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...

ECG Cases 43 – ECG Interpretation in Shortness of Breath

In this ECG Cases blog we look at 10 patients with shortness of breath, and discuss how the ECG can be used to help diagnose cardiac, respiratory and metabolic emergencies. We discover that for STEMI/OMI vs subendocardial ischemia, we should look for STEMI(-)OMI, subacute OMI, and OMI in the presence of LBBB and RBBB, and consider the differential for diffuse ST depression with reciprocal ST elevation in aVR. For RV strain, acute vs chronic, we should look for signs of acute RV strain and chronic pulmonary hypertension. for low voltages we should consider pericardial effusion and other causes, and for hyperkalemia we should look for multiple signs of hyperkalemia as a guide for empiric calcium...

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...

ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes

In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life...

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...

EM Quick Hits 48 – FAST in Pediatric Trauma, Multiple Myeloma, Drowning, AKA, Global EM

In this month's EM Quick Hits: Heather Cary on the use and misuse of abdominal FAST in pediatric trauma, Hans Rosenberg and Arleigh McCurdy on the diagnosis and management of Multiple Myeloma in the ED, David Jerome on practice tips for managing the drowning patient, Brit Long and Michael Gottlieb on the diagnosis and management of Alcohol-Induced Ketoacidosis, Navpreet Sahsi on his journey to becoming a humanitarian and global EM doctor...

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...

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... 

ECG Cases 41 – STEMI, Occlusion MI Complications

How can we use the awareness of complications to identify false positive STEMI and Occlusion MI that doesn’t meet classic STEMI criteria, and consider specific treatment? Dr. Jesse McLaren reviews the complications of MI through 10 ECG cases and how they alter management...

EM Quick Hits 47 HFNC, Dissection Drugs, ADJUST-UNLIKELY for PE, Antibiotic Course Duration, Skin Glue Hacks, ESP Block, Learner Oversight

In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UNLIKELY tool for pulmonary embolism...

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