CRACKCast & Physicians as Humans on CanadiEM

This episode of CRACKCast covers Rosen's Chapter 145, Drowning. Not only an important topic to know about in the resuscitation bay, but also out in the world!

This episode of CRACKCast covers Rosen's Chapter 143, Diving Injuries and Dysbarism. While infrequently encountered except for those centers frequented by SCUBA enthusiasts, we must know the hard facts on the potentially life-threatening diving related injuries that may occur suddenly and need urgent attention.

This episode of CRACKCast covers Chapter 134 of Rosen's Emergency Medicine (9th Ed.): Electrical and Lightning Injuries.

Core questions:

• What is the relationship between current, voltage and resistance? How does this relate to potential for injury from electrical and lightning injuries?

• What are the types of electrical injury? (based on type of current)

• Differentiate between AC and DC current injuries.

• List 4 types of electrical burns and 5 mechanisms of lightning injury

• List 5 expected injury patterns for high-voltage and lightning injuries

• List clinical findings (early and late) associated with electrical injuries.

• List clinical findings associated with lightning exposure.

• Describe the skin injuries associated with lightning and electricity.

• Describe the modifications in field triage of multiple victims following a lightning strike.

• Describe the prehospital management of electrical injuries

• List 6 admission criteria for electrical/lightning injuries

• List 6 complications of high-voltage injuries

• Tips to avoid getting hit by lightning

Wisecracks:

• List six mechanisms of lightning injury.

• ECG features of lightning strike.

• What is keraunoparalysis?

• Describe the management of a pregnant patient (1st trimester and 2nd /3rd trimester) in the setting of electrical injury.

• How are perioral electrical burns managed? List three early and three late complications.

This 141st episode of CRACKCast covers Rosen's 9th edition, Chapter 133, heat illness. Want to mentally escape from the throes of our gripping winter? Let's go straight into heat illnesses.

Core Questions

1. List 5 mechanisms of heat loss and 5 physiological responses to cold
2. Describe 3 CV manifestations of hypothermia
3. What are the risk factors for hypothermia? List 6.
4. Define mild, moderate and severe hypothermia.
5. Describe the CNS, CVS, hematologic and GU presentations associated with hypothermia for each stage (mild, moderate, severe)
6. What are the changes made to BLS and ACLS in the setting of hypothermia?
7. What are the indications for CPR, defibrillation, and antidysrhythmics in the hypothermic patient?
8. Differentiate between active and passive rewarming. What are the two types of active rewarming?
9. What are five indications for active rewarming? Describe 6 techniques for active rewarming.
   1. Active External Rewarming
   2. Active Core Rewarming
10. What are examples of:
11. In what situations would you not initiate resuscitation of a hypothermic patient?

Wisecracks

1. What is core-temperature afterdrop?
2. List 5 DDx for an Osborne J-wave
3. List 5 laboratory abnormalities expected in hypothermia
4. What three mechanisms cause worsening bleeding in trauma in hypothermia?
5. Describe 5 management considerations other than rewarming in hypothermia
6. What are the prehospital management priorities for the hypothermic patient in each of these categories: mild, moderate and severe?

This episode of CRACKCast covers Rosen's Chapter 131, Frostbite. You will be a pro at managing the spectrum of cold injury that can present to the ED!

This episode of CRACKCast covers Rosen's Chapter 138, Sepsis Syndromes. Sepsis is a topic that has undergone a lot of change in the last 15 years since the Rivers paper was published. This episode covers the original definitions of SIRS and sepsis, while also covering more recent evidence & the newest evidence-based treatment protocols.

This episode of CRACKCast covers Rosen's Chapter 129, Skin Infections. These are common and rarely life threatening, but careful consideration should be given for those who may benefit from admission over outpatient treatment. This is a big episode covering the bugs, presentations, and useful tips when treating these infections in the ED.

Episode Overview:

1. List 6 risk factors for bone and joint infections
2. Describe the classification of osteomyelitis (based on pathophysiology)
3. List the 3 most common bacteria causing osteomyelitis/septic arthritis for each age group: neonate, child, adult; and the following circumstances:
   • Sexually active adolescent
   • Infected prosthesis
   • Sickle cell disease
   • IVDU
   • Human bite
   • Plantar puncture wound
   • Diabetic foot
4. Describe a diagnostic approach to osteomyelitis. What is the utility of bloodwork?
5. List 4 early findings of osteomyelitis on Xray
6. List 5 complications of osteomyelitis
7. List 6 differential diagnoses for osteomyelitis
8. Describe the empiric management of suspected osteomyelitis
9. What is the clinical triad of septic arthritis? Describe typical findings in joint aspiration + radiography.
10. List 5 complications of septic arthritis
11. What is the triad of disseminated Gonococcal disease?
12. List X-ray findings of septic arthritis in a joint with a prosthesis.
13. List 10 differential diagnoses for septic arthritis
14. Describe the empiric management of suspected septic arthritis

Wisecracks:

1. What is Kocher's Criteria?
2. What is a Biofilm? What is its clinical significance?

Episode 135 of CRACKCast covers Rosen's 9th edition, Chapter 127, tuberculosis. TB, or not TB, that is the question. This episode will elucidate the early recognition, risk factors, therapy and precautions regarding this worldwide killer.