Emergency Medicine Cases

Episode 46 – Social Media and Emergency Medicine Learning

In early June of this year I caught up with Dr. Rob Rogers of iTeach EM and The Teaching Course, Dr. Ken Milne of The Skeptics Guide to EM and Dr. Brent Thoma of Academic Life in EM and Boring EM at the Canadian Association of Emergency Medicine Conference in Ottawa to chat about the evolution of Social Media & Emergency Medicine Learning. In this podcast, we discuss how Social Media can enhance your career, tips on how to get the most out of FOAMed without getting overwhelmed by the volume of material, swarm-based medicine, tacit knowledge sharing, the flipped classroom, the use of FOAMed in emergency medicine training curricula, how Twitter, Google+, Google Hangout and Google Glass have changed the face of medical education, and much more.

By Anton Helman|2021-03-30T17:06:39-04:00June 24th, 2014|Categories: Clinical Practice, EM Cases, Emergency Medicine, Episodes|Tags: #FOAMed, Brent Thoma, flipped classroom, FOAM, Ken Milne, knowledge translation, Rob Rogers, social media, swarm based medicine, tacit knowledge|2 Comments

Episode 45: NYGH EM Update Conference 2014

This past May in Toronto, the largest and, in my opinion, best Canadian EM conference, North York General Hospital's Emergency Medicine Update Conference, attracted 'Captain Cortex' himself, Stuart Swadron, a Toronto native to talk about his approach to vertigo, which highlights how not to miss a posterior circulation stroke. For the seventh year running the EMU conference was proud to have one of the worlds most well known EM educators, Amal Mattu who presented the most important Cardiology Literature from the past year. This podcast includes edited versions of their talks with commentary and summaries.

By Anton Helman|2023-02-06T12:56:19-05:00June 6th, 2014|Categories: Cardiology, Conference, Ears Nose & Throat, EM Cases, Emergency Medicine, Episodes, Neurology, NYGH EM Update|Tags: Amal Mattu, head impulse test, HINTS exam, LBBB, Sgarbosa, STEMI, Stuart Swadron, vertigo|3 Comments

Best Case Ever 24: COPD, Baggging and Vent Settings

In anticipation of the Highlights from North York General's Emergency Medicine Update Conference 2014 we have the master educator himself, Dr. Amal Mattu's Best Case ever of a patient who presented with a COPD exacerbation, that we recorded at the conference in Toronto just a couple of weeks ago. Dr. Mattu gives you a string of pearls and pitfalls when it comes to management of COPD, bagging & vent settings that you will never forget. In the upcoming episode Dr. Mattu will review his favorite papers from the cardiology literature of the past year and Dr. Stuart Swadron will give you his approach to the challenges of the patient with vertigo. This will the first of two parts of the highlights from the conference - the largest and best EM conference in Canada.

By Anton Helman|2017-02-03T11:42:29-05:00May 27th, 2014|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Respirology, Resuscitation|Tags: Amal Mattu, COPD, Emergency Medicine Update, EMU, pneumothorax, tension pneumothorax|2 Comments

Episode 44 – Whistler Update in Emergency Medicine Conference 2014

In this episode on Whistler's Update in Emergency Medicine Conference 2014 Highlights we have... Chapter 1 with David Carr on his approach to Shock, including the RUSH protocol, followed by a discussion on Thrombolysis for Submassive Pulmonary Embolism.... Then in Chapter 2 Lisa Thurgur presents a series of Toxicology Cases packed with pearls, pitfalls and surprises and reviews the use of Lipid Emulsion Therapy in toxicology....Finally in Chapter 3 Joel Yaphe reviews the most important articles from 2013 including the Targeted Temperature Managment post-arrest paper, the use of Tranexamic Acid for epistaxis, return to play concussion guidelines and clinical decision rules for subarachnoid hemorrhage. Another Whistler's Update in Emergency Medicine Conference to remember.......

By Anton Helman|2021-03-30T17:08:05-04:00May 12th, 2014|Categories: Conference, Ears Nose & Throat, Emergency Medicine, Episodes, Neurology, Resuscitation, Whistler Update in EM|Tags: cardiac arrest, clinical decision rules, David Carr, head injury, Joel Yaphe, lipid emulsion, Lisa Thurgur, POCUS, post arrest care, RUSH, subarachnoid hemorrhage, therapeutic hypothermia, tranexamic acid|2 Comments

Best Case Ever 22: Nonconvulsive Status Epilepticus (NCSE)

In the first of our series on Best Case Ever of 'Carr's Cases' we have, the legend himself, Dr. David Carr. This series will run on the theme of interesting diagnoses that we don't think of too often, but that are not as rare as we might think and can make a significant difference to your patient's outcome if you pick up on them early - and maybe even make you look as smart as David! Dr. Carr will be highlighted in our upcoming episode on Whistler's Update in EM Conference highlights 2014 when he will be speaking about his approach to the shocky patient as well as the controversial management of submassive pulmonary embolism. He will be featured along with Dr. Lisa Thurgur speaking about lipid emulsion therapy and other toxicologic goodies and Joel Yaphe will give us his take on the best of the EM literature from 2013 including the TTM trial, tranexamic acid for epistaxis, return to sport after concussion guidelines and more. Please go to the 'Next Time on EM Cases' page to submit your question about these topics.

