Best Case Ever is a mini podcast where an Emergency Medicine Cases guest expert describes a practice changing case, what they learned from it, and clinical pearls and pitfalls you can use on your next shift.

Best Case Ever 64 Salicylate Poisoning

In this EM Cases Best Case Ever Hans Rosenberg and Rajiv Thavanathan discuss recognition and management pearls and pitfalls in salicylate poisoning. They answer question such as: What are the most important diagnostic clues of salicylate poisoning in the patient who presents with undifferentiated fever and altered level of awareness? What is the best timing and ventilation strategy for intubation? Which electrolyte abnormalities do you need to be on the lookout for? and many more...

Best Case Ever 63 Failing Up after Medical Error

Dr. Sarah Gray tells us the story of her worst case ever and what she learned from it. About 50% of North American physicians involved in a serious medical error report increased anxiety for future errors, decreased confidence in their job, decreased job satisfaction, insomnia, PTSD, panic disorder – the list goes on. Dr. Gray shares how and why many of us react to medical error - the embarrassment, the shame, the guilt and sense of failure. She then explains the notion of acceptance that we all fail, that perfection is a myth, and how she learned that "failing up" after of the most difficult case of her career is the best choice after making a medical error...

Best Case Ever 62 Penetrating Upper Airway Injury Awake Intubation Do’s & Don’ts

If you were faced with stab wound to the neck and had to act fast, would you have a well-thought out plan that you are comfortable with? In this EM Cases Best Case Ever podcast we discuss the do's and don'ts of penetrating upper airway injury awake intubation with airway expert George Kovacs....

Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue

In anticipation of EM Cases Main Episode 100 on Disaster Medicine with Laurie Mazurik, David Kollek and Joshua Bezanson, Dr. Mazurik tells of her experience as a disaster medicine leader with keeping health care workers safe during the SARS era. If you were faced with a patient with suspected Ebola or drug resistant TB or any other biohazard patient who required intubation, would you know how to handle the situation so that you and your colleagues were safe...

Best Case Ever 60 What we can learn from Prehospital Trauma Management

In this EM Cases podcast Dr. Joel Lockwood tells his Best Case Ever of a prehospital trauma resuscitation, bringing to light the challenges faced by EMS with the complicated trauma patient. He discusses the importance of checklists, practice and simulation to help streamline the process, offloading some cognitive burden, prepare the team, reduce the change of errors, improve efficiency and etch actions into each team member's muscle memory.

Best Case Ever 59 Management of Acute Renal Failure with Volume Overload

Sometimes our renal failure patients present short of breath with volume overload and we don't have immediate access to dialysis. What then? Dr. Mike Betzner, EM doc and medical director of STARS air ambulance service and collaborator on EM Cases CritCases blog tells his Best Case Ever and his approach to this challenging clinical situation. He offers two commonly used solutions: nitroglycerin and BiPAP as well as two not so common solutions: phlebotomy and rotating BP cuffs blown to above SBP...

Best Case Ever 58 Euglycemic DKA

It's not only run of the mill DKA, starvation and alcoholic ketoacidosis that can cause a metabolic acidosis with elevated ketones. Euglycemic DKA can be caused by the newer diabetes medications sodium-glucose co-transporter 2 inhibitors like Canagliflozin; and it's important to recognize this tricky diagnosis early and initiate treatment for DKA despite a normal serum glucose level...

Best Case Ever 57 PREPARE mnemonic for Airway Management

Airway management requires a lot things; it requires not only technical skills and specific considerations of anatomy and physiology but a co-ordinated team who can communicate clearly and react to a whole slew of potentially challenging situations. On this month's Best Case Ever podcast we use the framework of a new mnemonic PREPARE to discuss human factors, situational awareness and some airway tips and tricks with intensivist Peter Brindley, human factors expert Chris Hicks and EM-intensivist Sara Gray...

Best Case Ever 56 Anion Gap Metabolic Acidosis

In this month's Best Case Ever on EM Cases Dr. Ross Claybo and Dr. Keerat Grewal tell the story of a patient with a complicated anion gap metabolic acidosis. We discuss how to sort through the differential diagnosis with a better mnemonic than MUDPILES, the controversy around administering sodium bicarbonate for metabolic acidosis, the indications for fomepizole and the value of taking time to to build a therapeutic relationship with your ED patients...

Best Case Ever 55 Pediatric Cerebral Herniation

In anticipation of the upcoming EM Cases main episode on Pediatric Polytrauma Dr. Suzanne Beno, Co-director of the Trauma Program at the Hospital for Sick Children in Toronto, tells her Best Case Ever of a child who suffers a severe traumatic head injury with signs of raised intracranial pressure and cerebral herniation. She discusses the importance of being vigilant when presented with classic patterns of injury, the use of hypertonic saline, crisis resource management and shared decision making with consultants...