Episode 84 – Congenital Heart Disease Emergencies

Congenital Heart Disease Emergencies on EM cases with Gary Joubert and Ashley Strobel. You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. And if you’re like me, you don’t feel quite as confident managing sick infants with critical heart disease as you do managing sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. When I was in medical school I vaguely remember learning the complex physiology and long lists of congenital heart diseases, which I’ve now all but forgotten. What we really need to know about congenital heart disease emergencies is what actions to take in the ED when we have a cyanotic or shocky baby in front of us in the resuscitation room. So with the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do.

Episode 56 The Stiell Sessions: Clinical Decision Rules and Risk Scales

There are hundreds of clinical decision rules and risk scales published in the medical literature, some more widely adopted than others. Ian Stiell, the father of clinical decision rules, shares with us his views and experiences gained from co-creating some of the most influential CDRs and risk scales to date. He explains the criteria for developing a CDR, the steps to developing a valid CDR, how best to apply CDRs and risk scales to clinical practice, and the hot-off the-press new Ottawa COPD Risk Score and Ottawa Heart Failure Risk Score for helping you with disposition decisions. It turns out that in Canada, we discharge about two thirds of the acute decompensated heart failure patients that we see in the ED, while the US almost all patients with decompensated heart failure are admitted to hospital. Dr. Stiell's new risk scores may help physicians in Canada make safer disposition decisions while help physicians in the US avoid unnecessary admissions.

Episode 41: Hypertensive Emergencies

In this episode on Hypertensive Emergencies, Dr. Joel Yaphe, EM residency program director at the University of Toronto & Dr. Clare Atzema, one of Canada's leading cardiovascular EM researchers will discuss the controversies of how to manage patients who present to the ED with high blood pressure and evidence of end organ damage related to the high blood pressure. Hypertensive emergencies are a grab bag of diagnoses that all need to be treated differently. Hypertensive Encephalopathy, Aortic Dissection, Acute Pulmonary Edema, Pre-eclampsia & Eclampsia, Acute Renal Failure, Subarachnoid Hemorrhage and Intracranial Hemorrhage all need individualized blood pressure management.

Best Case Ever 6 Can Point of Care Ultrasound Save Lives?

As a bonus to Episode 18: Point of Care Ultrasound Controversies with the gurus of POCUS, Dr. Greg Hall, Dr. Jordan Chenkin, Dr. Paul Hannam and Dr. Jason Fischer, we present here, Dr. Hall's Best Case Ever. In the related episode our panel of experts answer questions such as: How does 2-point compression Point of Care Ultrasound of the leg compare to radiology department ultrasound for DVT? How does POCUS for pneumothorax compare to CXR and CT? In what situations does cardiac standstill on POCUS not suggest futile resuscitation? Can evaluation of RV function on Point of Care Ultrasound help us decide whether or not to thrombolyse a patient with submassive pulmonary embolism? How can POCUS help in diagnosing CHF? What is the best anatomical approach for pericardiocentesis? How can Point of Care Ultrasound help us in the crashing pediatric patient? and many more…… [wpfilebase tag=file id=380 tpl=emc-play /] [wpfilebase tag=file id=381 tpl=emc-mp3 /]