In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma? Dr. George Kovacs and Dr. Andrew Petrosoniak...

Topics in this EM Quick Hits podcast Kevin Wasko on post-tonsillectomy hemorrhage management (1:06) Brit Long on assessment and management of post-CABG surgical incision infections (15:40) Anand Swaminathan on evidence, pitfalls and tips on using Bougies (23:07) Leah Flannigan on when to suspect vascular injury in patients with low energy mechanism pelvic fractures (31:05) Andrew Petrosoniak on debriefing after cases: why, when and how (38:35) Podcast production, editing and sound...

There is a culture problem in medicine. 70% of us are disengaged, more than 50% contribute nothing to our departments and more than 15% actively work against a healthy culture in our departments. What makes an Emergency Department run like a well-oiled machine with staff that find meaning in their work and who are grateful for serving the public? There are individual skills; there are team skills; there is the admin, and then there is the oh-so-important culture which permeates all of these...

Topics in this EM Quick Hits podcast Ian Chernoff on traumatic coronary artery dissection (1:05) Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia (15:50) Brit Long & Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management (21:47) Dave Jerome on managing exercise-associated hyponatremia and heat illness (33:47) Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG (50:50) Podcast production,...

We’d like to think that we’re getting better at identifying acute heart failure and making good disposition decisions. But the facts are, ED physicians are only about 80% accurate diagnosing acute heart failure, and 30-day mortality outcomes and readmission rates for acute heart failure have been about the same in North America for the last few decades – plus we often send home patients who should be admitted and admit patients who should be sent home. This is because there are many...

Topics in this EM Quick Hits podcast Megan Landes on providing HIV PEP and PrEP in the ED (1:05) Justin Morgenstern and George Kovacs on evidence for pre-oxygenation with NIPPV before intubation in RSI (19:05) Brit Long on recognition and management of blast crisis in the ED (41:31) Leah Flanagan and Liam Loughrey on the rise of nitrous oxide toxicity (50:40) Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient (59:55) Podcast production, editing and sound...

In this EM Cases main episode podcast with Dr. Shannon MacPhee and Dr. Jeanette Comeau we discuss the recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis including antibiotic choices and dexamethasone. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages? How does one...

Topics in this EM Quick Hits podcast Megan Landes on the importance of diagnosing HIV in the ED (1:10) Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion (22:33) Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient (29:25) Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis (37:32) Matt Poyner on the most lucrative side-gig, DIY investing...

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr. Katie Lin and Dr. Jeff Perry we answer questions such as: what are the 4 critical priorities in the...

Anton is joined by the world's leading EM researcher in subarachnoid hemorrhage diagnosis Dr. Jeff Perry and EM-Stroke team clinician Dr. Katie Lin for a deep dive into why we still miss this life-threatening diagnosis, the key clinical clues, proper use of decision tools, indications for CT, indications for CTA, indications for LP and CSF interpretation for the sometimes elusive diagnosis of subarachnoid hemorrhage... Help support EM Cases by making a donation:...

In this month's EM Quick Hits podcast: Justin Morgenstern on the first RCT of high dose nitroglycerin in SCAPE, Andrew Neill on Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) indications and evidence, Brit Long on indications for CT in suspected diverticulitis, Tahara Bhate on Central Retinal Artery Occlusion (CRAO) and diagnostic error, Matthew McArthur on penicillin allergy labels, myths and penicillin challenges, and Susan Lu on how ED physician personality influences...

In this part 2 of our 2-part podcast on asthma with Dr. Sameer Mal and Dr. Leeor Sommer, we dig into the recognition and management of life-threatening asthma. We answer such questions as: what are the key elements in recognition of threatening asthma? What are the most time-sensitive interventions required to break the vicious cycle of asthma? What are the best options for dosing and administering magnesium sulphate, epinephrine, fentanyl and ketamine in the management of the crashing...

In this part 1 of our 2-part podcast series on Asthma Management we explore a systematic approach to managing patients presenting to the ED with asthma exacerbations. Our discussion will emphasize the critical role of a thorough history and physical examination in effectively stratifying patient risk and guiding treatment/disposition decisions. Additionally, we'll examine the importance of providing comprehensive discharge medications and instructions to mitigate both mortality and morbidity...

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/

In order fix EM, each of us needs to understand systems issues and systems thinking, and advocate for a better system based on sound systems principles and specific solutions. In this main episode EM Cases podcast Anton is joined by Dr. Alecs Chochinov and Dr. Davie Petrie, two systems thinkers and leaders in EM. They discuss solutions for how to fix EM in 5 spheres: having a coordinated mission, optimizing access points, accountability, disaster preparedness and adaptation/evolution. They...

Olivia Ostrow on the management of button battery ingestions, Brit Long on C difficile infection, Jesse McLaren on an approach to ECG's in the tox patient, Joe Mullally on the identification and treatment of bed bug bites, Andrew Petrosoniak on fibrinogen replacement in bleeding trauma patients, Justin Morganstern on Cold Air for Croup... https://emergencymedicinecases.com/donation/

Triquetrum chip fractures, scapholunate injuries, hook of the hamate fractures, and of course, scaphoid fractures can be easily missed with serious consequences for our patients. In this part 2 of our 2-part podcast series on wrist injuries we highlight the "Big 4" most commonly missed and mismanaged carpal bone injuries, elucidating the key historical, physical exam and x-ray findings, as well as management strategies...

In this part 1 or our 2-part podcast series on wrist injuries Dr. Arun Sayal and Dr. Matt DiStefano answer such questions as:when should we suspect a DRUJ injury, why is it important to pick up DRUJ injuries in the ED, and how does it change our management? Why is the lateral x-ray view so important in picking up commonly missed wrist injuries? When it comes to distal radius fractures, how are Colles vs Barton's vs Smith's fractures managed differently in the ED? What are the 2 key x-ray...

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine immobilization controversies and techniques, Navpreet Sahsi on the difference between humanitarian and development work

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? What are the best strategies for suctioning blood from the airway to improve visualization during...

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 Hine on Procedural Skills Decay, Aaron Billin on Altitude Sickness...

I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma. The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a...

On this month's EM Quick Hits podcast: Anand Swaminathan on the role of methylene blue in septic shock, Nour Khatib on jaw dislocation reduction techniques, Hans Rosenberg on a phenotypic approach to Crohn's disease emergencies, Gil Yehudaiff on evidence based analgesics in renal colic, Brit Long on the importance of inhaled steroids for asthma, and Andrew Petrosoniak on the "lethal diamond" in polytrauma patients and the current state of hypocalcemia in bleeding trauma patients...

In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer questions like: at what age is it safe to attempt reimplantation of an avulsed tooth in the ED? What are the 3 most time-sensitive dental trauma emergencies? When is Panorex X-ray or CT indicated in dental trauma? What is the preferred solution to transport an avulsed...