By Anton Helman|2017-02-05T14:30:29-05:00May 5th, 2014|Categories: Best Case Ever, EM Cases, Emergency Medicine, Neurology, Resuscitation|Tags: benzodiazepine, David Carr, epilepsy, found down, seizure, Whistler|0 Comments

Episode 43 – Appendicitis Controversies

In this episode on Appendicitis Controversies, we have the continuation of our discussion on abdominal pain emergencies with Dr. Brian Steinhart & Dr. David Dushenski. We kick off the discussion with key clinical pearls and pitfalls in the history and physical exam with their respective liklihood ratios when assessing patients with abdominal pain for appendicitis - a diagnosis that is still sometimes missed despite its prevalence. Dr. Dushenski hacks apart the Alvarado and Appendicitis Inflammatory Response Scores and we discuss the value of WBC, CRP and urinalysis in the work-up of appendicitis. Next up are the controversies of imaging algorithms using ultrasound and CT abdomen, as well as the factors affecting which imaging algorithm you might pursue. We wrap up the discussion on Appendicitis Controversies with a critical look at the value of antibiotics in the ED for appendicitis and which patients might be appropriate for non-surgical management.

By Anton Helman|2022-01-05T23:15:48-05:00April 22nd, 2014|Categories: EM Cases, Emergency Medicine, Episodes, Gastroenterology|Tags: Alvarado Score, Brian Steinhart, clinical decision rules, CT Abdomen, David Dushenski, ultrasound|2 Comments

Episode 42: Mesenteric Ischemia and Pancreatitis

In this episode Dr. Steinhart, (one of my biggest mentors – the doc that everyone turns to when no one can figure out what’s going on with a patient in the ED), & Dr. Dave Dushenski, (a master of quality assurance and data analysis, who would give David Newman a run for his money), discuss the 4 diagnoses that make up the deadly & difficult diagnosis of Mesenteric Ischemia, it’s key historical and physical exam features, the value of serum lactate, D-dimer & blood gas, when CT can be misleading, ED management of Mesenteric Ischemia, the difficult post-ERCP abdominal pain patient, the pitfalls in management of Pancreatitis, the BISAP score for Pancreatitis compared to the APACHE ll & Ranson Score, the comparative value of amylase and lipase, ultrasound vs CT for pancreatitis and much more…

By Anton Helman|2021-03-30T17:11:05-04:00March 29th, 2014|Categories: EM Cases, Emergency Medicine, Episodes, Gastroenterology|Tags: Amylase, BISAP score, Brian Steinhart, clinical decision rules, D-dimer, David Dushenski, Lactate, Lipase, Mesenteric Ischemia, pancreatitis, post-ERCP|1 Comment

Best Case Ever 21 Abdominal Pain – Thinking Outside the Box

As a bonus to Episode 42 on Mesenteric Ischemia & Pancreatitis, Dr. Brian Steinhart presents his Best Case Ever of Abodominal Pain – Thinking Outside the Box. While about 10% of abdominal pain presentations to the ED are surgical, there are a variety of abdominal pain presentations that have diagnoses outside the abdomen – so one needs to be thinking outside the box. In the related episode, Dr. Steinhart, (one of my biggest mentors – the doc that everyone turns to when no one can figure out what’s going on with a patient in the ED), & Dr. Dave Dushenski, (a master of quality assurance and data analysis, who would give David Newman a run for his money), discuss the 4 diagnoses that make up the deadly & difficult diagnosis of Mesenteric Ischemia, it’s key historical and physical exam features, the value of serum lactate, D-dimer & blood gas, when CT can be misleading, ED management of Mesenteric Ischemia, the difficult post-ERCP abdominal pain patient, the pitfalls in management of Pancreatitis, the BISAP score for Pancreatitis compared to the APACHE ll & Ranson Score, the comparative value of amylase and lipase, ultrasound vs CT for pancreatitis and much more…

By Anton Helman|2017-02-03T11:40:37-05:00March 26th, 2014|Categories: Best Case Ever, EM Cases, Emergency Medicine, Gastroenterology|Tags: abdominal pain, APACHE, BISAP, Brian Steinhart, D-dimer, Lactate, Mesenteric Ischemia, pancreatitis, Ranson|0 Comments

Episode 41: Hypertensive Emergencies

In this episode on Hypertensive Emergencies, Dr. Joel Yaphe, EM residency program director at the University of Toronto & Dr. Clare Atzema, one of Canada's leading cardiovascular EM researchers will discuss the controversies of how to manage patients who present to the ED with high blood pressure and evidence of end organ damage related to the high blood pressure. Hypertensive emergencies are a grab bag of diagnoses that all need to be treated differently. Hypertensive Encephalopathy, Aortic Dissection, Acute Pulmonary Edema, Pre-eclampsia & Eclampsia, Acute Renal Failure, Subarachnoid Hemorrhage and Intracranial Hemorrhage all need individualized blood pressure management.

By Anton Helman|2024-08-10T19:20:03-04:00March 24th, 2014|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Resuscitation|Tags: acute renal failure, aortic dissection, Clare Atzema, congestive heart failure, eclampsia, hypertensive encephalopathy, intractranial hemorrhage, Joel Yaphe, labetolol, nicardipine, nitroprusside, subarachnoid hemorrhage|18 Comments

Episode 40: Asymptomatic Hypertension

University of Toronto EM Residency program director, Joel Yaphe and cardiovascular EM researcher, Clare Atzema discuss the guidelines, controversies, pearls & pitfalls of Asymptomatic Hypertension in the ED. The literature is thin in this area, and there are many controversies: Does an elevated BP measured in the ED represent true essential hypertension? Do these patients need to be worked up? Are they at risk of serious morbidity and mortality? Should we treat these patients in the ED with antihypertensives? Should we send them home on antihypertensives? and many more......

By Anton Helman|2024-08-10T19:18:54-04:00February 20th, 2014|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes|Tags: ACE Inhibitor, acep guidelines, antihypertensive, b-blocker, calcium channel blocker, Clare Atzema, feature, hydralazine, hydrocholorthiazide, hypertensive emergency, Joel Yaphe|2 Comments