round table discussions on emergency medicine cases

Ep 189 Commonly Missed and Mismanaged Wrist Injuries

In this part 1 or our 2-part podcast series on wrist injuries Dr. Arun Sayal and Dr. Matt DiStefano answer such questions as:when should we suspect a DRUJ injury, why is it important to pick up DRUJ injuries in the ED, and how does it change our management? Why is the lateral x-ray view so important in picking up commonly missed wrist injuries? When it comes to distal radius fractures, how are Colles vs Barton's vs Smith's fractures managed differently in the ED? What are the 2 key x-ray signs we should look for on the AP and the 2 key x-ray signs we should look for on the lateral for every wrist injury? and many more...

By Anton Helman|2024-06-18T19:42:16-04:00December 19th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Orthopaedics|Tags: Barton fracture, Colles fracture, Distal Radius Fracture, Galeazzi, Smith's fracture, TFC injury|0 Comments

Ep 188 Hemoptysis – ED Approach and Management

Key principles and approach to management of both non-massive and massive hemoptysis with Dr. Scott Weingart and Dr. Bourke Tillmann, who answer questions such as: What are the factors to consider in the decision to intubate patients with massive hemoptysis? How can one reliably distinguish hemoptysis from pseudohemoptysis? What is the evidence for tranexamic acid in patients with hemoptysis? What are the best strategies for suctioning blood from the airway to improve visualization during endotracheal intubation in crashing hemoptysis patients? What is the role of bronchoscopy and how should it be integrated into the hemoptysis management algorithm? How does one's hemorrhage control strategy change when pulmonary embolism is the underlying diagnosis? and many more... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:26:04-04:00November 7th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology, Resuscitation|Tags: bronchoscopy, ketamine facilitated awake intubation, mainstem intubation, suction catheter, TXA|2 Comments

Ep 187 Crashing Anaphylaxis – AMAX4 Algorithm and The Max McKenzie Case

I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma. The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framework... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:27:40-04:00September 26th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology, Resuscitation|Tags: AMAX4, anaphylaxis, asthma, Ben McKenzie, bronchospasm, respiratory arrest|2 Comments

Ep 186 Traumatic Dental Emergencies

In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer questions like: at what age is it safe to attempt reimplantation of an avulsed tooth in the ED? What are the 3 most time-sensitive dental trauma emergencies? When is Panorex X-ray or CT indicated in dental trauma? What is the preferred solution to transport an avulsed tooth in? What are 3 dental splinting methods we should consider for dental subluxations and avulsions? How should we handle an avulsed tooth to maximize the chances of a successful reimplantation? When are antibiotics indicated after dental trauma? What role does chlorhexidine rinses play in preventing infection after dental trauma? What are the recommended first and second line treatments for persistent dental hemorrhage? and many more...

By Anton Helman|2024-06-18T19:46:17-04:00August 22nd, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Trauma|Tags: alveolar fracture, calcium hydroxide, dental bleed, dental fracture, dental splint, dental trauma, Panorex, tongue blade bite test, tooth avulsion, tooth intrusion, tooth subluxation|0 Comments

Ep 185 Atraumatic Dental Emergencies

In this Part 1 of our 2-part podcast series on dental emergencies, with the help of Dr. Chris Nash and Dr. Richard Ngo, we tackle these atraumatic dental emergencies: infections ranging from dental caries to pulpitis and gingivitis to dental abscess, cellulitis and deep space infection, as well as acute necrotizing gingivitis, pericoronitis and dry socket. These all have specific clinical characteristics and require specific management...

By Anton Helman|2024-06-18T19:46:46-04:00August 8th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: acute necrotizing gingivitis, dental abscess, dry socket, gingivitis, pericoronitis, pulpitis|0 Comments

Ep 184 Must Know Drug Interactions in Emergency Medicine

We miss potentially dangerous and even lethal drug interactions in EM more often than we realize. In this main episode EM Cases podcast with Dr. David Juurlink and Dr. Walter Himmel we review the common categories of drugs, the high risk patients and the key drug interactions that we need to know about in Emergency Medicine... Please support EM Cases by giving a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:29:39-04:00June 27th, 2023|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Psychiatry, Toxicology|Tags: antidepressants, antipsychotics, DOACs, hyperkalemia, macrolides, neuroleptic malignant syndrome, NSAIDs, opioids, pharmacodynamics, pharmacokinetics, phosphate binders, QT prolongation, serotonin syndrome, statins|3 Comments

Ep 183 STIs: Pelvic Inflammatory Disease and Genital Lesions – HSV, Syphilis and LVG

In this part 2 of our 2-part series on STIs with Dr. Catherine Varner and Dr. Robyn Shafer we answer such questions as: Why should we care about making the diagnosis of pelvic inflammatory disease (PID) in the ED? What combination of clinical features and lab tests should trigger a presumptive diagnosis and empiric treatment of PID? Which patients with PID require admission to hospital? What are the test characteristics of ultrasound for the diagnosis of PID and for Fitz-Hugh-Curtis Syndrome? When and how should we work up patients for syphilis in the ED? When should we suspect and empirically treat for lymphogranuloma venereum and granuloma inguinale? does an IUD need to be removed in patients with PID? and many more...

By Anton Helman|2024-06-18T19:49:55-04:00May 23rd, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty, Obstetrics & Gynecology, Uncategorized|Tags: Chancroid, genital ulcers, granuloma inguinale, LGV, lymphogranuloma venereum, pelvic inflammatory disease, PID, syphilis|0 Comments

Ep 182 STIs: Cervicitis, Vulvovaginitis and Urethritis Emergency Recognition and Management

In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key...

By Anton Helman|2024-06-18T19:50:14-04:00May 9th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty|Tags: bacterial vaginosis, chlamydia, gonorrhea, mycoplasma genitalium, STI, trichomoniasis|0 Comments

Ep181 Cerebral Venous Thrombosis, Idiopathic Intracranial Hypertension, Giant Cell Arteritis and Peripartum Headaches

In this episode, Dr. Roy Baskind and Dr. Ahmit Shah answer such questions as: when is an opening pressure on LP required? When should we pull the trigger on ordering a CT venogram in the patient with unexplained headache? Which older patients who present with headache require an ESR/CRP? How do the presentations of cerebral venous thrombosis (CVT) and idiopathic intracranial hypertension (IIH) compare and contrast? When is it safe to start steroids in the ED for patients suspected of giant cell arteritis (GCA); will starting steroids affect the accuracy of a temporal artery biopsy? How soon should patients suspected of GCA get a temporal artery biopsy? When should we consider posterior reversible encephalopathy syndrome (PRES) and pituitary apoplexy in the peripartum patient? How should we think about the differential diagnosis of vascular headaches? and many more...

By Anton Helman|2024-07-10T22:32:00-04:00April 11th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: cerebral venous thrombosis, CT venogram, CVT, Dr. Ahmit Shah, Dr. Roy Baskind, GCA, giant cell arteritis, idiopathic intracranial hypertension, IIH, peripartum headache, PRES, vascular headaches|1 Comment

Ep 180 Acetaminophen Poisoning – Pitfalls in Assessment and Management

In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes? What are the common ways in which we misinterpret the Rumack-Matthew nomogram? What are indications for fomepizole and dialysis after acetaminophen poisoning? Is hyperphosphatemia the best predictor of need for liver transplant in acetaminophen poisoning? and many more... Please support EM Cases by giving a donation: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-04-02T22:30:17-04:00March 14th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Toxicology|Tags: APAP, fomepizole, massive overdose, N-acetylcysteine, NAC, Rumack-Matthew nomogram|0 Comments