Most Recent
Best Case Ever 10: Pediatric Syncope
Pediatric Syncope usually has a benign cause, but may be a warning for sudden death. As a bonus to Episode 25 on ‘Pediatric & Adult Syncope’ with Dr. Eric Letovsky and Dr. Anna Jarvis, 'Canada's mother of Pediatric Emergency Medicine', we have Dr. Jarvis’s Best Case Ever. In the related episode we will cover how to differentiate syncope from seizure, key historical and physical exam clues to determine a cause of syncope, ECG pearls of syncope causing cardiac conditions, from Congenital Prolonged QT Syndrome to Arrhythmogenic Right Ventricular Cardiomyopathy, the value of syncope decision rules such as the ROSE rule and the San Francisco Syncope Rule, the value of ancillary testing, including Holter monitoring, Echocardiograms and Stress Testing and much more...... [wpfilebase tag=file id=386 tpl=emc-play /] [wpfilebase tag=file id=387 tpl=emc-mp3 /]
Episode 24: COPD and Pneumonia
In this episode we have the continuation of our discussion on Respiratory Emergencies with Dr. Anil Chopra and Dr. John Foote. We discuss key clinical decisions in COPD assessment and management - how to assess for impending respiratory failure, how best to oxygenate the COPD patient, medication pearls and how best to approach intubating the COPD patient. We then review an approach to hemoptysis as well as tricks of the trade for managing massive hemoptysis. Many pearls of pneumonia work-up and management are detailed as well as how to make important disposition decisions.
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.
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 /]
Episode 22a: Whistler Update in Emergency Medicine Conference 2012
In this bonus episode, our second installment of the highlights from Whistler Update in Emergency Medicine Conference 2012, we have Dr. Eric Letovsky talking about complications of MI and the importance of listening for cardiac murmurs. Next, I moderate an expert panel on the current trends on imaging patients who present with renal colic and query appendicitis with Dr. Connie Leblanc, Dr. Joel Yaphe, Dr. David MacKinnon & Dr. Eric Letovsky. We then hear from Dr. Adam Cheng, Dr. Dennis Scolnick & Dr. Anna Jarvis in a pediatric expert panel about the newest on minor head injury, otitis media, mastoiditis and bronchiolitis. Dr. David Carr reviews one of the most important articles in 2011 regarding subarachnoid hemorrhage, and Dr. David MacKinnon gives us tonnes of clinical pearls when it comes to everyone's favourite subject, anorectal disorders.
Episode 21: Pulmonary Embolism
In this episode on Pulmonary Embolsim we have the triumphant return of Dr. Anil Chopra, the Head of the Divisions of Emergency Medicine at University of Toronto, and Dr. John Foote the CCFP(EM) residency program director at the University of Toronto. We kick it off with Dr. Foote's approach to undifferentiated dyspnea and explanation of Medically Unexplained Dyspea ('MUD') and go on to discuss how best to develop a clinical pre-test probability for the diagnosis of pulmonary embolism using risk factors, the value of the PERC rule, Well's criteria and how clinical gestalt plays into pre-test probability. Dr. Chopra tells about the appropriate use of D-dimer to improve our diagnostic accuracy without leading to over-investigation and unwarranted anticoagulation. We then discuss the value of V/Q scan in the workup of PE, and the pitfalls of CT angiography. A discussion of anticoagulation choices follows and the controversies around thrombolysis for submassive PE are reviewed.
