Anton Helman, Author at Emergency Medicine Cases

Episode 31: LP, Spontaneous Pneumothorax and Ultrasound Guided Fracture Reduction

In this episode, Dr. Jordan Chenkin & Dr. Jamie Blicker discuss positioning, landmarking, and best technique for lumbar puncture, how to minimize post-LP headache and traumatic taps, as well as when CT head is not required prior to LP. They discuss the indications, contraindications, trouble-shooting and pros and cons of needle aspiration, small bore pleural catheter with Heimlich valve and large bore chest tube for the treatment of spontaneous pneumothorax. Dr. Chenkin presents an intriguing argument for why he uses ultrasound-guided fracture reduction routinely in the ED, and we end with a few tips and tricks using skin adhesive for some unorthodox indications.

By Anton Helman|2021-03-31T13:02:17-04:00March 11th, 2013|Categories: EM Cases, Emergency Medicine, Episodes, Neurology, Orthopaedics, Respirology|Tags: fracture managment, Heimlich valve, Jamie Blicker, Jordan Chenkin, lumbar puncture, pigtail cathether, POCUS, post-LP headache, spontaneous pneumothorax, ultrasound|2 Comments

Episode 30: Central Lines, Surgical Airways and Pericardiocentesis

In this episode dedicated to emergency procedures pearls and pitfalls, tips and tricks, Dr. Jordan Chenkin & Dr. Jamie Blicker take us step by step through how best to perform surgical airways and pericardiocentesis, as well as place central lines and intraosseous lines. They explain the various methods for surgical airways including the bougie-assisted surgical airway. They review the indications, contraindications, and complications for all of these life saving procedures, and give us some amazing tips and tricks on what to do when things aren't going as expected.

By Anton Helman|2021-03-31T13:03:23-04:00February 11th, 2013|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Resuscitation|Tags: bougie, central line, Cricothyrotomy, intraosseus line, Jamie Blicker, Jordan Chenkin, pericardiocentesis, surgical airway|0 Comments

Episode 29: Hand Emergencies

Dr. Andrew Arcand & Dr. Laura Tate discuss the key clinical pearls and pitfalls in the recognition and management of many apparently benign hand emergencies that have serious morbidity, including high pressure injection injuries, flexor tenosynovitis, gamekeeper's thumb, fight bites, hook of the hammate fractures and many more important hand emergencies. Dr. Tate & Arcand answer such questions as: which lacerations require prophylactic antibiotics? Which hand lacerations do not require sutures? How is rotational deformity best tested for metacarpal fractures? What are the pearls of tendon repair? How do you test for instability when you suspect a Gamekeeper's thumb? How is compartment syndrome of the hand different to compartment syndrome in the leg? What are Kanavel's signs of tenosynovitis? How should felons be managed in the ED? What are the most common errors that plastic surgeons see ED docs make?

By Anton Helman|2021-03-31T13:04:02-04:00January 15th, 2013|Categories: EM Cases, Emergency Medicine, Episodes, Orthopaedics, Trauma|Tags: Andrew Arcand, fight bite, flexor tenosynovitis, gamekeeper's thumb, high pressure injection injuries, hook of the hammate fracture, Laura Tate|4 Comments

Best Case Ever 14: High Pressure Injection Injury

Dr. Laura Tate, plastic surgeon extraordinaire, presents her best hand emergency case. In the upcoming episode, she and Dr. Andrew Arcand will discuss key pearls and pitfalls in the recognition and management of flexor tenosynovitis, high pressure injection injuries, fight bites, hook of the hammate fractures, gamekeeper's thumb and many more potentially devastating hand emergencies.

By Anton Helman|2016-10-20T12:48:55-04:00December 26th, 2012|Categories: Best Case Ever, EM Cases, Emergency Medicine, Orthopaedics, Trauma|Tags: high pressure injection injuries, Laura Tate|0 Comments

Best Case Ever 13: Aortic Dissection

Dr. David Carr, the past author of Tintinalli's chapter on occlusive arterial disease, tells us his Best Case Ever related to Aortic Dissection. In the related Episode 28: Aortic Dissection, Acute Limb Ischemia & Compartment Syndrome, we discuss the breadth of presentations and key diagnostic clues of Aortic Dissection. We review the value of ECG, CXR, biomarkers and the use of Transesophageal Echo and CTA in this sometime elusive diagnosis. We debate lots of clinical pearls and pitfalls when it comes to acute limb ischemia, and end with a discussion on the trials and tribulations of Compartment Syndrome. [wpfilebase tag=file id=398 tpl=emc-play /] [wpfilebase tag=file id=399 tpl=emc-mp3 /]

By Anton Helman|2020-05-31T23:19:18-04:00November 11th, 2012|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Neurology|Tags: aortic dissection, D-dimer, David Carr, echocardiogram, troponin|0 Comments

Episode 27: Drugs of Abuse – Stimulants and Opiates

Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more....

