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PODCAST

Emergency Medical Minute

Emergency Medical Minute

Our near daily podcasts move quickly to reflect current events, are inspired by real patient care, and speak to the true nature of what it"s like to work in the Emergency Room or Pre-Hospital Setting. Each medical minute is recorded in a real emergency department, by the emergency physician or clinical pharmacist on duty – the ER is our studio and everything is live.

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All Episodes

16:16

Mental Health Monthly #13: Substance-Induced...

Emergency Medical Minute ·

2022/06/08

Substance-Induced Psychosis (Part I) In this first episode of a two-part mini-series, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, as they discuss the different substances that cause psychosis and their unique presentations in the ED and in the psychiatric world. First, Dr. Haddad establishes a medical definition of psychosis. Then, Dr. Haddad and Dr. Dhaliwal partake in a fruitful discussion, each providing their unique perspective

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05:00

Podcast 788: Tracheostomy Bleeding

Emergency Medical Minute ·

2022/06/07

Contributor: Aaron Lessen, MD Educational Pearls: Tracheostomy bleeding is a rare but potentially life-threatening complication that usually occurs within the first month of tracheostomy tube placement No matter how severe the bleeding, every patient should be evaluated to rule out a tracheo-innominate fistula between the tracheostomy and the innominate artery If the patient is currently bleeding and has a cuffed tracheostomy tube, over-inflate the balloon to compress the bleeding vessel Consider

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04:46

Podcast 787: TAVR and Stroke

Emergency Medical Minute ·

2022/06/06

Contributor: Nick Hatch, MD Educational Pearls: Transcatheter aortic valve replacement (TAVR) is an increasingly common endovascular procedure to treat aortic stenosis TAVR is an alternative to the open approach surgical aortic valve replacement (SAVR) for patients who are inoperable or are high risk surgical candidates Following TAVR, there is increased risk of stroke, particularly in the first 30 days TAVR-related strokes are due to embolic debris left on the valve root, which is generally

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06:07

Podcast 786: Smiling Death

Emergency Medical Minute ·

2022/05/31

Contributor: Nick Hatch, MD Educational Pearls: “Smiling Death” describes the prehospital phenomenon of a person who is happy to be extricated from an extended period of crush injury, but dies suddenly soon after the rescue. Smiling Death is caused by Crush Syndrome. Crush Syndrome begins when large areas of tissue are damaged by compression and subsequent impeded blood flow. Resultant cell death is followed by release of myoglobin and efflux of electrolytes including potassium. Upon removal of

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06:36

Podcast 785: Pepper Spray

Emergency Medical Minute ·

2022/05/30

Contributor: Jared Scott, MD Educational Pearls: Pepper spray is a chemical irritant derived from oleoresin capsicum (OC), an extract from pepper plants. It can be used by police for riot or crowd control, or by individuals for self defense. In the event of an exposure, those affected should immediately disperse from the area, remove contact lenses with clean or gloved hands, and remove contaminated clothing. Pepper spray can spread from patients to providers by contact. When caring for those

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05:06

Podcast 784: Wastewater Surveillance for COVID

Emergency Medical Minute ·

2022/05/24

Contributor: Jared Scott, MD Educational Pearls: About 50% of those infected with SARS-CoV-2 will shed the virus in their feces Wastewater surveillance can be used to track COVID burden, which may be easier than collating test data from multiple hospitals across a region Viral shedding begins 5-7 days prior to symptom onset, so wastewater data can be used to anticipate outbreaks and inform policy and public health initiatives Some existing limitations to wastewater surveillance include:

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05:18

Podcast 783: LAD Occlusion & Troponin

Emergency Medical Minute ·

2022/05/23

Contributor: Jared Scott, MD Educational Pearls: A study randomized 34 healthy patient to have their left anterior descending artery (LAD) occluded by balloon for 0, 15, 30, or 90 seconds Subsequently, cardiac troponins (cTns) and Copeptin were measured every 15 minutes for 3 hours, then every 30 minutes for the next 3 hours 5 conclusions were drawn: Copeptin is not a useful marker of cardiac ischemia cTn may be detected after only 30 seconds of ischemia cTn may be detected in a little as 15

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03:13

Podcast 782: Ventilator Management

Emergency Medical Minute ·

2022/05/17

Contributor: Aaron Lessen, MD Educational Pearls: Tidal volume is the amount of breath a patient receives in a single ventilation Traditional tidal volume (TV) setting was 10 ml/kg but studies showed lower TV had less incidence of respiratory distress, ARDS, and overall better outcomes ED ventilation settings may get carried on for hours or days when a patient is admitted, making this an important part of patient care Recent large systematic review shows that low TV setting in the ED leads to

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04:16

Podcast 781: Foxglove, Dropsy, and Salvador Dali

Emergency Medical Minute ·

2022/05/16

Contributor: Chris Holmes, MD Educational Pearls: Foxglove plant contains the cardiac glycoside digoxin Foxglove leaf potions were once used to treat Dropsy; a historic term for symptoms of heart failure Digoxin, previously used for treating heart failure, works by increases heart contraction strength and slows heart rate Of note, the EKG of patient on digitalis may have a ‘Dali Mustache’ appearance Digoxin toxicity can lead to a variety of dysrhythmias as well as neurological, GI, and metabolic

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03:21

Podcast 780: Pediatric Sedation Post-Intubation

Emergency Medical Minute ·

2022/05/10

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looking at a pediatric emergency department to determine what percentage of patients after intubation received sedation within 10 minutes after intubation About 25% of the patients in the study received sedation within 10 minutes after intubation Only 75% of the patients in the study received sedation in the ED at some point after intubation Those who received rocuronium were less likely to received sedation post-intubation References

