round table discussions on emergency medicine cases

Episode 38: ENT Emergencies Pearls, Pitfalls, Tips and Tricks

Dr. Leeor Sommer who runs ENT hands-on workshops and Dr. Maria Ivankovic, lecturer extraordinaire on ENT emergencies discuss ENT Emergencies Pearls, Pitfalls, Tips & Tricks: Dr. Ivankovic's stepwise approach to managing epistaxis including the best local anesthetics, the use of ice to decrease nasal flow, who requires antibiotics, the management of hypertension in epistaxis, tranexamic acid for nose bleeds and managing posterior bleeds, tips for nasal and ear foreign body removal including the use of tissue adhesive, how to pick up and work up the dreaded Malignant Otitis Externa including key diagnostic pearls the best tests, sudden sensorineural hearing loss ('The Bells' Palsy of the Ear') including how to save a patient from losing their hearing, Epiglottitis including diagnostic clues and imaging findings, Pharyngitis work-up and treatment: Do we need to work-up and treat with antibiotics at all? & The Toronto Throat Score, Tips and Tricks for peritonsillar abscess drainage, Hereditary and ACE-inhibitor associated Angioedema presentations and management including the use of C1 Esterase inhibitors.

By Anton Helman|2021-04-02T13:17:21-04:00November 19th, 2013|Categories: Ears Nose & Throat, EM Cases, Emergency Medicine, Episodes, Respirology, Resuscitation|Tags: angioedema, epiglottitis, epistaxis, Leeor Sommer, malignant otitis externa, Maria Ivankovic, nasal foreign body, peritonsillar abscess, pharyngigits, pharyngitis, sudden sensorineural hearing loss, tranexamic|1 Comment

Episode 37: Anticoagulants, PCCs and Platelets

In the second part of this epic 2-part authoritative episode, Anticoagulants, PCCs & Platelets, we have Dr. Walter Himmel (also known as 'The walking encyclopedia of EM') along with Dr. Katerina Pavenski (Head of Transfusion Medicine at St. Michael's Hospital) & Dr. Jeannie Callum (Head of Transfusion Medicine at Sunnybrook Hospital) who will discuss the latest on comparative efficacy and reversal of Warfarin vs Dabigatran vs Rivaroxiban vs Abixaban, the use of prothrombin complex concentrates (PCCs), the ins and outs of thrombocytopenia & platelet transfusions, ITP, TTP, anti-platelet associated intracranial bleeds, indications for Tranexamic Acid & more...

By Anton Helman|2024-08-10T19:22:17-04:00October 7th, 2013|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Hematology, Neurology, Resuscitation|Tags: Abixaban, anticoagulants, dabigitran, ICH, intracranial hemorrhage, ITP, Jeannie Callum, Katerina Pavenski, Octaplex, PCCs, Recombinant Factor 7a, rivaroxiban, tranexamic acid, transfusions, TTP, Walter HImmel, Warfarin|1 Comment

Episode 36: Transfusions, Anticoagulants and Bleeding

In the first part of this epic 2 part must-hear episode, Transfusions, Anticoagulants & Bleeding, we have the triumphant return of Dr. Walter Himmel (also known as 'The walking encyclopedia of EM') along with Dr. Katerina Pavenski (Head of Transfusion Medicine at St. Michael's Hospital) & Dr. Jeannie Callum (Head of Transfusion Medicine at Sunnybrook Hospital) who will update you on the latest in transfusion indications & risks, managing INRs and how Wararin compares to Dabigatran, Rivaroxiban & Apixaban. They give you the authoritative low down on: Indications for red cell transfusions in different clinical scenarios (GI bleed, cardiac disease, vaginal bleeding etc) and how to give them, Risks of red cell transfusions including Host vs Graft Disease, TRALI & TACO and how to manage them, IV Iron as an alternative to red cell transfusions, Managing INRs: indications for Vit K, Prothrombin Complex Concentrates (Octaplex & Beriplex), adjusting Warfarin Dose, liver patients, and much much more.........

