Core EM - Emergency Medicine Podcast

Delve into the world of Immune Checkpoint Inhibitors (ICIs) and discover how these innovative drugs revolutionize cancer treatment by enhancing the immune system's ability to attack cancer cells. Learn about the significant risks associated with ICIs, including autoimmune reactions that can present like infections. The discussion highlights the challenges emergency departments face in diagnosing and managing side effects such as pneumonitis and endocrinopathies. Effective strategies for early intervention are also explored, emphasizing collaboration with oncology teams for optimal care.

Explore the critical evaluation of pediatric ataxia through the lens of a troubling case involving an 18-month-old boy. Discover the common and rare causes of ataxia, like acute cerebellar ataxia and Guillain-Barre syndrome. Dive into the significance of history-taking and physical exams in diagnosis. Learn about essential diagnostic tests, including neuroimaging, and treatment strategies centered on identifying underlying conditions. It's a masterclass in pediatric emergency medicine and the art of thorough assessment.

Delve into hypernatremia, defined as elevated serum sodium levels over 145 mEq/L, and its wide-ranging symptoms from nausea to coma. Discover the risk factors and diagnostic prerequisites essential for vulnerable patients. Explore management strategies that consider the type and duration of hypernatremia, while avoiding the dangers of overcorrection. Learn practical advice on fluid administration and monitoring practices to ensure safe treatment in emergency scenarios.

Explore the challenges of recognizing and managing acute agitation in emergency medicine. Discuss terminology shift and multifactorial causes of agitation. Learn about assessing severity, pharmacologic management, and tailored interventions for specific patient populations.

Exploring the challenges of treating critically ill infants in the emergency department, focusing on trauma considerations and anatomical vulnerabilities. Discussion on cyanotic congenital heart diseases with the 5 T's mnemonic. Delving into critical cardiac conditions, endocrine emergencies, inborn errors of metabolism, sepsis recognition, and intestinal catastrophes in infants.

Exploring the diagnostic criteria and severity levels of ARDS, differentiation from cardiogenic pulmonary edema, pathophysiology phases, etiology, and comprehensive management strategies including fluid management, steroids, oxygenation techniques, and mechanical ventilation goals. Advanced strategies discussed are salvage ventilation modes, prone positioning, inhaled pulmonary vasodilators, and VV ECMO for unresponsive cases.

Stefanie Biondi, a dedicated senior resident, shares her insights on the rising concern of nitrous oxide toxicity. She discusses a compelling case study of a young man whose symptoms escalated due to recreational use of the gas. The conversation dives into the misconceptions surrounding nitrous oxide, particularly its perceived safety. Additionally, Stefanie highlights the significant neurological consequences of frequent use and the critical need for awareness and early diagnosis to prevent long-term health issues.

Exploration of threatened abortion in early pregnancy, initial assessment priorities, broad differentials, diagnostic tests like HCG level and urinalysis, importance of interpreting HCG values, use of ultrasound imaging, patient counseling on prognosis and psychosocial support, and follow-up strategies for management.

The podcast discusses the approach to syncope in children, including initial workup similarities for children and adults, the rule of 50s for dextrose administration, and the importance of ECG analysis for diagnosing dysrhythmias. Topics covered include long QT syndrome, Brugada syndrome, and Wolff-Parkinson-White syndrome, emphasizing the need for a comprehensive evaluation and management in pediatric syncope cases.

The podcast discusses the treatment of rapid atrial fibrillation (afib with RVR) including stability assessment, ACLS protocols, rate vs. rhythm control strategies, limitations in chronic AF, and identifying pre-excitation syndromes. It explores the challenges and limitations of current treatments and emphasizes the importance of a thoughtful approach for patients with AFib and suspected critical illness.