Emergency Medicine Cases

Ep 159 Geriatric Trauma Part 1: The Under-Triaging Problem, Resuscitation, Airway, Head and C-spine Imaging, Clearing the C-spine

Just as pediatric patients are not small adults, geriatric patients are not just old adults. In this Part 1 of our 2-part EM Cases podcast series on Geriatric Trauma, Dr. Barbara Haas, Dr. Camilla Wong and Dr. Bourke Tillman answer questions such as: why are older patients under-triaged to trauma centers and how does that affect outcomes? What is the utility of the Shock Index in older patients? How should we adjust airway management for the older trauma patient? Which older patients do not require head or c-spine imaging after a ground level fall? Why is it challenging, yet of utmost importance, to clear the c-spine of a geriatric trauma patient as soon as possible? When can anticoagulation medications be safely resumed after an older person has sustained a minor head injury? and many more...

By Anton Helman|2024-07-17T18:29:14-04:00August 24th, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Resuscitation, Special Populations, Trauma|Tags: c-spine, head injury, undertriage|2 Comments

EM Quick Hits 31 NG Tubes in SBO, Hyperacute T-Waves, Malignant Otitis Externa, CCTA in NSTEMI and Low-risk Chest Pain, Canadian Syncope Score

In this month's EM Quick Hits podcast: Justin Morgenstern on the evidence for NG tubes in SBO, Jesse MacLaren on recognition of hyperacute T-waves vs other causes of tall T-waves, Brit Long on malignant otitis externa clinical pearls, Salim Rezaie on the value of CCTA in NSTEMI, Justin Morgenstern on the value of CCTA in low-risk chest pain, Hans Rosenberg on how to use the Canadian Syncope Score and it's validation in Canada...

By Anton Helman|2024-10-27T20:29:00-04:00August 10th, 2021|Categories: Cardiology, Ears Nose & Throat, EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Medical Specialty|Tags: bowel obstruction, canadian syncope risk score, CCTA, hyperacute T wave, malignant otitis externa, myocardial infarction, nasogastric tube, NG tube, occlusion MI, syncope, tall T wave|1 Comment

ECG Cases 24 Reciprocal Change and Occlusion MI

Dr. Jesse MacLaren reviews 10 ECG cases highlighting how reciprocal change can be secondary to LBBB/LVH, primary changes, or both, how it can be the first and remain the dominant sign of occlusion, pointing to subtle ST elevation or hyperacute T waves, how it can can highlight subtle inferior, lateral or proximal LAD occlusions, how it can be the only sign of posterior OMI; and how it can be absent in mid-distal LAD occlusion...

By Jesse McLaren|2021-08-19T08:47:15-04:00August 10th, 2021|Categories: Cardiology, ECG Cases, EM Cases, Medical Specialty|Tags: ECG, ECG cases, occlusion MI, reciprocal change, STEMI|4 Comments

Ep 158 Management of Primary Spontaneous Pneumothorax

In this main episode podcast we discuss the conservative management of large spontaneous pneumothorax, when a pigtail chest tube with Heimlich valve is indicated, detection of persistent air leak, removal of chest tube, surgical indications for spontaneous pneumothorax, management pitfalls and more...

By Anton Helman|2022-10-29T17:47:37-04:00July 27th, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Respirology, Ultrasound|Tags: air leak, chest tube, Heimlich valve, needle aspiration, pigtail catheter, thoracentesis|5 Comments

ECG Cases 23 – Wellens syndrome, reperfusion and reocclusion MI

Eight patients presented with potentially ischemic symptoms and T-wave inversions. Which had occlusion MI, which were reperfused and which were reoccluded? Jesse McLaren helps you discover the nuances of Wellens syndrome and T-wave inversions on this month's ECG Cases blog...

