Emergency Medicine Cases Premium

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 thoracostomy for hydrothorax and integration of POCUS into pediatric resuscitation.

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 injured their shoulder and the x-ray appears normal? Which proximal humerus fractures are likely to require surgical management? Which shoulder injuries require a simple sling vs Velpeau sling vs collar and cuff vs sugar tong splint? When is an ultrasound of the shoulder indicated and how should they be interpreted? What is the best x-ray view to diagnose a sternoclavicular dislocation? What are the surgical indications for clavicle fractures? and many more...

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 Strayer on ketamine only breathing intubation (KOBI)...

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 the quickest and best way to test neurologic status of patients with shoulder injuries? Why is axillary view of the shoulder so valuable? What is the biggest myth when it comes to the mechanism of injury for posterior glenohumeral shoulder dislocations? What physical exam maneuvers increase suspicion for posterior glenohumeral dislocation? What are the subtle findings on x-ray we should look for in patients with suspected posterior glenohumeral dislocation? What is the preferred first line reduction technique for posterior shoulder dislocation? What are the most common and consequential pitfalls in the management of anterior shoulder dislocations? and many more...

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 is less than 1% (which pales in comparison to Ebola or SARS), historically these types of outbreaks have occured every 5-6 years (SARS 2003, HINI 2009, Ebola 2014, Coronavirus 2020), so they are somewhat predictable and we should know how to prepare for them in our EDs. In this special edition EM Cases podcast Dr. Megan Landes, a Global Health expert, researcher and EM educator runs us through how to best practically prepare our EDs for an outbreak like Coronavirus...

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 these NSTEMI and unstable angina patients with any ischemic changes seen on the ECG, right? And for STEMI too. But should we?....

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 diagnosis of ovarian torsion, Michelle Klaiman on emergency management of crystal methamphetamine use disorder, Hans Rosenberg & Rob Ohle on workup of suspected aortic dissection, and Anand Swaminathan on epinephrine and magnesium sulphate in severe asthma...

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...

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 the dreaded sequence “seizure, coma, death”. Status epilepticus can be nuanced to manage. Sure, most seizures self-abort or love an IV dose of lorazepam, but ask anyone who’s been down the propofol route, and they’re not likely to have forgotten the time they stared down a patient who just...would...not....stop...

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 MacLaren on nuances in inferior MI ECG changes and aVL, Andrew Petrosoniak on a practical approach to blunt cerebrovascular injury and Reuben Strayer on choicebo...