Conference Archives - Page 3 of 4 - Emergency Medicine Cases

Episode 92 – Aortic Dissection Live from The EM Cases Course

While missing aortic dissection was considered "the standard" in the late 20th century, our understanding of the clinical diagnoses has improved considerably since the landmark International Registry of Aortic Dissection (IRAD) study in 2000. Nonetheless, aortic dissection remains difficult to diagnosis with 1 in 6 being missed at the initial ED visit. With the help of Dr. David Carr we’ll discuss how to pick up atypical presentations of aortic dissection without over-imaging as well as manage them like pros by reviewing: 1. The 5 Pain Pearls, 2. The concepts of CP +1 and 1+ CP, 3. Physical exam pearls, 4. CXR pearls and blood test pitfalls, and 5. The importance of the correct order and aggressive use of IV medications. So with these objectives in mind…

By Anton Helman|2024-05-21T01:36:54-04:00February 21st, 2017|Categories: Cardiology, Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: David Carr, EM Cases Course, esmolol, labetolol, troponin|0 Comments

Episode 83 – 5 Critical Care Controversies from SMACC Dublin

EM Cases Episode 83 - 5 Critical Care Controversies from SMACC Dublin: I had the great opportunity to gather some of the brightest minds in Emergency Medicine and Critical Care from around the world (Mark Forrest from U.K., Chris Nickson from Australia, Chris Hicks from Canada and Scott Weingart from U.S.) at the SMACC Dublin Conference and ask them about 5 Critical Care Controversies and concepts: How to best prepare your team for a resuscitation Optimum fluid management in sepsis Direct vs. video laryngoscopy as first line tool for endotracheal intubation Early vs. late trauma intubation Whether or not to attempt a thoracotomy in non-trauma centres The discussion that ensued was enlightening...

By Anton Helman|2021-03-30T14:46:15-04:00July 5th, 2016|Categories: Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Resuscitation, Trauma|Tags: Chris Hicks, Chris Nickson, fluid responsiveness, fluid tolerance, Mark Forrest, rally point, Scott Weingart, team preparation, thoracotomy, trauma intubation, vasopressors|0 Comments

Episode 81 – A Balanced View on Recent EM Literature with Joel Yaphe

EM Cases - A Balanced View on recent EM Literature with Joel Yaphe Being an optimist, I'm constantly searching for EM literature that will change my practice in a positive way and ultimately improve the care that I deliver. The past year was filled with promising papers, some of which received a lot of attention. I'm not the only one who is biased towards craving a positive paper - so are the researchers, the journal editors and the public. We all want our field to mightily move forward! Enter Dr. Joel Yaphe. An EM Residency Program Director at University of Toronto and an ED doc who I admire for his balanced, sensible and practical approach to appraising the literature. In this episode Dr. Yaphe, at University of Toronto's Update in EM Conference - Whistler, leads us through a few key articles from the past year including the REVERT trial to convert SVT, medical expulsive therapy for urolithiasis, steroids in anaphylaxis, and analgesics for low back pain, and discusses whether they should (or rather, should not) change our practice. He challenges authors' conclusions and questions whether the findings are relevant to our patients....

By Anton Helman|2021-03-30T14:51:38-04:00May 23rd, 2016|Categories: Emergency Medicine, Episodes, Genitourinary, Medical Specialty, Whistler Update in EM|Tags: Joel Yaphe, low back pain, medical expulsive therapy, nephrolithiasis, renal colic, REVERT trial, SVT, tamsulosin, Whistler|0 Comments

Best Case Ever 45 – Mike Winters on Cardiac Arrest

I had the great pleasure of meeting Dr. Mike Winters on his first ever visit to Canada at North York General's Emergency Medicine Update Conference, where he gave two fantastic presentations. His credentials are impressive: He is the Medical Director of the Emergency Department, Associate Professor in both EM and IM, EM-IM-Critical Care Program co-director and Residency Program Director of EM-IM at the University of Maryland in Baltimore. Sometimes we are so caught up with the job we need to get done during cardiac arrest that we forget about the important and profound effect that this event has on patients' families. On this Best Case Ever Dr. Winters tells the story of witnessing his grandfather's cardiac arrest, being present in the ED during the resuscitation attempts, and how that experience has coloured his practice. We discuss some pearls on communication with patients' families after death, colour-coded cardiac arrest teams and how to integrate POCUS into cardiac arrest care while minimizing chest compressions.

