Ep 152 The 7 Ts of Massive Hemorrhage Protocols

Dr. Jeannie Callum, Dr. Andrew Petrosoniak and Dr. Barbara Haas join Anton in answering the questions: How do you decide when to activate the MHP? How do you know when it is safe to terminate the MHP? What lab tests need to be done, how often, and how should the results be shared with the clinical team? Once the dust settles, what do we need to tell the patient and/or their family about the consequences of being massively transfused? What should be the lab resuscitation targets? Why is serum calcium important to draw in the ED for the patient who is exsanguinating? How do we mitigate the risk of hypothermia? What can hospitals do to mitigate blood wastage? If someone is on anti-platelets or anticoagulants what is the best strategy to ensure the docs in the ED know what to give and how much? Until the results of lab testing come back and hemorrhage pace is slowed, what ratio of plasma to RBCs should we target? What's better, 1:1:1 or 2:1:1? Should we ever consider using Recombinant Factor 7a? If the fibrinogen is low, what is the optimal product and threshold for replacement? When and how much TXA? Anyone you wouldn’t give it to? and many more...

ECG Cases 18 – ST DEPRESSED Mnemonic and Occlusion MI

In this ECG Cases blog we look at 10 patients who presented with potentially ischemic symptoms and ST depression. Which had occlusion MI?

EM Quick Hits 25 Cerebral Venous Thrombosis, Diphenhydramine Alternatives, Abdominal Compartment Syndrome, Neonatal Constipation, Intubating Metabolic Acidosis

In this month's EM Quick Hits podcast: Justin Morgenstern on which patients to consider cerebral venous thrombosis in, Maria Ivankovic on diphenhydramine alternatives, Brit Long on abdominal compartment syndrome, Sarah Reid on neonatal "constipation" - when to worry, and Anand Swaminathan on intubating the patient with metabolic acidosis...

Journal Jam 17 – Steroids for CAP and COVID Pneumonia

What are the indications for steroids in patients with pneumonia besides those with concurrent COPD exacerbations, ARDS or adrenal shock? What is the evidence for benefit for steroids in CAP, the flu and COVID pneumonia? And if there is benefit, do those benefits outweigh the potential harms? To help us sort this out, Justin and Anton have the mighty return of a special guest - Dr. Andrew Morris in this Journal Jam podcast...

Ep 151 AKI Part 2 – ED Management

In this Part 2 of our AKI series we discuss the timing, volume and IV crystalloid of choice in AKI patients as well as dialysis indications and timing in light of the recent STARRT-AKI trial. We answer the questions: are piperacillin and vancomycin in combination contraindicated in patients with severe AKI? Is vasopressin preferred over norepinephrine in patients with AKI and septic shock? Is there a role for IV sodium bicarbonate in AKI? When should ACEi/ARBs be held in AKI patients? When, if ever, should NSAIDs be given in AKI patients, and if so, how should the dose be modified? and many more....

WTBS 25 COVID-19 Pandemic Exposes the Importance of Resilience in Health System Redesign

EM leaders have important voices for speaking on disaster preparation and response in our hospitals, health care systems, and communities. They also have a responsibility to bring their experience and perspectives to the recovery phase and to the redesign of health systems. Having a framework to inform our thinking will ensure our voices are aligned and have the greatest positive impact possible. Dr. David Petrie explores COVID-19 pandemic lessons and offers pointers for redesigning a better health care system...

ECG Cases 17 – ST ELEVATIONS mnemonic and Occlusion MI

In this ECG Cases blog we look at 10 patients who presented with ST elevation, and review the differential diagnosis of ST elevation using the ELEVATIONS mnemonic. Which had occlusion MI?

Reflections on 2020 COVID Pandemic – EM Physicians Words of Wisdom

It goes without saying that 2020 presented many challenges for the worldwide EM community. We all know what those challenges were, so I’m not going to list them here. As we enter 2021 I thought it important to reflect on what we did well in 2020, what made us proud to be EM docs, so that we keep this perspective and keep on growing as a community going forward. So I asked a few colleagues, educators and leaders in EM “what made you glad to be an EM doc in 2020?” And this is what they said….

By |2022-01-10T21:03:26-05:00December 30th, 2020|Categories: COVID-19, EM Cases, Emergency Medicine, Medical Specialty|Tags: , |2 Comments

EM Cases Top 13 Best of All Time 10th Anniversary Celebration

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 All Time 10th Year Anniversary Edition...

By |2020-12-31T16:46:25-05:00December 29th, 2020|Categories: EM Cases, Emergency Medicine, Medical Specialty, News|Tags: , |4 Comments

Ep 150 Acute Kidney Injury – A Simple Emergency Approach to AKI

In this first part of our 2 part podcast series on AKI we answer questions such as: Is there any value in the BUN:Cr ratio in distinguishing prerenal from intrarenal disease? Why is nephritic syndrome one of the most important intrarenal causes to pick up in the ED? Is there any value in urine electrolytes for the ED workup of AKI? Is there a role for bicarb in patients with severe AKI? How can we choose wisely when it comes to imaging for patients with AKI? How can we utilize POCUS best in working up the patient with AKI? What are the indications for ordering a CK to look for rhabdomyolysis? At what CK level do patients typically develop AKI? How can the McMahon score help us manage rhabdomyolysis? What is the value of urine myoglobin in the workup of rhabdomyolysis? What are indications for dialysis in patients with rhabdomyolysis? What are safe discharge criteria for patients with rhabdomyolysis? and many more...

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