emergency medicine neurology

Journal Club 6 Which Older Patients Can Safely Forgo CT Head After a Fall? The Falls Decision Rule

The decision of whether or not to order a CT head for an older patient who falls is one I need to make on almost every shift. The Canadian CT Head Rule does not apply to older patients. Does the recently derived Falls Decision Rule give us an answer to the question of which older patients can safely forego a CT head after a fall? Dr. Rohit Mohindra reviews the latest evidence in this EM Cases Journal Club...

By Rohit Mohindra|2024-07-09T11:54:08-04:00July 9th, 2024|Categories: EM Cases, Journal Club, Medical Specialty, Neurology, Special Populations, Trauma|2 Comments

Ep 195 Management of Subarachnoid Hemorrhage

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr. Katie Lin and Dr. Jeff Perry we answer questions such as: what are the 4 critical priorities in the initial stabilization of the patient with a suspected massive subarachnoid hemorrhage? When is a CT plus CTA of the head indicated up front in the management of patients with suspected subarachnoid hemorrhage? What is the evidence for oral nimodipine in improving outcomes in patients with subarachnoid hemorrhage and how does it work? What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage? What are the simplest and best prognostic tools available for spontaneous subarachnoid hemorrhage to help counsel families and patients? and more...

By Anton Helman|2024-06-13T16:20:34-04:00May 28th, 2024|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: Dr. Jeff Perry, Dr. Katie Lin, nimodipine, raised ICP, SAH|0 Comments

Ep 194 Subarachnoid Hemorrhage – Recognition, Workup and Diagnosis Deep Dive

Anton is joined by the world's leading EM researcher in subarachnoid hemorrhage diagnosis Dr. Jeff Perry and EM-Stroke team clinician Dr. Katie Lin for a deep dive into why we still miss this life-threatening diagnosis, the key clinical clues, proper use of decision tools, indications for CT, indications for CTA, indications for LP and CSF interpretation for the sometimes elusive diagnosis of subarachnoid hemorrhage... Help support EM Cases by making a donation: https://emergencymedicinecases.com/donation/

By Sara Brade|2024-06-18T19:29:10-04:00May 13th, 2024|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: CSF interpretation, CT head, Dr. Jeff Perry, Dr. Katie Lin, LP, SAH, SAH decision rule|0 Comments

EM Quick Hits 55 – Induction Agents, Gabapentinoids, Neuroprotective Intubation, Approach to Paresthesias, Preventing Burnout

Anand Swaminathan on an update on the appropriate selection of induction agents. Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Katie Lin on pearls for neuroprotective intubation. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Eric Wortmann on preventing burnout in emergency medicine. Please support EM Cases with a donation https://emergencymedicinecases.com/donation/

By Shaila Gunn|2024-05-21T01:31:13-04:00February 27th, 2024|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology|Tags: gabapentin, induction agent, intubation, ketamine, neuroprotective intubation, paresthesia, pregabalin, propofol|1 Comment

EM Quick Hits 53 Postpartum Hemorrhage, Serotonin Syndrome, TBI Herniation Syndromes, Ulcerative Colitis, Pediatric C-Spine Immobilization, Global EM

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine immobilization controversies and techniques, Navpreet Sahsi on the difference between humanitarian and development work... Please support EM Cases with a donation: https://emergencymedicinecases.com/donation/

By Shaila Gunn|2024-09-27T20:19:38-04:00November 28th, 2023|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Medical Specialty, Neurology, Obstetrics & Gynecology, Pediatrics, Resuscitation, Toxicology, Trauma|Tags: brain herniation, c-spine, c-spine collar, cardiocerebral resuscitation, cerebral herniation, colitis, global EM, postpartum hemorrhage, serotonin syndrome, tbi, ulcerative colitis|0 Comments

EM Quick Hits 49 Stroke Management Update, Intussusception, 5 Penetrating Trauma Tips, Skin Foreign Body Hack, CT Radiation Risk, Emergency Fund

On this month's EM Quick HIts podcast: Anand Swaminathan on EVT for large vessel occlusion strokes, Sarah Reid on picking up intussusception, Andrew Petrosoniak on 5 Penetrating Trauma Tips, Peter Toth on using a slit lamp to manage skin foreign body hack, Nour Khatib and Jonathan Wallace on CT Radiation Risk and Matt Poyner on setting up an emergency fund...

By Anton Helman|2024-05-21T01:55:42-04:00June 6th, 2023|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Pediatrics, Plastics, Trauma|Tags: CT radiation, emergency fund, endovascular therapy, GSW, intussusception, ischemic stroke, penetrating trauma, skin foreign body, slip lamp|2 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

EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing... https://emergencymedicinecases.com/donation/

By Anton Helman|2024-10-10T12:45:15-04:00February 14th, 2023|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Trauma|Tags: ECG pacemaker, hyponatremia, Morel Lavallee, NCSE, wilderness medicine|0 Comments

EM Quick Hits 41 – IO Limitations, Missed Ectopic Pregnancy, Bronchiolitis O2 Monitoring, DRE in Cauda Equina Syndrome, Withdrawal of Life Sustaining Care

In this EM Quick Hits podcast: Anand Swaminathan on limitations and practical tips on intraosseus access,Tahara Bhate QI corner on missed ectopic pregnancy, Sarah Reid from EM Cases Summit on oxygen saturation monitoring in bronchiolitis and management of infant gastro-esophageal reflux, Brit Long on the value of rectal exam in diagnosis of cauda equina syndrome, Hans Rosenberg & Ariel Hendin on withdrawal of life-sustaining care in the ED...

By Anton Helman|2024-10-10T12:54:22-04:00August 16th, 2022|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Obstetrics & Gynecology, Pediatrics, Resuscitation|Tags: bronchiolitis, cauda equina syndrome, DRE, ectopic pregnancy, intraosseus access, IO, withdrawal of life-sustaining care|1 Comment

EM Quick Hits 40 – GI Balloon Tamponade, SVT and Troponin, Falls in Older Patients, Vertical Vertigo, VAFEI Airway

In this month's EM Quick Hits podcast: Anand Swaminathan on GI balloon tamponade preparation and indications, Jesse McLaren on why troponin is rarely useful in SVT, Christina Shenvi on why we should not use the term "mechanical fall" in older patients, Nour Khatib & Jonathan Wallace on rural vertical vertigo case and Reuben Strayer on VAFEI - Video-Assisted Flexible Endoscopic Intubation for the anatomically challenging airway...

By Anton Helman|2022-07-19T12:55:32-04:00July 19th, 2022|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Medical Specialty, Neurology, Resuscitation, Special Populations|Tags: airway, balloon tamponade, falls, geriatric, SVT, troponin, VAFEI, vertigo|1 Comment