Emergency Medicine Cases

By Dr. Anton Helman

Education Medicine

What's Emergency Medicine Cases about?

In-depth round table discussions with two or more of Canada’s brightest minds in Emergency Medicine on practical practice changing EM topics since 2010. For show notes, written summaries, links, ebooks & discussions visit emergencymedicinecases.com

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Journal Jam 16 Heparin for ...

01.28.2020

Does heparin - LMWH or unfractionated heparin - benefit the patient with a pretty good story for angina with a bump in their troponin and some ST depression in the lateral leads? We’re expected to routinely give heparin for all ...

Emergency Medicine Cases episodes:

01.28.2020 Journal Jam 16 Heparin for ACS and STEMI Does heparin - LMWH or unfractionated heparin - benefit the patient with a pretty good story for angina with a bump in their troponin and some ST depression in the lateral leads? We’re expected to routinely give heparin for all ...
01.14.2020 EM Quick Hits 12 AFib Early vs Delayed Cardioversion, Snake Bites, Ovarian Torsion Myths, Crystal Meth, Aortic Dissection, Severe Asthma Meds In this EM Quick Hits podcast we have Paul Dorion on immediate cardioversion vs rate control/delayed cardioversion for atrial fibrillation, Justin Morgenstern & Justin Hensley on emergency management of snake bites, Brit Long on reliability of clinical features in the ...
12.31.2019 Ep 134 Shift Preparation: Pre-gaming with Rob Orman The question is: how do we best mentally and physically prepare for an ED shift? Dr. Rob Orman, master educator and fellow podcaster joins Anton to discuss a few options...
12.17.2019 Ep 133 Emergency Management of Status Epilepticus
12.03.2019 EM Quick Hits 11 Blunt Cerebrovascular Injury, Physostigmine, TEE in Cardiac Arrest, Understanding Nystagmus, Subtle Inferior MI, Choicebo In this EM Quick Hits podcast we have Emily Austin on physostigmine for anticholinergic toxidrome, Walter Himmel on understanding nystagmus to differentiate central vs peripheral causes of vertigo, Rob Devins on the role of transesophageal echocardiogram in cardiac arrest, Jesse ...
11.19.2019 Ep 132 Emergency Approach to Resolved Seizures What is the essential list of immediate life threats with specific antidotes that we must know for the ED patient with a seizure? What are the key elements for distinguishing a true seizure from syncope? From Psychogenic Non-Epileptic Seizure (PNES)? ...
11.05.2019 EM Quick Hits 10 – TXA CRASH-3, CJEM Cellulitis, Double Defib, Serratus Anterior Block, PARC score, Toxic Shock Syndrome Sarah Reid on pediatric appendicitis risk calculator, Sheldon Cheskes & Mark Ramzy on double defibrillation for refractory ventricular fibrillation, Hans Rosenberg & Krishan Yadav on cellulitis clinical pearls, Anand Swaminathan on serratus anterior block, Brit Long on recognition of toxic ...
10.22.2019 Ep 131 PEA Arrest, PseudoPEA and PREM – With Simard and Weingart Rob Simard of POCUS Cases fame and Scott Weingart go beyond ACLS and guide you through the complex world of PEA. We discuss that the palpation technique is poor at determining whether or not a patient has a pulse, that ...
10.08.2019 EM Quick Hits 9 Burn Blister Debridement, ECG Cases, Compartment Syndrome, Pediatric Asthma, Spinal Trauma, Motivational Interviewing P2 Justin Morgenstern on the lack of evidence for burn debridement, Jesse MacLaren on ECG Cases - missed ischemia and pitfalls of "normal" computer ECG interpretations, Arun Sayal on clinical diagnosis pitfalls of compartment syndrome, Sarah Reid on pediatric asthma pitfalls ...
09.25.2019 Ep 130 Community Acquired Pneumonia: Emergency Management While community acquired pneumonia (CAP) is 'bread and butter' emergency medicine, and the diagnosis is often a 'slam dunk', it turns out that up one third of the time, we are wrong about the diagnosis; that x-rays are not perfect; ...
09.10.2019 EM Quick Hits 8 Lemierre’s Syndrome, Clonidine Toxicity, Routine Coag Panel, Anticoagulation Reversal, Mechanical CPR Anand Swaminathan on Lemierre's syndrome, Emily Austin on clonidine toxicity, Brit Long on myths of routine coagulation panel testing, Hans Rosenberg and Michael Ho on reversal of anticoagulation, Sheldon Cheskes on mechanical CPR...
