emergency medicine education

JJ 12 BNP for Diagnosis of Acute CHF

BNP is currently in use in many EDs across North America and Europe. In this Journal Jam podcast we discuss the clinical utility of BNP and pro-NT-BNP in the work-up of the dyspneic ED patient. We ask the questions: does BNP add much beyond physician gestalt? Which patients might BNP be useful for? Should we abandon BNP as a dichotomous rule-in/rule-out variable and instead use it as a continuous variable? Does using BNP effect patient oriented outcomes? Is lung POCUS a better test? Are prediction models that include BNP useful? and many more....

By Anton Helman|2019-01-01T18:12:01-05:00March 13th, 2018|Categories: Cardiology, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty|Tags: acute heart failure, BNP, Brian Steinhart, CHF, Chris Carpenter, spectrum bias|4 Comments

WTBS 15 Planning to Fail: Why Warning Patients to Stay Away from the ED Will Never Work

It’s been another trying flu season in the northern hemisphere—for patients and for emergency department (ED) providers. EDs that are crowded at the best of times come close to a tipping point, waits to be seen and for beds climb, and hospitals struggle to handle the load, sometimes coping by putting patients in hallways or lounges. Even well-written surge plans fall apart in the face of staff illness or unit outbreaks. Too often when trying to help the system cope, a hospital, health region, or government puts out a call for the public to stay away from crowded EDs unless absolutely necessary—but are such warnings ethical or effective?

By Dr. Howard Ovens|2018-03-13T13:06:53-04:00March 13th, 2018|Categories: EM Cases, Emergency Medicine, Waiting to be Seen|Tags: Paul Hannam|0 Comments

Ep 107 Blunt Ocular Trauma Live from The EM Cases Course

In this live podcast on Blunt Ocular Trauma from The EM Cases Course 2018 with Anna MacDonald we discuss the most important diagnoses to consider, describe how physical exam in queen while CT can misguide you, explain a simple approach to orbital compartment syndrome with retrobulbar hematoma, give you tips on lateral canthotomy, how to pick up subtle hyphemas, why sickle cell patients are high risk, describe the key clinical clues to subtle globe rupture, the role of tranexamic acid in eye bleeds and much more...

By Anton Helman|2022-10-16T21:08:19-04:00February 27th, 2018|Categories: Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Ophthalmology, Whistler Update in EM|Tags: Anna MacDonald, globe rupture, hyphema, lateral conthotomy, orbital compartment syndrome, retrobulbar hematoma, TXA|2 Comments

BCE 66 CHD with Bronchiolitis: A Delicate Balance

When patients with known congenital heart disease present to the ED with common illnesses we need to consider how their physiology might alter our approach to those common illnesses. Max Ben-Yakov guides us through his Best Case Ever of a CHD patient who presents with bronchiolitis and gives us some tips on how best to approach these fragile patients in a crisis situation...

By Anton Helman|2018-06-08T12:09:04-04:00February 13th, 2018|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Medical Specialty, Pediatrics, Resuscitation|Tags: bronchiolitis, CHD, cogenital heart disease, cyanosis, cyanotic infant, Tet spell|1 Comment

Ep 106 Toxic Alcohols – Minding the Gaps

We see patients with toxic alcohol poisoning most commonly in three clinical scenarios. One, after an intentional suicide attempt where they tell you exactly what they took; two, when they come in agitated and won’t give you a history and the three, the inebriated patient found down. Alcohol is everywhere, and inevitably inebriated people show up at your ED with a myriad of medical and psychiatric problems. It’s our job as ED professionals, not only to identify traumatic, medical and psychiatric catastrophes in these patients but also to identify and manage the relatively rare but potentially life and sight threatening toxicologic diagnoses in the inebriated or agitated patient. And that isn’t so easy - especially when it comes to toxic alcohols. In this episode we help give you the knowledge of toxic alcohol poisoning recognition, clinical and lab clues, limitations of the osmolar gap, goals of management, time sensitive treatments and more...