By Jesse McLaren|2021-07-13T12:27:47-04:00July 13th, 2021|Categories: Cardiology, ECG Cases, Emergency Medicine, Medical Specialty|Tags: ECG, occlusion MI, T-waves, Wellens|0 Comments

EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines

In this month's EM Quick Hits podcast: Arun Sayal on the nuances of assessment for scaphoid fractures, Justin Morgenstern on the evidence for therapeutic hypothermia post-arrest and the TTM2 trial, Sarah Reid on HEADS-ED mental health screening tool for children, youth and young adults, Andrew Petrosoniak on pelvic trauma and pelvic binder tips and pitfalls, Michelle Klaiman on what we need to know about Kratom and Anand Swaminathan on why femoral lines are often a great central line choice...

By Anton Helman|2024-10-27T20:32:11-04:00July 13th, 2021|Categories: EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Orthopaedics, Pediatrics, Psychiatry, Resuscitation, Trauma|Tags: central line, femoral line, HEADS-ED, Kratom, pediatric depression screen, pediatric suicide risk assessment, pelvic fracture, pelvic trauma, scaphoid fracture, therapeutic hypothermia, TTM2|1 Comment

Journal Jam 18 The Evidence for TXA – Should Tranexamic Acid Be Routine Therapy in the Bleeding Patient?

With the help of a special guest, EBM guru Dr. Ken Milne of the The SGEM, Anton and Justin look at all the various potential indications for TXA and review the available evidence. Should we be using TXA for epistaxis, postpartum hemorrhage, hyphema or hemoptysis? Is it a miracle drug that stops all bleeding? Or has it been drastically overhyped? Was CRASH-2 enough to be definitive, or does the classic EBM mantra of "we need more studies" remain true?...

By Anton Helman|2023-05-14T18:12:30-04:00June 29th, 2021|Categories: EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty, Obstetrics & Gynecology, Ophthalmology, Trauma|Tags: CRASH-2, CRASH-3, DUB, epistaxis, GI bleed, HALT-IT, head injujry, hemoptysis, SAH, subarachnoid hemorrhage, tranexamic acid, TXA|2 Comments

EM Quick Hits 29 Vasopressor Failure, Asplenic Considerations, Bronchiolitis Update, ICD Electrical Storm, Night Shift Tips

In this month's EM Quick Hits podcast: Anand Swaminathan on vasopressor failure, Brit Long and Michael Gottlieb on aspleic considerations, Sarah Reid on a bronchiolitis update and evolving patterns in the COVID era, Hans Rosenberg and Lindsay Cheskes on ICD electrical storm, Justin Morgenstern on night shift tips...

By Anton Helman|2024-11-30T13:34:16-05:00June 15th, 2021|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Pediatrics, Resuscitation, Special Populations|Tags: asplenia, bronchiolitis, electrical storm, ICD, night shift, OPSI, vasopressors|0 Comments

ECG Cases 22: T-wave INVERSION mnemonic

The differential for T-wave INVERSION includes: Incorrect lead placement, No bundle (RBBB, LBBB), Ventricular hypertrophy (LVH, RVH), Embolism, Reciprocal/refractory/reperfused occlusion MI, Sudden death (ARVD), Iatrogenic (digoxin), Obtunded (eg SAH), and Normal variant. Jesse McLaren runs through 10 cases of patients who present to the ED who have T-wave inversions on their ECGs...

By Jesse McLaren|2021-06-15T12:12:33-04:00June 15th, 2021|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine, Medical Specialty|Tags: ECG, ECG cases, ECG intepretation, T-wave inversion|0 Comments

Ep157 Neuromuscular Disease for Emergency Medicine

There is a long list of rare neuromuscular diseases. Nonetheless, there are a few that you are likely to see in the ED, that are relevant to Emergency Medicine because they require timely diagnosis and treatment. In this Part 2 of our 2-part series on acute motor weakness with Roy Baskind and George Porfiris, we keep it short and simple by limiting our discussion to the key clinical clues and management strategies of two of the more common acute life-threatening neuromuscular diseases, myasthenia gravis and Guillain Barré syndrome, and how to distinguish them from their mimics...

By Anton Helman|2024-07-17T18:35:00-04:00June 1st, 2021|Categories: EM Cases, Emergency Medicine, Episodes, Medical Specialty, Neurology|Tags: GBS, Guillain Barre, myasthenia gravis, neuromuscular disease|4 Comments