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Adrenal Crisis

February 2019
34min

The adrenal glands do a lot of important jobs including production of  cortisol, aldosterone, epinephrine, and norepinephrine. But how well do you really understand these tiny glandular powerhouses? Emergency physician Bob Zemple walks us through some adrenal basics as well as how to recognize and manage patients in adrenal crisis.  

N of One: Life, Death, and Medicine

February 2019
28min

Christiaan Maurer, a Colorado internist and hospitalist recently diagnosed with glioblastoma, reflects on life, medicine, and what’s important.  

EEM: Post-Tonsillectomy Bleeding

February 2019
24min

Not all post tonsillectomy bleeds are created equal, and not all portend decompensation into hemorrhagic shock (though some do). Emergency physician Gene Hern and ENT surgeon Clay Finley give their thoughts on approach and management.    

The PE Bounceback

February 2019
30min

When a patient with a known and treated pulmonary embolism returns to the ED with increased pain or shortness of breath, what’s the next step? There is no textbook answer for this one, so we reached out to the PE expert, Jeff Kline, to give his approach.

Flu: Test and Treat. Or Not.

January 2019
29min

How one approaches and manages influenza is part science and part preferred practice style.  Today’s podcast presents AK’s interpretation of the literature and how she manages patients during a shift. As you will see, AK is a testing and treatment minimalist.

Perfectionism, EQ, Middle Way

January 2019
39min

What does the former CFO of Pixar have to do with physician burnout and the culture of medicine? We find out in this segment. Neda Frayha from Primary Care RAP interviews Dr. Todd Cassese and Lawrence Levy, who helped build Pixar into the company it is today. Together they talk about changing professional cultures, the narrative of medicine being out of sync with the reality of medicine, perfectionism, emotional intelligence, and how Eastern philosophy’s The Middle Way can apply to all of our lives.

EEM: Can You Fix Asystole?

January 2019
11min

There is a dearth of evidence guiding our management of asystole.  At Essentials of emergency medicine 2018, Anand Swaminathan gave his approach to managing this rhythmless dysrhythmia, bridging the gap between acting just to act, and acting with intent to save.  

Frostbite

January 2019
35min

Managing frostbite is both simple and complex. It's been around since human skin met the cold but  research within the past few decades and even the past few years has dramatically changed how we care for  thermal cold injury. in this episode, frostbite expert and burn surgeon Dr. Anne Wagner discusses frostbite diagnosis, simple and advanced management.  

Strokes, Stones, and Standing in Feces

January 2019
32min

In this episode we discuss: Should we use TPA in patients with non disabling, low NIH score strokes? A massive study on POCUS for suspected ureteral colic, and some surprising recommendations in the recent ACEP Clinical Policy on acute thromboembolic disease.

Neurologic Emergencies in Pregnancy

December 2018
34min

Neurological complaints can be a challenge even when they’re straightforward. Add pregnancy the equation and the complexity can increase exponentially. Luz Silverio breaks down a case of altered mental status, very high BP, and looks at lytics in pregnant patients.

Alcohol Withdrawal Made Simple

December 2018
36min

In this episode, Cam Berg presents a standardized, cohesive, and evidence-based pathway for the management of alcohol withdrawal that was developed for North Memorial Health Hospital.

Debriefing INFO

December 2018
27min

There’s no getting around it, finding time to debrief challenging or difficult cases can feel nearly impossible in the task saturated emergency department environment. In this episode, Dr. Stuart Rose discusses a novel approach to making debriefs more likely to happen in the ED as well as a tool to make them less intimidating.  

N of One: Can Burnout Be a Good Thing?

December 2018
29min

Dike Drummond from thehappymd.com is back to discuss: how burnout can end up being a good thing; how burnout can be a path to leadership but not necessarily in a good way, pitfalls to avoid when going from clinician to leader of clinicians; dealing with uncertainty in your career choice; why it’s wise to get away from the whirlwind of clinical work when you’re making important long term decisions.

EEM: What to do With the Wayward Chest Tube

December 2018
14min

Discuss strategies for managing misplaced chest tubes.

The Chest Pain Summit

December 2018
28min

A consensus summit with world experts and primary researchers focused on the question, “After a negative ED evaluation for ACS, is an expedited outpatient evaluation a safe alternative to admission?”  

The Case of the Red Anus

November 2018
18min

Discuss Evaluation and treatment of pediatric patients with perianal streptococcal infection.

IV Iron - The Bloodless Transfusion

November 2018
36min

Discuss management of anemic patients with intravenous iron infusion.

The Zen of EM: The Emergency Medicine Mindset

November 2018
25min

Discuss a mindset conducive to successful emergency medicine practice.

