Ep 123 Pediatric UTI Myths and Misperceptions
On the one hand, UTI is one of the most common bacterial infections in children younger than 2 years of age and could lead to sepsis acutely and theoretically renal failure in the long run. On the other hand, it is important not to over-diagnose UTIs because we know that overuse of antibiotics increases costs, side effects and leads to antibiotic resistance. The first principles questions very much apply here: who to screen, how to screen, and what to do with the screen results. There are risks associated with not having a standardized approach to diagnosing pediatric UTIs. In this EM Cases main episode podcast with Dr. Olivia Ostrow and Dr. Michelle Science we discuss an approach to diagnosing pediatric UTIs whilst revealing some common pediatric UTI myths and misperceptions...
EMU 365 Thrombolysis in Pulmonary Embolism with Amit Shah
The final EMU365 video from EMU2018 features Dr. Amit Shah who discusses decision making and dosing around the use of thrombolytics in PE in the context of cardiac arrest, massive PE and submassive PE; the controversy around using half dose alteplase, and nuanced decision making around which patients with submassive PEs should have thrombolysis...
JJ 15 Cardiac Stress Testing After Negative ED Workup for MI
In this Journal Jam podcast we do a deep dive into the hugely complex literature of cardiac stress testing and see whether or not stress testing portends any benefit for patients who we assess in the ED for chest pain. The problem is - if stress testing doesn’t benefit our patients and isn’t a good screening test for preventing MIs, then what do we do with our low risk chest pain patients we see in the ED?
BCE 79 Pediatric UTI – Choosing Wisely
In anticipation of EM Cases Episode 123 Pediatric UTI Myths and Misconceptions, Dr. Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric UTI can lead to over-testing, over-treating and even worse outcomes...
Ep 122 Sepsis and Septic Shock – What Matters from EM Cases Course
In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? How does SIRS, qSOFA and NEWS compare in predicting poor outcomes in septic patients? Which fluid and how much fluid is best for resuscitation of the septic shock patients? What are the indications for norepinephrine, and when in the resuscitation should it be given, in light of the CENSER trial? What are the goals of resuscitation in the patient with sepsis or septic shock? When should antibiotics administered, given that the latest Surviving Sepsis Campaign Guidelines recommend that antibiotics be administered within one hour of arrival for all patients suspected of sepsis or septic shock? What are the indications for a second vasopressor after norepinephrine? Given the conflicting evidence for steroids in sepsis, what are the indications for steroids? Should we be considering steroids with Vitamin C and thiamine for patients in septic shock? What are the pitfalls of lactate interpretation, and how do serial lactates compare to capillary refill in predicting poor outcomes in light of the ANDROMEDA trial? Is procalcitonin a valuable prognostic indicator in septic patients? and many more...
EMU365 Pediatric EM Expert Panel
This EMU 365 video features Drs. Anthony Crocco, Farhan Bhanji and Angelo Mikrogianakis on a potpourri of Pediatric Emergency topics including pediatric trauma resuscitation, adjuncts in bronchiolitis management as well as disposition decision making, ketamine in procedural sedation, nuances of fluid resuscitation, antibiotics to avoid, the evidence for TXA in pediatrics, initial management of pediatric seizures including IM fosphenytoin, and more...