EM Quick Hits 55 – Induction Agents, Gabapentinoids, Neuroprotective Intubation, Approach to Paresthesias, Preventing Burnout

Anand Swaminathan on an update on the appropriate selection of induction agents. Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Katie Lin on pearls for neuroprotective intubation. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Eric Wortmann on preventing burnout in emergency medicine. Please support EM Cases with a donation https://emergencymedicinecases.com/donation/

Ep 171 Posterior Stroke, EP Lead, HEAR Score, Ketamine for Suicidal Ideation, Peer Support Workers – Highlights from Calgary EM Hodsman Lecture Day

In this special edition main EM Cases podcast episode we feature the highlights from live podcasts recorded at Calgary EM during their annual Hodsman Lecture Day, covering a variety of current EM topics: The challenges of posterior circulation stroke (PCIS); Emergency Physician Lead to improve ED overcrowding, access block and job satisfaction; When not to order a troponin - The HEAR Score; Ketamine to relieve suicidal ideation and reduce acute risk; Peer Support Workers for ED patients with mental health issues and substance use disorder, plus a description of the Pathway to Peers program...

EM Quick Hits 34 Carr’s Case, Septic Arthritis vs Transient Synovitis, Managing Tracheostomies, Ethylene Glycol Poisoning, Ketamine for Agitation

In this months EM Quick Hits podcast: The mighty return of Carr's Cases! Sarah Reid on differentiating septic arthritis from transient synovitis in pediatric limp, Anand Swaminathan on managing tracheostomy complications in the ED, Nour Khatib on rural medicine and ethylene glycol poisoning, Justin Morgenstern on RCTs for ketamine in patients with severe agitation...

EM Quick Hits 33 Polytrauma Tips & Tricks, Toxic Megacolon, ECG in PE, Patch Calls, CT Before LP, Nebulized Ketamine

In this month's EM Quick Hits podcast, Anand Swaminathan on tips and tricks in polytrauma, Rohit Mohindra on diagnosis and management of toxic megacolon, Jesse McLaren on ECG in pulmonary embolism, Victoria Myers on approach to the patch call for cardiac arrest, Brit Long on when to do a CT head before LP, Salim Rezaie on nebulized ketamine - the ketaBAN study...

Ep 115 Emergency Management of the Agitated Patient

Managing acutely agitated patients can cause anxiety in even the most seasoned emergency doctor. These are high risk patients and they are high risk to you and your ED staff. It’s important to understand that agitation or agitated delirium is a cardinal presentation – not a diagnosis. There is pathology lurking beneath - psychiatric, medical, traumatic and toxicological diagnoses driving these patients and we just won’t know which until we can safely calm them down...

Episode 97 EM Literature Review 2016 from EMU & Whistler Conferences

Quick and insightful reviews of 17 important adult and pediatric emergency medicine studies from 2016: The PROCAMIO study for stable VT, platelets for head bleeds (PATCH), BP lowering in ICH (ATACH II), antibiotics for abscesses, work up of subarachnoid hemorrhage, dosing IV ketorolac, the PESIT trial, ketamine dosage for sedation in pediatrics, instructions after minor head injury, Salter-Harris I fractures of the lateral malleolus, interpreting oxygen saturation for disposition making in children with bronchiolitis, clinical pathways in pediatric asthma and sepsis and more...

CritCases 6 – Airway Obstruction

In this EM Cases CritCases blog - a collaboration with STARS Air Ambulance Service, Mike Betzner, we present a challenging airway obstruction case, the limitations of non-rebreather masks, using PEEP on bag-valve-masks, heliox, tips on awake intubation, and the differential for high peak inspiratory pressures in the post intubation period. With commentary by Michael Betzner and Reuben Strayer as well as expert peer review by George Kovacs...

Episode 79 – Management of Acute Pediatric Asthma Exacerbations

In this EM Cases episode on Pediatric Asthma we discuss risk stratification (including the PASS and PRAM scores), indications for CXR, the value of blood gases, MDIs with spacer vs nebulizers for salbutamol and ipatropium bromide, the best way to give corticosteroids, the value of inhaled steroids, the importance of early administration of magnesium sulphate in the sickest kids, and the controversies around the use of ketamine, heliox, high flow nasal cannuala oxygen, NIPPV, epinephrine and IV salbutamol in severe asthma exacerbations. So, with the multinational and extensive experience of Dr. Dennis Scolnik, the clinical fellowship Program Director at The Hospital for Sick Children in Toronto and Dr. Sanjay Mehta, multiple award winning educator who you might remember from his fantastic work on our Pediatric Orthopedics episode, we'll help you become more comfortable the next time you are faced with a child with asthma who is crashing in your ED...

Episode 76 Pediatric Procedural Sedation

In this EM Cases episode on Pediatric Procedural Sedation with Dr. Amy Drendel, a world leader in pediatric pain management and procedural sedation research, we discuss how best to manage pain and anxiety in three situations in the ED: the child with a painful fracture, the child who requires imaging in the radiology department and the child who requires a lumbar puncture. Without a solid understanding and knowledge of the various options available to you for high quality procedural sedation, you inevitably get left with a screaming suffering child, upset and angry parents and endless frustration doe you. It can make or break an ED shift. With finesse and expertise, Dr. Drendel answers such questions as: What are the risk factors for a failed Pediatric Procedural Sedation? Why is IV Ketamine preferred over IM Ketamine? In what situations is Nitrous Oxide an ideal sedative? How long does a child need to be observed in the ED after Procedural Sedation? Do children need to have fasted before procedural sedation? What is the anxiolytic of choice for children requiring a CT scan? and many more...

Episode 74 Opioid Misuse in Emergency Medicine

Pain leads to suffering. Opioid misuse leads to suffering. We strive to avoid both for our patients. On the one hand, treating pain is one of the most important things we do in emergency medicine to help our patients and we need to be aggressive in getting our patients' pain under control in a timely, effective, sustained and safe fashion. This was the emphasis 10-20 years ago after studies showed that we were poor at managing pain and our patients were suffering. On the other hand, opioid dependence, addiction, abuse and misuse are an enormous public health issue. Opioid misuse in Emergency Medicine has become a major problem in North America over the past 10 years at least partly as a reaction to the years that we were being told that we were failing at pain management. As Dr. Reuben Strayer said in his SMACC talk on the topic: “Opioid misuse explodes in our face on nearly every shift, splattering the entire department with pain and suffering, and addiction and malingering and cursing and threats and hospital security, and miosis and apnea and naloxone and cardiac arrest.” So how do we strike a balance between managing [...]

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