EM Cases Best of 2015 Top Ten

2015 was the most productive year in the entire 6 year history of EM Cases with a total of 33 podcast releases, the introduction of the Waiting to Be Seen Blog, the first EM Cases Digest ebook and the planning of the first ever EM Cases Course. The website racked up 393,616 page views, and podcast downloads totaled a whopping 1,027,744 downloads in 2015. Based on a blend of the number of podcast downloads, webpage views, social media engagement, scores on the questionnaires at the bottom of each post, number of positive emails and comments that I received, and my own favs, I'm pleased to bring you the EM Cases Best of 2015 top 10 picks of 2015. Many huge thanks to the entire EM Cases team, Advisory Board, SREMI, the amazing guest experts and you, the listeners, for making 2015 the most successful year for EM Cases! And here they are.....

Episode 65 – IV Iron for Anemia in Emergency Medicine

For years we’ve been transfusing red cells in the ED to patients who don’t actually need them. A study looking at trends in transfusion practice in the ED found that about 1/3 of transfusions given were deemed totally inappropriate. As we explained in previous EM Cases episodes, there have been a whole slew of articles in the literature over the years that have shown that morbidity and mortality outcomes with lower hemoglobin thresholds, like 70g/L for transfusing ICU patients (TRICC trial), patients in septic shock (TRISS trial), and patients with GI bleeds are similar to outcomes with traditional higher hemoglobin thresholds of 90 or 100g/L. We’re simply transfusing blood way too much! The American Association of Blood Banks in conjunction with the American Board of Internal Medicine’s Choosing Wisely campaign, as one of its 5 statements on overuse of procedures, stated, “don’t transfuse iron deficiency without hemodynamic instability”. So, in this episode with the help of Transfusion specialist, researcher and co-author of the American Association of Blood Banks transfusion guidelines Dr. Jeannie Callum, Transfusion specialist and researcher Dr. Yulia Lin, and 'the walking encyclopedia of EM' Dr. Walter Himmel, we give you an understanding of why it’s important to avoid red cell transfusions in certain situations, why IV iron is sometimes a better option in a significant subset of anemic patients in the ED, and the practicalities of exactly how to administer IV iron.

Episode 36: Transfusions, Anticoagulants and Bleeding

In the first part of this epic 2 part must-hear episode, Transfusions, Anticoagulants & Bleeding, we have the triumphant return of Dr. Walter Himmel (also known as 'The walking encyclopedia of EM') along with Dr. Katerina Pavenski (Head of Transfusion Medicine at St. Michael's Hospital) & Dr. Jeannie Callum (Head of Transfusion Medicine at Sunnybrook Hospital) who will update you on the latest in transfusion indications & risks, managing INRs and how Wararin compares to Dabigatran, Rivaroxiban & Apixaban. They give you the authoritative low down on: Indications for red cell transfusions in different clinical scenarios (GI bleed, cardiac disease, vaginal bleeding etc) and how to give them, Risks of red cell transfusions including Host vs Graft Disease, TRALI & TACO and how to manage them, IV Iron as an alternative to red cell transfusions, Managing INRs: indications for Vit K, Prothrombin Complex Concentrates (Octaplex & Beriplex), adjusting Warfarin Dose, liver patients, and much much more.........