round table discussions on emergency medicine cases

Ep 193 The Crashing Asthmatic – Recognition and Management of Life Threatening Asthma

In this part 2 of our 2-part podcast on asthma with Dr. Sameer Mal and Dr. Leeor Sommer, we dig into the recognition and management of life-threatening asthma. We answer such questions as: what are the key elements in recognition of threatening asthma? What are the most time-sensitive interventions required to break the vicious cycle of asthma? What are the best options for dosing and administering magnesium sulphate, epinephrine, fentanyl and ketamine in the management of the crashing asthmatic? What is the role of NIPPV in the management of life-threatening asthma? What are the factors we should consider when it comes to indications for endotracheal intubation of the crashing asthmatic? What role do blood gases play in the decision to intubate? What are the most appropriate ventilation strategies in the intubated asthma patient? and many more... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:24:46-04:00April 2nd, 2024|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology, Resuscitation|Tags: airway management, Dr. Leeor Sommer, Dr. Sameer Mal, endotracheal intubation, fentanyl, ketamine, NIPPV, SABA, salbutamol, ventilation settings|3 Comments

Ep 192 ED Adult Asthma Management Strategies For Improved Prognosis – A Stepwise Approach

In this part 1 of our 2-part podcast series on Asthma Management we explore a systematic approach to managing patients presenting to the ED with asthma exacerbations. Our discussion will emphasize the critical role of a thorough history and physical examination in effectively stratifying patient risk and guiding treatment/disposition decisions. Additionally, we'll examine the importance of providing comprehensive discharge medications and instructions to mitigate both mortality and morbidity associated with asthma exacerbations. We answer questions such as: which patients, if any, require peak expiratory flow measurements in the ED? Why is it so important to add steroid MDI therapy to oral steroid therapy in patients being discharged from the ED after an asthma exacerbation? What are the most predictive variables to risk stratify patients with asthma exacerbations to help guide treatment and disposition? and many more. Stay tuned for Part 2, where we'll delve deep into the management of the crashing asthmatic. Please support EM Cases FOAMed with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-03-22T15:13:07-04:00March 19th, 2024|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology|Tags: asthma action plan, asthma risk stratification, asthma severity, Dr. Leeor Sommer, Dr. Sameer Mal, ipatropium bromide, MDIs, SABA, salbutamol|3 Comments

Ep 191 The Future of EM – Systems Thinking

In order fix EM, each of us needs to understand systems issues and systems thinking, and advocate for a better system based on sound systems principles and specific solutions. In this main episode EM Cases podcast Anton is joined by Dr. Alecs Chochinov and Dr. Davie Petrie, two systems thinkers and leaders in EM. They discuss solutions for how to fix EM in 5 spheres: having a coordinated mission, optimizing access points, accountability, disaster preparedness and adaptation/evolution. They answer questions such as: What can we glean from how EM has evolved in the last few decades to help shape the future? How can we utilize virtual care to make it work for us and our patients well? How can we improve our EMS systems? How can we change the system to prevent emergency provider burnout? How can we integrate systems thinking into the daily operations of EDs to improve patient flow and outcomes? and many more... -Support EM Cases with a Donation https://emergencymedicinecases.com/donation/

By Anton Helman|2024-02-13T11:44:56-05:00February 13th, 2024|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: access block, accountability failure, disaster preparedness, Dr. Alecs Chochinov, Dr. David Petrie, ED overcrowding, health care system, virtual health care|0 Comments

Ep 190 Carpal Bone Injuries – The Big 4

Triquetrum chip fractures, scapholunate injuries, hook of the hamate fractures, and of course, scaphoid fractures can be easily missed with serious consequences for our patients. In this part 2 of our 2-part podcast series on wrist injuries we highlight the "Big 4" most commonly missed and mismanaged carpal bone injuries, elucidating the key historical, physical exam and x-ray findings, as well as management strategies...