By Anton Helman|2022-10-19T06:32:57-04:00January 30th, 2018|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Toxicology|Tags: dialysis, diethylene glycol, Emily Austin, ethanol, ethlyne glycol, fomepizole, isopropyl alcohol, Margaret Thompson, metabolic aci, methanol, osmolar gap|1 Comment

BCE 65 Intimate Partner Violence – A Silent Epidemic

I was taken aback when I came across the statistic that approximately every 6 days a woman in Canada is killed by her intimate partner. Victims of intimate partner violence and domestic violence that we see in the ED typically involve an abuse story of repeated escalating violence over time that ends up in a crisis situation. The woman is often financially dependent on her abuser and has no one to turn to for help. In one of her worst cases ever from Janus General, Dr. Meeta Patel and I discuss the notions that Emergency providers have a unique opportunity to identify patients who are victims of intimate partner violence; that we should begin by thinking of how we can screen every woman of childbearing age about intimate partner violence in a private, safe and respectful way. We describe the quick Partner Violence Screen and finally how to offer supportive, empowering statements and connect your patients with resources like assaulted women’s helpline and shelters in your community...

By Anton Helman|2018-01-28T23:45:28-05:00January 23rd, 2018|Categories: Best Case Ever, Clinical Practice, EM Cases, Emergency Medicine, Medical Specialty, Special Populations|Tags: domestic violence, Meeta Patel, partner violence screen, universal screening|2 Comments

Ep 105 Commonly Missed Ankle Injuries

You probably can't remember the last time you worked a shift in the ED and didn’t see at least one patient with an ankle injury. While almost all of these patients are relatively straightforward to diagnose and manage a small but significant minority of these patients will have a more elusive diagnosis, that if not identified early, could lead to significant morbidity...

By Anton Helman|2025-06-01T13:08:11-04:00January 8th, 2018|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Orthopaedics|Tags: Arun Sayal, deltoid ligament, Dupuytren's, high ankle sprain, Hossein Mehdian, Masonneuve, ottawa ankle rules, snowboarder's fracture, syndesmosis, tillaux, Weber B|2 Comments

EM Cases Best of 2017 Top 10

Based on a blend of the number of podcast downloads, webpage views, social media engagement, number of positive emails and comments that I received, and my own favs, I'm pleased to bring you the EM Cases Best of 2017 Top 10. Many huge thanks to the entire EM Cases team, Advisory Board, SREMI, the amazing guest experts and you, the listeners of the podcasts, readers of the blogs, viewers of the videos and participants in the course, for making 2017 another successful year for EM Cases! And here they are...

By Anton Helman|2018-01-01T13:45:25-05:00January 1st, 2018|Categories: EM Cases, Emergency Medicine, Medical Specialty, News|Tags: aortic dissection, ASA overdose, failing up, ICH, Lyme disease, occult knee injuries, PCAKI, pulmonary hypertension, UGIB, UTI myths|0 Comments

Ep 104 Emergency Management of Intracerebral Hemorrhage – The Golden Hour

There exists a kind of self-fulfilling prognostic pessimism when it comes to ICH. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome if they were managed aggressively. Despite the poor prognosis of these patients overall, there is some evidence to suggest that early aggressive medical management may improve outcomes. As such, the skill with which you manage your patient with ICH in those first few hours could be the most important determinant of their outcome. In this Golden Hour you have a chance to prevent hematoma expansion, stabilize intracerebral perfusion and give your patient the best chance of survival with neurologic recovery.

By Anton Helman|2022-12-06T07:54:06-05:00December 19th, 2017|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology, Resuscitation|Tags: anticoagulant reversal, hypertonic saline, ICH, ICH score, ICP, optic nerve sheath, Scott Weingart, Walter HImmel|4 Comments

Journal Jam 11 Post Contrast Acute Kidney Injury – PCAKI

Lauren Westafer joins Justin Morgenstern, Rory Spiegel and Anton Helman in a deep dive discussion on the world's literature on Post Contrast Acute Kidney Injury (PCAKI) in this Journal Jam podcast. Hospitals continue to insist on time consuming, and potentially dangerous protocols for administration of fluids to patients with renal dysfunction prior to CT IV contrast despite the lack of evidence that Contrast Induced Nephropathy (CIN) even exists. Would you choose a different imaging modality if your radiologist suggested that a patient with renal dysfunction who required a CT with IV contrast should forgo the contrast risking a missed diagnosis?

By Anton Helman|2023-05-14T18:19:36-04:00November 21st, 2017|Categories: EM Cases, Emergency Medicine, Genitourinary, Journal Jam, Medical Specialty|Tags: contrast induced nephropathy, IV contrast, Lauren Westafer, PCAKI|0 Comments