08.27.2019 Ep 129 ED Overcrowding and Access Block – Causes and Solutions Howard Ovens, Grant Innes, Sam Campbell and Anton discuss the root causes, challenges and some of the solutions of one of the defining characteristics of emergency medicine in the 21st century - overcrowding. It is absolutely in the interest of ...
08.13.2019 EM Quick Hits 7 Approach to Status Epilepticus, Codeine Interactions, Anticoagulation in Malignancy, Atrial Fibrillation Rate vs Rhythm Control, Peripheral Vasopressors, Motivational Interviewing Anand Swaminathan on a simple approach to status epilepticus, David Juurlink on codeine and tramadol interactions: nasty drugs with nastier drug interactions, Brit Long on DOACS in patients with malignancy: which patient's with cancer can be safely prescribed DOACs? Ian ...
08.13.2019 BCE 80 Pediatric Respiratory Failure In this EM Cases Best Case Ever podcast Rajiv interviews Dr. Eric Russell, Assistant Professor of Pediatrics at the Baylor College of Medicine, Pediatric Emergency Medicine attending physician at the Texas Children's Hospital, and editor at the Human Diagnosis Project. ...
07.30.2019 Ep 128 Low Risk Chest Pain and High Sensitivity Troponin – A Paradigm Shift In the age of high sensitivity troponins and the HEART pathway, which patients are safe to discharge home from the ED? What are the most useful historical factors to increase and decrease your pretest probability for ACS? Which cardiac risk ...
07.16.2019 EM Quick Hits 6 Blunt Cardiac Trauma, Atrial Fibrillation Anticoagulation, Hydromorphone vs Morphine, Myasthenia Gravis, Venous Access In this EM Quick Hits episode: Andrew Petrosoniak on diagnosis and risk stratification of blunt cardiac trauma, Clare Atzema on latest guidelines for anticoagulation in atrial fibrillation, Maria Ivankovic on hydromorphone vs morphine for acute pain, Brit Long on clinical ...
07.02.2019 Ep 127 EM Drugs that Work and Drugs that Don’t Part 2 – Antiemetics, Angioedema, Oxygen In this Episode 127 Drugs that Work and Drugs that Don't Part 2 - Antiemetics, Angioedema and Oxygen, with Justin Morgenstern and Joel Lexchin we discuss the evidence for various antiemetics like metoclopramide, prochlorperazine, promethazine, droperidol, ondansetron, inhaled isopropyl alcohol ...
06.18.2019 Ep 126 EM Drugs That Work and Drugs That Don’t – Part 1: Analgesics In this podcast we discuss the key concepts in assessing drug efficacy trials, and provide you with a bottom line recommendation for the use of gabapentinoids, NSAIDs and acetaminophen for low back pain and radicular symptoms, topical NSAIDs and cyclobenzaprine ...
06.04.2019 Ep 125 Electrical Injuries – The Tip of the Iceberg Electrical injuries are rare, representing less than 1% of burn center admissions. So there is a paucity of robust evidence for the management of these patients. Nonetheless, in this podcast we’ll give you the tools to help risk stratify electrical ...
06.04.2019 EM Quick Hits 5 Ludwig’s Angina, Transient Monocular Vision Loss, D-dimer for PE Workup in Pregnancy, Pediatric Nasal Foreign Bodies, Trimethoprim Drug Interactions, Airway Management in Cardiac Arres In this EM Quick Hits Podcast: Ludwig's Angina Emergency Management - Approach, Airway, Imaging, Transient Monocular Vision Loss (TMVL), D-dimer in the Work-up of Pulmonary Embolism in Pregnancy, Management of Pediatric Nasal Foreign Bodies: Tips and Tricks, Sulfamethoxazole-Trimethoprim Drug Interactions ...
05.21.2019 Ep 124 Burn and Inhalation Injuries: ED Wound Care, Resuscitation and Airway Management It turns out that for all burn patients—from minor to severe—there is a lot of room for improvement in ED management, counselling and disposition. Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation ...
05.07.2019 EM Quick Hits 4 Acetaminophen Overdose & Warfarin Interaction, Dental Infections, MTP RABT Score, Statins for STEMI, Cricothyrotomy Tips In this Quick Hits Podcast: David Juurlink on acetaminophen and warfarin drug interaction, Hans Rosenberg on management of dental infections, Emily Austin on dialysis in massive acetaminophen overdose, Andrew Petrosoniak on MTP decisions and the RABT score in trauma , ...
