Emergency Medicine Cases

NOVEMBER 7, 2023

Key principles and approach to management of both non-massive and massive hemoptysis with Dr. Scott Weingart and Dr. Bourke Tillmann, who answer questions such as: What are the factors to consider in the decision to intubate patients with massive hemoptysis? How can one reliably distinguish hemoptysis from pseudohemoptysis? What is the evidence for tranexamic acid in patients with hemoptysis?

ED 222

ED EMS 222

Emergency Medicine Cases

OCTOBER 17, 2023

In this ECG Cases blog Dr. Jesse McLaren guides us through 10 cases, driving home the points that sepsis is a common cause of rapid Afib and diffuse ST depression with reciprocal ST elevation in aVR, myo/pericarditis is a diagnosis of exclusion, endocarditis or lyme carditis can cause AV block, PE can cause low grade fever and ECG signs of acute RV strain and that fever can unmask Brugada syndrome.

OR 221

OR STEMI EMS 221

Emergency Medicine Cases

OCTOBER 17, 2023

In this month's EM Quick Hits podcast: Sarah Reid on an approach to Infant Vomiting, Brit Long on Orbital Cellulitis essentials, Justin Morgenstern on the PATCH trial - Prehospital TXA in Trauma, Christina Shenvi on Prevention and Treatment of Delirium, Jason Hines on Procedural Skills Decay, Aaron Billin on Altitude Sickness. The post EM Quick Hits 52 Infant Vomiting, Orbital Cellulitis, Prehospital TXA in Trauma, Prevention and Treatment of Delirium, Procedural Skills Decay, Altitude Sickness

EMS 227

EMS 227

Emergency Medicine Cases

AUGUST 8, 2023

In this ECG Cases blog with Dr. Jesse McLaren we interpret 10 ECG cases and explore cardiac, metabolic and GI causes: We consider anginal equivalents, and look for ECG signs of Occlusion MI, including subacute occlusion from delayed presentations. We consider electrolyte disturbances and look for ECG signs of hyperkalemia or hypokalemia/hypomagnesemia, and we consider the differential of diffuse ST depression with reciprocal ST elevation in aVR, and false positive STEMI.

STEMI 201

STEMI OR EMS 201

Emergency Medicine Cases

AUGUST 8, 2023

In this Part 1 of our 2-part podcast series on dental emergencies, with the help of Dr. Chris Nash and Dr. Richard Ngo, we tackle these atraumatic dental emergencies: infections ranging from dental caries to pulpitis and gingivitis to dental abscess, cellulitis and deep space infection, as well as acute necrotizing gingivitis, pericoronitis and dry socket.

EMS 130

EMS 130

Emergency Medicine Cases

MAY 9, 2023

In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key.

ED 130

ED OR EMS 130

Emergency Medicine Cases

MAY 10, 2023

In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life. The post ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes appeared first on Emergency Medicine Cases.

STEMI 130

STEMI EMS 130

Emergency Medicine Cases

SEPTEMBER 12, 2017

As ED docs we’re particularly well suited to take a lead in disaster medicine. We own this. In this EM Cases podcast, with the help of Laurie Mazurik, Daniel Kollek and Joshua Bezanson we will help you become familiar with a general approach to mass casualties, how to handle critical infrastructure disruption in your ED, management of biohazards including airway management, chemical hazards including decontamination and finally evacuation principles in the case of a natural disaster.

ED 130

ED EMS 130

Emergency Medicine Cases

SEPTEMBER 26, 2017

If you were faced with stab wound to the neck and had to act fast, would you have a well-thought out plan that you are comfortable with? In this EM Cases Best Case Ever podcast we discuss the do's and don'ts of penetrating upper airway injury awake intubation with airway expert George Kovacs. The post Best Case Ever 62 Penetrating Upper Airway Injury Awake Intubation Do’s & Don’ts appeared first on Emergency Medicine Cases.

EMS 130

EMS 130

Emergency Medicine Cases

OCTOBER 10, 2017

In this Part 1 of our two part podcast on GI bleed emergencies we answer questions such as: How do you distinguish between an upper vs lower GI bleed when it's not so obvious clinically? What alterations to airway management are necessary for the GI bleed patient? What do we need to know about the value of fecal occult blood in determining whether or not a patient has a GI bleed?

