Core EM - Emergency Medicine Podcast

By Core EM

Core EM Emergency Medicine Podcast... more

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FAQs about Core EM - Emergency Medicine Podcast:

How many episodes does Core EM - Emergency Medicine Podcast have?

The podcast currently has 214 episodes available.

Core EM - Emergency Medicine Podcast episodes:

October 23, 2017Episode 118.0 – Acute Cholangitis
Part II of II on gallbladder disorders finishing up with acute cholangitis.

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Tags: Gallbladder, Gastroenterology, General Surgery, GI

Show Notes

Take Home Points
Cholangitis is an acute bacterial infection of the bile ducts resulting from common bile duct obstruction and is potentially life-threatening (mortality 5-10%, acute bacterial infection of the bile ducts
Diagnosis is based on clinical findings and while imaging can be supportive, it is frequently non-diagnostic. Look for RUQ tenderness with peritoneal signs and fever
A normal ultrasound does not rule out acute cholangitis
Treatment focuses on supportive care, broad spectrum antibiotics and consultation with a provider that can provide biliary tract decompression (IR, gastroenterology or general surgery)
Read More
Radiopaedia: Acute cholangitis
Core EM: Cholangitis

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8min
October 16, 2017Episode 117.0 – Acute Cholecystitis
Part I of II on gallbladder pathology starting with cholecystitis.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_117_0_Final_Cut.m4a

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Tags: Gallbladder, Gastroenterology, General Surgery, GI

Show Notes

Take Home Points
Acute cholecystitis is an inflammation of the gallbladder and is a clinical diagnosis. Imaging can be helpful but US and CT can both have false negatives.
Lab tests are insensitive and non-specific and, as such, they can neither rule in or rule out the diagnosis.
Treatment focuses on fluid resuscitation when indicated, supportive care, antibiotics and surgical consultation for cholecystectomy
Although uncommon, be aware that patients can develop gangrene, necrosis and perforation as well as frank sepsis and require aggressive resuscitation
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Core EM: Acute Cholecystitis
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.
Leschka S et al. Chapter 5.1: Acute abdominal pain: diagnostic strategies In: Schwartz DT: Emergency Radiology: Case Studies. New York, NY: McGraw-Hill, 2008.
Menu Y, Vuillerme MP. Chapter 5.5: Non-traumatic Abdominal Emergencies: Imaging and Intervention in Acute Biliary Conditions In: Schwartz DT: Emergency Radiology: Case Studies. New York, NY: McGraw-Hill, 2008.

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10min
October 10, 2017Episode 116.0 – Button Battery Ingestion
This podcast discusses the presentation and management of button battery ingestions in kids.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_116_0_Final_Cut.m4a

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Tags: Button Battery, GI, Pediatrics

Show Notes

NBIH Button Battery Ingestion Algorithm
Button Battery XR (scielo.br)
Take Home Points
Button battery ingestions are extremely dangerous. Necrosis, perforation and erosion into vessels can occur in as little as 2 hours
ALL esophageal button batteries should be removed within 2 hours of presentation to minimize mucosal damage
Consider button battery ingestion in children presenting with dysphagia, refusal to eat and hematemesis
Co-ingestion of a button battery with a magnet requires emergency removal regardless of where it is in the GI system
Read More
National Capital Poison Center: NBIH Button Battery Ingestion Triage and Treatment Guideline
Pediatric EM Morsels: Button Battery Ingestion
St. Emlyn’s: Button Batteries – Hide and Seek in the Emergency Department
ENT Blog: Lithium Disc Battery Danger for Kids

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10min
October 02, 2017Episode 115.0 – Wernicke’s Encephalopathy
This week we sit down with toxicologist Meghan Spyres to talk about Wernicke's Encephalopathy.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_115_0_Final_Cut.m4a

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Tags: Alcohol Abuse, Thiamine, Toxicology, Wernicke's Encephalopathy

Show Notes

Take Home Points
Consider the diagnosis in all patients with nutritional deficiencies, not just alcoholics.
Look for ophthalmoplegia, ataxia and confusion in patients that have risk factors for thiamine deficiency.
Don’t think that it can’t be Wernicke’s because the triad isn’t complete; any two of the components (dietary deficiency, oculomotor abnormalities, cerebellar dysfunction or altered mental status) makes the diagnosis.
Treat Wernicke’s with an initial dose of 500 mg of thiamine IV and admit for continued parenteral therapy.
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LITFL: Thiamine Deficiency
EMRAP: Remember to Take Your Vitamins
ALiEM: Mythbusting the Banana Bag

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13min
September 25, 2017Episode 114.0 – Evaluation of the Alcohol Intoxicated Patient
This week we discuss the initial approach to assessment of the alcohol intoxicated patient.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_114_0_Final_Cut.m4a

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Tags: Alcohol Intoxication, Chronic Alcoholism, Wernicke's Encephalopathy

