emergency medicine neurology

EM Quick Hits 11 Blunt Cerebrovascular Injury, Physostigmine, TEE in Cardiac Arrest, Understanding Nystagmus, Subtle Inferior MI, Choicebo

In this EM Quick Hits podcast we have Emily Austin on physostigmine for anticholinergic toxidrome, Walter Himmel on understanding nystagmus to differentiate central vs peripheral causes of vertigo, Rob Devins on the role of transesophageal echocardiogram in cardiac arrest, Jesse MacLaren on nuances in inferior MI ECG changes and aVL, Andrew Petrosoniak on a practical approach to blunt cerebrovascular injury and Reuben Strayer on choicebo...

By Anton Helman|2024-12-15T17:37:13-05:00December 3rd, 2019|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Toxicology, Trauma, Ultrasound|Tags: aVL, cardiac arrest, cerebrovascular injury, choicebo, Denver criteria, inferior MI, nystagus, physostigmine, TEE|2 Comments

Ep 132 Emergency Approach to Resolved Seizures

What is the essential list of immediate life threats with specific antidotes that we must know for the ED patient with a seizure? What are the key elements for distinguishing a true seizure from syncope? From Psychogenic Non-Epileptic Seizure (PNES)? From TIA? From migraine? How do you distinguish Todd's Paralysis from TIA or stroke? What are indications for lactate and troponins in patients who present with a seizure? Do all patients with first time unprovoked seizures require anti-seizure medication in the ED? What is the preferred anti-seizure medication and route for ED loading for the patient with a first time seizure? Which patients who present with seizure require a CT head in the ED? What are indications and ideal timing for EEG for patient who present to the ED with seizure? and many more...

By Anton Helman|2024-08-01T00:28:13-04:00November 19th, 2019|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: CT head, Dr. Aylin Reid, Dr. Paul Koblic, Keppra, Lactate, mandatory reporting, migraine, phenytoin, PNES, syncope, TIA, Todd's Paralysis|3 Comments

EM Quick Hits 7 Approach to Status Epilepticus, Codeine Interactions, Anticoagulation in Malignancy, Atrial Fibrillation Rate vs Rhythm Control, Peripheral Vasopressors, Motivational Interviewing

Anand Swaminathan on a simple approach to status epilepticus, David Juurlink on codeine and tramadol interactions: nasty drugs with nastier drug interactions, Brit Long on DOACS in patients with malignancy: which patient's with cancer can be safely prescribed DOACs? Ian Stiell on atrial fibrillation rate vs rhythm control controversy, Justin Morgenstern on peripheral vasopressors: safe or unsafe? Michelle Klaiman, Taryn Lloyd on motivational interviewing that makes a difference to patient's lives...

By Anton Helman|2024-05-21T01:24:56-04:00August 13th, 2019|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Neurology, Psychiatry, Resuscitation, Toxicology|Tags: anticoagulants, atrial fibirillation, codeine, Dr. David Juurlink, DVT, motivational interviewing, pain management, pulmonary embolism, seizure, status epilepticus, vasopressors|5 Comments

EM Quick Hits 6 Blunt Cardiac Trauma, Atrial Fibrillation Anticoagulation, Hydromorphone vs Morphine, Myasthenia Gravis, Venous Access

In this EM Quick Hits episode: Andrew Petrosoniak on diagnosis and risk stratification of blunt cardiac trauma, Clare Atzema on latest guidelines for anticoagulation in atrial fibrillation, Maria Ivankovic on hydromorphone vs morphine for acute pain, Brit Long on clinical pearls in the diagnosis of myasthenia gravis, Anand Swaminathan on venous access tips and tricks, and bonus material from EM Cases Course June 2018 with Walter Himmel and Barbara Tatham on Physician Compassion and tools to prevent burnout...