OR 130

OR EMS 130

Emergency Medicine Cases

OCTOBER 17, 2017

In Part 2 of our two part podcast on GI Bleed Emergencies Anand Swaminathan and Salim Rezaie kick off with a discussion on the evidence for benefit of various medications in ED patients with upper GI bleed. PPIs, somatostatin analogues such as Octreotide, antibiotic prophylaxis and prokinetics have varying degrees of benefit, and we should know which ones to prioritize.

ED 130

ED EMS 130

Emergency Medicine Cases

OCTOBER 31, 2017

Dr. Sarah Gray tells us the story of her worst case ever and what she learned from it. About 50% of North American physicians involved in a serious medical error report increased anxiety for future errors, decreased confidence in their job, decreased job satisfaction, insomnia, PTSD, panic disorder – the list goes on. Dr. Gray shares how and why many of us react to medical error - the embarrassment, the shame, the guilt and sense of failure.

EMS 130

EMS 130

Emergency Medicine Cases

NOVEMBER 7, 2017

Burnout – it’s the elephant in the room that we all know about but prefer not to discuss. Yet according to a 2013 Medscape survey, 40% of physicians reported burnout in U.S. In this episode, Sara Gray and Chris Trevelyan present an honest approach to preventing burnout and promoting wellness, outlining strategies both at the individual and systems levels.

OR 130

OR EMS 130

Emergency Medicine Cases

NOVEMBER 21, 2017

Lauren Westafer joins Justin Morgenstern, Rory Spiegel and Anton Helman in a deep dive discussion on the world's literature on Post Contrast Acute Kidney Injury (PCAKI) in this Journal Jam podcast. Hospitals continue to insist on time consuming, and potentially dangerous protocols for administration of fluids to patients with renal dysfunction prior to CT IV contrast despite the lack of evidence that Contrast Induced Nephropathy (CIN) even exists.

EMS 130

EMS 130

Emergency Medicine Cases

DECEMBER 5, 2017

In this EM Cases Best Case Ever Hans Rosenberg and Rajiv Thavanathan discuss recognition and management pearls and pitfalls in salicylate poisoning. They answer question such as: What are the most important diagnostic clues of salicylate poisoning in the patient who presents with undifferentiated fever and altered level of awareness? What is the best timing and ventilation strategy for intubation?

EMS 191

EMS 191

Emergency Medicine Cases

DECEMBER 19, 2017

There exists a kind of self-fulfilling prognostic pessimism when it comes to ICH. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome if they were managed aggressively. Despite the poor prognosis of these patients overall, there is some evidence to suggest that early aggressive medical management may improve outcomes.

Emergency Management 130

Emergency Management Emergency Manager EMS 130

Emergency Medicine Cases

JANUARY 1, 2018

It is both an evidence-based truth and almost a mantra of emergency department (ED) providers and leaders that the major cause of ED overcrowding is boarded patients. Yet 10 years of experience in more than 70 EDs has shown that impressive flow gains can be achieved despite a poor flow of admitted patients out of the ED. While I have always been and continue to be an advocate for improved admission processes and better ED resources, these issues should never excuse us from exploring our own role

ED 130

ED Emergency Department EMS 130

Emergency Medicine Cases

JANUARY 1, 2018

Based on a blend of the number of podcast downloads, webpage views, social media engagement, number of positive emails and comments that I received, and my own favs, I'm pleased to bring you the EM Cases Best of 2017 Top 10. Many huge thanks to the entire EM Cases team, Advisory Board, SREMI, the amazing guest experts and you, the listeners of the podcasts, readers of the blogs, viewers of the videos and participants in the course, for making 2017 another successful year for EM Cases!

EMS 130

EMS Overdose 130

Emergency Medicine Cases

JANUARY 8, 2018

You probably can't remember the last time you worked a shift in the ED and didn’t see at least one patient with an ankle injury. While almost all of these patients are relatively straightforward to diagnose and manage a small but significant minority of these patients will have a more elusive diagnosis, that if not identified early, could lead to significant morbidity.

