emergency medicine ophthalmology

EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality

In this month's EM Quick Hits podcast: Justin Morgenstern on the first RCT of high dose nitroglycerin in SCAPE, Andrew Neill on Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) indications and evidence, Brit Long on indications for CT in suspected diverticulitis, Tahara Bhate on Central Retinal Artery Occlusion (CRAO) and diagnostic error, Matthew McArthur on penicillin allergy labels, myths and penicillin challenges, and Susan Lu on how ED physician personality influences patient outcomes...

By Shaila Gunn|2024-04-23T11:52:10-04:00April 23rd, 2024|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Medical Specialty, Ophthalmology, Resuscitation, Trauma|Tags: allergic reaction, diverticulitis, hemorrhagic shock, nitroglycerin, penicillin, personality, roboa, SCAPE|1 Comment

EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome

In this month's EM Quick Hits podcast: Brit Long on Surving Sepsis Campaign -2021 Updates, Nour Khatib on rural medicine case - angle closure glaucoma, Reuben Strayer on bougie vs endotracheal tube and stylet on first-attempt intubation, Justin Hensley on management of frostbite, Sarah Foohey on the hot and altered patient, and Andrew Petrosoniak on central cord syndrome...

By Anton Helman|2023-02-06T13:12:57-05:00March 1st, 2022|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Ophthalmology, Plastics, Resuscitation, Toxicology, Trauma|Tags: altered mental status, bougie, central cord syndrome, fluid resuscitation, frostbite, glaucoma, hyperthermia, iloprost, sepsis, spinal cord injury, vasopressors|0 Comments

Journal Jam 18 The Evidence for TXA – Should Tranexamic Acid Be Routine Therapy in the Bleeding Patient?

With the help of a special guest, EBM guru Dr. Ken Milne of the The SGEM, Anton and Justin look at all the various potential indications for TXA and review the available evidence. Should we be using TXA for epistaxis, postpartum hemorrhage, hyphema or hemoptysis? Is it a miracle drug that stops all bleeding? Or has it been drastically overhyped? Was CRASH-2 enough to be definitive, or does the classic EBM mantra of "we need more studies" remain true?...

By Anton Helman|2023-05-14T18:12:30-04:00June 29th, 2021|Categories: EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty, Obstetrics & Gynecology, Ophthalmology, Trauma|Tags: CRASH-2, CRASH-3, DUB, epistaxis, GI bleed, HALT-IT, head injujry, hemoptysis, SAH, subarachnoid hemorrhage, tranexamic acid, TXA|2 Comments

EM Quick Hits 24 Lateral Canthotomy, Cannabis Poisoning, Hyperthermia, Malignant Otitis Externa, BBB in Occlusion MI, Prone CPR

In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis of occlusion MI in patients with BBB and Peter Brindley on prone CPR...

By Anton Helman|2022-01-10T21:02:55-05:00December 8th, 2020|Categories: Cardiology, Ears Nose & Throat, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Ophthalmology, Toxicology|Tags: cantholysis, cooling, hyperthermia, ice water bath, lateral canthotomy, LBBB, malignant otitis externa, occlusion MI, orbital compartment syndrome, otitis externa, prone chest compressions, prone CPR, RBBB, retrobulbar hematoma, STEMI|1 Comment

EM Quick Hits 5 Ludwig’s Angina, Transient Monocular Vision Loss, D-dimer for PE Workup in Pregnancy, Pediatric Nasal Foreign Bodies, Trimethoprim Drug Interactions, Airway Management in Cardiac Arrest

In this EM Quick Hits Podcast: Ludwig's Angina Emergency Management - Approach, Airway, Imaging, Transient Monocular Vision Loss (TMVL), D-dimer in the Work-up of Pulmonary Embolism in Pregnancy, Management of Pediatric Nasal Foreign Bodies: Tips and Tricks, Sulfamethoxazole-Trimethoprim Drug Interactions and Airway Options in Cardiac Arrest - LMA for all?...

By Anton Helman|2020-11-29T15:10:37-05:00June 4th, 2019|Categories: Ears Nose & Throat, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Ophthalmology, Pediatrics, Respirology, Resuscitation|Tags: cardiac arrest, D-dimer, LMA, Ludwig's angina, nasal foreign body, trimethoprim, vision loss|3 Comments

POCUS Cases 3 Idiopathic Intracranial Hypertension and Ocular POCUS

In this POCUS Cases 3 - Idiopathic Intracranial Hypertension & Ocular POCUS, Dr. Simard explains the limitations of CT head in the diagnosis of idiopathic intracranial hypertension, how to identify papilledema on ocular POCUS, how to measure Optic Nerve Sheath Diameter (ONSD) on POCUS and the limitations of ONSD on ocular POCUS.

