Em Basic

Today's episode is another installment of the EM Basic Project.  Dr. Sheyna Gifford and Dr. Chrisanna Mink will talk about measles.  This is a disease that we thought we had stamped out long ago with vaccination but the rise of the anti-vaccine movement has caused several small outbreaks so we need to be ready and on the lookout.  They will discuss how to recgonize measles, how to order the right testing and treatment, how to properly disposition these patients and the importance of getting your public health colleagues involved.

Today marks the 4th anniversary of the EM Basic podcast.  To celebrate this occasion, we are going to do a screencast on aortic dissection.  This is a very challenging disease to diagnose because patients have lots of different presentations that can make it difficult to diagnose.  We'll talk about the common presentations of dissection, the not-so-common presentations, how to order the right imaging, how to treat these patients in the ED, and how to get them to the right level of care.

Today's episode of EM Basic will review vaginal bleeding in patients who are not pregnant.  This is a much different workup from pregnant patients with vaginal bleeding so we have to know how to effectively manage this chief complaint. This episode was written and recorded by Dr. Adaira Landry, an EM senior resident at NYU/Bellevue and Joe Kennedy, a 4th year medical student at Mayo who matched into EM just after this episode was recorded.  They'll review what vital signs to look out for, the important parts of this history and physical, what labs and imaging to order (if any), and the proper disposition of patients with this chief complaint.

Today's episode will cover Tactical Combat Casualty Care (TCCC), aka Care Under Fire, aka Care in the Immediately Unsafe Environment.  Dr. Andy Bohn, a residency colleague, recorded today's episode to talk about the basics of taking care of any patient in an unsafe environment.  While the military connotations of this may make you uncomfortable, the techniques and protocols he discusses can be directly translated into any civilian mass casualty scenario such as the Boston Marathon bombing or the fertilizer plant explosion in West, Texas.  Andy will discuss how to stay safe in these hostile environments, how to perform the right interventions that will save lives while elimintating the useless interventions that won't (I'm looking at you- c-collars...), and how to get the casualty to the next level of care safely.

EM Basic is back with a brand new episode.  Today's episode was done by Dylan Norton and David Murphy, both 4th year medical students at the University of Colorado Medical School.  We see epistaxis a lot in the ED and while most of it is mild and self limiting, there are frequently cases that take a lot of skill to manage.  They'll talk about the basics of the history and physical with epistaxis, how to order the necessary lab tests, how to manage any case of epistaxis in a step-wise manner, and some newer areas of research.

This is a quick announcement to let you know that EM Basic is now partnering with EB Medicine as our bandwidth sponsor.  EB Medicine publishes many resources in Emergency Medicine to include EM Practice, Pediatric EM Practice, as well as LLSA reviews.  These reviews are made by EM physicians for EM providers and provide the latest evidence based medicine reviews of common EM chief complaints.  Recent issues include management of seizures in the ED, hand injuries, and angioedema.  These are quick and to the point reviews that review everything you need to know and nothing that you don't. For residents and students, you can get free electronic access to all of EB Medicine's issues for free- no obligation and no strings attached.  EB Medicine is so confident in the quality of their resources that they know you will want to subscribe once you are done training.  I started reading EB Medicine as a resident and it is one of the few resources that I read cover to cover each month. For attendings and those needing CM

In this episode we are going to talk about febrile seizures.  We see this chief complaint a lot in the ED so it's important that we know this topic really well.  Today's script was written by Dr. Andrea Sarchi and will review how to do a good history and physical, how to rule out serious pathology without overtesting, and how to talk with parents.  While simple febrile seizures don't cause any harm to the child, they are very scary for parents so it's important that we know the facts so we can re-assure them and prevent future worry.

Ebola has been in the news for the past few months and it has taken on more urgency in the US as cases have arrived from outside the country  Within the past week, transmission to two healthcare workers outside of Africa has been reported.  Dr. Prabu Selvam, an intern at the Wright-Pratt Emergency Medicine Residency, provided the resources for today's episode on Ebola.  In this short episode we will discuss appropriate screening for Ebola, it's signs and symptoms, lab abnormalities, how to confirm infection with laboratory testing, treatment of Ebola, and how to properly isolate patients with this disease.  While now is not the time to panic and think that every fever and sniffle is Ebola, we should certainly be aware of how to properly screen, diagnose, and treat this deadly disease.

Today's episode is the second and final part of Dr. Sheyna Gifford's interview with Dr. Les Zun on psychiatric emergencies.  This episode will talk more about treating depressed patients, what you can do for patients who board in your ED for hours to days to even a week, and medications used for treatment of acute agitation in the ED.

