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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Ep 151 AKI Part 2 – ED Mana...

01.12.2021

In this Part 2 of our AKI series we discuss the timing, volume and IV crystalloid of choice in AKI patients as well as dialysis indications and timing in light of the recent STARRT-AKI trial. We answer the questions: are ...

Emergency Medicine Cases episodes:

01.12.2021 Ep 151 AKI Part 2 – ED Management In this Part 2 of our AKI series we discuss the timing, volume and IV crystalloid of choice in AKI patients as well as dialysis indications and timing in light of the recent STARRT-AKI trial. We answer the questions: are ...
12.31.2020 Reflections on 2020 COVID Pandemic – EM Physicians Words of Wisdom It goes without saying that 2020 presented many challenges for the worldwide EM community. We all know what those challenges were, so I’m not going to list them here. As we enter 2021 I thought it important to reflect on ...
12.22.2020 Ep 150 Acute Kidney Injury – A Simple Emergency Approach to AKI In this first part of our 2 part podcast series on AKI we answer questions such as: Is there any value in the BUN:Cr ratio in distinguishing prerenal from intrarenal disease? Why is nephritic syndrome one of the most important ...
12.08.2020 EM Quick Hits 24 Lateral Canthotomy, Cannabis Poisoning, Hyperthermia, Malignant Otitis Externa, BBB in Occlusion MI, Prone CPR In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis ...
11.24.2020 Ep 149 Liver Emergencies: Thrombosis and Bleeding, Portal Vein Thrombosis, SBP, Paracentesis Tips and Tricks In this part 2 of our 2 part series on Liver Emergencies we clear up the confusing balance between thrombosis and bleeding in liver patients, the elusive diagnosis of portal vein thrombosis, spontaneous bacterial peritonitis diagnosis and treatment and some ...
11.10.2020 Ep 148 Liver Emergencies: Acute Liver Failure, Hepatic Encephalopathy, Hepatorenal Syndrome, Liver Test Interpretation & Drugs to Avoid In this 1st part of our 2 part series on Liver Emergencies Walter Himmel, Brian Steinhart and Anton discuss: What are the most important causes of acute liver failure that we need to identify in the ED so we can ...
10.27.2020 EM Quick Hits 23 – Clinical Probability Adjusted D-dimer, ARDS Part 2, Pharyngitis Mimics, Barotrauma, Vertigo, CPR Gender-Based Differences In this month's EM Quick Hits podcast we have Salim Rezaie on clinical probability adjusted D-dimer for pulmonary embolism, Bourke Tillmann on ARDS for the ED Part 2, Brit Long & Michael Gottlieb on pharyngitis mimics, Justin Hensley on the ...
10.13.2020 Ep 147 HHS Recognition and ED Management In this podcast, Part 2 of our diabetic emergencies series with Melanie Baimel, Bourke Tillmann and Leeor Sommer, we dive into the recognition and ED management of Hyperglycemic Hyperosmolar State (HHS). We answer questions such as: how does one differentiate ...
09.29.2020 Ep 146 DKA Recognition and ED Management In this first part of our 2-part podcast on DKA and HHS, Drs Melanie Baimel, Bourke Tillman and Leeor Sommer discuss the importance of identifying the underlying cause or trigger in DKA patients, the pitfall of ruling out DKA in ...
09.15.2020 EM Quick Hits 22 Postpartum Hemorrhage, Phenobarbital in Status Epilepticus, Managed Alcohol Programs, Traumatic Cardiac Arrest, Cholangitis, ED Approach to ARDS In this month's EM Quick Hits podcast, Anand Swaminathan on postpartum hemorrhage, Justin Morgenstern on phenobarbital in pediatric status epilepticus, Michelle Klaiman on managed alcohol programs, Andrew Petrosoniak on traumatic cardiac arrest, Brit Long on cholangitis pearls and pitfalls and ...
08.25.2020 Ep 145 Physician Compassion – The Barbara Tatham Memorial Podcast Dr. Barbara Tatham, EM colleague and educator, died of metastatic sarcoma at the age of 32 in October 2019. During her last year of life, in between surgeries, ICU stays and rounds of chemotherapy and radiation, she gave lectures on ...
