trauma emergency medicine

Ep 174 Is Less More? Saving EM and Traumatic Pneumothorax – Highlights from CAEP 2022

Emergency Medicine has undergone many changes over the last couple of decades and especially during the COVID pandemic. Most of these changes have been very positive, but increasing volumes, staff shortages, aging populations, increasing breadth of responsibilities and better access to more imaging have made some of us question how we should define the scope of our practices. In this main episode podcast, highlights from CAEP 2022 conference, Anton discusses the article 'Saving EM: Is Less More?' with Dr. Paul Atkinson and Dr. Grant Innes and offer some solutions to this current state of affairs in EM. In another CAEP highlight, trauma team leader Dr. Mathieu Toulouse delivers the latest on management of traumatic pneumothorax. He answers such questions as: Do all patients with a traumatic pneumothorax require tube thoracostomy? How do CXR and CT differ in determining which patients require a chest tube? Do all patients receiving positive pressure ventilation require a chest tube for their traumatic pneumothorax? Does the presence of hemothorax necessitate placement of a chest tube? Are 14Fr pigtail catheters adequate for all traumatic pneumothoraces? and many more...

By Anton Helman|2023-02-15T11:34:33-05:00September 27th, 2022|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Trauma|Tags: access block, overcrowding, pigtail catheter, pneumothorax, PPV, PTX, tube thoracostomy|2 Comments

EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Drowning, Polio, Head-up CPR

In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain management in the polytrauma, Nour Khatib on a rural EM case on management of near-drowning patient, Sara Reid delivers a polio primer, Anand Swaminathan on head-up CPR...

By Anton Helman|2022-10-10T21:38:09-04:00September 13th, 2022|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Hematology, Medical Specialty, Resuscitation, Trauma|Tags: analgesia, CPR, drowning, polio, polytrauma, pulmonary embolism, trauma|0 Comments

EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome

In this month's EM Quick Hits podcast: Brit Long on Surving Sepsis Campaign -2021 Updates, Nour Khatib on rural medicine case - angle closure glaucoma, Reuben Strayer on bougie vs endotracheal tube and stylet on first-attempt intubation, Justin Hensley on management of frostbite, Sarah Foohey on the hot and altered patient, and Andrew Petrosoniak on central cord syndrome...

By Anton Helman|2023-02-06T13:12:57-05:00March 1st, 2022|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Ophthalmology, Plastics, Resuscitation, Toxicology, Trauma|Tags: altered mental status, bougie, central cord syndrome, fluid resuscitation, frostbite, glaucoma, hyperthermia, iloprost, sepsis, spinal cord injury, vasopressors|0 Comments

EM Quick Hits 33 Polytrauma Tips & Tricks, Toxic Megacolon, ECG in PE, Patch Calls, CT Before LP, Nebulized Ketamine

In this month's EM Quick Hits podcast, Anand Swaminathan on tips and tricks in polytrauma, Rohit Mohindra on diagnosis and management of toxic megacolon, Jesse McLaren on ECG in pulmonary embolism, Victoria Myers on approach to the patch call for cardiac arrest, Brit Long on when to do a CT head before LP, Salim Rezaie on nebulized ketamine - the ketaBAN study...

By Anton Helman|2022-05-03T21:15:05-04:00October 18th, 2021|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Neurology, Respirology, Resuscitation, Trauma, Ultrasound, Uncategorized|Tags: cardiac arrest, colitis, ECG, ketamine, lumbar puncture, meningitis, nebulized ketamine, pseudo PEA, pulmonary embolism, right heart strain, trauma resuscitation|1 Comment

Ep 160 Geriatric Trauma 2 Rib Fractures, Pelvic Fractures, Prognostication, Elder Abuse, Discharge Planning

In Geriatric Trauma Part 2 we answer questions such as: what are the indications for transfer to a trauma center in older patients with rib fractures and why? Can we accurately prognosticate older trauma patients in the ED? How can we best engage family members in goals of care discussions for the older trauma patient? What are the risk factors for elder abuse that we need to be aware of in the ED? How can we best minimize the risk for recurrent falls and bounce backs for the older trauma patient who is discharged from the ED? and many more...

