Featured Episode

Episode 53 Pediatric POCUS

Episode 53 Pediatric POCUS

In this Episode, a follow up to Episode 18 Point of Care Ultrasound Pearls and Pitfalls, which covered pericardial effusion, pneumothorax, undifferentiated shock, cardiac arrest & DVT, we bring you 4 of North America’s Pediatric Point of Care Ultrasound gurus recorded live from Toronto during the first ever P2 Conference (PEM POCUS) – Pediatric Emergency Medicine Point of Care Ultrasound.

The format will be a bit different for this episode. I’ve asked each our P2 gurus to describe a case that illustrates their favorite point of care ultrasound application, why they think it is useful, how it improves patient care, a step by step description of how to perform the application, the pearls and pitfalls of the application, and bit about what the literature says about the application. Dr. Jason Fischer on ultrasound-guided nerve blocks, Dr. Alyssa Abo on pediatric lung POCUS, Dr. Adam Sivitz on pediatric appendicitis POCUS and Dr. Alex Arroyo on intussesception.

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Best Case Ever

Best Case Ever 30 Rob Rogers’ Mother

Best Case Ever 30 Rob Rogers’ Mother

Dr-Rob-Rogers
I caught up with my friend and education innovation mentor Dr. Rob Rogers at ACEP in Chicago where he told me the tale of his mother's devastating illness - the only EM Cases occurrence of a second Best Case Ever. This powerful story begs many questions, some of which we discuss in the podcast: The importance of considering a lumbar puncture in the setting of altered mental status NYD, cognitive de-biasing strategies and the importance of being a humble patient advocate. We discuss a diagnosis that we should never miss in the ED, how to recognize it early, some pearls and pitfals, as well as how to manage it effectively. We touch how to recover from personal tragedy in anticipation of his upcoming SMACC talk in June 2015. Enough of this.....listen.
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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).
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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.
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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.
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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.
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Quick Links to Recent Emergency Medicine Cases Episodes

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

Episode 52 Uncommon Commonly Missed Orthopedic Injuries with Ivy Cheng & Hossein Mehdian

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