respiratory emergency medicine

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|2024-04-23T12:37:49-04:00April 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|2024-04-23T12:29:16-04:00March 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 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

EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients

On this month's EM Quick Hits podcast: Anand Swaminathan on the role of methylene blue in septic shock, Nour Khatib on jaw dislocation reduction techniques, Hans Rosenberg on a phenotypic approach to Crohn's disease emergencies, Gil Yehudaiff on evidence based analgesics in renal colic, Brit Long on the importance of inhaled steroids for asthma, and Andrew Petrosoniak on the "lethal diamond" in polytrauma patients and the current state of hypocalcemia in bleeding trauma patients... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Shaila Gunn|2024-04-02T22:28:08-04:00September 12th, 2023|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Genitourinary, Medical Specialty, Orthopaedics, Respirology, Resuscitation, Trauma|Tags: asthma, colitis, Crohn's, hemorrhagic shock, hypocalcemia, inhaled corticosteroid, lethal diamond, methylene blue, NSAIDs, renal colic, sepsis, TMJ dislocation, trauma resuscitation, vasopressors|1 Comment

EM Quick Hits 50 Normal Unenhanced CT Renal Colic DDx, Perichondritis, Magnesium in Pediatric Asthma, Steroids for Pneumonia, OMI Cath Lab Activation

On this month's EM Quick Hits podcast David Carr on differential diagnosis of normal unenhanced CT renal colic, Leeor Sommer on recognition and management of perichondritis and auricular abscess, Suzanne Schuh on IV magnesium sulphate for pediatric asthma, Jess McLaren on Occlusion MI ECG interpretation requiring cath lab activation and Justin Morgenstern on update on steroids for pneumonia... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:28:35-04:00July 18th, 2023|Categories: Cardiology, Ears Nose & Throat, EM Quick Hits, Emergency Medicine, Genitourinary, Medical Specialty, Pediatrics, Respirology|Tags: ACS, atrial fibrillation, chest pain, community acquired pneumonia, ECG, hyperacute T wave, magnesium sulphate, occlusion MI, pediatric asthma, PRAM score, renal infarct, Sgarbosa criteria, STEMI, steroids|0 Comments

EM Quick Hits 48 – FAST in Pediatric Trauma, Multiple Myeloma, Drowning, AKA, Global EM

In this month's EM Quick Hits: Heather Cary on the use and misuse of abdominal FAST in pediatric trauma, Hans Rosenberg and Arleigh McCurdy on the diagnosis and management of Multiple Myeloma in the ED, David Jerome on practice tips for managing the drowning patient, Brit Long and Michael Gottlieb on the diagnosis and management of Alcohol-Induced Ketoacidosis, Navpreet Sahsi on his journey to becoming a humanitarian and global EM doctor...

By Anton Helman|2023-04-25T10:48:32-04:00April 25th, 2023|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Oncology, Respirology, Resuscitation, Special Populations, Trauma, Ultrasound|Tags: AKA, alchohol ketoacidosis, drowning, FAST, global EM, multiple myeloma, pediatric trauma|2 Comments

EM Quick Hits 47 HFNC, Dissection Drugs, ADJUST-UNLIKELY for PE, Antibiotic Course Duration, Skin Glue Hacks, ESP Block, Learner Oversight

In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UNLIKELY tool for pulmonary embolism...

By Anton Helman|2023-04-01T08:22:21-04:00March 28th, 2023|Categories: Best Case Ever, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Respirology|Tags: adjust unlikely, antibiotic duration, antibiotic stewardship, aortic dissection, esmolol, ESP block, handover, HFNC, high flow nasal canulae, learner oversight, patient handoff, QI Corner, renal colic, ROX index|0 Comments

EM Quick Hits 39 Overdiagnosis, Lytics for Submassive PE, Pericardial Effusion, Hemophilia Treatment

In this month's EM Quick Hits podcast Justin Morgenstern & Eddy Lang discuss the problem of overdiagnosis in EM, Anand Swaminathan's approach to indications and dosing of thrombolytics for submassive (intermediate risk) pulmonary embolism, Tahara Bhate's QI Corner on a patient with unexplained shortness of breath, Brit Long on emergency treatment of the bleeding hemophilia patient...

By Anton Helman|2023-02-06T12:51:13-05:00June 21st, 2022|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Hematology, Medical Specialty, Respirology|Tags: hemophilia, overdiagnosis, pericardial effusion, submassive pulmonary embolism, thrombolytics|5 Comments

EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update

In this months EM Quick Hits podcast: Ken Milne expertly walks us through the 10 biggest EM papers of 2021, Brit Long on a careful structured approach to Febrile Neutropenia to improve outcomes, Catherine Varner on how not to miss Peripartum Cardiomyopathy, Joe Nemeth on Anaphylaxis update and Anand Swaminathan gives us his approach to the Crashing Asthmatic...

By Anton Helman|2022-01-26T11:38:21-05:00January 18th, 2022|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Obstetrics & Gynecology, Oncology, Respirology, Resuscitation|Tags: anaphylaxis, asthma, bias, BIPAP, crashing asthmatic, epinephrine, epistaxis, EVT, febrile neutropenia, GI bleed, hyponatremia, infant fever, IV epinephrine, magnesium, pediatric fever, pediatric pneumonia, peripartum cardiomyopathy, pink lady, steroids, stroke, therapeutic hypothermia, tPA, tranexamic acid|5 Comments