Resuscitation
Best Case Ever 46 – Chris Nickson on Hickam’s Dictum
EM Cases Best Case Ever - Chris Nickson on Hickam's Dictum. Usually we use the heuristic of Occam's razor to help us arrive at one diagnosis that makes sense of all the data points that a particular patient presents to us. However sometimes it's not so straight forward and we need to think about multiple diagnoses that explain a patient's condition - Hickam's Dictum. Dr. Chris Nickson, the brains behind the Life in the Fast Lane blog tells his Best Case Ever from the SMACC Conference in Dublin, in which a patient thrombolysed for massive pulmonary embolism suffers a cardiac arrest, and the thought process he went through to discover the surprising complicating diagnoses that ensue...
CritCases 3 – GSW to the Chest
EM Cases CritCases 3 - GSW to the chest in a rural setting. In this CritCases we discuss preparation for penetrating trauma in a rural setting, the ABC score, massive transfusion protocol, clamshell thoracotomy, trauma intubation and more. The Case... You are the transport physician on call. A 50-year old male with a history of depression allegedly shot himself in the chest with a rifle. A bystander called 911. The local paramedics are en route and the air transport team is activated with a plan to rendezvous at the nearest hospital, Janus General, which is 90 minutes by ground from the nearest tertiary care centre. You contact the rural hospital for a status update but all they can tell you is that his GCS is 14 and he has a GSW to the central chest.
Best Case Ever 45 – Mike Winters on Cardiac Arrest
I had the great pleasure of meeting Dr. Mike Winters on his first ever visit to Canada at North York General's Emergency Medicine Update Conference, where he gave two fantastic presentations. His credentials are impressive: He is the Medical Director of the Emergency Department, Associate Professor in both EM and IM, EM-IM-Critical Care Program co-director and Residency Program Director of EM-IM at the University of Maryland in Baltimore. Sometimes we are so caught up with the job we need to get done during cardiac arrest that we forget about the important and profound effect that this event has on patients' families. On this Best Case Ever Dr. Winters tells the story of witnessing his grandfather's cardiac arrest, being present in the ED during the resuscitation attempts, and how that experience has coloured his practice. We discuss some pearls on communication with patients' families after death, colour-coded cardiac arrest teams and how to integrate POCUS into cardiac arrest care while minimizing chest compressions.
Episode 78 Anaphylaxis and Anaphylactic Shock – Live from The EM Cases Course
Anaphylaxis is the quintessential medical emergency. We own this one. While the vast majority of anaphylaxis is relatively benign, about 1% of these patients die from anaphylactic shock. And usually they die quickly. Observational data show that people who die from anaphylaxis and anaphylactic shock do so within about 5-30mins of onset, and in up to 40% there’s no identifiable trigger. The sad thing is that many of these deaths are because of two simple reasons: 1. The anaphylaxis was misdiagnosed and 2. Treatment of anaphylaxis and anaphylactic shock was inappropriate. So there’s still lots of room for improvement when it comes to anaphylaxis and anaphylactic shock management. With the help of Dr. David Carr of Carr's Cases fame, we’ll discuss how to pick up atypical presentations of anaphylaxis, how to manage the challenging situation of epinephrine-resistant anaphylactic shock, whether or not we should abandon steroids, a rare but ‘must know’ diagnosis related to anaphylaxis, and much more. Plus, we have a special guest apperance by George Kovacs, airway guru, to walk us through an approach to the impending airway obstruction we might face in anaphylaxis.
CritCases 2 – Is this Septic Shock with Pneumonia?
Welcome to EM Cases' CritCases blog, a collaboration between Mike Betzner, the STARS air ambulance service and EM Cases’ Michael Misch and Anton Helman! These are educational cases with multiple decision points where there is no strong evidence to guide us. Various strategies and opinions from providers around the world are coalesced and presented to you in an engaging format. Enjoy!
CritCases 1: Massive TCA Overdose
Welcome to the new EM Cases CritCases blog, a collaboration between Mike Betzner, the STARS air ambulance service and EM Cases' Michael Misch and Anton Helman! These are educational cases with multiple decision points where there is no strong evidence to guide us. Various strategies and opinions from providers around the world are coalesced and presented to you in an engaging format. Enjoy!