ED 130

ED EMS 130

Emergency Medicine Cases

JANUARY 23, 2018

I was taken aback when I came across the statistic that approximately every 6 days a woman in Canada is killed by her intimate partner. Victims of intimate partner violence and domestic violence that we see in the ED typically involve an abuse story of repeated escalating violence over time that ends up in a crisis situation. The woman is often financially dependent on her abuser and has no one to turn to for help.

ED 130

ED EMS 130

Emergency Medicine Cases

JANUARY 30, 2018

We see patients with toxic alcohol poisoning most commonly in three clinical scenarios. One, after an intentional suicide attempt where they tell you exactly what they took; two, when they come in agitated and won’t give you a history and the three, the inebriated patient found down. Alcohol is everywhere, and inevitably inebriated people show up at your ED with a myriad of medical and psychiatric problems.

ED 130

ED OR EMS 130

Emergency Medicine Cases

FEBRUARY 12, 2018

In this CritCases blog we present a case of a 30 week gestational age pregnant woman with high blood pressure, headache, blurry vision and pelvic cramping. We discuss the management challenges of transporting a patient with severe pre-eclampsia and preterm labor, with special attention to dosing of magnesium, antihypertensive agents choice, and indications for steroids, tocolytics and antibiotics.

EMS 130

EMS 130

Emergency Medicine Cases

FEBRUARY 13, 2018

When patients with known congenital heart disease present to the ED with common illnesses we need to consider how their physiology might alter our approach to those common illnesses. Max Ben-Yakov guides us through his Best Case Ever of a CHD patient who presents with bronchiolitis and gives us some tips on how best to approach these fragile patients in a crisis situation.

ED 130

ED EMS 130

Emergency Medicine Cases

FEBRUARY 27, 2018

In this live podcast on Blunt Ocular Trauma from The EM Cases Course 2018 with Anna MacDonald we discuss the most important diagnoses to consider, describe how physical exam in queen while CT can misguide you, explain a simple approach to orbital compartment syndrome with retrobulbar hematoma, give you tips on lateral canthotomy, how to pick up subtle hyphemas, why sickle cell patients are high risk, describe the key clinical clues to subtle globe rupture, the role of tranexamic acid in eye blee

EMS 130

EMS 130

Emergency Medicine Cases

MARCH 13, 2018

It’s been another trying flu season in the northern hemisphere—for patients and for emergency department (ED) providers. EDs that are crowded at the best of times come close to a tipping point, waits to be seen and for beds climb, and hospitals struggle to handle the load, sometimes coping by putting patients in hallways or lounges. Even well-written surge plans fall apart in the face of staff illness or unit outbreaks.

ED 130

ED Emergency Department OR EMS 130

Emergency Medicine Cases

MARCH 13, 2018

In anticipation of EM Cases Episode 107 on Pediatric Physical Abuse with Dr. Carmen Coombs and Dr. Alyson Holland, Dr. Coombs tells her Best Case Ever (actually worst case ever) that inspired her to pursue expertise in pediatric physical abuse. The post BCE 67 Child Abuse – Sentinel Injuries appeared first on Emergency Medicine Cases.

EMS 130

EMS 130

Emergency Medicine Cases

MARCH 13, 2018

BNP is currently in use in many EDs across North America and Europe. In this Journal Jam podcast we discuss the clinical utility of BNP and pro-NT-BNP in the work-up of the dyspneic ED patient. We ask the questions: does BNP add much beyond physician gestalt? Which patients might BNP be useful for? Should we abandon BNP as a dichotomous rule-in/rule-out variable and instead use it as a continuous variable?

ED 130

ED EMS 130

Emergency Medicine Cases

MARCH 26, 2018

Just one case of missed pediatric physical abuse I consider a travesty. The sad state of affairs is that thousands of cases of paediatric physical abuse are missed on initial presentation to EDs across North America. And a small but significant minority of these children die. In fact, 20-30% of children who died from abuse and neglect had previously been evaluated by medical providers for abusive injuries that were not recognized as abuse.