By Anton Helman|2020-11-29T15:11:10-05:00July 16th, 2019|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Neurology, Trauma|Tags: atrial fibrillation, blunt cardiac trauma, Dr. Clare Atzema, hydromorphone, morphine, myasthenia gravis, physician compassion, venous access|1 Comment

Ep 120 ED Stroke Management in the Age of Endovascular Therapy

In this EM Cases main episode podcast, a follow up to our episode on TIA released in November 2018 with Walter Himmel and David Dushenski, we’ll try to simplify the confusing time-based and brain tissue-based options for stroke management. We’ll answer the questions that have been plaguing us for a while now: Which patients are eligible for endovascular therapies? Which patients are the ones who’ll benefit from these therapies and how do we make that happen in our different practice environments? Which patients should be considered for lytic therapy? Which patients should be considered for both lytic and endovascular therapy? and many more...

By Anton Helman|2024-08-19T19:34:40-04:00January 29th, 2019|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: Dr. David Dushenski, Dr. Walter Himmel, endovascular therapy, NIHSS, thrombolytics, tPA, VAN tool|2 Comments

Ep 117 TIA Update – Risk Stratification, Workup and Dual Antiplatelet Therapy

Much has changed in recent years when it comes to TIA risk stratification, workup and antiplatelet therapy. In this podcast we use the overarching theme of timing to elucidate how to distinguish true TIA from the common TIA mimics, the importance of timing in the workup of TIA, why the duration of therapy with dual antiplatelet therapy and timing of starting anticoagulation in patient with atrial fibrillation, contributes to the difference between preventing catastrophic strokes and causing intracranial hemorrhage...

By Anton Helman|2024-08-19T19:34:39-04:00November 20th, 2018|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: ABCD2, DAPT, David Dushenski, dual antiplatelet therapy, endarterectomy, tia mimics, Walter HImmel|5 Comments

CritCases 10 Hyponatremia Associated Seizures

In this EM Cases CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, a middle aged woman presents to a rural ED with headache and vomiting, normal vital signs with subsequent status epilepticus and serum sodium of 110 mmol/L. What management recommendations would you make to the rural ED physician, the transport team and in your ED with regards to treatment of seizures, safe correction of hyponatremia, airway management, search for underlying cause and prevention of Osmotic Demyelenation Syndrome?

By Anton Helman|2018-06-18T22:47:15-04:00June 19th, 2018|Categories: CritCases, EM Cases, Emergency Medicine, Medical Specialty, Neurology, Resuscitation|Tags: hypertonic saline, ODS, status epilepticus|2 Comments

POCUS Cases 3 Idiopathic Intracranial Hypertension and Ocular POCUS

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.

By Anton Helman|2018-06-04T21:35:29-04:00June 4th, 2018|Categories: EM Cases, Emergency Medicine, Medical Specialty, Neurology, Ophthalmology, POCUS Cases|Tags: Dr. Rob Simard, IIH, ONSD, papilledema|0 Comments

Ep 104 Emergency Management of Intracerebral Hemorrhage – The Golden Hour

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. As such, the skill with which you manage your patient with ICH in those first few hours could be the most important determinant of their outcome. In this Golden Hour you have a chance to prevent hematoma expansion, stabilize intracerebral perfusion and give your patient the best chance of survival with neurologic recovery.

By Anton Helman|2022-12-06T07:54:06-05:00December 19th, 2017|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology, Resuscitation|Tags: anticoagulant reversal, hypertonic saline, ICH, ICH score, ICP, optic nerve sheath, Scott Weingart, Walter HImmel|4 Comments

Episode 99 Highlights from EMU 2017

North York General Hospital's 30th Annual Emergency Medicine Update (EMU) Conference 2017 featured some of the best talks I've ever heard from the likes of Sara Gray, Amal Mattu, David Carr and many more. I had a hard time choosing which talks to feature on this EM Cases podcast. I settled on a potpourri of clinical topics and practice tips: Leeor Sommer on Lyme disease, Chris Hicks on signover, Matt Poyner on patient complaints and Walter Himmel on acute vestibular syndrome...

By Anton Helman|2023-06-12T10:29:21-04:00August 15th, 2017|Categories: Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology, NYGH EM Update|Tags: acute vestibular syndrome, Chris Hicks, EMU, Leeor Sommer, Lyme, Matt Poyner, patient complaints, signover, stroke, vertebral artery dissection, vertigo, Walter HImmel|0 Comments