By Anton Helman|2021-03-31T13:05:16-04:00October 15th, 2012|Categories: EM Cases, Emergency Medicine, Episodes, Toxicology|Tags: acute coronary syndrome, bath salts, cocaine, dantrolene, drug screen, dysrhthmia, ecstacy, hypertensive emergency, levamisole, Lisa Thurgur, Margaret Thompson, naloxone, opiate, seizure, sympathomimetic, vasculitis|0 Comments

Best Case Ever 12: Drugs of Abuse

As a bonus to Episode 27 on Drugs of Abuse -Stimulants & Opiates, Dr. Margaret Thompson, one of Canada's leading Toxicologists and the medical director of the Ontario Poison Control Centre tells us 2 of her Best Cases Ever about stimulant overdose surprises. In the related Episode, Dr. Margaret Thompson & Dr. Lisa Thurgur Canada's toxicologist gurus discuss several cases of stimulant drugs of abuse such as cocaine, MDMA & bath salts, as well as the pearls and pitfalls of managing opiates toxicity. We discuss: The management of the intoxicated patient including seizures, dysrhythmias, cardiac ischemia and hypertensive emergencies related to cocaine toxicity, the recognition and management of necrotizing vasculitis caused by cocaine cut with Levamisole, the differential diagnosis and management of the "hot and crazy" patient, including the role of dantrolene and cyproheptidine, pearls and pitfalls of naloxone, the utility of urine drug screens and much more.... [wpfilebase tag=file id=396 tpl=emc-play /] [wpfilebase tag=file id=397 tpl=emc-mp3 /]

By Anton Helman|2019-11-11T21:38:55-05:00October 7th, 2012|Categories: Best Case Ever, EM Cases, Emergency Medicine, Resuscitation, Toxicology|Tags: acute coronary syndrome, bath salts, cocaine, dantrolene, drug screen, dysrhthmia, ecstacy, hypertensive emergency, levamisole, Lisa Thurgur, Margaret Thompson, naloxone, opiate, seizure, sympathomimetic, vasculitis|0 Comments

Episode 26: Low Back Pain Emergencies

In this episode we go through seven cases that display the breadth of presentations of limb or life threatening causes of low back pain emergencies with my huge mentors, Dr. Walter Himmel and Dr. Brian Steinhart. We cover everything from spinal epidural abscess to cauda equina syndrome to retroperitoneal bleeds, elucidating the key historical, physical exam, lab, imaging and treatment pearls for all of these diagnoses. We then go on to review the best management for the most common cause of back pain presentation, lumbosacral strain and debate the various medication options.

By Anton Helman|2022-01-05T23:26:07-05:00September 12th, 2012|Categories: EM Cases, Emergency Medicine, Episodes, Neurology, Oncology, Orthopaedics|Tags: Brian Steinhart, cauda equina syndrome, disc herniation, inflammatory markers, lumbosacral sprain, mechanical low back pain, metastatic cancer, pain managment, retroperitoneal bleed, siatica, spinal cord compression, spinal epidural hematoma, Walter HImmel|2 Comments

Best Case Ever 11: Cauda Equina Syndrome

As a bonus to Episode 26 on Low Back Pain Emergencies with Dr. Brian Steinhart & Dr. Walter Himmel, we have Dr. Walter Himmel's own personal incredible case of Cauda Equina Syndrome. In the related Episode we will cover the most serious spinal and vascular causes that present with low back pain including Cauda Equina Syndrome, Spinal Epidural Abscess, Spinal Epidural Hematoma, Metastases to the spine, Abdominal Aortic Aneurysm and Retroperitoneal Hematoma. [wpfilebase tag=file id=394 tpl=emc-play /] [wpfilebase tag=file id=395 tpl=emc-mp3 /]

By Anton Helman|2022-01-04T19:51:07-05:00September 6th, 2012|Categories: Best Case Ever, EM Cases, Emergency Medicine, Neurology|Tags: abdominal aortic aneurysm, Brian Steinhart, cauda equina syndrome, disc herniation, inflammatory markers, lumbosacral sprain, mechanical low back pain, metastatic cancer, pain managment, retroperitoneal bleed, siatica, spinal cord compression, spinal epidural hematoma, Walter HImmel|2 Comments

Episode 25: Pediatric Syncope and Adult Syncope

In this episode on Pediatric Syncope & Adult Syncope, Dr. Eric Letovksy & Dr. Anna Jarvis run through the key clinical pearls of the history, the physical, interpretation of the ECG and the value of clinical decision rules such as the ROSE rule and the San Francisco Syncope Rule in working up these patients. We discuss how to differentiate syncope from seizure, cardiac causes of syncope such as Arrhthmogenic Right Ventricular Cardiomyopthy & Prolonged QT Syndrome, and the indications for Holter monitoring, Echocardiograms and stress testing in patients with Syncope. Dr. Letvosky & Dr. Jarvis answer such questions as: How can we diagnose Hypertrophic Cardiomyopathy in the ED? What is the value of Troponin and BNP in the work-up of syncope? In what ways are patients with Down Syndrome at high risk for serious causes of syncope? In what ways are patients with alcohol dependence at risk for serious causes of syncope? Why is 'Benign' early repolarization not a benign condition in patients with syncope? Which children with syncope should be admitted? and many more....

By Anton Helman|2025-06-01T13:04:33-04:00July 16th, 2012|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Pediatrics|Tags: Anna Jarvis, benign early repolarization, BNP, clinical decsion rules, echocardiogram, Eric Letovsky, holter, hypertrophic cardiomyopathy, prolonged QT, troponin|0 Comments

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