CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries

Core Questions: What structure controls body temperature and how does it go about controlling it? What are pyrogens and how are they classified? What is the difference between fever and hyperthermia? What is the role of PGE2 in fever and what medications can you give to combat its effects? List four factors that blunt the febrile response. What are the benefits and pitfalls of the febrile response? List five infectious and five non-infectious causes of fever. (see Box/Table 9.1) Describe your approach to the febrile patient. (see Figure 9.1/9.2) Wisecracks: What is the most accurate temperature measurement site? How are heart rate and body temperature related? How are respiratory rate and body temperature related? How high must a fever be to necessitate rapid cooling interventions?

Dive into the world of adult resuscitation with fascinating insights on techniques and differential diagnoses for pulseless electrical activity (PEA) arrest. Learn about the importance of echo-guided life support and how to recognize electromechanical dissociation. Discover the metrics for effective CPR and critical concepts like cough CPR. The discussions also cover essential medications to improve outcomes and the triad of cardiac arrest, all underscored by engaging anecdotes about community support during emergencies.

Core Questions: What is cerebral autoregulation? Describe your parameters for post-arrest care of a brain injured patient. List 7 interventions for management of a patient with elevated ICP. What are the equations for cerebral blood flow and cerebral perfusion pressure? Describe a protocol for induced hypothermia after cardiac arrest. In the patient with a traumatic brain injury, what is the optimal drug for and duration of seizure prophylaxis?   Wisecracks: What are Lundberg A waves? What is the relationship between PaCO2 and CBF? What is the Monro-Kellie hypothesis?    How do these values change in patients with severe coma? What is the probability that a survivor of cardiac arrest has a full neurologic recovery?

Dive into the intricate world of shock management, revealing how circulatory shock can go unnoticed with normal blood pressure. Discover the various types of shock and their treatment strategies, emphasizing accurate diagnosis and early intervention. Learn to recognize signs of tissue hypoperfusion and the controversial concept of permissive hypotension in trauma care. Explore evolving approaches to sepsis management and the critical role of vasopressors in treatment. Finally, understand the importance of balanced resuscitation strategies in hemorrhagic shock for improved patient outcomes.

Are you a Family Medicine resident about to graduate and embark on an extra year of training in Emergency Medicine (EM)? Are you worried you don’t know what it is really like to be an Emergency Medicine resident and you want to find a guide to help maximize your learning in a short and extremely fast year? As a recent CCFP-EM graduate, I can strongly relate to your fears. The one year of extra training is an important one, and you will learn a plethora of information that will be pertinent to your success as a future Emergency physician. Thus, it is paramount that you maximize and optimize this year. In this blog post, I hope to act as a guide and provide insight into how to get the most out of your training. For those individuals who do not know what the CCFP-EM program is, it is an Emergency Medicine residency fellowship (or added competency program) stemming from the tree of Family Medicine in Canada. Residents completing this program will have the ability to complete the Emergency Medicine Licensing Exam (administered by the Canadian College of Family Physicians) and practice EM across the country. It is a highly competitive program and as a one year program, the training is rigorous and substantive. Residents are expected to achieve a large volume of objectives, and experience various teaching requirements in different specialties to achieve competency for independent practice. See the companion blog post: https://canadiem.org/steps-to-success-in-enhanced-training-in-emergency-medicine-ccfp-em-year 

This updated episode of CRACKCast covers Rosen’s Chapter 005, Monitoring the Emergency Patient (9th Ed.). Core Questions: List modalities for measurement of BP and note which modalities are likely to over and underestimate blood pressure. What is pulse pressure and how does it relate to stroke volume? List 4 indications for an arterial line. What is the Beer-Lambert Law and how does it allow us to measure pulse oximetry? How do dyshemoglobinemias affect your measured SpO2? What are the 4 phases of the ETCO2 waveform? List 5 uses for ETCO2. Wisecracks: List the pitfalls of pulse oximetry. Purple Yellow Tan   Describe colorimetric ETCO2 monitoring and cite the ranges at which you would expect to see the following colours: How are ETCO2 values related to PaCO2? What are causes of elevated ETCO2? What does MOVIE stand for (aka - how to rock your oral exam resus questions)?

This updated episode of CRACKCast cover’s Rosen’s Chapter 004, Procedural Sedation and Analgesia (9th Ed.).

This episode of CRACKCast covers Chapter 3 in Rosen’s Emergency Medicine (9th Ed.) – Pain Management. This podcast will give you a solid approach to the basics pain management to use on your next shift! Core Questions: 1. Define the following terms (Box 3.1): Allodynia Amnesia/amnestic Local anesthesia Analgesia Hypnotic Narcotic Nociceptor Noxious stimulus Opiate Opioid Pain Procedural Sedation Sedative 2. Describe a practical approach to stepwise management of pain in the ED. 3. Describe the adult parenteral and oral doses for: Morphine Hydromorphone Fentanyl  4. Differentiate between opioid side effects and opioid toxicity. 5. How do you manage opioid toxicity? 6. Describe relative safety profiles for the NSAIDS. 7. List the classes of local anesthetics. How do they work? 8. List the toxic doses for each local anesthetic: Lidocaine Lidocaine with Epi Bupivicaine 9. List 5 techniques to reduce pain of injection of local anesthetic. 10. List agents that can be used for topical anesthesia of: Intact skin Mucous membranes Open skin/lacerations  Wisecracks: 1. What agent can be used as a substitute in cases of anaphylaxis to local anesthetic? 2. Why should you avoid use of the following agents: Tramadol Demerol 3. How does local anesthetic toxicity present?

The first episode of the Thrombophonia podcast addresses three objectives: 1. Summarize an approach to the acute management of patients with intracerebral hemorrhage while on anticoagulation for a mechanical heart valve 2. Describe the benefits and risks of anticoagulant reversal, including the risk of thromboembolism 3. Describe the principles of effective communication and collaboration of bleeding & clotting cases with consultants

Dive into the essentials of mechanical ventilation! Explore the intricacies of ventilator settings tailored for emergencies and the significance of effective patient care. Learn about non-invasive support like BiPAP and CPAP while navigating the complexities of intubation. Uncover strategies to ensure comfort in intubated patients and the role of the Richmond Agitation Sedation Scale. Also discussed are the benefits of high-flow nasal cannula in treating hypoxia and tactics to prevent ventilator-acquired pneumonia. A must-listen for healthcare enthusiasts!