Lupus, Wegener’s, and a Weird Vasculitis

November 2018
24min

Discuss emergency department evaluation and treatment of patients with lupus, Wegener's granulomatosis, and levamisole vasculitis.

Evidence Based Hyperkalemia Management

November 2018
33min

Hyperkalemia is one of, if not the most, common electrolyte abnormalities we see. But much of what we do in treatment is what someone told us to do when we were young learners. In this episode we debunk hyperkalemia myths and discuss an evidence based approach to management

Essentials of EM Bonus: When to Call a Code in the Field + 2019 Reg is Open!

November 2018
9min

Corey Slovis from Essentials of EM 2016 breaking down when to call a prehospital code, and when to keep the resus going. Why a bonus episode? Well, if all I said was that registration for EEM 2019 was now open, and left it at that, well, that would be lame. This way, I can say it, but there’s some meat with the potatoes. Not just potatoes.  

Rhabdo: Sick vs Not, How to Treat, Who Needs Admission

October 2018
25min

Discuss the evaluation, treatment, and disposition for patients with rhabdomyolysis.

UTI Treatment Made (sort of) Easy

October 2018
40min

Rob and Adam Rowh discuss treatment options for UTI's.

Primum Non Nocere (First, Do No Harm)

October 2018
22min

Discuss application of the principle of ‘First Do No Harm’ in modern day medical practice.  

TIA Evaluation and Disposition

October 2018
24min

Rob and Cam Berg discuss TIA Evaluation and Disposition.

Las Vegas Mass Casualty: How One ED Made Order Out of Chaos

October 2018
33min

A first hand account of the emergency department response to the 2017 Las Vegas strip shooting that left 59 dead and over 800 wounded. Discussion of preparation with 20 minutes warning, how to keep patients flowing as they enter the hospital as well as once they’re in the treatment area, effective triage, critical steps to simultaneously resuscitating large numbers of trauma patients.

What Would Weingart Do (WWWD)? Septic Shock: Oxygen, Airway, and the Vent

September 2018
31min

Discuss any magnet in hemodynamically and fragile patients with significant pulmonary insult.

What Would Weingart Do (WWWD)? Septic Shock: Fluid, Pressors and Bug Juice

September 2018
33min

Discuss management of refractory Type 1 respiratory failure and borderline hypotension in patients in septic shock.  

Should I give antibiotics to a patient with diarrhea?

September 2018
31min

Discuss pros and cons of different antibiotics choices for acute cystitis.

Skill Decay

September 2018
12min

Discuss methods to combat skill decay in emergency medicine practice.

Essentials of EM Segment: Topical Steroids

September 2018
23min

Discuss classification and use of topical steroids in the acute care setting.

Emergency Complications of Cirrhosis

September 2018
30min

Discuss emergency department management of patients with complications of cirrhosis.  

Is There a Role for a Two Hour APAP Level?

August 2018
29min

Discuss utility of obtaining an acetaminophen level before four hours post ingestion in overdose patients.  

Ischemic Bowel

August 2018
32min

Discuss diagnosis and treatment of mesenteric ischemia.

How To Be An Effective Leader

August 2018
36min

Discuss methods of effective (and ineffective) leadership.

Button Battery Ingestion and Removal

August 2018
13min

Discuss evaluation and treatment of children who have ingested a button battery.  

The Dying Asthmatic

August 2018
31min

Discuss airway and ventilatory management of the asthma patient in extremis who is recalcitrant to standard therapy.

Mononucleosis

July 2018
30min

How long is mono shed in saliva?

What’s The Best IV Fluid?

July 2018
25min

Clay Smith from Journal Feed gives the ins and outs of recent data comparing normal saline to balanced crystalloids.  

Should I Get an Ultrasound or CT?

July 2018
35min

Mike Mallin from the Ultrasound Podcast breaks down when we should start with ultrasound versus go straight to CT.  

Reframing

July 2018
23min

Discuss use of cognitive reframing in the emergency department setting.

Essentials of Emergency Medicine: Extremity Stab Wounds

July 2018
14min

Kenji Inaba breaks down management of stab wounds - irrigation, wound repair, and vascular evaluation.  

Why Epi Might (and might not) Work in Cardiac Arrest

July 2018
22min

The pendulum never seems to stop swinging when it comes to the efficacy of epi in cardiac arrest.  

IM in the ED

June 2018
24min

Internist Neda Frayha sprinkles some IM in the ED - how to interpret TSH levels and why aspirin is no longer recommended for a-fib thromboprophylaxis.  

Henoch Schonlein Purpura

June 2018
15min

Sometimes HSP is no big deal and sometimes it’s catastrophic. Emily Rose walks us through diagnosis, treatment, and when we should worry.  