By Anton Helman|2024-08-10T19:22:28-04:00September 20th, 2013|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Hematology, Resuscitation|Tags: Apixiban, dabigitran, IV Iron, PCCs, Red Cell Transfusion, rivaroxiban, TACO, TRALI, Walter HImmel, Warfain|2 Comments

Episode 35: Pediatric Orthopedics Pearls and Pitfalls

Dr. Sanjay Mehta & Dr. Jonathan Pirie, two experienced Pediatric EM docs from The Hospital for Sick Children in Toronto discuss their approach to a variety of common, occult, challenging and easy to miss pediatric orthopedics diagnoses including: differentiating Septic Arthritis from Transient Synovitis of the hip, Toddler's Fracture, Tillaux Fracture, Suprachondylar Fracture, ACL tear, tibial spine & Segond fractures. They also debate the value of the Ottawa Knee Rules in kids, non-accidental trauma, pediatric orthopedic pain management, the evidence for the best management of Buckle, Greenstick, Salter 1 and 2 distal radius fractures and lateral malleolus fractures.

By Anton Helman|2025-06-01T13:12:54-04:00August 9th, 2013|Categories: EM Cases, Emergency Medicine, Episodes, Orthopaedics, Pediatrics, Trauma|Tags: ACL, Buckle Fracture, Distal Radius Fracture, Greenstick Fracture, Jonathan Pirie, Ottawa Knee Rules, Sanjay Mehta, Segond fracture, septic arthritis, suprachondylar fracture, tillaux fracture, toddler's fracture, transient synovitis|1 Comment

Episode 34: Geriatric Emergency Medicine

In this episode Dr. Don Melady, Canada's leading educator in Geriatric Emergency Medicine (Geri-EM) & Dr. Jaques Lee, one of Canada's leading researchers in Geri-EM, discuss the common yet challenging Geriatric Emergencies: a practical approach to geriatric Delirium, best practice for managing agitation and pain in the older patient, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, atypical presentations of common life threatening emergencies including ACS and surgical abdomen, key drug interactions in the geriatric patient and more..

By Anton Helman|2021-03-31T12:58:46-04:00July 8th, 2013|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Gastroenterology, Neurology, Trauma|Tags: delirium, Don Melady, drug interactions, falls, Geri-EM, Jaques Lee, Warfarin, weak and dizzy|1 Comment

Episode 33: Oncologic Emergencies

In this episode on Oncologic Emergencies Dr. John Foote (University of Toronto's CCFP(EM) residency program director) and Dr. Joel Yaphe (the director of the University of Toronto’s Annual Update in Emergency Medicine conference in Whistler), review 5 important presentations in the patient with cancer: fever, shortness of breath, altered mental status, back pain and acute renal failure; with specific attention to key cancer-related emergencies such as febrile neutropenia, hypercalcemia, superior vena cava syndrome, hyperviscosity syndrome and tumor lysis syndrome.

By Anton Helman|2021-03-31T12:59:54-04:00May 21st, 2013|Categories: EM Cases, Emergency Medicine, Episodes, Hematology, Oncology|Tags: Appendicitis, brain herniation, febrile neutropenia, Hypercalcemia, Hyperviscosity Syndrome, ICP, Joel Yaphe, John Foote, multiple myeloma, SVC Syndrome, tumor lysis syndrome, Typhlitis|2 Comments

Episode 32: Whistler Update in Emergency Medicine Conference 2013

Whistler's Update in Emergency Medicine Conference 2013 in Whistler, British Columbia is U of Toronto's case-based interactive small group EM conference. There were so may great talks with amazing clinical pearls that I decided to wade through the 18 hours of audio recordings and packaged some of the key highlights for you here......EM Literature Review 2012 by Dr. Joel Yaphe, Neonatal Resuscitation Pearls by Dr. Nicole Kester-Greene, Fever of Unknown Origin by Dr. Shirley Lee, Improving Cosmesis in Wound Management by Dr. Maria Ivankovic, Hepato-biliary Disease by Dr. Sara Gray, & Pediatric Cardiac & Respiratory Cases by Dr. Donna Goldenberg.

By Anton Helman|2022-09-05T18:03:34-04:00April 10th, 2013|Categories: Cardiology, Conference, Emergency Medicine, Episodes, Gastroenterology, Pediatrics, Respirology, Whistler Update in EM|Tags: anticoagulants, azithromycin, cholangitis, cholycystitis, FUO, gonorrhea, hepatic encephalopathy, intubation, Joel Yaphe, laceration, Maria Ivankovic, pain managment, peritonsillar abscess, pneumothorax, Sara Grey, Shirley Lee, sinusitis, tissue adhesive, wound managment|0 Comments

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