By Anton Helman|2024-01-23T14:43:29-05:00January 2nd, 2024|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Orthopaedics|Tags: carpal tunnel view, clenched fist view, hook of hamate fracture, lunate dislocation, lunate injury, perilunate dislocation, scaphoid fracture, scapholunate dissociation, triquetrum fracture|0 Comments

Ep 189 Commonly Missed and Mismanaged Wrist Injuries

In this part 1 or our 2-part podcast series on wrist injuries Dr. Arun Sayal and Dr. Matt DiStefano answer such questions as:when should we suspect a DRUJ injury, why is it important to pick up DRUJ injuries in the ED, and how does it change our management? Why is the lateral x-ray view so important in picking up commonly missed wrist injuries? When it comes to distal radius fractures, how are Colles vs Barton's vs Smith's fractures managed differently in the ED? What are the 2 key x-ray signs we should look for on the AP and the 2 key x-ray signs we should look for on the lateral for every wrist injury? and many more...

By Anton Helman|2024-01-02T11:13:54-05:00December 19th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Orthopaedics|Tags: Barton fracture, Colles fracture, Distal Radius Fracture, Galeazzi, Smith's fracture, TFC injury|0 Comments

Ep 188 Hemoptysis – ED Approach and Management

Key principles and approach to management of both non-massive and massive hemoptysis with Dr. Scott Weingart and Dr. Bourke Tillmann, who answer questions such as: What are the factors to consider in the decision to intubate patients with massive hemoptysis? How can one reliably distinguish hemoptysis from pseudohemoptysis? What is the evidence for tranexamic acid in patients with hemoptysis? What are the best strategies for suctioning blood from the airway to improve visualization during endotracheal intubation in crashing hemoptysis patients? What is the role of bronchoscopy and how should it be integrated into the hemoptysis management algorithm? How does one's hemorrhage control strategy change when pulmonary embolism is the underlying diagnosis? and many more... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:26:04-04:00November 7th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology, Resuscitation|Tags: bronchoscopy, ketamine facilitated awake intubation, mainstem intubation, suction catheter, TXA|2 Comments

Ep 187 Crashing Anaphylaxis – AMAX4 Algorithm and The Max McKenzie Case

I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma. The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framework... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:27:40-04:00September 26th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology, Resuscitation|Tags: AMAX4, anaphylaxis, asthma, Ben McKenzie, bronchospasm, respiratory arrest|2 Comments

Ep 186 Traumatic Dental Emergencies

In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer questions like: at what age is it safe to attempt reimplantation of an avulsed tooth in the ED? What are the 3 most time-sensitive dental trauma emergencies? When is Panorex X-ray or CT indicated in dental trauma? What is the preferred solution to transport an avulsed tooth in? What are 3 dental splinting methods we should consider for dental subluxations and avulsions? How should we handle an avulsed tooth to maximize the chances of a successful reimplantation? When are antibiotics indicated after dental trauma? What role does chlorhexidine rinses play in preventing infection after dental trauma? What are the recommended first and second line treatments for persistent dental hemorrhage? and many more...

By Anton Helman|2023-09-12T12:09:22-04:00August 22nd, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Trauma|Tags: alveolar fracture, calcium hydroxide, dental bleed, dental fracture, dental splint, dental trauma, Panorex, tongue blade bite test, tooth avulsion, tooth intrusion, tooth subluxation|0 Comments

Ep 185 Atraumatic Dental Emergencies

In this Part 1 of our 2-part podcast series on dental emergencies, with the help of Dr. Chris Nash and Dr. Richard Ngo, we tackle these atraumatic dental emergencies: infections ranging from dental caries to pulpitis and gingivitis to dental abscess, cellulitis and deep space infection, as well as acute necrotizing gingivitis, pericoronitis and dry socket. These all have specific clinical characteristics and require specific management...

By Anton Helman|2023-09-12T12:10:15-04:00August 8th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: acute necrotizing gingivitis, dental abscess, dry socket, gingivitis, pericoronitis, pulpitis|0 Comments

Ep 184 Must Know Drug Interactions in Emergency Medicine

We miss potentially dangerous and even lethal drug interactions in EM more often than we realize. In this main episode EM Cases podcast with Dr. David Juurlink and Dr. Walter Himmel we review the common categories of drugs, the high risk patients and the key drug interactions that we need to know about in Emergency Medicine... Please support EM Cases by giving a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:29:39-04:00June 27th, 2023|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Psychiatry, Toxicology|Tags: antidepressants, antipsychotics, DOACs, hyperkalemia, macrolides, neuroleptic malignant syndrome, NSAIDs, opioids, pharmacodynamics, pharmacokinetics, phosphate binders, QT prolongation, serotonin syndrome, statins|3 Comments