The SimKit Podcast

This episode features the presentation of a complex case involving a patient with altered mental status, facial swelling, and dental pain. The discussion highlights key elements of diagnostic reasoning and the importance of maintaining a broad differential when evaluating high-risk patients. The case ultimately underscores the need for vigilance in recognizing rare but life-threatening conditions and using the history, physical, and work-up to nail the diagnosis.

In this episode, we dive into the case of a patient who presents with facial swelling—a common complaint with a wide differential. We walk through the clinical reasoning process, exploring key questions, potential red flags, and common diagnostic traps. As the case unfolds, we highlight the importance of thinking beyond the obvious before ultimately revealing the true diagnosis. Tune in for a thoughtful discussion packed with pearls you can apply on your next shift.

Dr. Neena Kashyap, an emergency medicine trained palliative care fellow at Cooper University Hospital, discusses the vital role of serious illness conversations in patient care. She shares techniques for engaging families in tough discussions, emphasizing empathy and clear communication. Listeners learn about implementing structured frameworks in the fast-paced emergency department, addressing emotional responses, and ensuring continuity of care. Dr. Kashyap highlights the importance of understanding patient values to facilitate deeper connections and better align care decisions with their preferences.

In this discussion, Rob Orman, an emergency physician and physician coach, shares his journey from emergency medicine to coaching. He tackles the critical issue of burnout, offering actionable strategies for self-care and effective communication with hospital administrators. Orman introduces the driveway debrief technique, emphasizing mindfulness in transitioning from work to home life. He highlights the importance of personalized approaches to burnout prevention and shares tools to help clinicians manage stress and cultivate resilience in high-pressure environments.

Join George Willis, an endocrinology expert, as he unpacks the 2024 ADA consensus report on diabetic emergencies. They delve into revised diagnostic criteria for DKA and HHS, shedding light on new glucose testing methods and the vital role of beta hydroxybutyrate. Discover advancements in treatment protocols, including fluid administration and potassium management, while challenging old beliefs. Willis emphasizes the critical differences between DKA and HHS, the importance of patient education, and innovative approaches to diabetic emergencies.

Join Dr. George Willis, an expert in endocrinology, as he dives into the latest American Diabetes Association guidelines on DKA and HHS management. The discussion unveils the rising prevalence of these hyperglycemic crises and emphasizes the critical role of mental health in effective diabetes care. Dr. Willis highlights the complex pathophysiology of DKA, the importance of sodium levels in HHS, and offers vital insights for recognizing these conditions in pediatric patients, especially during respiratory illnesses.

In this discussion, Dr. Crafton Schreier, an Associate Professor of Emergency Medicine, and Dr. Maureen Kanaeus, a pioneering researcher on boarding costs, dive into the pressing issue of patient boarding in emergency departments. They reveal its adverse effects on patient care, staff wellness, and hospital finances. With insights from a recent study, they discuss the complexities of pricing patient boarding and the innovative time-driven activity-based costing (TDABC) method. Their conversation emphasizes the need for systemic changes to optimize patient outcomes.

Struggling with rare medical procedures? This discussion delves into the skills decay that can occur with high-pressure tasks like cricothyrotomy and transvenous pacing. Discover innovative learning strategies to keep you sharp, including the power of mental practice. Learn how mental imagery techniques can aid in skill acquisition and reduce stress, ensuring you're prepared when it matters most. It's a fresh take on staying competent in emergency medicine.

Explore a radical shift in understanding how calcium influences hyperkalemia. Traditional views focus on membrane stabilization, but new research highlights its surprising connection to cardiac conduction velocity. Discover practical guidelines for using calcium in treatment, challenging long-held beliefs and opening the door to innovative clinical practices. Tune in for a fresh perspective that might change how you approach hyperkalemia!

In this discussion, Dr. Evie Marcolini, an emergency medicine and neurocritical care physician, sheds light on the intricate world of stroke management in community hospitals. She shares insights on the advancements in stroke care, including endovascular therapies like mechanical thrombectomy. Dr. Marcolini also delves into the complexities of administering TPA, emphasizing collaboration with neurologists. She highlights the significance of the NIH Stroke Scale in treatment decisions and reinforces the importance of patient education for informed consent in stroke management.