04.23.2019 Ep 123 Pediatric UTI Myths and Misperceptions On the one hand, UTI is one of the most common bacterial infections in children younger than 2 years of age and could lead to sepsis acutely and theoretically renal failure in the long run. On the other hand, it ...
04.09.2019 JJ 15 Cardiac Stress Testing After Negative ED Workup for MI In this Journal Jam podcast we do a deep dive into the hugely complex literature of cardiac stress testing and see whether or not stress testing portends any benefit for patients who we assess in the ED for chest pain. ...
04.09.2019 BCE 79 Pediatric UTI – Choosing Wisely In anticipation of EM Cases Episode 123 Pediatric UTI Myths and Misconceptions, Dr. Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in ...
03.26.2019 Ep 122 Sepsis and Septic Shock – What Matters from EM Cases Course In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? How does SIRS, qSOFA and NEWS compare in predicting poor outcomes in ...
03.12.2019 EM Quick Hits 3 – Kawasaki Disease, Suturing Dog Bites, BVM in RSI, Anticraving Meds for Alcohol Misuse, ED Violence On this EM Quick Hits podcast we have Natalie May on Kawasaki disease clues to diagnosis, Justin Morgenstern on suturing dog bites: the evidence, Anand Swaminathan on BVM prior to laryngoscopy, Michelle Klaiman on anticraving medications for alcohol use disorder ...
02.26.2019 Ep 121 Elbow Injuries – Ten Pitfalls in Diagnosis and Management In this main episode podcast we discuss the pitfalls in the diagnosis and management of elbow injuries and answer questions such as: What is an easy way to remember the surgical indications for radial head fractures? What is the significance ...
02.12.2019 EM Quick Hits 2 Organophosphate Poisoning, TXA for Hemoptysis, Metacarpal Fracture Rotation, Abdominal Stab Wounds, Pediatric IV Cannulation On this EM Quick Hits podcast we have Emily Austin on organophosphate poisoning, Arun Sayal on malrotation of metacarpal fractures, Andrew Petrosoniak on pitfalls in abdominal stab wound management, Anand Swaminathan on tranexamic acid for non-massive hemoptysis, and Natalie May ...
01.29.2019 Ep 120 ED Stroke Management in the Age of Endovascular Therapy In this EM Cases main episode podcast, a follow up to our episode on TIA released in November 2018 with Walter Himmel and David Dushenski, we’ll try to simplify the confusing time-based and brain tissue-based options for stroke management. We’ll ...
01.15.2019 EM Quick Hits 1 Massive PE, Gabapentin for Alcohol Withdrawal, Dental Avulsions, Pediatric Eye Exam, Best Resuscitation Fluid EM Quick Hits is a brand new EM Cases podcast that contains 5 minute segments chosen from 10 specific topics by 10 different experts and educators. These topics are ones that either are not taught very well in training and/or ...
01.01.2019 Ep 119 Trauma – The First and Last 15 Minutes Part 2 What should your resuscitation targets be in the first 15 minutes for trauma patients with hemorrhagic shock, neurogenic shock, severe head injury? When is a pelvic binder indicated? Is a bedsheet good enough? What are the most common pitfalls in ...
12.18.2018 Ep 118 Trauma – The First and Last 15 Minutes Part 1 In this part 1 of Trauma - The First and Last 15 Minutes, we answer questions such as: how should we best prepare our team, our gear and ourselves for the trauma patient? How does resequencing the initial trauma resuscitation ...
12.04.2018 BCE 78 Traumatic Cardiac Arrest In anticipation of EM Cases Episode 118 Trauma: The First and Last 15 minutes with Andrew Petrosoniak, Kylie Bosman and Chris Hicks we have Joe Nemeth, Trauma Fellowship Director at Montreal General and Associate Professor at both McGill University and ...
11.20.2018 Ep 117 TIA Update – Risk Stratification, Workup and Dual Antiplatelet Therapy Much has changed in recent years when it comes to TIA risk stratification, workup and antiplatelet therapy. In this podcast we use the overarching theme of timing to elucidate how to distinguish true TIA from the common TIA mimics, the ...
11.06.2018 JJ 14 Epinephrine in Cardiac Arrest Does epinephrine improve the chances of return of spontaneous circulation at the expense of the brain? In other words, while we know that epinephrine doubles rates of ROSC in all comers in cardiac arrest, there’s never been robust evidence for ...
