Episode Chapters
- Early Appy in Kids20:35What Would I Do Next? 18yo Male with Hand Laceration, Part 114:33Paper Chase 1 - Discharge Tachycardia Doesn’t Predict Outcomes in Kids5:12Cannabis Hyperemesis Syndrome13:52Medical Malpractice Stress SyndromeFree Chapter22:50Paper Chase 2 - Tamsulosin is Reasonable to Prescribe for Ureteral Stones6:16Bee/Hornet Stings (Hymenoptera) Stings15:46DKA/HHS in the UC, Part 117:00Paper Chase 3 - Sterile Gloves Not Necessary For Simple Cutaneous Procedures3:02What Would I Do Next? 18yo Male with Hand Laceration, Part 215:58Knee Immobilizer10:48Chronic Wound Care - Pearls and Pitfalls16:14Paper Chase 4 - Probiotics Do Not Help Older Adults5:17DKA/HHS in the UC, Part 214:49Paper Chase 5 - Free-Standing EDs…A More Expensive Alternative?6:50The Summary19:41
Children present with appendicitis atypically and decision to workup a child should take age/presentation into consideration.
A Disposition Conundrum?! Full episode audio for MD edition 207:57 min - 98 MB - M4AHippo Urgent Care RAP - June 2017 Summary 283 KB - PDF
Miriam M. - June 11, 2017 4:38 PM
Love the section on Cannibinoid Hyperemesis syndrome, I saw a guy recently in Greymouth ED with CHARF -"cannabinoid hyperemesis acute renal failure", said he had vomited 40X+ in the previous 2-3 days. He is the first patient though that swore by a cold pack rather than hot pack, however, had classical history and resolved +++ with olanzapine. I hear that some people also use haloperidol. I had not heard of topical capsaicin cream 0.075% so will get the ED stock it in the after hours medications. Has been in a couple of times now so advice has not sunken in. I printed him out the wiki page -I also find this page to be considered reputable from the patients point of view!
Mike W., MD - June 12, 2017 6:49 AM
Thx for your comments - it's always funny w the temperature thing, like w low back pain; heat... ice... just not room temperature! Keep up the great work!
Amber L. - July 11, 2018 12:57 PM
Crud! I just missed an appy in a 3 yo female who had decreased appetite, vomiting and fever- no localized pain and negative psoas. Came back 2 days later with increased abdominal pain, per the return precautions. She had a ruptured appy so here I am soaking up all the appy info that's available, figuring out what could I have done better..
Mike W., MD - July 11, 2018 5:22 PM
HI Amber, classic appy is easy - my neighbor can figure it out. Which is why WE are there. I have missed an appy as I guessing have most experienced clinicians - the trick is to not start scanning and CBCing everyone as that will cause more hard than good. The most important teaching point I give is the aftercare instructions to reliable parents; return immediately w fever, increased pain, vomiting and return for a recheck in 8-12 hours if still symptomatic at all. Tough case as often at this age, the nonspecific initial symptoms are nondiagnostic