ED 130

ED EMS 130

Emergency Medicine Cases

MARCH 26, 2018

The long wait has been well worth it. The EM Cases POCUS Cases Video Series has officially been launched! POCUS Cases is an original EM Cases video series led by Dr. Robert Simard, an Emergency Physician at North York General Hospital and Sunnybrook Health Sciences Centre in Toronto. Rob always wished he had x-ray vision…but since he possesses no special powers…using Point-of-Care Ultrasound (POCUS) is the next closest thing.

EMS 130

EMS 130

Emergency Medicine Cases

APRIL 11, 2018

This month's EM Cases Best Case Ever podcast features Dr. Catherine Varner, Emergency Physician at Sinai Health System and researcher at Schwartz-Reisman Emergency Medicine Institute (SREMI) discussing the key pitfalls in the diagnosis of ectopic pregnancy and ruptured ectopic pregnancy. It turns out that we're missing the diagnosis more than we'd like to admit.

EMS 130

EMS 130

Emergency Medicine Cases

APRIL 17, 2018

In anticipation of EM Cases Episode 109 Recognition and Management of Skin and Soft Tissue Infections with Melanie Baimel and Andrew Morris we have Dr. Morris telling us his Best Case Ever of a nurse that he worked with diagnosed with Necrotizing Fasciitis. We discuss some of the diagnostic pearls for this difficult diagnosis as well as issues around privacy when health care workers become patients at their hospital.

EMS 130

EMS 130

Emergency Medicine Cases

APRIL 24, 2018

How do you distinguish cellulitis from the myriad of cellulitis mimics? At what point do we consider treatment failure for cellulitis? What is the best antibiotic choice for patients who are allergic to cephalosporins? Which patients with cellulitis or skin abscess require IV antibiotics? Coverage for MRSA? What is the best and most resource wise method for analgesia before I&D of a skin abscess?

OR 130

OR EMS 130

Emergency Medicine Cases

MAY 8, 2018

In this POCUS Cases 2 - Pneumothorax, Dr. Simard explains the limitations of supine chest x-rays for ruling out pneumothorax in trauma patients, how to recognize lung sliding and/or comet tails on POCUS and how to understand that they rule out pneumothorax in supine trauma patients, how to recognize the lung point in pneumothorax and distinguishing it from physiologic lung points, how to understand the limitations and false positives of pneumothorax POCUS and much more.

OR 130

OR EMS 130

Emergency Medicine Cases

MAY 8, 2018

Urinary retention is 13 times less common in woman than it is in men, and the differential diagnosis is wide. In this EM Cases Best Case Ever we have the return of Dr. David Carr describing a woman with an unusual diagnosis who presents with urinary retention. We discuss issues around the appropriate use of chaperones and what to do in the situation when you are in over your head.

EMS 130

EMS 130

Emergency Medicine Cases

MAY 15, 2018

In anticipation of EM Cases Episode 110 Airway Pitfalls Live from EMU 2018 with Scott Weingart, we have Dr. Shira Brown tell her Best Case Ever of a pediatric trauma patient who required a cricothyrotomy. She explains how, despite working in a non-trauma center with limited resources, her team was well prepared because of the robust simulation program specifically designed for practicing emergency physicians that she had developed in her region.

EMS 130

EMS 130

Emergency Medicine Cases

MAY 22, 2018

The last decade has seen a torrent of literature and expert opinion on emergency airway management. It is challenging to integrate all this new information into a seamless flow when faced with a challenging airway situation. In this live podcast recorded at North York General's Emergency Medicine Update Conference 2018, Scott Weingart and Anton Helman put together the latest in emergency airway management by outlining 6 common airway pitfalls: Failure to prepare for failure, failure to position

EMS 130

EMS 130

Emergency Medicine Cases

JUNE 4, 2018

In this POCUS Cases 3 - Idiopathic Intracranial Hypertension & Ocular POCUS, Dr. Simard explains the limitations of CT head in the diagnosis of idiopathic intracranial hypertension, how to identify papilledema on ocular POCUS, how to measure Optic Nerve Sheath Diameter (ONSD) on POCUS and the limitations of ONSD on ocular POCUS. The post POCUS Cases 3 Idiopathic Intracranial Hypertension and Ocular POCUS appeared first on Emergency Medicine Cases.

EMS 130

EMS 130