Em Basic

Join Dan McCollum as he discusses COVID-19, the disease caused by the novel coronavirus. What are the symptoms of this disease? How is it spread? What personal protective equipment is needed? What are key elements of the history and physical exam? Are there any treatments that help? This is a rapidly evolving topic, so please use multiple sources, stay informed, and follow your local hospital's guidance as this disease develops.

Join Zac Hodges and Dan McCollum as they have a conversation about neonatal fevers with Dr. Kathryn McLeod, an experienced pediatrician at the Children's Hospital of Georgia.  We discuss the general approach to taking the history and physical exam of a patient with a fever under the age of 90 days.  Where did prior guidelines on the initial workup come from?  How did immunizations change the risk of serious bacterial infection?  What are some recent new approaches to the febrile neonate?  Join us as we discuss this and more!

Join physicians Eric Ring, Zac Hodges, and Dan McCollum as they discuss how to properly care for the pediatric patient with sickle cell disease.  Dr. Eric Ring is a pediatric specialist in Hematology and Oncology at the Children's Hospital of Georgia in Augusta, GA.  What are the critical elements of a history of present illness?  What red flags should you look for on physical exam?  What are the dreaded complications of sickle cell disease that you should be wary of?  Join us for these questions and more!

Join Zac Hodges, Chris Watson, and Dan McCollum as they discuss the management of pediatric diabetic ketoacidosis, or DKA.  What are key findings on the history and physical exam that point to DKA?  What is the initial management of these patients?  How is the management similar and different than the management of DKA in adults?  Join us for the answer to this and more.

Today's episode of the podcast is a myth busting on all the media reports about first responders overdosing by being exposed to fentanyl in the field by incidental contact. This is physically impossible and the misinformation out there has scared a lot of people, cost us lots of money in the form of hazmat responses and shutting down hospitals, and prevented overdose patients from getting the timely care they need in an emergency. This episode will systematically go through every argument why fentanyl is NOT harmful via incidental exposure and debunk these myths to give first responders one less thing to worry about while they do their frequently dangerous yet vital work.

EM Basic is finally back with a new episode. Today's episode will discuss neonatal resuscitation with Dr. Azif Safarulla, a neonatologist at Augusta University. Dr. Dan McCollum and Dr. Jessica Gancar interview Dr. Safarulla on the nuts and bolts of running a successful neonatal resuscitation in the ED. These can be one of the scariest populations we have in the ED so it's important to have a rational and logical approach to quickly assess and intervene on our smallest and youngest patient population.

Just a few days after the new EM interns start, today's episode will talk about my advice to new EM interns.  Think of this as the "big picture advice" or a 30,000 foot view of how to approach EM residency.  I'll talk about 4 major big picture points to keep in mind as you start your residency.  This will go way beyond arrive early, stay late, and always keep learning and expand on some big picture ideas of how to function well as a new intern.

Today’s episode is on the evaluation and management of sickle cell anemia in the Emergency Department. Dr Jared Walker, a third year EM resident at the University of Florida Jacksonville, has written and recorded this excellent review of sickle cell disease. This episode will discuss how to properly assess patients with sickle cell, how to order the right labs and imaging, what red flags to look out for, how to control sickle cell pain, how to catch the various complications of sickle cell, and proper patient disposition.

Today's episode will discuss North American poisonous reptile bites with a focus on snake bites.  This episode was written and recorded by Dr. David Hansen, an active duty physician with the US Army.  It will review common presentations of snake bites, the relevant history and exam findings, the labs to order, how to decide when to use anti-venom and properly administer it.  There is also a bonus section on how to avoid snake bites in the wilderness and what to do if you are bitten by a poisonous snake.

This episode is on hyperthermia- just in time for the warmer weather.  However, hyperthermia has many different causes so this episode will review them all.  Dr. Andrea Sarchi wrote this script which was recorded by Jacob Schriner, MS-3 at Emory University School of Medicine.  This episode will review the necessary history and physical exam findings, ordering the right labs and tests, and how to treat this condition to ensure the best patient outcomes.  

