Is That a Thing?

Today we explore the nuances of corticosteroid use and indications in the emergency department with Dr. Kyle Mcatee.  We delve into when steroids should be used and what the evidence behind steroids is in certain commonly encountered scenarios such as sore throat, anaphylaxis, and many others.  We also answer what the appropriate dose of steroids is and whether or not all steroids are created equal.  

This brief episode examines the right size and location for peripheral IV's for contrasted CT scanning in the emergent setting.  We also explore whether External Jugular IV's, hand IV's and central lines can be used for CT imaging.

This episode is part 2 in our contrast chronicles and tackles the mythical beast of iodine, shellfish, and contrast allergy.  Join us as we explore the evidence behind contrast allergy, contrast mediated anaphylaxis and anaphylactoid reactions.  We take a retro look back to the original papers from the 70’s and 80’s all the way through the present day.  On this deep dive, we will also explore the efficacy of pretreatment for these reactions and the utility of this strategy in the Emergent setting.

In this episode, we dissect the controversy surrounding contrast-induced nephropathy (CIN) and modern IV contrast dye.  Dr. Thomas Ulmer joins us to look at the science and history of IV contrast and CIN.    Turn down your lights, get out your collection of vintage CT scout films, and listen in as we discuss whether it's safe to scan that suspected dissection with a creatinine of 5 or in Hugh's case that mild gastroenteritis with a GFR of 35.

On this cast, we do a deep dive into the origins, history, and evidence behind targeted temperature management (TTM) with our special guest Dr. Thomas Riney.  We discuss the key studies and debate the evidence on length of cooling and ideal temperature for post-cardiac arrest patients and whether or not TTM is a thing after the publication of the TTM2 trial this year.  

In this episode, we discuss the history and development of resuscitative endovascular balloon occlusion of the aorta (REBOA) and its application in civilian and military trauma.  We explore the reasons behind the surge in REBOA research as well as the recent controversy associated with REBOA.  We look at its application in the civilian and military realm and argue that in these settings where injury patterns may differ, REBOA may have different specific roles.  In either case, the specific indications are relatively narrow and REBOA is not a panacea for all trauma.

In this episode, we take a deep dive into the utility of respiratory viral panels.  Are respiratory viral panels (RVP) a sure-fire way to find out what ails a febrile child?  How accurate are these tests and what does it really mean if a febrile child has a positive RVP?  Here we explore the diagnostic biases that these tests can create and discuss the evidence behind them and their place in the Emergency care setting.

This episode focuses on treatment options for intermediate-risk pulmonary emboli (PE).  We define the intermediate-risk (or submassive )PE and controversies surrounding its detection including imaging and laboratory evaluation.  Evidence suggests that it is not only the PE that makes it intermediate risk but also the kind of patient that we find the PE in.  Most of our time in the episode we discuss therapies, specifically thrombolytics, and the evidence and controversy behind their use in this entity.

This episode discusses the role of calcium in trauma patients and whether or not the lethal triad of trauma should be updated to the lethal diamond to include calcium.