By Anton Helman|2022-10-29T17:43:01-04:00September 7th, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Special Populations, Trauma|Tags: elder abuse, falls, frailty scale, hip fracture, non-accidental trauma, pelvic fracture, rib fracture|2 Comments

Ep 159 Geriatric Trauma Part 1: The Under-Triaging Problem, Resuscitation, Airway, Head and C-spine Imaging, Clearing the C-spine

Just as pediatric patients are not small adults, geriatric patients are not just old adults. In this Part 1 of our 2-part EM Cases podcast series on Geriatric Trauma, Dr. Barbara Haas, Dr. Camilla Wong and Dr. Bourke Tillman answer questions such as: why are older patients under-triaged to trauma centers and how does that affect outcomes? What is the utility of the Shock Index in older patients? How should we adjust airway management for the older trauma patient? Which older patients do not require head or c-spine imaging after a ground level fall? Why is it challenging, yet of utmost importance, to clear the c-spine of a geriatric trauma patient as soon as possible? When can anticoagulation medications be safely resumed after an older person has sustained a minor head injury? and many more...

By Anton Helman|2022-10-29T17:45:02-04:00August 24th, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Resuscitation, Special Populations, Trauma|Tags: c-spine, head injury, undertriage|2 Comments

EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines

In this month's EM Quick Hits podcast: Arun Sayal on the nuances of assessment for scaphoid fractures, Justin Morgenstern on the evidence for therapeutic hypothermia post-arrest and the TTM2 trial, Sarah Reid on HEADS-ED mental health screening tool for children, youth and young adults, Andrew Petrosoniak on pelvic trauma and pelvic binder tips and pitfalls, Michelle Klaiman on what we need to know about Kratom and Anand Swaminathan on why femoral lines are often a great central line choice...

By Anton Helman|2021-07-13T11:16:50-04:00July 13th, 2021|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Orthopaedics, Pediatrics, Psychiatry, Resuscitation, Trauma|Tags: central line, femoral line, HEADS-ED, Kratom, pediatric depression screen, pediatric suicide risk assessment, pelvic fracture, pelvic trauma, scaphoid fracture, therapeutic hypothermia, TTM2|1 Comment

Journal Jam 18 The Evidence for TXA – Should Tranexamic Acid Be Routine Therapy in the Bleeding Patient?

With the help of a special guest, EBM guru Dr. Ken Milne of the The SGEM, Anton and Justin look at all the various potential indications for TXA and review the available evidence. Should we be using TXA for epistaxis, postpartum hemorrhage, hyphema or hemoptysis? Is it a miracle drug that stops all bleeding? Or has it been drastically overhyped? Was CRASH-2 enough to be definitive, or does the classic EBM mantra of "we need more studies" remain true?...

By Anton Helman|2023-05-14T18:12:30-04:00June 29th, 2021|Categories: EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty, Obstetrics & Gynecology, Ophthalmology, Trauma|Tags: CRASH-2, CRASH-3, DUB, epistaxis, GI bleed, HALT-IT, head injujry, hemoptysis, SAH, subarachnoid hemorrhage, tranexamic acid, TXA|2 Comments

POCUS Cases 9 Abdominal Free Fluid in Trauma

Rob Simard explains how to incorporate abdominal POCUS into your assessment of the trauma patient, he reviews the literature on accuracy of POCUS for assessment of abdominal free fluid, reviews the key POCUS steps and cautions us about interpretation of your findings in trauma patients who have sustained an injury to their abdomen...

By Anton Helman|2021-03-08T16:19:16-05:00February 23rd, 2021|Categories: EM Cases, Emergency Medicine, Medical Specialty, POCUS Cases, Trauma, Ultrasound|Tags: abdominal POCUS, bedside ultrasound, Dr. Rob Simard, free fluid, Morrison's pouch, trauma POCUS|0 Comments

Ep 152 The 7 Ts of Massive Hemorrhage Protocols

Dr. Jeannie Callum, Dr. Andrew Petrosoniak and Dr. Barbara Haas join Anton in answering the questions: How do you decide when to activate the MHP? How do you know when it is safe to terminate the MHP? What lab tests need to be done, how often, and how should the results be shared with the clinical team? Once the dust settles, what do we need to tell the patient and/or their family about the consequences of being massively transfused? What should be the lab resuscitation targets? Why is serum calcium important to draw in the ED for the patient who is exsanguinating? How do we mitigate the risk of hypothermia? What can hospitals do to mitigate blood wastage? If someone is on anti-platelets or anticoagulants what is the best strategy to ensure the docs in the ED know what to give and how much? Until the results of lab testing come back and hemorrhage pace is slowed, what ratio of plasma to RBCs should we target? What's better, 1:1:1 or 2:1:1? Should we ever consider using Recombinant Factor 7a? If the fibrinogen is low, what is the optimal product and threshold for replacement? When and how much TXA? Anyone you wouldn’t give it to? and many more...

By Anton Helman|2022-06-07T21:34:16-04:00February 9th, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Hematology, Medical Specialty, Trauma|Tags: cryoprecipitate, FFP, fibrinogen, MHP, MTP, PCCs, RABT score, transfusion, TXA|5 Comments