Respirology
Ep 130 Community Acquired Pneumonia: Emergency Management
While community acquired pneumonia (CAP) is 'bread and butter' emergency medicine, and the diagnosis is often a 'slam dunk', it turns out that up one third of the time, we are wrong about the diagnosis; that x-rays are not perfect; that blood work is seldom helpful; that not all antibiotics are created equal and that deciding who can go home and who needs to go to the ICU isn’t always so clear cut. With this in mind we are taking a deep dive into CAP, from diagnosis to disposition so that we can better achieve our EM goals of stabilizing sick patients, getting the right diagnosis, initiating the best treatment with the information at hand, prognosticating/appropriately deciding on disposition of patients, and being healthcare and antimicrobial stewards...
BCE 80 Pediatric Respiratory Failure
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...
EM Quick Hits 5 Ludwig’s Angina, Transient Monocular Vision Loss, D-dimer for PE Workup in Pregnancy, Pediatric Nasal Foreign Bodies, Trimethoprim Drug Interactions, Airway Management in Cardiac Arrest
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?...
BCE 77 Pulmonary Embolism Workup in Pregnancy
This Best Case Ever elucidates the practical challenges of working up pregnant patients in the ED with a suspicion of pulmonary embolism. Since this recording, the first ever multi-center prospective outcome study looking at the pulmonary embolism workup in pregnancy was published in the Annals of Internal Medicine. A suggested algorithm and analysis of the study by Lauren Westafer are provided in these show notes....
Ep 114 Pulmonary Embolism Challenges in Diagnosis 2 – Imaging, Pregnancy, Subsegmental PE
In Part 1 of Pulmonary Embolism Challenges in Diagnosis Drs. Helman, Lang and DeWit discussed a workup algorithm using PERC and Wells score, the bleeding risk of treated pulmonary embolism, pearls in decision making on whether or not to work up a patient for pulmonary embolism, how risk factors contribute to pretest probability, the YEARS criteria and age-adjusted D-dimer. In this Part 2 we answer questions such as: what are the important test characteristics of CTPA we need to understand? Which patients with subsegmental pulmonary embolism should we treat? When should we consider VQ SPECT? What is the best algorithm for the work up of pulmonary embolism in pregnant patients? How best should we implement pulmonary embolism diagnostic decision tools in your ED? and many more…
Ep 113 Pulmonary Embolism Challenges in Diagnosis Part 1
Dr. Kerstin DeWit and Dr. Eddy Lang answer the questions that plague us on almost every shift: Which patients require any work-up at all for PE? What’s the utility of PERC and Well’s scores? Should the newer YEARS decision tool supplant Well’s? When should we order a D-dimer? What’s the diagnostic role of CXR, ECG, POCUS, CTA and VQ? How should we work up pregnant patients for PE? How can we use shared decision making strategies for PE to help us do what’s best for our patients, and many more...
