resuscitation and critical care medicine

Best Case Ever 27: Pediatric Shock

Ottawa this year, I had the pleasure of discussing pediatric shock and sepsis with Dr. Sarah Reid, a good medical school friend of mine from the Gretzky Year ('99) graduating class. I knew back then that she was heading for PEM educator stardom. Lo and behold, she is the now the director of CME at the Children's Hospital of Eastern Ontario and a national PEM speaker extraordinaire. After recording an eye-opening session on Pediatric Fever Without a Source and Pediatric Sepsis, she told me the story of her Best Case Ever where the initial presumptive diagnosis was sepsis. Maximize your learning and submit your questions on 'Pediatric Fever Without a Source' on the Next Time on EM Cases page.

By Anton Helman|2020-05-15T09:15:57-04:00July 16th, 2014|Categories: Best Case Ever, EM Cases, Emergency Medicine, Pediatrics, Resuscitation|Tags: Addison's disease, adrenal insufficiency, Sarah Reid, sepsis, septic shock, steroids|0 Comments

Best Case Ever 26: Chloral Hydrate Poisoning and Cardiac Arrest

I met up with Mike Betzner at North York General's Update in EM Conference in Toronto. He is the medical director of Air Transport STARS air ambulance out of Calgary and an amazing speaker on the national lecturing circuit. His Best Case Ever on Chloral Hydrate poisoning & cardiac arrest describes a young man in cardiac arrest with resistant Ventricular Fibrillation and Torsades de Pointes. There is only one class of drugs that can get him back into normal sinus rhythm. Dr. Betzner describes how he recognized that this patient was suffering from Chloral Hydrate poisoning and how he saved his life with one simple intervention.

By Anton Helman|2017-02-03T13:59:54-05:00July 3rd, 2014|Categories: Best Case Ever, EM Cases, Emergency Medicine, Resuscitation, Toxicology|Tags: b-blocker, cardiac arrest, chloral hydrate, Mike Betzner, Torsades de Pointes|1 Comment

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 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 39: Update in Trauma Literature

Dr. Dave MacKinnon & Dr. Mike Brzozowski return for an Update in Trauma Literature since the epic Episode 10: Trauma Pearls & Pitfalls. In this episode we discuss predicting the sick trauma patient, videolaryngoscopy vs traditional laryngoscopy, Damage Control Resuscitation, Occult Hemothorax, Blunt Thoracic Aorta and Cardiac Injury, Sternal Fractures, Tranexamic Acid, Communication in the trauma bay and much more......

By Anton Helman|2021-03-30T17:13:06-04:00February 4th, 2014|Categories: EM Cases, Emergency Medicine, Episodes, Hematology, Resuscitation, Trauma|Tags: aortic injury, blunt cardiac injury, damage control resuscitation, Dave MacKinnon, hemothorax, laryngoscopy, Mike Brzozowski, occult hemothorax, sternal fracture, tranexamic acid, video laryngoscopy|0 Comments

Best Case Ever 20: CPR in Trauma

BEST CASE EVER 20: CPR in Trauma?!?! Closed Chest Compressions in Traumatic Arrest?!?! Is CPR ever successful in the trauma patient? Dr. Dave MacKinnon, Trauma Team Leader at St. Michael's Hospital in Toronto, gives you his Best Case Ever in the cardiac arrest trauma patient. The literature is full of case series of zero survival in trauma patients requiring CPR. For example, this report in CJEM. Normally, we should not be thinking of CPR in traumatic arrests, but instead, ED thoracotomy as Scott Weingart of emcrit describes in his podast 36 - Traumatic Arrest. But just wait until you here Dave's Best Case Ever..........

By Anton Helman|2020-05-31T23:22:21-04:00December 3rd, 2013|Categories: Best Case Ever, EM Cases, Emergency Medicine, Resuscitation, Trauma|Tags: best, cardiac arrest, CPR, Dave MacKinnon, penetrating trauma, trauma resuscitation, traumatic arrest|0 Comments

Episode 38: ENT Emergencies Pearls, Pitfalls, Tips and Tricks

Dr. Leeor Sommer who runs ENT hands-on workshops and Dr. Maria Ivankovic, lecturer extraordinaire on ENT emergencies discuss ENT Emergencies Pearls, Pitfalls, Tips & Tricks: Dr. Ivankovic's stepwise approach to managing epistaxis including the best local anesthetics, the use of ice to decrease nasal flow, who requires antibiotics, the management of hypertension in epistaxis, tranexamic acid for nose bleeds and managing posterior bleeds, tips for nasal and ear foreign body removal including the use of tissue adhesive, how to pick up and work up the dreaded Malignant Otitis Externa including key diagnostic pearls the best tests, sudden sensorineural hearing loss ('The Bells' Palsy of the Ear') including how to save a patient from losing their hearing, Epiglottitis including diagnostic clues and imaging findings, Pharyngitis work-up and treatment: Do we need to work-up and treat with antibiotics at all? & The Toronto Throat Score, Tips and Tricks for peritonsillar abscess drainage, Hereditary and ACE-inhibitor associated Angioedema presentations and management including the use of C1 Esterase inhibitors.

By Anton Helman|2021-04-02T13:17:21-04:00November 19th, 2013|Categories: Ears Nose & Throat, EM Cases, Emergency Medicine, Episodes, Respirology, Resuscitation|Tags: angioedema, epiglottitis, epistaxis, Leeor Sommer, malignant otitis externa, Maria Ivankovic, nasal foreign body, peritonsillar abscess, pharyngigits, pharyngitis, sudden sensorineural hearing loss, tranexamic|1 Comment

Episode 37: Anticoagulants, PCCs and Platelets

In the second part of this epic 2-part authoritative episode, Anticoagulants, PCCs & Platelets, we have Dr. Walter Himmel (also known as 'The walking encyclopedia of EM') along with Dr. Katerina Pavenski (Head of Transfusion Medicine at St. Michael's Hospital) & Dr. Jeannie Callum (Head of Transfusion Medicine at Sunnybrook Hospital) who will discuss the latest on comparative efficacy and reversal of Warfarin vs Dabigatran vs Rivaroxiban vs Abixaban, the use of prothrombin complex concentrates (PCCs), the ins and outs of thrombocytopenia & platelet transfusions, ITP, TTP, anti-platelet associated intracranial bleeds, indications for Tranexamic Acid & more...

By Anton Helman|2024-08-10T19:22:17-04:00October 7th, 2013|Categories: EM Cases, Emergency Medicine, Episodes, Genitourinary, Hematology, Neurology, Resuscitation|Tags: Abixaban, anticoagulants, dabigitran, ICH, intracranial hemorrhage, ITP, Jeannie Callum, Katerina Pavenski, Octaplex, PCCs, Recombinant Factor 7a, rivaroxiban, tranexamic acid, transfusions, TTP, Walter HImmel, Warfarin|1 Comment