11.06.2018 BCE 77 Pulmonary Embolism Workup in Pregnancy This Best Case Ever elucidates the practical challenges of working up pregnant patients in the ED with a suspicion of pulmonary embolism. Since this recording, the first ever multi-center prospective outcome study looking at the pulmonary embolism workup in pregnancy ...
10.23.2018 Ep 116 Emergency Management of Opioid Misuse, Overdose and Withdrawal In this episode Dr. Kathryn Dong, Dr. Michelle Klaiman and Dr. Aaron Orkin discuss the latest in naloxone in opioid overdose cardiac arrest and altered LOA, a 5-step approach to ED opioid withdrawal management and how we can improve mortality ...
10.09.2018 BCE 76 Opioid Withdrawal In anticipation of EM Cases Episode 116 on Opioid Misuse, Overdose and Withdrawal, Dr. Michelle Klaiman, Addictions and Emergency Medicine specialist, tells her Best Case Ever exemplifying how we can positively impact the lives of ED patients for years to ...
09.25.2018 Ep 115 Emergency Management of the Agitated Patient Managing acutely agitated patients can cause anxiety in even the most seasoned emergency doctor. These are high risk patients and they are high risk to you and your ED staff. It’s important to understand that agitation or agitated delirium is ...
09.11.2018 BCE 75 Reuben Strayer’s Agitated Patient In anticipation of Episode 115 Management of the Agitated Patient, Dr. Reuben Strayer tells the story of the case that got him interested in developing an expertise around management of the agitated patient that includes an important simple pitfall and ...
08.28.2018 JJ 13 Regional Nerve Blocks for Hip Fractures In this EM Cases Journal Jam podcast with Anton Helman, Justin Morgenstern, Rory Spiegel, and special guest Jacques Lee we explore the evidence for femoral nerve blocks and fascia iliaca blocks as well as discuss the practical implementation of them ...
08.28.2018 Ep 114 Pulmonary Embolism Challenges in Diagnosis 2 – Imaging, Pregnancy, Subsegmental PE In Part 1 of Pulmonary Embolism Challenges in Diagnosis Drs. Helman, Lang and DeWit discussed a workup algorithm using PERC and Wells score, the bleeding risk of treated pulmonary embolism, pearls in decision making on whether or not to work ...
08.14.2018 Ep 113 Pulmonary Embolism Challenges in Diagnosis Part 1 Dr. Kerstin DeWit and Dr. Eddy Lang answer the questions that plague us on almost every shift: Which patients require any work-up at all for PE? What’s the utility of PERC and Well’s scores? Should the newer YEARS decision tool ...
08.01.2018 BCE 74 Coding in the Scanner In anticipation of EM Cases Episode 113 Diagnosis an Workup of Pulmonary Embolism with Dr. Kerstin DeWit and Dr. Eddy Lang, we have Dr. Peter Reardon telling us his Best Case Ever (Coding in the Scanner) of a young woman ...
07.17.2018 Ep 112 Tachydysrhythmias with Amal Mattu and Paul Dorion In this EM Cases main Episode 112 Tachydysrhythmias with Amal Mattu and Paul Dorion we discuss a potpurri of clinical goodies for the recognition and management of both wide and narrow complex tachydysrhythmias and answer questions such as: Which patients ...
07.03.2018 BCE 73 Esmolol in Refractory Ventricular Fibrillation In anticipation of EM Cases Episode 112 on Tachydysrhthmias with Amal Mattu and Paul Dorion, Melanie Baimel tells her Best Case Ever of a previously healthy young man who presents in refractory ventricular fibrillation after receiving multiple single shocks, ongoing ...
06.19.2018 Ep 111 Effective Learning Strategies in Emergency Medicine
06.05.2018 BCE 72 Overinvestigation in Emergency Medicine With increased access to timely advanced diagnostic testing in ED rational resource utilization is becoming ever more important. In his Best Case Ever Dr. Shabhaz Syed argues that a patient at Janus General who presented to the ED with chest ...
05.22.2018 Ep 110 Airway Pitfalls – Live from EMU 2018 The last decade has seen a torrent of literature and expert opinion on emergency airway management. It is challenging to integrate all this new information into a seamless flow when faced with a challenging airway situation. In this live podcast ...

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