By Anton Helman|2020-05-31T23:22:52-04:00May 10th, 2016|Categories: Best Case Ever, Cardiology, Clinical Practice, Emergency Medicine, Medical Specialty, NYGH EM Update, Resuscitation, Ultrasound|Tags: cardiac arrest, Mike Winters, patient centered care, patient communication, POCUS|1 Comment

Episode 78 Anaphylaxis and Anaphylactic Shock – Live from The EM Cases Course

Anaphylaxis is the quintessential medical emergency. We own this one. While the vast majority of anaphylaxis is relatively benign, about 1% of these patients die from anaphylactic shock. And usually they die quickly. Observational data show that people who die from anaphylaxis and anaphylactic shock do so within about 5-30mins of onset, and in up to 40% there’s no identifiable trigger. The sad thing is that many of these deaths are because of two simple reasons: 1. The anaphylaxis was misdiagnosed and 2. Treatment of anaphylaxis and anaphylactic shock was inappropriate. So there’s still lots of room for improvement when it comes to anaphylaxis and anaphylactic shock management. With the help of Dr. David Carr of Carr's Cases fame, we’ll discuss how to pick up atypical presentations of anaphylaxis, how to manage the challenging situation of epinephrine-resistant anaphylactic shock, whether or not we should abandon steroids, a rare but ‘must know’ diagnosis related to anaphylaxis, and much more. Plus, we have a special guest apperance by George Kovacs, airway guru, to walk us through an approach to the impending airway obstruction we might face in anaphylaxis.

By Anton Helman|2023-09-26T13:11:01-04:00March 15th, 2016|Categories: Conference, Emergency Medicine, Episodes, Medical Specialty, Resuscitation|Tags: anaphylactic shock, David Carr, George Kovacs, IV epinephrine, Kounis Syndrome, push dose pressors|1 Comment

Episode 66 Backboard and Collar Nightmares from Emergency Medicine Update Conference

In the first of our series on Highlights from North York General's Emergency Medicine Update Conference, Dr. Kylie Boothdiscusses Backboard and Collar Nightmares. The idea that backboards and c-spine collars prevent spinal cord injuries came from level 3 evidence in the 1960's and there has never been an RCT to prove this theory. In fact a Cochrane review on the topic in 2007 concluded that "the effect of pre-hospital spinal immobilisation on mortality, neurological injury, spinal stability and adverse effects in trauma patients remains uncertain" and that "the possibility that immobilisation may increase mortality and morbidity cannot be excluded". There have subsequently been several observational studies that describe increased morbidity and mortality associated with backboard and collars in a subset of patients. Dr. Booth argues that the time has long past that a major paradigm shift needs to occur toward a safer more rational use of backboards and collars in our trauma patients.

By Anton Helman|2021-03-30T16:46:31-04:00June 9th, 2015|Categories: Conference, EM Cases, Episodes, NYGH EM Update, Trauma|Tags: backboard, BB&C, c-spine, c-spine collar, Canadian c-spine rule, clinical decision rules, spinal cord injury|2 Comments

Best Case Ever 36 Tracheo-innominate Fistula

In this Best Case Ever with Dr. Scott Weingart, the brains behind EMcrit.org, we hear the devastating story of a tracheostomy gone bad. Dr. Weingart shares with us what he has learned about how to manage massive hemoptysis in tracheostomy patients, and in particlar, a step-wise approach to managing a tracheo-innominate fistula. We discuss the balance between providing maximal aggrressive critical care while maintaining a deep respect for the risks associated with the procedures we perform. Recorded at North York General's EM Update Conference 2015.