08.11.2020 EM Quick Hits 21 TXA in GI Bleed, Pediatric DKA, POCUS for Shoulder Dislocations, Lisfranc Injuries, Dexamethasone for COVID Pneumonia, Consultation Tips Salim Rezaie on HALT-IT trial for TXA in unstable GI bleed, Sarah Reid on pediatric DKA update in fluid management and cerebral edema, Hans Rosenberg on POCUS in shoulder dislocations via CJEM, Arun Sayal on Lisfranc injury pearls and pitfalls, ...
07.28.2020 Ep 144 Testicular Torsion: A Diagnostic Pathway In this Part 2 of Urologic Emergencies EM Cases main episode podcasts Dr. Natalie Wolpert and Dr. Yonah Krakowsky answer questions about testicular torsion including: when, after the onset of symptoms, is the testicle salvageable? How sensitive is the presence ...
07.14.2020 Ep 143 Priapism and Urinary Retention: Nuances in Management This month's main episode podcast on Urologic Emergencies - Priapism and Urinary Retention asks: for priapism how much time to do we have to fix it before there’s irreversible tissue damage? How is priapism managed differently depending on the cause? ...
06.30.2020 EM Quick Hits 20 Imaging Renal Colic, Human Trafficking, Atrial Fibrillation During COVID, Transvenous Pacemaker Placement, COVID Lung POCUS, COVID Derm, Virtual Simulation Justin Morgenstern on imaging choices in renal colic, Hanni Stoklosa on recognition and management of human trafficking, Rohit Mohindra on management of atrial fibrillation during COVID-19, Anand Swaminathan on transvenous pacemaker placement, Rob Simard on COVID-19 lung POCUS, Brit Long ...
06.16.2020 BCE 82 Perimortem C-section – The Resuscitative Hysterotomy In this EM Cases Best Case Ever podcast, Dr. Kari Sampsel, Emergency Physician at Ottawa Hospital and Assistant Professor at University of Ottawa, Medical Director of Sexual Assault and Partner Abuse Care Program guides us through an example of a ...
06.02.2020 EM Quick Hits 19 Angioedema, SAH Decision Tool, Breastfeeding Myths, COVID-19 Neurology, Spider Bites, Skin Abscess Management Anand Swaminathan on airway management in angioedema, Jeff Perry on Ottawa subarachnoid hemorrhage rule and 6hr CT rule, Hania Bielawska on ED breastfeeding myths and misconceptions, Brit Long on neurologic associations with COVID-19, Justin Hensley on management of spider bites ...
05.19.2020 Ep142 Neonatal Resuscitation – Airway, Temperature Control, Central Access, Hemodynamics, Glucose Control and Tranport Dr. Hilary Whyte, Dr. Jabeen Fayyaz, Dr. Emily MacNeill discuss a neonatal resuscitation algorithm, airway management, fluid resuscitation, central access tips, glucose and temperature control and transport tips...
05.05.2020 EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors Justin Morgenstern on watchful waiting for large spontaneous pneumothoraces, Michelle Klaiman on mirco-dosing buprenorphine for opiate use disorder, Arun Sayal on the practical application of CRITOE in pediatric elbow fractures, Jeff Perry on The Canadian TIA Score, Sarah Reid on ...
04.21.2020 EM Quick Hits 17 Adrenal Crisis, Strep Throat, Posterior MI, DKA Just the Facts, Ovarian Torsion Imaging, HINTS Exam, Canadian CT Head Rule Anand Swaminathan on recognition and ED management of adrenal crisis, Maria Ivankovic on indications for antibiotics in strep throat from EM Cases Course 2020, Jesse McLaren on recognition of posterior MI from ECG Cases, Justin Yan & Hans Rosenberg on ...
04.07.2020 EM Quick Hits 16 COVID-19 Oxygenation Strategies, Trauma Care, Addictions Considerations, Cardiovascular Complications and Compassionate Care Anand Swaminathan on oxygenation strategies for COVID-19 learned from the New York experience, Andrew Petrosoniak on trauma care modifications in the COVID-19 era, Michelle Klaiman on addiction medicine considerations, Brit Long & Michael Gottlieb on cardiac complications of COVID-19 and ...
04.02.2020 EM Quick Hits 15 – COVID-19 Practical Tips, Pediatric COVID and Human Factors Drs. Sara Gray, Emily Austin, Chris Keefer, Justin Morgenstern, Sarah Reid, Chris Hicks, Peter Brindley and Andrew Cameron share their experience with the COVID-19 pandemic and offer some practical tips on human factors, pandemic airway checklist, deliberate practice airway safety ...
