Medical Specialty Archives - Page 30 of 52

Ep 112 Tachydysrhythmias with Amal Mattu and Paul Dorian

In this EM Cases main Episode 112 Tachydysrhythmias with Amal Mattu and Paul Dorion we discuss a potpurri of clinical goodies for the recognition and management of both wide and narrow complex tachydysrhythmias and answer questions such as: Which patients with stable Ventricular Tachycardia (VT) require immediate electrical cardioversion, chemical cardioversion or no cardioversion at all? Are there any algorithms that can reliably distinguish VT from SVT with aberrancy? What is the "verapamil death test"? While procainamide may be the first line medication for stable VT based on the PROCAMIO study, what are the indications for IV amiodarone for VT? How should we best manage patients with VT who have an ICD? How can the Bix Rule help distinguish Atrial Flutter from SVT? What is the preferred medication for conversion of SVT to sinus rhythm, Adenosine or Calcium Channel Blockers (CCBs)? Why is amiodarone contraindicated in patients with WPW associated with atrial fibrillation? What are the important differences in the approach and treatment of atrial fibrillation vs. atrial flutter? How can we safely curb the high bounce-back rate of patients with atrial fibrillation who present to the ED? and many more...

By Anton Helman|2022-10-16T12:53:36-04:00July 17th, 2018|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Resuscitation|Tags: Amal Mattu, amiodarone, atrial fibirillation, atrial flutter, diltiazem, electrical cardioversion, ICD, Paul Dorion, procainamide, SVT, ventricular tachycardia, WPW|9 Comments

$esmolol for refractory ventricular vibrillation$

BCE 73 Esmolol in Refractory Ventricular Fibrillation

In anticipation of EM Cases Episode 112 on Tachydysrhthmias with Amal Mattu and Paul Dorion, Melanie Baimel tells her Best Case Ever of a previously healthy young man who presents in refractory ventricular fibrillation after receiving multiple single shocks, ongoing chest compressions, several rounds of epinephrine, amiodarone and dual sequence defibrillation without ROSC...

By Anton Helman|2023-05-14T17:54:52-04:00July 3rd, 2018|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Medical Specialty, Resuscitation|Tags: Melanie Baimel, ventricular fibrillation, ventricular storm, VF|3 Comments

CritCases 10 Hyponatremia Associated Seizures

In this EM Cases CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, a middle aged woman presents to a rural ED with headache and vomiting, normal vital signs with subsequent status epilepticus and serum sodium of 110 mmol/L. What management recommendations would you make to the rural ED physician, the transport team and in your ED with regards to treatment of seizures, safe correction of hyponatremia, airway management, search for underlying cause and prevention of Osmotic Demyelenation Syndrome?

By Anton Helman|2018-06-18T22:47:15-04:00June 19th, 2018|Categories: CritCases, EM Cases, Emergency Medicine, Medical Specialty, Neurology, Resuscitation|Tags: hypertonic saline, ODS, status epilepticus|2 Comments

Ep 111 Effective Learning Strategies in Emergency Medicine

In this episode we explore the most effective learning strategies while debunking 5 myths in learning, and answer questions such as: How do we maximize our learning in the face of an ever-growing body of knowledge and procedure skill set so that we can become better doctors? What can we learn from the Dunning-Kruger effect? How do we best minimize distractions while we learn? How do we improve retrieval strength for easy recall? How can deliberate practice inform learning procedures? How can social learning improve our knowledge base? and many more...

By Anton Helman|2022-10-16T15:03:43-04:00June 18th, 2018|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: deliberate practice, distributed learning, Dunning-Kruger, Jonathan Sherbino, learning science, multimodal learning, retrieval practice, Rick Penciner, spaced repetition|0 Comments

BCE 72 Overinvestigation in Emergency Medicine

With increased access to timely advanced diagnostic testing in ED rational resource utilization is becoming ever more important. In his Best Case Ever Dr. Shabhaz Syed argues that a patient at Janus General who presented to the ED with chest pain, died as a result of overinvestigation, and explains how understanding the factors that contribute to overinvestigation, Baysian theory, diagnostic decision analysis, radiation risk, and teaching "dogma" may help prevent overinvestigation in Emergency Medicine...

