emergency medicine obstetrics & gynecology education

EM Quick Hits 12 AFib Early vs Delayed Cardioversion, Snake Bites, Ovarian Torsion Myths, Crystal Meth, Aortic Dissection, Severe Asthma Meds

In this EM Quick Hits podcast we have Paul Dorion on immediate cardioversion vs rate control/delayed cardioversion for atrial fibrillation, Justin Morgenstern & Justin Hensley on emergency management of snake bites, Brit Long on reliability of clinical features in the diagnosis of ovarian torsion, Michelle Klaiman on emergency management of crystal methamphetamine use disorder, Hans Rosenberg & Rob Ohle on workup of suspected aortic dissection, and Anand Swaminathan on epinephrine and magnesium sulphate in severe asthma...

By Anton Helman|2020-11-29T15:14:11-05:00January 14th, 2020|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Obstetrics & Gynecology, Toxicology|Tags: aortic dissection, asthma, atrial fibrillation, crystal meth, epinephrine, magnesium sulphate, ovarian torsion, snake bite, snake envenomation|3 Comments

BCE 77 Pulmonary Embolism Workup in Pregnancy

This Best Case Ever elucidates the practical challenges of working up pregnant patients in the ED with a suspicion of pulmonary embolism. Since this recording, the first ever multi-center prospective outcome study looking at the pulmonary embolism workup in pregnancy was published in the Annals of Internal Medicine. A suggested algorithm and analysis of the study by Lauren Westafer are provided in these show notes....

By Anton Helman|2023-05-14T17:49:37-04:00November 6th, 2018|Categories: Best Case Ever, EM Cases, Emergency Medicine, Medical Specialty, Obstetrics & Gynecology, Respirology|Tags: CTPA, D-dimer, doppler ultrasound, Dr. Elisha Targonsy|1 Comment

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

BCE 68 Ectopic Pregnancy Pitfalls in Diagnosis

This month's EM Cases Best Case Ever podcast features Dr. Catherine Varner, Emergency Physician at Sinai Health System and researcher at Schwartz-Reisman Emergency Medicine Institute (SREMI) discussing the key pitfalls in the diagnosis of ectopic pregnancy and ruptured ectopic pregnancy. It turns out that we're missing the diagnosis more than we'd like to admit. Dr. Varner debunks much of the traditional teaching around ectopic pregnancy so that we can improve our diagnostic skills for this potentially life threatening diagnosis...

By Anton Helman|2021-11-04T00:08:47-04:00April 11th, 2018|Categories: Best Case Ever, EM Cases, Emergency Medicine, Medical Specialty, Obstetrics & Gynecology, Ultrasound|Tags: BhCG, Catherine Varner, discriminatory zone, first trimester bleed, transvaginal ultrasound|2 Comments

CritCases 9 Pre-Eclampsia and Preterm Labor – Time Sensitive Management

In this CritCases blog we present a case of a 30 week gestational age pregnant woman with high blood pressure, headache, blurry vision and pelvic cramping. We discuss the management challenges of transporting a patient with severe pre-eclampsia and preterm labor, with special attention to dosing of magnesium, antihypertensive agents choice, and indications for steroids, tocolytics and antibiotics.

By Anton Helman|2020-09-18T15:23:20-04:00February 12th, 2018|Categories: CritCases, EM Cases, Medical Specialty, Obstetrics & Gynecology, Resuscitation|Tags: fetal lung maturity, HELLP, latetolol, MgSO4, nifedipine, tocolytic|5 Comments

CritCases 4 – Uterine Inversion and Postpartum Hemorrhage

In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Dr. James Brokenshire presents a case of acute unstable Uterine Inversion and discusses key therapeutic maneuvers including the Johnson Maneuver, tocolytics and resuscitation of postpartum hemorrhage.

By Anton Helman|2021-01-19T14:47:52-05:00August 29th, 2016|Categories: CritCases, EM Cases, Medical Specialty, Obstetrics & Gynecology, Resuscitation|Tags: pitocin, postpartum hemorrhage, tocolytic, tranexamic acid|2 Comments

Episode 23: Vaginal Bleeding in Early Pregnancy

In this episode on Vaginal Bleeding in Early Pregnancy Dr. David Dushenski & Dr. Ross Claybo run through the key clinical pearls of the history, the physical, interpretation of the BhCG and the value of serum progesterone in working up these patients. The newest on bedside emergency department ultrasound is discussed in the patient with vaginal bleeding in early pregnancy. The various types of spontaneous abortion including septic abortion are reviewed as well as the management of the unstable patient with massive vaginal hemorrhage. Ectopic pregnancy, in all it's various presentations is reviewed with particular attention to the most common pitfalls and how to avoid them.