By Anton Helman|2018-06-04T21:35:29-04:00June 4th, 2018|Categories: EM Cases, Emergency Medicine, Medical Specialty, Neurology, Ophthalmology, POCUS Cases|Tags: Dr. Rob Simard, IIH, ONSD, papilledema|0 Comments

Ep 107 Blunt Ocular Trauma Live from The EM Cases Course

In this live podcast on Blunt Ocular Trauma from The EM Cases Course 2018 with Anna MacDonald we discuss the most important diagnoses to consider, describe how physical exam in queen while CT can misguide you, explain a simple approach to orbital compartment syndrome with retrobulbar hematoma, give you tips on lateral canthotomy, how to pick up subtle hyphemas, why sickle cell patients are high risk, describe the key clinical clues to subtle globe rupture, the role of tranexamic acid in eye bleeds and much more...

By Anton Helman|2022-10-16T21:08:19-04:00February 27th, 2018|Categories: Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Ophthalmology, Whistler Update in EM|Tags: Anna MacDonald, globe rupture, hyphema, lateral conthotomy, orbital compartment syndrome, retrobulbar hematoma, TXA|2 Comments

Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions

This is EM Cases Journal Jam Podcast 6 - Outpatient Topical Anesthetics for Corneal Abrasions. I’ve been told countless times by ophthalmologists and other colleagues NEVER to prescribe topical anesthetics for corneal abrasion patients, with the reason being largely theoretical - that tetracaine and the like will inhibit re-epithelialization and therefore delay epithelial healing as well as decrease corneal sensation, resulting in corneal ulcers. With prolonged use of outpatient topical anesthetics for corneal abrasions, corneal opacification could develop leading to decreased vision. Now this might be true for the tetracaine abuser who pours the stuff in their eye for weeks on end, but when we look at the literature for toxic effects of using topical anesthetics in the short term, there is no evidence for any clinically important detrimental outcomes. Should we ignore the dogma and use tetracaine anyway? Is there evidence that the use of topical anesthetics after corneal abrasions is safe and effective for pain control without adverse effects or delayed epithelial healing? To discuss the paper "The Safety of Topical Anesthetics in the Treatment of Corneal Abrasions: A Review" by Drs. Swaminathan, Otterness, Milne and Rezaie published in the Journal of Emergency Medicine in 2015, we have EM Cases’ Justin Morgenstern, a Toronto-based EM Doc, EBM enthusiast as well as the brains behind the First10EM blog and Salim Rezaie, Clinical Assistant Professor of EM and Internal Medicine at University of Texas Health Science Center at San Antonio as well as the Creator & Founder of the R.E.B.E.L. EM blog and REBELCast podcast. In this Journal Jam podcast, Dr. Morgenstern and Dr. Rezaie also discuss a simple approach to critically appraising a systematic review article, how to handle consultants who might not be aware of the literature and/or give you a hard time about your decisions and much more...

By Anton Helman|2019-11-11T15:55:23-05:00March 29th, 2016|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Ophthalmology|Tags: corneal abrasion, Justin Morgenstern, Salim Rezaie, systematic review, tetracaine, topical anesthetics|0 Comments

Episode 9: Nontraumatic Eye Emergencies

Nontraumatic Eye Emergencies are seldom very satisfying for the emergency physician to manage. However, with systematic approach and timely management they can save a patient's vision. Dr. George Porfiris and Dr. Simon Kingsley discuss four non-traumatic eye emergency presentations. The painful red eye, the painless red eye, acute painful loss of vision and acute painless loss of vision. Several cases are discussed in which an accurate diagnosis and timely ED management are of critical importance in order to prevent permanent vision loss and significant morbidity. A systematic approach to the eye examination is described with particular attention to important maneuvers such as the swinging flashlight test. The utility of ED ultrasound of the eye is debated, and a discussion around systemic diseases that cause eye problems provides fodder for many clinical pearls.

By Anton Helman|2021-03-31T13:33:31-04:00November 22nd, 2010|Categories: Ears Nose & Throat, EM Cases, Emergency Medicine, Episodes, Ophthalmology|Tags: George Porfiris, glaucoma, iritis, optic neuritis, painful loss of vision, painful red eye, painless loss of vision, painless red eye, POCUS, retinal artery occlusion, Simon Kingsley, subarachnoid hemorrhage, temporal arteritis|1 Comment