Show Notes

Take Home Points
Chronic drinkers and even just acutely intoxicated patients are at risk of many medical emergencies including life threatening trauma, infections, metabolic derangements and tox exposures. Don’t dismiss them as “just drunk”
Undress these patients and perform a thorough head to toe examination, focusing on looking for e/o trauma and infection. Get as much history as you can and be sure to ask about their drinking habits and etoh w/d hx to risk stratify them in your brain
Always check FS glucose and replete glucose as needed.
Consider giving your chronic intoxicated patients thiamine injections semi-regularly to prevent WE, and look for e/o the triad in your patients as it can be easily overlooked and deadly if missed!
Read More
EM Docs: EM@3AM Alcohol Intoxication
EM Updates: Emergency Management of the Agitated Patient
Life in the Fastlane: Ethanol Intoxication, Abuse and Dependence

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15min
September 18, 2017Episode 113.0 – Preeclampsia + Eclampsia
This podcast takes a deep dive into the presentation, diagnosis and management of preeclampsia and eclampsia.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_113_0_Final_Cut.m4a

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Tags: Eclampsia, Hypertensive Disorders of Pregnancy, Obstetrics, Preeclampsia

Show Notes

Take Home Points
Suspect preeclampsia in any pregnant women presenting with epigastric/RUQ pain, severe or persistent headache, visual disturbances, nausea or vomiting, shortness of breath, increased edema or weight gain
Evaluate for preeclampsia by looking at the blood pressure, urine for protein and obtaining a panel to evaluate for HELLP syndrome
Severe preeclampsia and eclampsia are treated with bolus and infusion of MgSO4
Emergency delivery is the “cure” for preeclampsia and eclampsia. Consult obstetrics early for an evaluation for delivery
Don’t forget to consider preeclampsia and eclampsia in the immediate postpartum period
Read More
Core EM: Preeclampsia and Eclampsia
LITFL: Preeclampsia and Eclampsia
LITFL: Eclampsia
EM Curious: ED Management of Severe Preeclampsia
Houry DE, Salhi BA. Acute Complications of Pregnancy. In: Marx, J et al, ed. Rosen’s Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014: 178: 2282-2302

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11min
September 11, 2017Episode 112.0 – Herpes Zoster
This week we discuss the presentation and management of herpes zoster.

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Tags: Infectious Diseases, Varicella

Show Notes

Take Home Points
Classically, herpes zoster will present with rash and pain in a dermatomal distribution
Immunocompromised patients are at greater risk for significant complications of zoster, including visceral dissemination and zoster ophthalmicus
Appropriate therapy includes antiviral therapy within 72 hours of onset of symptoms and analgesia for acute neuritis
Disseminated zoster and zoster ophthalmicus threatening sight should be treated with IV antivirals
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Emergency Medicine Ireland: Tasty Morsels of EM 073: FRCEM Varicella
Life in the Fast Lane: Herpes zoster ophthalmicus
Core EM: Herpes Zoster

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7min
September 04, 2017 Episode 111.0 – Snake Bites

This week we discuss the presentation and management of native US snake bites with Dr. Meghan Spyres

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_111_0_Final_Cut.m4a

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Tags: Rattlesnakes, Snake Bites, Snake Envenomation, Toxicology, Vipers

Show Notes

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ALiEM: Envenomations: Initial Management of Common US Snakebites

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18min
August 21, 2017Episode 110.0 – Advanced RSI Topics
This week we dive into some advanced topics in RSI including patient positioning and pre-intubation resuscitation.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_110_0_Final_Cut.m4a

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Show Notes

Take Home Points
Bed up head elevated position for intubation may reduce intubation related complications.
Patients who are hypotensive or at risk of hypotension should be aggressively resuscitation prior to intubation with fluids and liberal use of pressors
Shock patients would be intubated with decreased induction agent dose, preferably ketamine, and increased paralytic dose.
Bed-Up-Head-Elevated Positioning
Show Notes
EMCrit: Podcast 104 – Laryngosocpe as a Murger Weapon (LAMW) Series – Hemodynamic Kills
Life in the Fastlane: Intubation, hypotension and shock
Core EM: Bed Up Head Elevated Position for Airway Management Video
REBEL EM: Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)
ALiEM: The Dirty Epi Drip: IV Epinephrine When You Need It
emDocs: Roc Rocks and Sux Sucks! Why Rocuronium is the Agent of Choice for RSI
Swaminathan A, Mallemat H. Rocuronium Should Be the Default Paralytic in Rapid Sequence Intubation. Ann Emerg Med 2017. PMID: 28601274
Khandelwal N et al. Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit. Anesth Analg 2016; 122(4): 1101-7. PMID: 26866753

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10min
August 14, 2017 Episode 109.0 – Renal + GU Emergencies

This week we discuss some quick pearls from our conference covering an array of renal and GU pathologies.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_109_0_Final_Cut.m4a

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Tags: GU, Renal, Urology

Show Notes

Read More
Core EM: Testicular Torsion
Core EM: Podcast Episode 92.0 – Dialysis Emergencies
Al Sacchetti: ED Repair of Bleeding Dialysis Shunt
EM: RAP: Episode 107 – Dialysis Emergencies
EMBlog Mayo Clinic: How to Stop a Post-Dialysis Site Bleeding
emDocs: Managing Fistula Complications in the Emergency Department
References
Mellick LB. Torsion of the testicle: It is time to stopping tossing the dice. Pediatric Emer Care 2012; 28: 80-6. PMID: 22217895

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8min

FAQs about Core EM - Emergency Medicine Podcast:

How many episodes does Core EM - Emergency Medicine Podcast have?

The podcast currently has 214 episodes available.

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