Core EM - Emergency Medicine Podcast

This installment dives into altered mental status, stressing the importance of categorizing potential causes. There’s a focus on children, highlighting the rarity of primary psychosis and the need to consider toxic ingestions. Discussing hyperleukocytosis in patients with acute lymphoblastic leukemia, it emphasizes timely intervention with hematology. Finally, the urgency of managing severe hyponatremia is explored, detailing treatment protocols to avoid complications. A wealth of practical insights for emergency medicine practitioners awaits!

Carl Prickshitis, a fourth-year medical student and trauma assessment blogger, shares invaluable insights on evaluating trauma efficiently. He emphasizes the importance of a systematic approach for minimizing missed injuries. The conversation covers pre-arrival information from EMS, the distinction between blunt and penetrating trauma, and the critical ABCDE primary survey method. Carl highlights effective airway assessments, circulation checks, and the role of the AMPLE mnemonic for focused history-taking. He also critiques the routine use of the digital rectal exam in trauma care.

Dive into the intriguing world of air embolism, a rare but deadly complication often linked to central line placements. Explore the subtle symptoms that can mimic other medical crises, making accurate diagnosis a challenge. Uncover critical treatment strategies, including positioning and hyperbaric oxygen therapy, that can enhance patient recovery. The discussion also sheds light on gas embolisms related to trauma and scuba diving, emphasizing the importance of proper management and supportive care.

This week we explore the presentation, diagnosis and management of SBP. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_131_0_Final_Cut.m4a Download Leave a Comment Tags: Gastroenterology, Infectious Diseases, SBP Show Notes Take Home Points SBP is a difficult diagnosis to make because presentations are variable. Consider a diagnostic paracentesis in all patients presenting to the ED with ascites from cirrhosis An ascites PMN count > 250 cells/mm3 is diagnostic of SBP but treatment should be considered in any patient with ascites and abdominal pain or fever Treatment of SBP is with a 3rd generation cephalosporin with the addition of albumin infusion in any patient meeting AASLD criteria (Cr > 1.0 mg/dL, BUN > 30 mg/dL or Total bilirubin > 4 mg/dL) Read More Oyama LC: Disorders of the liver and biliary tract, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 90: p 1186-1205. REBEL EM: Spontaneous Bacterial Peritonitis EMRAP: C3 Live Paracentesis Video LITFL: Spontaneous Bacterial Peritonitis SinaiEM: SBP Pearls REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)? Core EM: Episode 123.0 – Paracentesis Journal Update Read More

Dive into a treasure trove of medical insights, where non-specific viral syndromes meet tick-borne illnesses. Discover the safety of Doxycycline for children and the critical need to differentiate it from other drugs. Learn how various medications can trigger myasthenia gravis exacerbations. With each pearl, the importance of careful diagnosis and treatment strategies shines through, making this a must-listen for emergency medicine practitioners.

We welcome Meghan Spyres back to the podcast to discuss toxic alcohol ingestion diagnosis and management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_129_0_Final_Cut.m4a Download Leave a Comment Tags: Ethylene Glycol, Fomepizole, Methanol, Toxic Alcohols, Toxicology Show Notes Take Home Points Suspect a toxic alcohol in any patient with a large osmol gap or a large anion gap metabolic acidosis and consider treating these patients empirically. Fomepizole is the critical antidote for toxic alcohol ingestions but, patients are likely going to require dialysis as well. Call your local poison control center if you suspect a toxic alcohol ingestion to help guide management. Read More LITFL: Toxic Alcohol Ingestion ER Cast: Mind the Gap: Anion Gap Acidosis FOAMCast: Episode 43 – Alcohols Read More

This week, we sit down with Billy Goldberg - senior faculty at NYU/Bellevue, to discuss some nuances of hip dislocation management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_128_0_Final_Cut.m4a Download Leave a Comment Tags: Orthopedics, Trauma Show Notes Read More Core EM: Hip Dislocation OrthoBullets: Hip Dislocation EMin5: Hip Dislocation Read More

This week we talk about the subacute headache and the dangerous, can't miss diagnoses of cerebral venous thrombosis and IIH https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_127_0_Final_Cut.m4a Download Leave a Comment Tags: Cerebral Venous Sinus Thrombosis, Headache, Neurology Show Notes Take Home Points Keep IIH and CVST on the differential for patient’s coming in with a subacute headache, particularly if they have visual or neuro symptoms. Consider an ocular ultrasound! It’s quick, shockingly easy to do, and can help point you toward a diagnosis you may have otherwise overlooked.  I have made it my practice now to include a quick look in the physical exam of my patients with a concerning sounding headache or a headache with neurologic symptoms.  Consider IIH particularly in an overweight female of child bearing age with a subacute headache, but remember patients outside that demographic can have IIH as well. Consider CVST in a patient with a thrombophilic process like cancer, pregnancy or the use of OCPs or androgens or in a patient with a recent facial infection like sinusitis or cellulitis. Read More WikEM: Idiopathic Intracranial Hypertension WikEM: Ocular Ultrasound Sinai EM Ultrasound – Pseutotumor Cerebri Read More

This discussion dives into the rare but essential diagnosis of flexor tenosynovitis. The hosts humorously introduce vital signs like tenderness and the infamous 'sausage digit' look. They differentiate it from cellulitis through a case study, stressing accurate diagnosis for optimal recovery. Key treatment strategies include administering targeted antibiotics and the need for surgical consultation. Their engaging take on symptoms and management makes this clinical topic both informative and entertaining!

Discover invaluable insights from a morning report conference focused on emergency medicine. Key discussions include critical case management strategies, the intricacies of medication absorption, and treatment protocols for febrile asplenic patients. The experts dive into the complexities of antibiotic use for community-acquired pneumonia, sharing valuable pearls that enhance patient care. This engaging exchange of knowledge empowers emergency professionals with practical advice to tackle real-world challenges.