Featured Episode

Episode 52 Commonly Missed Uncommon Orthopedic Injuries

Episode 52 Commonly Missed Uncommon Orthopedic Injuries

We rarely discuss medico-legal issues on EM Cases because it misguides us a bit from good patient centered care – which is what emergency medicine is really all about.

Nonetheless, missed orthopedic injuries are the most common reason for an emergency doc to be sued in Canada. This is partly because missed orthopedic injuries are far more common than missed MIs for example, but it’s also because it’s easy to miss certain orthopedic injuries – especially the ones that aren’t super common. And orthopedics is difficult to learn and remember for the EM practitioner as there are so many injuries to remember.

And so, you guessed it – on this episode we’re going to run through some key not-so-common, easy to miss orthopedic injuries, some of which I, personally had to learn about the hard way, if you know what I mean.

After listening to this episode, try some cognitive forcing strategies – for every patient with a FOOSH that you see, look for and document a DRUJ injury. Wait, hold on….I don’t wanna give it all away at the top of the post.

Let’s hear what EM doc and sports medicine guru Ivy Cheng, and the orthopedic surgeon who everyone at North York General turns to when they need help with a difficult ortho case, Hossein Medhian, have to say about Commonly Missed Uncommon Orthopedic Injuries.

Title
EMC-052-Oct2014-Ortho-Misses-Part1
Title
EMC-052-Oct2014-Ortho-Misses-Part1
 

Learn More »

Best Case Ever

A Rational Approach to Emergency Ebola Preparedness

A Rational Approach to Emergency Ebola Preparedness

Ebola preparedness
In this special 15 minute EM Cases podcast on Ebola preparedness we bring you an interview with Professor Howard Ovens, the director of emergency medicine at Mount Sinai Hospital in Toronto. As an EM physician who took care of many SARS patients and the chief of the ED during the SARS outbreak, Dr. Ovens has a very rational approach to how to prepare our emergency departments for patients who present with fever who have been traveling in an Ebola outbreak region, including triaging and personal protective equipment (PPE).
Title
EMC-BonusCast-Howard-Ovens-Ebola
Title
EMC-BonusCast-Howard-Ovens-Ebola
 

Read More...

Best Case Ever 29 Carr’s Cases – Drug Induced Aseptic Meningitis

Best Case Ever 29 Carr’s Cases – Drug Induced Aseptic Meningitis

drug induced aseptic meningitis
Dr. David Carr presents his third of EM Cases' Carr's Cases. This series features potentially debilitating diagnoses that may be thought of as 'zebras', but actually have a higher incidence then we might think - and if diagnosed early, can significantly effect patient outcomes. Dr. Carr tells the story of young woman with an MRSA supra pateller abscess who was put on trimethoprim sulfamethoxazole and presents looking very ill with a severe headache. Not only has trimethoprim sulfamethoxazole been implicated in aseptic meningitis, but NSAIDS, immunomodulators and antibiotics have also been implicated. The reason this is so important for ED practitioners to know, is that case reports of drug-induced aseptic meningitis have shown that symptoms will resolve completely within 24 hours, once the offending drug has been stopped. Not only that, but if the patient receives the drug again in the future, they are at risk for a more severe case of drug induced aseptic meningitis.
Title
ECM-BCE-029-Sept2014-Carr-Asceptic-Meningitis
Title
ECM-BCE-029-Sept2014-Carr-Asceptic-Meningitis
 

Read More...

Best Case Ever 28 David Carr on Anti-NMDA Receptor Encephalitis

Best Case Ever 28 David Carr on Anti-NMDA Receptor Encephalitis

anti nmda receptor encephalitis
Dr. David Carr presents his second of Carr's Cases. This series features some potentially life-threatening diagnoses that may be perceived as zebras, but actually have a higher incidence then we might think - and if diagnosed early, can significantly effect patient outcomes. This Best Case Ever is about Anti-NMDA Receptor Encephalitis, a diagnosis that was only discovered in 2005, and has only recently been recognized by the Emergency Medicine community. Anti-NMDA Receptor Encephalitis may mimic a first presentation of schizophrenia or Neuraleptic Malignant Syndrome. It may present with seizure, altered mental status, autonomic instability or movement disorder in the absence of drug exposure. When you are faced with any of these presentations and no other diagnosis seems to fit, do an LP and send the CSF for anti-NMDA receptor antibodies. The time-sensitive treatment is IVIG and steroids. Anti-NMDA receptor Encephalitis is a must know diagnosis for all emergency medicine practitioners. Learn how to pick up this important diagnosis by listening to Dr. Carr's Best Case Ever and following the links to further resources.
Title
BCE-028-Aug2014-Carr-Anti-NMDA
Title
BCE-028-Aug2014-Carr-Anti-NMDA
 

Read More...