By Anton Helman|2017-02-05T14:58:12-05:00June 2nd, 2015|Categories: Best Case Ever, Conference, Ears Nose & Throat, Emergency Medicine, Medical Specialty, NYGH EM Update, Resuscitation|Tags: EMU, hemoptysis, Scott Weingart, tracheostomy|0 Comments

Episode 64 Highlights from Whistler’s Update in EM Conference 2015 Part 2

In this Part 2 of EM Cases' Highlights from Whistler's Update in EM Conference 2015 Dr. David Carr gives you his top 5 pearls and pitfalls on ED antibiotic use including when patients with sinusitis really require antibiotics, when oral antibiotics can replace IV antibiotics, how we should be dosing Vancomycin in the ED, the newest antibiotic regimens for gonorrhea and the mortality benefit associated with antibiotic use in patients with upper GI bleeds. Dr. Chris Hicks gives you his take on immediate PCI in post-cardiac arrest patients with a presumed cardiac cause and The Modified HEART Score to safely discharge patients with low risk chest pain.

By Anton Helman|2024-08-09T21:15:19-04:00May 13th, 2015|Categories: Cardiology, Conference, Ears Nose & Throat, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Resuscitation, Whistler Update in EM|Tags: cardiac arrest, chest pain, Chris Hicks, David Carr, gonorrhea, HEART score, McIasaac score, PCI, pharyngitis, PROCAT, sinusitis, vancomycin|0 Comments

Episode 61 Whistler’s Update in EM Conference 2015 Highlights Part 1

This EM Cases episode is Part 1 of The Highlights of The University of Toronto, Divisions of Emergency Medicine, Update in EM Conference from Whistler 2015 with Paul Hannam on Pearls and Pitfalls of Intraosseus Line Placement, Anil Chopra on who is at risk and how to prevent Contrast Induced Nephropathy, and Joel Yaphe on the Best of EM Literature from 2014, including reduction of TMJ dislocations, the TRISS trial (on transfusion threshold in sepsis), PEITHO study for thrombolysis in submassive PE, Co-trimoxazole and Sudden Death in Patients Receiving ACE inhibitors or ARBs, the effectiveness and safety of outpatient Tetracaine for corneal abraisons, chronic effects of shift work on cognition and much more...

By Anton Helman|2024-08-09T21:15:57-04:00March 26th, 2015|Categories: Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Orthopaedics, Resuscitation, Whistler Update in EM|Tags: Anil Chopra, CIN, Contrast Nephropathy, corneal abrasion, intraosseous, IO, Joel Yaphe, Paul Hannam, PEITHO, pulmonary embolism, TMJ dislocation, TRISS trial, Update in EM Conference, VISAT|1 Comment

Episode 47: Evidence Based Medicine from NYGH EMU Conference 2014

Dr. Walter Himmel (the 'walking encyclopedia of EM') gave a fantastic talk from North York General's Emergency Medicine Update Conference in Toronto, which have edited into a podcast with key commentary and summaries. Dr. Himmel eloquently shows us, through absolutely stunning personal cases, how evidence based medicine can be appropriately or inappropriately applied in real practice, resulting in major outcome differences for your patients. He elucidates the importance of clinical experience, patient values and ED resources in helping apply the medical literature to your practice. He reviews the essence of critical appraisal, the hierarchy of evidence and how to keep up with the emergency medicine literature. The famous NINDS thrombolysis for stroke trial is distilled down to a few key considerations and the NEJM transfusion for upper GI bleed trial from last year is dissected, analyzed and then applied to Dr. Himmel's personal cases, to help us understand exactly how to apply the literature to our daily practice. Blog post and written summary prepared by Keerat Grewal, edited by Anton Helman July 2014

By Anton Helman|2021-03-30T17:06:00-04:00July 8th, 2014|Categories: Clinical Practice, Conference, EM Cases, Emergency Medicine, Episodes, Gastroenterology, Neurology, NYGH EM Update|Tags: critical apprraisal, EBM, evidence based medicine, GI bleed, NINDS, thrombolysis, Walter HImmel|4 Comments