely on a negative CT within 6 hours for diagnosing SAH, but what if we could through the time limits out the window?

What Drip After the Drop - Post Cardiac Arrest Hypotension Nov 18, 2022

Show notes

During a cardiac arrest resuscitation, finally palpating a pulsatile flow beneath your gloved fingertips brings a sense of satisfaction like no other. But just as you go to finally breathe a sigh of relief and wipe the beading sweat off your brow, your now widening pupils focus on the patient’s steadily plummeting blood pressure. As you begin to sense your own heart palpitating, you think about medications to utilize in hopes of staving off another round of chest compressions. Since you’ve already given four doses of code-dose epinephrine, maybe an epinephrine infusion is best? You also recall that norepinephrine seems to be a popular choice in patients with shock, so maybe you should start that instead?

Family Presence During Cardiac Arrest Resuscitations Nov 11, 2022

Show notes

Cardiac arrests are an inevitable reality for emergency medicine providers. There is often a debate on whether family members presence during CPR will lead to more emotional burdens on the family members who witnessed these resuscitations. Dr Melanie Yates summarizes this recent study that aimed to determine if there are increased rates of PTSD-related symptoms of close relatives who witnessed CPR of a family member.

Doppler US For Pulse Checks Nov 04, 2022

Show notes

Palpating a pulse during a resuscitation can be more challenging than it seems. Digital palpation of femoral pulses may lack sensitivity and specificity needed to accurately detect the presence of a pulse. In this Journal Club recap, Dr Martina Diaz summarizes a recently published paper looking at the use of Doppler ultrasound for pulse checks.

A Life Saving Bolus? Fluids at the Time of Intubation Aug 31, 2022

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In this podcast, Dr. Courtney Kein breaks down a recently published article examining the effects of a bolus of IVF at the time of intubation. Does a push of fluid prevent peri-intubation hemodynamic collapse?

Bougie so Bougie Aug 24, 2022

Show notes

In this Journal Club paper breakdown, Dr Bailee Stark recaps the findings of a recently published study by Driver et al looking at the effect of bougie aided intubation vs standard stylet intubation.

Tube Thoracostomy - Tiny Tubes for Bloody Effusions Aug 17, 2022

Show notes

In this Journal Club podcast, PGY-3 Tony Fabiano breaks down a paper from the Journal of Trauma comparing the effectiveness and patient perception of pigtail catheters versus standard chest tubes for hemothorax in the setting of trauma. Is a tiny tube effective at all in draining blood from the chest?

ECG to Activation May 26, 2021

Show notes

Time is myocardium, and minimizing door-to-activation time improves outcomes in patients with acute coronary occlusion. There are a number of existing quality metrics used to help drive improvements in the time-based care of STEMI patients. Could a new quality metric help the decision making time of Emergency Physicians?

The Danger of the OMI May 19, 2021

Show notes

The paradigm of STEMI vs NSTEMI is one of the most well known in Emergency Medicine. Could a change in thinking shift this paradigm to OMI vs NOMI and result in a more complete identification of patients with significant morbidity and mortality?

How Good is a Post-ROSC EKG? May 12, 2021

Show notes

One of the first tests ordered for a patient with ROSC following cardiac arrest is an EKG. Many of these EKGs are profoundly abnormal. Current practice is to evaluate for STEMI and to activate the cardiac cath lab if one is found. But, the test characteristics (sensitivity and specificity) of post-ROSC EKGs are likely different than the test characteristics for patients presenting to the ED with complaints of chest pain/symptoms concerning for ACS. This meta-analysis looked to pull together the existing literature and determine those test characteristics for this critically ill patient population. Read the summary after the link and listen to the podcast to hear a breakdown of this study.

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