Best Case Ever 27 – Sarah Reid on Pediatric Shock

Best Case Ever 27 – Sarah Reid on Pediatric Shock

dr sarah reid
Ottawa this year, I had the pleasure of discussing pediatric shock and sepsis with Dr. Sarah Reid, a good medical school friend of mine from the Gretzky Year ('99) graduating class. I knew back then that she was heading for PEM educator stardom. Lo and behold, she is the now the director of CME at the Children's Hospital of Eastern Ontario and a national PEM speaker extraordinaire. After recording an eye-opening session on Pediatric Fever Without a Source and Pediatric Sepsis, she told me the story of her Best Case Ever where the initial presumptive diagnosis was sepsis. Maximize your learning and submit your questions on 'Pediatric Fever Without a Source' on the Next Time on EM Cases page.
Title
EMC-BCE-027-Jul2014-REID
Title
EMC-BCE-027-Jul2014-REID
 

Read More...

Best Case Ever 26 – Mike Betzner on Chloral Hydrate Poisoning & Cardiac Arrest

Best Case Ever 26 – Mike Betzner on Chloral Hydrate Poisoning & Cardiac Arrest

torsades de pointes
I met up with Mike Betzner at North York General's Update in EM Conference in Toronto. He is the medical director of Air Transport STARS air ambulance out of Calgary and an amazing speaker on the national lecturing circuit. His Best Case Ever on Chloral Hydrate poisoning & cardiac arrest describes a young man in cardiac arrest with resistant Ventricular Fibrillation and Torsades de Pointes. There is only one class of drugs that can get him back into normal sinus rhythm. Dr. Betzner describes how he recognized that this patient was suffering from Chloral Hydrate poisoning and how he saved his life with one simple intervention.
Title
EMC-BCE-026-Jun2014BETZNER
Title
EMC-BCE-026-Jun2014BETZNER
 

Read More...

 

Quick Links to Recent Emergency Medicine Cases Episodes

Login required for some posts – Entire EM Cases Library is Free Access

Episode 51 Managing Difficult Patients with Walter Himmel, Jean Pierre Champagne & Ann Shook

Episode 50 Recognition & Management of Pediatric Sepsis and Septic Shock with Sarah Reid & Gina Neto

Journal Jam 1 Age-Adjusted D-dimer with Jeff Kline & Jonathan Kirschner

Episode 49 Effective Patient Communication, Patient Centered Care & Satisfaction with Walter Himmel, Jean Pierre Champagne & Ann Shook

Episode 48 Pediatric Fever Without a Source with Sarah Reid & Gina Neto

Episode 47 Evidence Based Medicine with Walter Himmel

Episode 46 Social Media in Emergency Medicine Learning with Rob Rogers, Ken Milne & Brent Thoma

Episode 45 Swadron on Vertigo, Mattu on Cardiology Literature from EM Update Conference 2014 with Stuart Swadron & Amal Mattu

Episode 44 Whistler’s Update in EM Conference Highlights 2014 with Joel Yaphe, Lisa Thurgur & David Carr

Episode 43 Appendicitis Controversies with David Dushenski & Brian Steinhart

Episode 42 Mesenteric Ischemia & Pancreatitis with David Dushenski & Brian Steinhart

Episode 41 Hypertensive Emergencies with Joel Yaphe & Clare Atzema

Episode 40 Asymptomatic Hypertension with Joel Yaphe & Clare Atzema

Episode 39 Update in Trauma Literature with Dave MacKinnon & Mike Brzozowski

Episode 38 ENT Emergencies with Leeor Sommer & Maria Ivankovic

Episode 37 Anticoagulants, PCCs & Platelets with Walter Himmel, Katerina Pavenski & Jeannie Callum

Episode 36 Transfustions, Anticoagulants & Bleeding with Walter Himmel, Katerina Pavenski & Jeannie Callum