emergency medicine gastroentrology education

EM Quick Hits 22 Postpartum Hemorrhage, Phenobarbital in Status Epilepticus, Managed Alcohol Programs, Traumatic Cardiac Arrest, Cholangitis, ED Approach to ARDS

In this month's EM Quick Hits podcast, Anand Swaminathan on postpartum hemorrhage, Justin Morgenstern on phenobarbital in pediatric status epilepticus, Michelle Klaiman on managed alcohol programs, Andrew Petrosoniak on traumatic cardiac arrest, Brit Long on cholangitis pearls and pitfalls and Bourke Tillman on ED approach to ARDS...

EM Quick Hits 21 TXA in GI Bleed, Pediatric DKA, POCUS for Shoulder Dislocations, Lisfranc Injuries, Dexamethasone for COVID Pneumonia, Consultation Tips

Salim Rezaie on HALT-IT trial for TXA in unstable GI bleed, Sarah Reid on pediatric DKA update in fluid management and cerebral edema, Hans Rosenberg on POCUS in shoulder dislocations via CJEM, Arun Sayal on Lisfranc injury pearls and pitfalls, Justin Morgenstern on RECOVERY Trial for Dexamethasone in COVID pneumonia, Walter Himmel on getting what you need from consultants...

EMU365 Massive GI Bleed with Sara Gray

The Niagara falls of GI bleeding is occuring before your eyes. The patient is hypotensive and altered. What is your medical management algorithm and how do you deal with a grossly contaminated airway? What rescue device will you use? At EMU 2019, Dr. Sara Gray takes us through one of her best cases of damage control resuscitation for a patient with massive GI bleeding...

Ep 127 EM Drugs that Work and Drugs that Don’t Part 2 – Antiemetics, Angioedema, Oxygen

In this Episode 127 Drugs that Work and Drugs that Don't Part 2 - Antiemetics, Angioedema and Oxygen, with Justin Morgenstern and Joel Lexchin we discuss the evidence for various antiemetics like metoclopramide, prochlorperazine, promethazine, droperidol, ondansetron, inhaled isopropyl alcohol and haloperidol as well as why should not use an antiemetic routinely with morphine in the ED. We then discuss the evidence for various drugs options for a potpourri of true emergencies like angioedema and hyperkalemia, and wrap it up with a discussion on oxygen therapy...

EMU 365 Upper GI Bleed with Walter Himmel

Walter Himmel takes us through the resuscitation of a sick patient with an UGIB and the management priorities including blood products, antibiotics, TXA, octreotide, pantoprazole and endoscopy in this EMU 365 video...

CritCases 11 LVAD Management in the GI Bleed Patient

In this CritCases blog Mike Misch presents a case of a patient with a left ventricular assist device (LVAD) with a postoperative acute lower GI bleed and answers practical questions such as:  How do you measure blood pressure in a patient with an LVAD? What are the common complications of LVADs that we must be aware of? What information can the LVAD controller provide? Why are LVAD patients at high risk for bleeding? and many more...

POCUS Cases 5 – Small Bowel Obstruction

In this POCUS Cases 5 - Small Bowel Obstruction, Dr. Simard explains the limitations of x-rays for small bowel obstruction, the three signs of small bowel obstruction on POCUS including the "keyboard sign", the most important literature on the topic and the limitations of using POCUS for the diagnosis of small bowel obstruction...

Episode 102 GI Bleed Emergencies Part 2

In Part 2 of our two part podcast on GI Bleed Emergencies Anand Swaminathan and Salim Rezaie kick off with a discussion on the evidence for benefit of various medications in ED patients with upper GI bleed. PPIs, somatostatin analogues such as Octreotide, antibiotic prophylaxis and prokinetics have varying degrees of benefit, and we should know which ones to prioritize. We then discuss the usefulness of the Glasgow-Blatchford and Rockall scores for risk stratification and disposition of patient with upper GI bleeds and hit it home with putting it all together in a practical algorithm. Enjoy!

Episode 101 GI Bleed Emergencies Part 1

In this Part 1 of our two part podcast on GI bleed emergencies we answer questions such as: How do you distinguish between an upper vs lower GI bleed when it's not so obvious clinically? What alterations to airway management are necessary for the GI bleed patient? What do we need to know about the value of fecal occult blood in determining whether or not a patient has a GI bleed? Which patients require red cell transfusions? Massive transfusion? Why is it important to get a fibrinogen level in the sick GI bleed patient? What are the goals of resuscitation in a massive GI bleed? What's the evidence for using an NG tube for diagnosis and management of upper GI bleeds?  In which patients should we give tranexamic acid and which patients should we avoid it in? How are the indications for massive transfusion in GI bleed different to the trauma patient? What are your options if the bleeding can't be stopped on endoscopy? and many more...

Episode 89 – DOACs Part 2: Bleeding and Reversal Agents

In this Part 2, DOACs Bleeding and Reversal we discuss the management of bleeding in patients taking DOACs with minor risk bleeds, like epistaxis where local control is easy to access, moderate risk bleeds, like stable GI bleeds and high risk bleeds, like intracranial hemorrhage. We answer questions such as: How do we weigh the risks and benefits of stopping the DOAC? When is reversal of the DOAC is advised? How best do we accomplish the reversal of DOACs? Is there any good evidence for the newest reversal agent? When should we stop DOACs for different procedures, and when should we delay the procedure?

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