emergency medicine genitourinary

EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients

On this month's EM Quick Hits podcast: Anand Swaminathan on the role of methylene blue in septic shock, Nour Khatib on jaw dislocation reduction techniques, Hans Rosenberg on a phenotypic approach to Crohn's disease emergencies, Gil Yehudaiff on evidence based analgesics in renal colic, Brit Long on the importance of inhaled steroids for asthma, and Andrew Petrosoniak on the "lethal diamond" in polytrauma patients and the current state of hypocalcemia in bleeding trauma patients...

By Shaila Gunn|2023-09-12T13:53:21-04:00September 12th, 2023|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Genitourinary, Medical Specialty, Orthopaedics, Respirology, Resuscitation, Trauma|Tags: asthma, colitis, Crohn's, hemorrhagic shock, hypocalcemia, inhaled corticosteroid, lethal diamond, methylene blue, NSAIDs, renal colic, sepsis, TMJ dislocation, trauma resuscitation, vasopressors|0 Comments

EM Quick Hits 50 Normal Unenhanced CT Renal Colic DDx, Perichondritis, Magnesium in Pediatric Asthma, Steroids for Pneumonia, OMI Cath Lab Activation

On this month's EM Quick Hits podcast David Carr on differential diagnosis of normal unenhanced CT renal colic, Leeor Sommer on recognition and management of perichondritis and auricular abscess, Suzanne Schuh on IV magnesium sulphate for pediatric asthma, Jess McLaren on Occlusion MI ECG interpretation requiring cath lab activation and Justin Morgenstern on update on steroids for pneumonia...

By Anton Helman|2023-07-18T11:25:01-04:00July 18th, 2023|Categories: Cardiology, Ears Nose & Throat, EM Quick Hits, Emergency Medicine, Genitourinary, Medical Specialty, Pediatrics, Respirology|Tags: ACS, atrial fibrillation, chest pain, community acquired pneumonia, ECG, hyperacute T wave, magnesium sulphate, occlusion MI, pediatric asthma, PRAM score, renal infarct, Sgarbosa criteria, STEMI, steroids|0 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|2023-06-16T10:48:02-04:00May 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|2023-09-07T16:08:30-04:00May 9th, 2023|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty|Tags: bacterial vaginosis, chlamydia, gonorrhea, mycoplasma genitalium, STI, trichomoniasis|0 Comments

Journal Club 3 – Dexamethasone and Ketorolac in Acute Renal Colic

Does the addition of dexamethasone to ketorolac improve pain scores in patients suffering from renal colic? Find out through this critical appraisal of a recent RCT on this EMC Journal Club...

By Min Joon Lee|2023-04-24T15:53:27-04:00April 24th, 2023|Categories: EM Cases, Emergency Medicine, Genitourinary, Journal Club|Tags: critical appraisal, dexamethasone, Dr. Rohit Mohindra, EM Cases, journal club, ketorolac, randomized clinical trial, renal colic|0 Comments

Ep 151 AKI Part 2 – ED Management

In this Part 2 of our AKI series we discuss the timing, volume and IV crystalloid of choice in AKI patients as well as dialysis indications and timing in light of the recent STARRT-AKI trial. We answer the questions: are piperacillin and vancomycin in combination contraindicated in patients with severe AKI? Is vasopressin preferred over norepinephrine in patients with AKI and septic shock? Is there a role for IV sodium bicarbonate in AKI? When should ACEi/ARBs be held in AKI patients? When, if ever, should NSAIDs be given in AKI patients, and if so, how should the dose be modified? and many more....

By Anton Helman|2022-10-26T20:09:33-04:00January 12th, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty|Tags: acute kidney injury, acute renal failure, dialysis, Dr. Bourke Tillmann, Dr. Ed Etchells, sodium bicarbonate, STARRT-AKI, vasopressin|0 Comments

Ep 150 Acute Kidney Injury – A Simple Emergency Approach to AKI

In this first part of our 2 part podcast series on AKI we answer questions such as: Is there any value in the BUN:Cr ratio in distinguishing prerenal from intrarenal disease? Why is nephritic syndrome one of the most important intrarenal causes to pick up in the ED? Is there any value in urine electrolytes for the ED workup of AKI? Is there a role for bicarb in patients with severe AKI? How can we choose wisely when it comes to imaging for patients with AKI? How can we utilize POCUS best in working up the patient with AKI? What are the indications for ordering a CK to look for rhabdomyolysis? At what CK level do patients typically develop AKI? How can the McMahon score help us manage rhabdomyolysis? What is the value of urine myoglobin in the workup of rhabdomyolysis? What are indications for dialysis in patients with rhabdomyolysis? What are safe discharge criteria for patients with rhabdomyolysis? and many more...

By Anton Helman|2022-10-30T08:42:59-04:00December 21st, 2020|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty|Tags: acute renal failure, AKI, ARF, hyperkalemia, rhabdomyolysis|3 Comments

Ep 144 Testicular Torsion: A Diagnostic Pathway

In this Part 2 of Urologic Emergencies EM Cases main episode podcasts Dr. Natalie Wolpert and Dr. Yonah Krakowsky answer questions about testicular torsion including: when, after the onset of symptoms, is the testicle salvageable? How sensitive is the presence of cremasteric reflex in ruling out testicular torsion? Are there any set of clinical symptoms and signs or decision tools (such as the TWIST Score) that can rule in or rule out testicular torsion with confidence? How accurate is doppler ultrasound in the diagnosis of testicular torsion? To what degree does Prehn's sign help distinguish epididymitis from testicular torsion? How can you distinguish testicular torsion from torsion of testicular appendage? When is manual de-torsion indicated and how effective is it? and many more...

By Anton Helman|2022-06-11T15:55:59-04:00July 28th, 2020|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty, Pediatrics|Tags: cremasteric reflex, doppler ultrasound, Dr. Natalie Wolpert, Dr. Yonah Krakowsky, Prehn's, TWIST score|0 Comments

Ep 143 Priapism and Urinary Retention: Nuances in Management

This month's main episode podcast on Urologic Emergencies - Priapism and Urinary Retention asks: for priapism how much time to do we have to fix it before there’s irreversible tissue damage? How is priapism managed differently depending on the cause? What is the value of a corporal blood gas for managing priapism? What are the indications for cavernosal phenylephrine injections? What are the common medications that cause urinary retention that we often miss leading to needless recurrent urinary retention? Why is a suprapubic catheter in many respects safer than a urethral catheter for managing urinary retention? Which patients are at high risk for complications of post-obstructive diuresis? and many more...

By Anton Helman|2022-06-11T16:08:20-04:00July 14th, 2020|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Medical Specialty|Tags: phenylephrine, post obstructive diuresis, priapism, triple mix, urethral catheter, urinary retention|4 Comments

BCE 70 Female Urinary Retention – The Return of Carr’s Cases!

Urinary retention is 13 times less common in woman than it is in men, and the differential diagnosis is wide. In this EM Cases Best Case Ever we have the return of Dr. David Carr describing a woman with an unusual diagnosis who presents with urinary retention. We discuss issues around the appropriate use of chaperones and what to do in the situation when you are in over your head...

By Anton Helman|2018-05-09T10:01:32-04:00May 8th, 2018|Categories: Best Case Ever, EM Cases, Emergency Medicine, Genitourinary, Medical Specialty, Obstetrics & Gynecology|Tags: chaperone, Dr. David Carr, imperforate hymen, urinary retention|2 Comments