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EEM: Avoiding the EMTALA Police

April 2019
25min

From Essentials of Emergency Medicine 2017, Corey Slovis and Sanjay Arora break down what's required of us in the ED regarding EMTALA, as well as what happens behind the scenes when there is a violation.  

Infected and Obstructing Nephrolithiasis

April 2019
30min

Patients with infected ureteral stones present a true medical emergency. I very well may be obvious what's going on but, often, it's not so clear. Maybe the patient has no fever but a few white cells in the urine, or maybe they look sick but have a negative UA. In this wide-ranging discussion, we interview urologist Nora Takla about her approach to infected stones, how she manages those with equivocal presentations, as well as the logistics following up non-infected stones, the significance of extravasation on CT scan, and the sometimes surprisingly complicated decision making when it comes to admitting ureteral colic patients.  

A Child With Acute Airway Swelling

March 2019
33min

A child presents with acute airway swelling and is heading toward extremis. What’s the next step? In this case based episode, we break down evaluation and management of pediatric and adult patients with acute angioedema.

Are Some Moderate Risk Chest Pain Patients Actually Low Risk?

March 2019
25min

The HEART score is now well accepted as a decision instrument in determining what chest pain patients are low-risk. New data suggest that higher score patients may actually be much lower risk than previously thought.  Dr. Adam Sharp, lead author of a recent JACC study, explains why his data on almost 30,000 ED patients may reshape our thinking on low-risk chest pain.  

Damage Control Resuscitation

March 2019
38min

Canadian trauma team leader Andrew Petrosoniak is back to break down strategies in trauma resus including: CPR and critical actions in trauma arrest, why we should show more love to fibrinogen, the importance of remembering calcium, prioritizing hemostasis over resuscitation, and how to simplify transfusion decisions.

N of One: Bouncing Back After a Tough Case

March 2019
36min

The nature of emergency medicine dictates that we will have tough cases. Patients will die, we will have to deliver bad news, and we will, at some point, make mistakes. We have high expectations of ourselves so when we get figuratively knocked down, how do we get back up? In this episode, performance coach Jason Brooks guides us through strategies for dealing with the emotional and intellectual fallout of a bad case as well as how to re-engage during a shift when the last thing we feel like doing is seeing the next patient.  

EEM: How to Use the Pulse Ox Like a Boss

March 2019
19min

From Essentials of Emergency Medicine NYC 2017, Reuben Strayer explains how the pulse ox might be the most useful bit of tech in the ED.  

Clogged and Dislodged: A Guide to PEG Tube Badassery

March 2019
33min

We may not place PEG tubes but we certainly encounter their complications.  From blockages to dislodgement, PEG issues are a frequent occurrence in the emergency department. In this episode, we get perspectives from emergency physician Walker Foland, as well as gastroenterologist Mike Phillips, on troubleshooting and managing the misbehaving G-tube.  

Abdominal Stab Wounds: The WTA Algorithm

February 2019
25min

When a patient presents with an abdominal stab wound and there are intestines coming out of the hole, it’s no great mystery as to what’s going on. But what about the equivocal case where the patient has a small puncture and is relatively well appearing? Image, observe, explore the wound? In this episode, Clay Smith from Journal Feed walks us through a recently published guideline on how to evaluate patients stabbed in the abdomen that addresses this and pretty much every other stabby abdominal scenario.  

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.