Influencing Patient Behavior

June 2018
24min

ERcast’s resident philosopher Dan McCollum walks us through simple techniques and strategies to influence positive behavior in our patients.  

Suboxone for Opiate Withdrawal

June 2018
27min

Addiction medicine specialist Ken Starr argues in favor of buprenorphine in the acute treatment of opiate withdrawal.  

Resuscitation Resequenced

June 2018
33min

Trauma team leader Andrew Petrosoniak explains why when providers rigidly follow ATLS, patients may suffer.  

Massive GI Bleed on Anticoagulants

May 2018
28min

Rob and Tom Deloughery discuss management of actively bleeding patients who have been prescribed anticoagulation medications.

Essentials of EM Segment - Extubation in the ED

May 2018
17min

Recorded at Essentials of Emergency Medicine 2016, Scott Weingart walks us through the whys and hows of extubating patients in the emergency department.

Are Scribes Worth It?

May 2018
13min

While scribes clearly can be helpful in adding to the efficiency of the ED workflow, they have understandable challenges when it comes to documenting critical parts of the medical record.

Should I Get a Second Troponin

May 2018
29min

Rob and Adam Rowh discuss what is the utility of a second (delta) troponin in a patient presenting with chest pain.  

Neonatal Intubation

May 2018
38min

Rob and Andy Sloas, DO discuss Neonatal Intubation.  

Contrast Associated Nephropathy

May 2018
21min

Rob Orman, Clay Smith and Dave Hollander discuss current radiology guidelines regarding GFR cutoffs for administration of contrast media.

C Diff Treatment Changes

April 2018
12min

A few weeks ago, a post on Clay Smith’s Journal Feed about the new IDSA C diff guidelines caught my attention (specifically, that metronidazole is no longer recommended as first line therapy). Whuut? I tweeted this and @medquestioning tweeted back, “Need to dig to see why they dropped metro in the bucket.” Yes, @medquestioning, my thoughts exactly.

ZdoggMD

April 2018
44min

Zubin Damania (ZDoggMD) is an internist and founder of Turntable Health, an innovative healthcare startup that was part of an urban revitalization movement in Las Vegas. During a decade-long hospitalist career at Stanford, he experienced our dysfunctional health care system firsthand leading to burnout and depression. He created videos under the pseudonym ZDoggMD as an outlet to find his voice. This launched a grassroots movement — half a billion youtube views and a passionate tribe dedicated to improving health care for everyone.

Mind of an Addict

April 2018
22min

Our guest today is Joe Polish. Unlike most guests on this show, Joe is not involved in medicine- he is one of the best known marketing minds on the planet. He is the creator of the Genius Network which is the place high level entrepreneurs go to get their next big breakthrough with access to connection, contribution, and collaboration. Joe is also a best selling author and renown podcaster with I Love Marketing, genius network, Rich Cleaner and 10x Talk. But none of those things are why Joe is on the show today. Joe is also an addict, but deeper than that, he’s turning his experience with addiction into a force for change with Genius Recovery  and Artists for Addicts.

Pseudoseizures (PNES)

March 2018
15min

Walker Foland, an emergency physician practicing in Michigan, breaks down why pseudoseizures, now termed PNES (Psychogenic Nonepileptic Seizures), are a real disease.

What Canada Can Teach Everyone About CAT Scans

March 2018
22min

Joe Habbousche is the CEO of MDCalc, the worlds most used online medical calculator. Chances are, you’ve used it yourself. Joe is a passionate advocate for the practice of evidence based medicine and the proper use of clinical decision tools. In this episode, we dissect one of his favorites: the Canadian CT Head Injury/Trauma Rule

Anorexia Nervosa may not scare you but it should

February 2018
32min

Anorexia is often viewed as a chronic condition that doesn’t really warrant emergency care, but that’s not the case. Mortality with anorexia nervosa is high (on the order of 10-20%) and patients can present really sick.

When Consultants Give Bad Advice

February 2018
35min

In this episode, Dr. Sam Ashoo gives his strategies on what to do when the consultant on the other end of the phone call is giving questionable advice.

Haloperidol for Pain

February 2018
25min

One of the stress points when a patient taking chronic opioids presents with acute pain is that we feel we have little to offer them.

Should I give bicarbonate in DKA?

January 2018
19min

Should I give bicarbonate to DKA patients with severe acidemia?

Performance Coach Jason Brooks. Always Gratified, Never Satisfied

January 2018
1hr 6min

Jason Brooks PhD is a performance coach helping health care providers, athletes, and other high level performers live better, work better, and be better.

Cellulitis

January 2018
17min

Dr. Greg Moran reviews current thinking on cellulitis diagnosis and management.