By Anton Helman|2018-06-04T23:15:32-04:00June 4th, 2018|Categories: Best Case Ever, EM Cases, Emergency Medicine, Medical Specialty|Tags: Baysian theory, diagnostic testing, Dr. Shahbaz Syed, resource utilization, test threshold|1 Comment

POCUS Cases 3 Idiopathic Intracranial Hypertension and Ocular POCUS

In this POCUS Cases 3 - Idiopathic Intracranial Hypertension & Ocular POCUS, Dr. Simard explains the limitations of CT head in the diagnosis of idiopathic intracranial hypertension, how to identify papilledema on ocular POCUS, how to measure Optic Nerve Sheath Diameter (ONSD) on POCUS and the limitations of ONSD on ocular POCUS.

By Anton Helman|2018-06-04T21:35:29-04:00June 4th, 2018|Categories: EM Cases, Emergency Medicine, Medical Specialty, Neurology, Ophthalmology, POCUS Cases|Tags: Dr. Rob Simard, IIH, ONSD, papilledema|0 Comments

Ep 110 Airway Pitfalls – Live from EMU 2018

The last decade has seen a torrent of literature and expert opinion on emergency airway management. It is challenging to integrate all this new information into a seamless flow when faced with a challenging airway situation. In this live podcast recorded at North York General's Emergency Medicine Update Conference 2018, Scott Weingart and Anton Helman put together the latest in emergency airway management by outlining 6 common airway pitfalls: Failure to prepare for failure, failure to position the patient properly, failure to optimize oxygenation, failure to optimize hemodynamics, failure to consider an awake intubation and failure to prepare for a cricothyrotomy...

By Anton Helman|2024-05-05T14:41:02-04:00May 22nd, 2018|Categories: Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty, NYGH EM Update, Resuscitation|Tags: Cricothyrotomy, ear to sternal notch, EMU, preoxygenation, Scott Weingart, stress management, triple 15 rule|1 Comment

BCE 71 Cricothyrotomy and the Value of Simulation Training

In anticipation of EM Cases Episode 110 Airway Pitfalls Live from EMU 2018 with Scott Weingart, we have Dr. Shira Brown tell her Best Case Ever of a pediatric trauma patient who required a cricothyrotomy. She explains how, despite working in a non-trauma center with limited resources, her team was well prepared because of the robust simulation program specifically designed for practicing emergency physicians that she had developed in her region. We also discuss the advantages and disadvantages of the scalpel-Bougie vs scalpel-finger-Bougie cricothyrotomy techniques and to maintain an optimistic attitude in seemingly futile cases...

By Anton Helman|2024-05-05T14:38:24-04:00May 15th, 2018|Categories: Best Case Ever, EM Cases, Emergency Medicine, Medical Specialty, Resuscitation, Trauma|Tags: Bougie cric, cric kit, Dr. Shira Brown, scalpel Bougie, simulation training|0 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

POCUS Cases 2 Pneumothorax

In this POCUS Cases 2 - Pneumothorax, Dr. Simard explains the limitations of supine chest x-rays for ruling out pneumothorax in trauma patients, how to recognize lung sliding and/or comet tails on POCUS and how to understand that they rule out pneumothorax in supine trauma patients, how to recognize the lung point in pneumothorax and distinguishing it from physiologic lung points, how to understand the limitations and false positives of pneumothorax POCUS and much more...

By Anton Helman|2018-05-08T12:27:03-04:00May 8th, 2018|Categories: EM Cases, Emergency Medicine, Medical Specialty, POCUS Cases, Respirology, Trauma|Tags: Dr. Rob Simard, lung POCUS, lung point, pneumothorax|1 Comment