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 221 episodes available.

Core EM - Emergency Medicine Podcast episodes:

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.
Read More
LITFL: Thiamine Deficiency
EMRAP: Remember to Take Your Vitamins
ALiEM: Mythbusting the Banana Bag

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...more
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.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_112_0_Final_Cut.m4a

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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
Read More
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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...more
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

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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
July 31, 2017Episode 108.0 – Intubation in In-Hospital Cardiac Arrest
Should we intubate patients in cardiac arrest? We discuss this topic and some basics of running a good arrest.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_108_0_Final_Cut.m4a

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Tags: Advanced Airway Management, Cardiac Arrest, Critical Care, Resuscitation

Show Notes

Take Home Points
Intra-arrest intubation does not appear to improve outcomes. For most patients, support with BVM, or possibly an LMA, is adequate.
Instead of securing an advanced airway, focus on the two things that clearly make a difference in outcomes – good compressions and defibirillation
Good compressions should be fast and hard and you must minimize interruptions in compressions to minimize interruptions in perfusion
Don’t forget that a great resuscitation requires great preparation. Take whatever time you have to discuss with your team and assign roles.
Read More
Rebel EM: In-hospital Cardiac Arrest – The First 15 Minues
Core EM: Proper Defibrillator Pad Placement + Dual Sequential Defibrillation
REBEL EM: Beyond ACLS: Cognitively Offloading During a Cardiac Arrest
REBEL EM: Beyond ACLS: POCUS in Cardiac Arrest
REBEL EM: Beyond ACLS: CPR, Defibrillation and Epinephrine
REBEL EM: Beyond ACLS: Pre-Charging the Defibrillator

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...more
11min
July 24, 2017Episode 107.0 – Angioedema
Prompted by the recent CAMEO trial publication on icatibant, we dive into angioedema with a focus on airway management.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_107_0_Final_Cut.m4a

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Tags: ACE Inhibitors, Allergy/Immunology, Angioedema, Icatibant

Show Notes

Take Home Points
Airway management is paramount, expect a challenging intubation and consider controlling the airway early
When controlling the airway, consider an awake approach and fiberoptics if available. Always be prepared for the can’t intubate, can’t oxygenate scenario with a double set up.
If the patient has urticaria and pruritus, the process is likely histamine mediated and will respond to typical anaphylaxis treatment
Finally, observe the patient for progression of swelling and don’t forget to stop the inciting medication
Read More
Core EM: Angioedema
EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC
ERCast: Angioedema
REBEL EM: Icatibant Doesn’t Improve Outcomes in ACE-I Induced Angioedema
The SGEM: Icatibant Bites the Dust – For ACE-I Induced Angioedema

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9min
July 17, 2017Episode 106.0 – Procedural Sedation and Analgesia II
This week we drop into some of the nitty gritty on PSA including preparation and patient assessment as well as discuss some common pitfalls.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_106_0_Final_Cut.m4a

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Tags: Pitfalls, Procedural Sedation, PSA

Show Notes

Take Home Points
Always perform a full pre-PSA evaluation including an airway assessment. Time of last meal shouldn’t delay your sedation based on the best available evidence.
Always do a complete setup including consideration of different agents, dosage calculations, preparation of airway equipment and reversal agents.
PSA serious adverse events are rare but you still must be prepared for them. Careful agent selection and dosing can help prevent issues but, know your outs.
If apnea develops, do some basic maneuvers before you reach for the BVM or laryngoscope. Remember OOPS as in “oops, my patient went apneic.” Oxygen on, pull the mandible forward and sit the patient up. This fixes most issues
Show Notes
Core EM: Procedural Sedation and Analgesia Resources
EM Updates:Emergency Department Procedural Sedation Checklist v2
REBEL EM: Complications of Procedural Sedation
Bellolio MF et al. Incidence of adverse events in adults undergoing procedural sedation in the emergency department: a systematic review and meta-analysis. Acad Emerg Med 2016; 23: 119-34. PMID: 26801209

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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 221 episodes available.

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