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03:29

Podcast 779: Pulse Pressure in Trauma

Emergency Medical Minute ·

2022/05/09

Contributor: Aaron Lessen, MD Educational Pearls: Pulse pressure is the difference between the systolic and diastolic blood pressure, normal is about 40 A narrow pulse pressure is generally thought of as less than 30 mmHg which may signal peripheral vasoconstriction in response to lower blood volumes 2020 study examined hypotension and narrow pulse pressure in trauma and outcomes 37% of patients who were hypotensive on ED arrival had a severe injury, 22% of patients who had a narrow pulse pressure

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03:10

Podcast 778: tPA for Frostbite Injury

Emergency Medical Minute ·

2022/05/03

Contributor: Peter Bakes, MD Educational Pearls: Mild frostbite injury usually only requires supportive care In severe frostbite injury, patients should receive an immediate angiogram, be admitted, and receive tPA if there is evidence of vascular occlusion Salvage rate is around 80% for appropriate patients who receive tPA in phalangeal frostbite injury References Paine RE, Turner EN, Kloda D, Falank C, Chung B, Carter DW. Protocoled thrombolytic therapy for frostbite improves phalangeal salvage

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05:13

Podcast 777: Grass, Weed, and Ancient Rome

Emergency Medical Minute ·

2022/05/02

Contributor: Chris Holmes, MD Educational Pearls: Antiemetics were used in ancient Rome to help with sea-sickness and included toxic substances such as wine and wormwood and white hellborn The first antihistamine used for nausea, dramamine, was introduced in 1947 for motion sickness After this chlorpromazine, prochlorperazine, and promethazine came about in the 1950s and 1960s Cannabis, colloquially referred to as weed, isolates like THC used in the 1970s to help with chemotherapy-induced After

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25:34

Mental Health Monthly #12: Management of Opioid Use...

Emergency Medical Minute ·

2022/04/27

In this special episode of MHM, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, as they discuss the implications of OUD in Colorado. As a substance use disorder specialist, Dr. Haddad provides an invaluable perspective on various treatment modalities for OUD in the outpatient and inpatient settings. Finally, Dr. Haddad and Dr. Dhaliwal discuss the implications of the newly introduced Colorado legislation affecting patients with OUD and

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02:55

Podcast 776: Single-Site Blood Cultures

Emergency Medical Minute ·

2022/04/26

Contributor: Aaron Lessen, MD Educational Pearls: Traditionally, blood cultures are drawn from two separate sites despite no data to suggest this is better than drawing blood from one site Recent study evaluated multi-site versus single-site blood cultures to determine if there was a difference in accuracy or contamination Positive yield was 20% in the single-site year and 17% in the multi-site year No difference in contamination between the two groups References Ekwall-Larson A, Yu D, Dinnétz P,

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03:08

Podcast 775: Olecranon Bursitis

Emergency Medical Minute ·

2022/04/25

Contributor: Aaron Lessen, MD Educational Pearls: Olecranon bursitis refers to inflammation in the bursa of the elbow and can be due to infection or trauma Recent study examined treating suspected septic olecranon bursitis with antibiotics versus drainage About 90% of the patients treated with antibiotic therapy for this issue did not require subsequent drainage or hospitalization for intravenous antibiotics Consider treating suspected olecranon bursitis with antibiotic therapy and good return

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41:53

On the Streets #13: Pre-hospital Cardiology Concepts

Emergency Medical Minute ·

2022/04/20

On this episode of On the Streets, our host, Jordan Ourada, talks with cardiologist, Dr. Chirag Chauhan, about all things cardiac. Highlighted topics: Wrist versus femoral access in the cath lab The most important prehospital interventions for an MI Nitroglycerin: Who gets it and what are the precautions Lidocaine and amiodarone in a heart attack CPR assist devices

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05:27

Podcast 774: Maggots

Emergency Medical Minute ·

2022/04/19

Contributor: Chris Holmes, MD Educational Pearls: Maggots were discovered as a therapy to help wound healing in WWI, but this fell out of favor after the discovery of penicillin One study from Israel used maggots in treating diabetic foot wound with positive results but notable patient discomfort Maggots debride tissue, kill MRSA, promote angiogenesis, and promote fibroblast migration to lay down new tissue While maggots may be very useful in wound healing, the reality of the therapy may make

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03:30

Podcast 773: Atrial Fibrillation Medications

Emergency Medical Minute ·

2022/04/18

Contributor: Aaron Lessen, MD Educational Pearls: Atrial fibrillation is an irregular heart rhythm that sometimes requires rate control in setting of rapid ventricular response (RVR) Calcium channel blocker and beta blockers are the most frequently used medications to block the AV node and slow down the heart rate in atrial fibrillation with RVR If a patient is on one of these agents at home, the IV form should be used first Recent systematic review and meta-analysis found 3 trials addressing which

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04:53

Podcast 772: Firearms in Suicidal Ideation

Emergency Medical Minute ·

2022/04/12

Contributor: Aaron Lessen, MD Educational Pearls: Firearms are a dangerous potential method of committing suicide Death occurs in about 5-15% of suicide attempts overall, but death in suicide attempts using firearms occurs in 85-90% of cases In some states, families can petition a judge to remove firearms from a house although healthcare providers cannot do this References Sarai SK, Abaid B, Lippmann S. Guns and Suicide: Are They Related? Prim Care Companion CNS Disord. 2017 Dec

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