By Anton Helman|2021-03-31T13:08:01-04:00May 16th, 2012|Categories: EM Cases, Emergency Medicine, Episodes, Obstetrics & Gynecology|Tags: abortion, bedside ultrasound, David Dushenski, ectopic pregnancy, methotrexate, molar pregnancy, POCUS, Rhogam, Ross Claybo|0 Comments

Best Case Ever 9 Vaginal Bleeding in Early Pregnancy

As a bonus to Episode 23 on 'Vaginal Bleeding in Early Pregnancy' with Dr. Ross Claybo and Dr. David Dushenski, we have here, Dr. Claybo's Best Case Ever. While vaginal bleeding in early pregnancy is rarely life threatening, there are a significant percentage of woman who will require emergency resuscitation and surgical intervention. We don't have mountains of RCTs on this topic; still Dr. David Dushenski & Dr. Ross Claybo run through the key clinical pearls of the history, the physical, interpretation of the BhCG and the value of serum progesterone in working up these patients. The newest on point of care ultrasound is discussed in the patient with vaginal bleeding in early pregnancy. The various types of spontaneous abortion including septic abortion are reviewed as well as the management of the unstable patient with massive vaginal hemorrhage. Ectopic pregnancy, in all it’s various presentations is reviewed with particular attention to the most common pitfalls and how to avoid them. [wpfilebase tag=file id=388 tpl=emc-play /] [wpfilebase tag=file id=389 tpl=emc-mp3 /]

By Anton Helman|2016-10-20T13:22:25-04:00May 8th, 2012|Categories: Best Case Ever, EM Cases, Emergency Medicine, Obstetrics & Gynecology|Tags: ectopic pregnancy, POCUS, Ross Claybo, ultrasound|0 Comments

Episode 18 Part 2: More Point of Care Ultrasound

In Part 2 of this Episode on Emergency Ultrasound or Point of Care Ultrasound (POCUS) Dr. Fischer, Dr. Hannam, Dr. Chenkin & Dr. Hall, Canada's EM ultrasound gurus discuss how POCUS can help our decision-making in the pediatric patient with a limp, in the patient with necrotizing fasciitis, in the pregnant patient with vaginal bleeding and in the common and challenging elderly patient with undifferentiated abdominal pain. They cover POCUS indications from urinary retention to appendicitis and debate the utility of these indications. This is followed by a debate on how best to educate ourselves and the EM community in POCUS and how best to designs quality assurance programs so that point of care ultrasound (POCUS) becomes an accepted tool across the entire medical community.

By Anton Helman|2021-03-31T13:20:20-04:00November 8th, 2011|Categories: Clinical Practice, EM Cases, Emergency Medicine, Episodes, Obstetrics & Gynecology|Tags: abdominal pain, cauda equina syndrome, cholycystitis, deep vein thrombosis, emergency procedures, FAST, foreign body, Greg Hall, Jordan Chenkin, necrotizing faciitis, nerve block, POCUS, pulmonary embolism, quality assurance, septic arthritis, ultrasound, urinary retention, vaginal bleeding|1 Comment

Episode 7: Medical and Surgical Emergencies in Pregnancy

The whole playing field changes with pregnant patients in the emergency department. When you're faced with one of the Medical and Surgical Emergencies in Pregnancy that we'll cover in this episode, there are added challenges and considerations. Dr. Shirley Lee and Dr. Dominick Shelton discuss a challenging case of a pregnant patient presenting to the emergency department with shortness of breath and chest pain. They review those diagnoses that the pregnant patient is at risk for and discuss the challenges of lab test interpretation and imaging algorithms in the pregnant patient. Next, they walk us through the management of cardiac arrest in the pregnant patient. In another case of a pregnant patient who presents with abdominal pain and fever, they discuss strategies to minimize delays in diagnosis to prevent serious morbidity and mortality. The pros and cons of abdominal ultrasound, CT and MRI are reviewed as well as the management of appendicitis, pyelonephritis and septic abortion in pregnant patients.

By Anton Helman|2021-03-31T13:38:07-04:00August 1st, 2010|Categories: EM Cases, Emergency Medicine, Episodes, Obstetrics & Gynecology, Respirology, Resuscitation|Tags: abortion, ACLS, Alvarado Score, Appendicitis, BhCG, cardiomyopathy, dyspnea, post-partum, pulmonary embolism, pyelonephritis, VQ scan|3 Comments