Journal Jam Podcast

JJ 23 Laceration Aftercare – Dressings, Antibiotics, Improving Cosmesis, Preventing Infection

In this Part 3 of our 3-part podcast series on management of lacerations Dr. Haley Cochrane joins Anton and Justin to explore laceration aftercare and the evidence for keeping wounds dry or wet, wound dressings, topical antibiotics, prophylactic oral antibiotics, Vitamin E oil, aloe vera cream and UV protection with regards to cosmetic outcomes and infection rates. What may be the most important aspect of aftercare is educating the patient what to expect as the laceration heals and when they should seek medical attention...

By Anton Helman|2023-05-14T17:57:10-04:00February 14th, 2023|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Plastics|Tags: augmentin, clavulin, prophylactic antibiotics, topical antibiotics, vitamin E oil, wound dehiscence, wound dressings|1 Comment

JJ 22 Laceration Repair – Glue vs Strips vs Staples vs Sutures

In this Part 2 of our 3-part Journal Jam series on Laceration Management we dive into the evidence for the choice of material to close lacerations. Which is best for which kind of laceration? Surgical skin glue? Wound adhesive strips? Surgical staples? Absorbable sutures? Nonabsorbable sutures?...

By Anton Helman|2023-05-14T18:01:06-04:00January 17th, 2023|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Plastics|Tags: absorbable sutures, Dermabond, Dr. Haley Cochrane, hair apposition technique, laceration, skin glue, Steristrips, surgical glue, tissue adhesive|3 Comments

Journal Jam 21 Laceration Management – Does Timing of Closure, Irrigation, Gloves Type, Eversion Matter?

In this Journal Jam podcast Anton and Justin welcome special guest Dr. Haley Cochrane. We dive deep into the evidence for timing of closure and infection rate, fluid choice, volume and pressure of irrigation of lacerations, glove type and infection rate, how eversion of wound edges effects cosmetic outcomes and much more. You might be surprised to discover that the evidence for many things we do for lacerations that are considered "standard of care", is either weak or non-existent. But do not fret - we deliver practical bottom line practical recommendations to help improve outcomes, save time and decrease resource utilization...

By Anton Helman|2023-05-14T18:02:15-04:00December 6th, 2022|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Plastics|Tags: EBM, laceration repair, povidone-iodine, sterile gloves, wound irrigation|8 Comments

JJ 20 Outpatient Medications for COVID-19

In this Journal Jam podcast we dig deep into the science of FDA-approved outpatient medications for COVID with 3 critical appraisal masters: Dr. Andrew Morris, Dr. Rohit Mohindra and Dr. Justin Morgenstern. What is the evidence for the neutralizing monoclonal antibody medications like Sotrovimab? The nucleoside analogs like Remdesivir and Paxlovid? The inhaled corticosteroids like Budesonide and Ciclesonide? The SSRIs like Fluvoxamine? As you'll hear, there are many ways to interpret the data and a variety of philosophies on prescribing medications that have not had enough time to be studied adequately in a pandemic where millions of lives have been lost and we do not have much to offer patients to reduce morbidity and mortality...

By Anton Helman|2023-05-14T18:04:26-04:00February 14th, 2022|Categories: COVID-19, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty|Tags: Budesonide, Ciclesonide, Evusheld, Fluvoxamine, Molnupiravir, Paxlovid, Remdesivir, Sotrovimab|2 Comments

Journal Jam 19 Therapeutic Hypothermia After Cardiac Arrest – Mixed Evidence

In this Journal Jam podcast, special guest Dr. Mizuho Morrison joins Anton and Justin to clear up the muddy waters of therapeutic hypothermia with a deep dive into the world’s literature...

By Anton Helman|2024-05-05T14:46:37-04:00October 5th, 2021|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Resuscitation|Tags: journal jam, targeted temperature, therapeutic hypothermia, TTM2|0 Comments

Journal Jam 18 The Evidence for TXA – Should Tranexamic Acid Be Routine Therapy in the Bleeding Patient?

With the help of a special guest, EBM guru Dr. Ken Milne of the The SGEM, Anton and Justin look at all the various potential indications for TXA and review the available evidence. Should we be using TXA for epistaxis, postpartum hemorrhage, hyphema or hemoptysis? Is it a miracle drug that stops all bleeding? Or has it been drastically overhyped? Was CRASH-2 enough to be definitive, or does the classic EBM mantra of "we need more studies" remain true?...

By Anton Helman|2023-05-14T18:12:30-04:00June 29th, 2021|Categories: EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty, Obstetrics & Gynecology, Ophthalmology, Trauma|Tags: CRASH-2, CRASH-3, DUB, epistaxis, GI bleed, HALT-IT, head injujry, hemoptysis, SAH, subarachnoid hemorrhage, tranexamic acid, TXA|2 Comments

Journal Jam 17 – Steroids for CAP and COVID Pneumonia

What are the indications for steroids in patients with pneumonia besides those with concurrent COPD exacerbations, ARDS or adrenal shock? What is the evidence for benefit for steroids in CAP, the flu and COVID pneumonia? And if there is benefit, do those benefits outweigh the potential harms? To help us sort this out, Justin and Anton have the mighty return of a special guest - Dr. Andrew Morris in this Journal Jam podcast...

By Anton Helman|2024-05-21T01:53:54-04:00January 25th, 2021|Categories: COVID-19, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Respirology|Tags: CAP, community acquired pneumonia, COVID-19, dexamenthasone, Dr. Andrew Morris, EBM, hydrocortisone, methylprednisolone|0 Comments

JJ 16 Heparin for ACS and STEMI

Does heparin - LMWH or unfractionated heparin - benefit the patient with a pretty good story for angina with a bump in their troponin and some ST depression in the lateral leads? We’re expected to routinely give heparin for all these NSTEMI and unstable angina patients with any ischemic changes seen on the ECG, right? And for STEMI too. But should we?....

By Anton Helman|2020-08-19T10:54:45-04:00January 28th, 2020|Categories: Cardiology, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty|Tags: ACS, heparin, NSTEMI, PCI, STEMI|1 Comment

JJ 15 Cardiac Stress Testing After Negative ED Workup for MI

In this Journal Jam podcast we do a deep dive into the hugely complex literature of cardiac stress testing and see whether or not stress testing portends any benefit for patients who we assess in the ED for chest pain. The problem is - if stress testing doesn’t benefit our patients and isn’t a good screening test for preventing MIs, then what do we do with our low risk chest pain patients we see in the ED?

By Anton Helman|2019-04-09T12:03:23-04:00April 9th, 2019|Categories: Cardiology, EM Cases, Journal Jam, Medical Specialty|Tags: Dr. Justin Morgenstern, Dr. Rory Spiegel, EBM, inclusion bias, nuclear stress test, pretest probability, stress echo, stress test, treadmill test|2 Comments

JJ 14 Epinephrine in Cardiac Arrest

Does epinephrine improve the chances of return of spontaneous circulation at the expense of the brain? In other words, while we know that epinephrine doubles rates of ROSC in all comers in cardiac arrest, there’s never been robust evidence for long term improvements in neurologic functional outcomes. So, are we saving lives, or are we prolonging death? Find out the answer in this Journal Jam podcast with Justin Morgenstern and Rory Spiegel...

By Anton Helman|2023-05-14T18:16:23-04:00November 6th, 2018|Categories: Cardiology, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Resuscitation|Tags: adrenaline, cardiac arrest, epinephrine, journal jam, OHCA, PARAMEDIC2, ROSC|1 Comment