Today's episode is another installment in the EM Basic Project.  Dr. Sheyna Gifford took on the task of interviewing Dr. Les Zun, a nationally known speaker on the topic of psychiatric emergencies.  While we did an episode on psychiatric medical screening before, this episode will focus on some of the tougher situations we encounter in the ED.  For example- What do we do about the patient who is depressed but not suicidal?  How do we calm down agitated patients without reaching for medications?  These are tough questions but Dr. Zun goes througha methodical way of thinking about these issues and offers some real world practical advice that you can use on your next shift. 

Today I am handing over the podcast to FOAMcast by Drs. Lauren Westafer and Jeremy Faust.  A little more than a month ago, Dr. Nick Genes challenged twitter to create core content FOAM for hepatic emergencies.  Lauren and Jeremy did an excellent episode on this topic on FOAMcast so here it is- re-broadcasted on EM Basic.  They'll review common hepatic emergencies and their managementi in the ED and point you in the right direction to learn even more on this topic.  I haven't edited their episode at all- it's all Lauren and Jeremy's episode.  If you like what you hear, go to foamcast.org or look for FOAMcast on iTunes.

Today's episode is another installment for the EM Basic Project by Dr. Andrea Sarchi.  Salicylate overdose is a toxidrome that we have to be on the lookout for in the ED.  While some cases are obvious because the patient or EMS can tell us what they took, some cases are subtle and require vigilance to make the diagnosis.  In this episode we'll review the important history and physical points, how to order the right tests, manage the toxicity, and properly disposition the patient.

Today's episode talks about the diagnosis and management of Acetaminophen overdose.  This is another addition to the EM Basic Project written by Andrea Sarchi. We encounter acetaminophen overdose frequently in the ED and we need to be on the look out for this because patients can be completely asymptomatic.  If we don't catch it, acetaminophen overdose can result in liver failure requiring transplant or even death unless we interevene early.  This episode will review how to properly workup a patient with a known or suspected acetaminophen overdose, what tests to order, and how to decide who needs antidote therapy.

In today's episode we are going to talk about documentation in the ED.  It is very important that we are complete but concise in our documentation in order to provide an accurate record for the patient's ED patient to protect them and ourselves from problems down the road.  Good documentation is good patient care so we need to know how to do this efficiently.  We will review each part of the chart starting with the triage note and ending how to give good discharge instructions.  We'll also review some tips and tricks of the trade regarding abbreviations that will make your charting faster, how to document interactions with our consultants, and even what to do when you have to document a difficult situation with a consultant.

The patient's blood pressure is 190/80 but they feel fine...how do we treat these patients in the ED?  Labs?  EKG? BP meds?  Admission???...but they are here for an ankle sprain!  Asymptomatic hypertension is a challenging complaint to deal with in the ED because of so many conflicting opinions and worries but it doesn't have to be difficult.  In this episode, we'll discuss a systematic and rational way to evaluate patients with asymptomatic HTN, do limited and targeting testing, and get them the right followup while calming the patient's fears and avoiding harm.

This episode is part 2 of the PE podcast where we will discuss risk stratification and treatment of PE.  It's important that we accurately quanitfy the amount of clot burden that the patient has to order the right treatment and admit them (or maybe even discharge them) to the right location.  We'll talk about how to classify massive, sub-massive, and "non-massive" PEs and how to treat them. We'll also briefly talk about emergning evidence for the expanding role of thrombolytics and outpatient treatment of PE.

This episode has been a long time in the making- presenting Pulmonary Embolism, part 1.  PE is a deadly diagnose that we frequently have to consider in the ED.  The presentations can be very varied but we need to know how to work up this disease while avoid unnecessary testing and harm to our patients.  In part 1, we will discuss risk factors for PE, symptoms that should make you suspicious for PE, and how to order the correct labs and imaging to diagnose this serious condition.

The last podcast on COPD led to some great discussion online about the use of oxygen in patients with COPD.  To address this, Drs. Tim Peck and Colby Redfield are back with a quick summary to clarify how to best use oxygen in patients with COPD.  There's also another cameo by the one and only Dr. Peter Rosen on how to suceede in emergency medicine.

EM Basic is back with another episode of the EM Basic Project.  In today's episode Drs. Tim Peck and Colby Redfield review the chief complaint of shortness of breath with a focus on COPD.  Even though we did an episode on shortness of breath a while back, it's always great to get a new perspective on this chief complaint.  Today's episode also features a very special guest cameo by the name of Dr. Peter Rosen.  He pretty much started EM as a speciality and you may have seen his name on a textbook or two.

This is the premiere of the first contribution to the EM Basic Project.  Dr. Brian Cohn from Washington University in Saint Louis, Missouri is on the podcast today talking about mono-articular arthritis.  He reviews the common physical exam findings, the appropriate lab work and medications, how to avoid common pitfalls in this diagnosis, some evidence based medicine pearls and even some relevant medical trivia.  Dr. Cohn is one of the authors of the EMJ club podcast which reviews common EM topics in a journal club style format.