Ep 162 Managing Adversity with Walter Himmel
I asked Dr. Walter Himmel to give a talk at EM Cases Summit 2021 on what he has learned in 40 years of practice. Herein lies his profoundly thoughtful answer, that is especially relevant during the COVID pandemic - a special edition EM Cases video podcast of his live presentation at The Summit...
Ep 161 Red Flag Headaches: General Approach and Cervical Artery Dissections
In this Part 1 or our two part podcast series on Red Flag Headaches we discuss a general approach, tips and tricks to assessing patients who present with headache followed by a deep dive into cervical artery dissections. With the help of Dr. Roy Baskind and Dr. Amit Shah we answers questions such as: what are the big 4 headache diagnoses that are not routinely picked up on plain CT or LP? Why are the symptoms of cervical artery dissection often fluctuating? Why do the symptoms of cervical artery dissection sometimes seem to not fit an anatomical distribution? What are the key clinical features that would trigger you to suspect cervical artery dissection? How do you decide which patients require a CT angiogram? What is the evidence for a causal relationship between chiropractic manipulation and cervical artery dissections? What is evidence for antiplatelet agents, anticoagulants and thrombolysis in the management of cervical artery dissection? Which patients with cervical artery dissection can be safely discharged from the ED and many more...
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...
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...
Ep 158 Management of Primary Spontaneous Pneumothorax
In this main episode podcast we discuss the conservative management of large spontaneous pneumothorax, when a pigtail chest tube with Heimlich valve is indicated, detection of persistent air leak, removal of chest tube, surgical indications for spontaneous pneumothorax, management pitfalls and more...
Ep157 Neuromuscular Disease for Emergency Medicine
There is a long list of rare neuromuscular diseases. Nonetheless, there are a few that you are likely to see in the ED, that are relevant to Emergency Medicine because they require timely diagnosis and treatment. In this Part 2 of our 2-part series on acute motor weakness with Roy Baskind and George Porfiris, we keep it short and simple by limiting our discussion to the key clinical clues and management strategies of two of the more common acute life-threatening neuromuscular diseases, myasthenia gravis and Guillain Barré syndrome, and how to distinguish them from their mimics...