Today's episode is a quick review of Thyroid emergencies by Dr. Patrick Ng, a 3rd year EM resident in San Antonio, recorded by Jacob Schriner MS-3.  Thyroid emergencies can be difficult to recognize in the ED because they present in so many different ways.  Today's episode will review how to recognize these emergencies, order the right tests, and provide the correct critical treatments.

This episode is a re-broadcast of the first sepsis episode in February 2012.  I am republishing the part of that episode that deals with the definitions of sepsis.  I think the new sepsis guidelines rely too much on clinician judgment and gestalt in identifying septic patients so this will be helpful to learners.  To be clear- the term severe sepsis is not in use any more- we only have sepsis and septic shock.  However, learning this stepwise progression (even if patient's don't follow it) will help you better understand how to recognize sepsis in the ED.

This episode is a total revamp of the previous episode on sepsis.  A lot has changed with sepsis management since I published the sepsis episode in February 2012 so it was time for a complete overhaul.  The new sepsis guidelines have been out for about a year and I finally got around to updating the episode.  This episode will discuss the recognition of sepsis, how to do a good physical exam and ask the right history questions, order the right tests, and aggressively resuscitate these very sick patients.  There is a separate episode that discusses the old sepsis definitions and how you can use that framework to recognize sepsis.

Today's episode is on Croup- just in time for the middle of the croup season.  Your ED may even be filled with kids with a barking cough as we speak.  Today's episode was written by Taylor Fischer and Stewart Harsant, two physician assistants who have done an excellent job of summarizing this common pediatric disease process.  This episode will review the diagnosis of croup, how to risk stratify kids with croup, and how to treat and disposition them properly.  Most of the time, kids with croup do just fine with a little cold night air and some steroids but this episode will also help you figure out which kids are sicker and need much more attention and care.

Just in time for the midway point of the winter season, this is a podcast on management of hypothermia in the ED.  Dr. Andrea Sarchi wrote the script which was recorded by Jacob Schriner, a second year medical student at Emory University School of Medicine.  In this episode we'll review the basics of hypothermia diagnosis, history and physical exam pearls, treatment and disposition of these patients.  As always we'll start with the "not sick" patient and then work our way up to the critically ill patients.

In part 2, Dr Sheyna Gifford will discuss the how to differentiate opioid overdose from other causes of altered mental status, some special disposition situations (especially with methadone), and how we can quickly screen for opioid abuse and provide patients compassionate care, treatment, and referral.

It's no secret that we have a major opioid problem in the United States.  The number of people addicted to opioids has reached epidemic proportions and we are certainly seeing this everyday in the Emergency Department.  In this episode Dr. Sheyna Gifford discusses a few facts about the scope of this epidemic,  the basics of recognizing opioid overdose, and initial stabilization and treatment.  She'll discuss the many different ways of using naloxone (aka Narcan) that we can utilize to wake up patients safely and without precipitating acute withdrawal.

EM Basic is back with a re-broadcast from the awesome podcast Pediatric Emergency Playbook by Dr. Tim Horeczko.  Tim is a double boarded in EM and Peds EM and works at Harbor-UCLA hospital.  This was the first episode he published at the beginning of September and it is pure gold.  Tim goes beyond the febrile neonate and talks about how to consider all possible causes for a sick infant- not just anchoring on sepsis the whole time!  Tim presents a rational and systematic approach on how to deal with these young sick patients that get our anxiety and our adrenaline levels through the roof.

This is part 2 of the Heme Onc Emergencies series.  This episode will talk about common hematology emergencies that we see in the ED.  Sickle cell disease will be its own episode but this episode will talk about the approach to anemia in the ED, as well as the approach to hemophilias, ITP and TTP.  While you will see lots of anemic patients in the ED, the other diseases are rare but we have to be on the look out for them and know what to do.

This is the first of a two part series on Heme-Onc Emergencies.  In this episode, we'll discuss oncology emergencies to include neutropenic fever, tumor lysis syndrome, malignant spinal cord compression and malignant pericardial effusion.  Neutropenic fever is a common chief complaint for patients on chemotherapy so we have to be good at this chief complaint.