03.31.2020 Ep 141 COVID-19 Part 5 Epidemiology and Prediction Models Ashleigh Tuite infectious diseases mathematical modeler discusses factors predicting spread of SARS CoV-2, prediction models and flattening the curve of COVID-19. Is the COVID-19 virus likely to mutate? And if it does what are the most likely consequences? What do ...
03.28.2020 Ep 140 COVID-19 Part 4 – Protected Intubation There are many complicated guides on airway management and protected intubation since the COVID-19 pandemic broke. This can be confusing in our rush to develop protocols and guides in our own EDs. In this podcast, part of the COVID-19 EM ...
03.26.2020 Ep 139 COVID-19 Part 3 – PPE: What We Know, Conservation Strategies and Protected Code Blue The single most important thing we can do as ED providers in this COVID pandemic is to protect ourselves, our colleagues, our patients, our families and our friends against transmission of the virus; and there is no higher risk of ...
03.24.2020 EM Quick Hits 14 – COVID-19 Your Colleagues’ Experiences and Practical Tips In this special edition EM Quick Hits podcast, Drs. Eddy Lang, Salim Rezaie, Anand Swaminathan, Jonathan Sherbino and Reuben Strayer share their experience with the COVID-19 pandemic and offer some practical tips...
03.23.2020 Ep 138 COVID-19 Part 2 – ED Surge Capacity Strategies in the COVID-19 Pandemic No matter where you practice emergency medicine there will be, or has been, capacity problems in the COVID-19 crisis. Even if we "flatten the COVID-19 curve" there will be a load on the systems that exceeds our capacity. Dr. Daniel ...
03.21.2020 Ep 137 COVID-19 Part 1 – Screening, Diagnosis and Management In this early release first podcast in a series of main episodes on COVID-19, Infectious Diseases specialist at Mount Sinai Health Systems and University Health Network and Professor at the University of Toronto Andrew Morris joins Anton on the latest ...
03.10.2020 BCE 81 Tension Hydrothorax Tension hydrothorax is a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. Dr. Allan Shefrin tells his Best Case Ever of a child who presents in shock and discusses the causes of tension hydrothorax, indications for tube ...
02.25.2020 Ep 136 Occult Shoulder Injuries and Proximal Humerus Fractures Dr. Arun Sayal and Dr. Dale Dantzer answer questions such as: What should be included in the list of key occult shoulder injuries that we should have in our back pockets when we are faced with a patient who has ...
02.25.2020 EM Quick Hits 13 – One Syringe Adenosine, Pertussis Pearls, Hyperemesis Gravidarum, Tramadol, Hypertension Myths, KOBI Salim Rezaie on single syringe adenosine for SVT, Sarah Reid on pertussis pearls, Elisha Targonsky on management of hyperemesis gravidarum , Joe Nemeth on the utility of hypertension as a risk factor in EM, Justin Morgenstern on tramadol myths, Reuben ...
02.11.2020 Ep 135 Commonly Missed or Mismanaged Shoulder Injuries – Approach and Glenohumeral Dislocations Dr. Arun Sayal and Dr. Dale Dantzer answer questions such as: How do we know we have adequate shoulder x-ray views? How can we best remember the differential diagnosis of an orthopedic extremity emergency with a normal x-ray? What is ...
02.11.2020 Preparation for Emergency Infectious Outbreak in your ED – Coronavirus The current outbreak of the novel respiratory pathogen Coronavirus is an opportunity to remind ourselves of how to properly and adequately prepare for an emergency outbreak in our EDs. Although the mortality rate in patients with Coronavirus in this outbreak ...
01.28.2020 JJ 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 Among the presentations seen in the ED, few command the same respect as status epilepticus. It is, in itself, both a diagnostic dilemma and, at times, a therapeutic nightmare. There’s a reason it’s the very first domino to fall in ...
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 ...

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