Ep 208 Paradigm Shift in Ischemic Stroke Management Part 1: Disabling Strokes
We are amidst a paradigm shift in the emergency management of acute ischemic stroke. The traditional way of categorizing ischemic strokes as 'minor' vs 'major' is no longer relevant to what we do in the ED. It's now about 'disabling' vs 'non-disabling' strokes. And this is no small change. This categorization dictates urgency of ED work-up and treatments, imaging choices, treatment decisions and goals of care. In this Part 1 or our 2-part main episodes EM Cases podcast series on management of ischemic stroke with Dr. Walter Himmel and Dr. Katie Lin, we answer questions like: How can we best rapidly determine if an ischemic stroke is disabling or non-disabling at the bedside? In what ways are 'wake up strokes' managed uniquely and what's the latest thinking on their pathophysiology? How should we best prioritize imaging depending on timing, geography and resources? How do we best predict large vessel occlusion amenable to endovascular therapy (EVT) at the bedside? How can we efficiently establish goals of care at the bedside to inform our emergency decision making around strokes? Which is better for thrombolysis in ischemic stroke - Tenecteplase or Alteplase? How have contraindications to IV thrombolysis changed over the last decade? When should we consider bridge therapy with EVT after IV thrombolysis? What are 4 key items the ED physician should have ready for the stroke neurologist on the first call? and many more... If you enjoy EM Cases content please consider a donation to help support ongoing FOAMed here: https://emergencymedicinecases.com/donation/
Ep 207 Sleep Strategies for Shift Work
Discover evidence-based sleep strategies for shift workers. Optimize performance, recovery, and health with tips from sleep expert Dr. Michael Mak... If you find this beneficial please consider a donation to support EM Cases: https://emergencymedicinecases.com/donation/
Ep 206 Massive Hemorrhage Protocols 2.0 – Update on the 7 Ts
In this update to the 7 T’s of Massive Hemorrhage Protocols with Dr. Jeannie Callum and Dr. Andrew Petrosoniak, we explore the most current, evidence-informed strategies for bleeding patients, from polytrauma to obstetrical, drawing on the latest clinical trial data and real-world experience. We answer the questions: What is the evidence based alternative to FFP in EDs where FFP is not readily available? How accurate are decision scores in helping decide the trigger for MHP activation? Why is testing fibrinogen levels and giving fibrinogen concentrates so important in massive hemorrhage? How should we tailor our MHP to the GI bleed patient? To the obstetrical patient? and many more... Please donate to EM Cases to ensure ongoing Free Open Access Medical Education at https://emergencymedicinecases.com/donation/.
Ep 205 Leading from the Inside Out: Building Teams, Trust and Purpose in Emergency Medicine
In this podcast, with Dr. Thom Mayer, Dr. Carolyn Snider and Dr. Howard Ovens, on leading from the inside out, we cover foundational principles, practical habits, and transformative insights that can make any member of an ED team a more effective, compassionate, and adaptive leader. Here, you’ll find tools, philosophy, and stories that just might transform how you think about your role in the ED to make your work more satisfying, make your teams work together better and improve patient outcomes... Please consider a donation to EM Cases to help ensure we continue to provide high quality Free Open Access medical education into the future https://emergencymedicinecases.com/donation/
Ep 204 High Risk Pulmonary Embolism Management
There are many nuances in the management of patients with pulmonary embolism in cardiac arrest, peri-arrest or simply in shock: We need to optimize oxygenation and airway management, hemodynamic support, acid/base management, thrombolysis and/or catheter-directed therapies that Anton dives into with guest experts Dr. Lauren Westafer, Dr. Bourke Tillmann and Dr. Justin Morgenstern... EM Cases is proudly FOAMEd - Please consider a donation: https://emergencymedicinecases.com/donation/
Ep 203 Intermediate Risk Pulmonary Embolism Risk Stratification, Management and Algorithm
How do you predict which intermediate-risk patients will suddenly deteriorate? What role do risk scores, biomarkers, imaging, and hemodynamics play in decision-making? Should these patients receive anticoagulation alone, or is thrombolysis warranted? When should you consider catheter-directed or surgical interventions? This podcast focuses us to think critically about risk stratification, early interventions and escalation in care in PE. We include an algorithm in the show notes. Not all patients fit neatly into classification boxes, making clinical judgment crucial. Join Dr. Lauren Westafer, Dr. Justin Morgenstern, Dr. Bourke Tillman and Anton as they explore the key decision points, pitfalls, and lifesaving strategies for managing intermediate-risk PE in the ED...
