resuscitation and critical care medicine
Dr. Mike Misch guides us through this part 2 of a blunt chest trauma case with a presumed bronchopulmonary fistula requiring 3 chest tubes and describes options to optimize one-lung ventilation for safe transport...
In this CritCases blog, Shock and Hypoxia in Blunt Chest Trauma, a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Mike Misch guides us through a hairy thoracic trauma case, reviewing principles of trauma resuscitation, airway considerations, tension pneumothorax management and a rare and challenging trauma diagnosis...
Among the presentations seen in the ED, few command the same respect as status epilepticus. It is, in itself, both a diagnostic dilemma and, at times, a therapeutic nightmare. There’s a reason it’s the very first domino to fall in the dreaded sequence “seizure, coma, death”. Status epilepticus can be nuanced to manage. Sure, most seizures self-abort or love an IV dose of lorazepam, but ask anyone who’s been down the propofol route, and they’re not likely to have forgotten the time they stared down a patient who just...would...not....stop...
This EMU365 Video features Dr. Mike Betzner, medical director of STARS Air Ambulance service, collaborator on the CritCases blog, and bad-ass resuscitationist presenting his approach to the crashing asthmatic...
Rob Simard of POCUS Cases fame and Scott Weingart go beyond ACLS and guide you through the complex world of PEA. We discuss that the palpation technique is poor at determining whether or not a patient has a pulse, that the POCUS pulse is more accurate and as rapid compared to the palpation technique at determining whether or not a patient has a pulse, the difference between true PEA arrest, PseudoPEA and PREM, why epinephrine may be harmful in PEA, Weingart's chain of survival approach from PEA arrest to ROSC, four tools to help differentiate true PEA arrest from PseudoPEA, how to prevent long pauses in chest compressions using POCUS, EM Cases PEA arrest and PseudoPEA suggested dynamic algorithm, vasopressor choices in PseudoPEA, whether the "QRS wide vs narrow width" approach to PEA arrest underlying cause is useful or not and much more...
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...
In this EM Cases Best Case Ever podcast Rajiv interviews Dr. Eric Russell, Assistant Professor of Pediatrics at the Baylor College of Medicine, Pediatric Emergency Medicine attending physician at the Texas Children's Hospital, and editor at the Human Diagnosis Project. They discuss a challenging case of a pediatric patient who presents with what at first appears to be bronchiolitis...
In this EM Quick Hits Podcast: Ludwig's Angina Emergency Management - Approach, Airway, Imaging, Transient Monocular Vision Loss (TMVL), D-dimer in the Work-up of Pulmonary Embolism in Pregnancy, Management of Pediatric Nasal Foreign Bodies: Tips and Tricks, Sulfamethoxazole-Trimethoprim Drug Interactions and Airway Options in Cardiac Arrest - LMA for all?...
It turns out that for all burn patients—from minor to severe—there is a lot of room for improvement in ED management, counselling and disposition. Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation volumes, inadequate analgesia and inappropriate wound dressings are just some of the issues where a small change to ED practice patterns could have a huge impact on patient care. In this EM Cases main episode podcast we have the director of the Burn Unit at Hospital for Sick Children, Dr. Joel Fish and EM educator Dr. Maria Ivankovic discuss dozens of pearls and pitfalls in the management of both pediatric and adult burn and inhalation injuries management with a special appearance by airway master George Kovacs to talk about awake intubation in the burn and inhalation injuries patient...
In this Quick Hits Podcast: David Juurlink on acetaminophen and warfarin drug interaction, Hans Rosenberg on management of dental infections, Emily Austin on dialysis in massive acetaminophen overdose, Andrew Petrosoniak on MTP decisions and the RABT score in trauma , Joel Yaphe on statins for STEMI from Whistler's Update in EM Conference, and George Kovacs on how to maximize success of a cricothyrotomy from EM Cases Course 2019...