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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

04:16

Podcast 617: Masks and Understanding Data

Emergency Medical Minute ·

2020/11/30

Contributor: Peter Bakes, MD Educational Pearls: Recent study looked at if mask wearing protects the mask wearer from infection This group found 1.8% of mask wearers got COVID while 2.1% of non-mask wearers became infected, which was not statistically significant This was not statistically significant and has been used to justify not wearing masks by some groups While the numbers look small, it's close to a 20% reduction in infections for the mask wearers The results reported had concerns for being

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16:49

Pharmacy Phriday #4: mRNA Vaccines

Emergency Medical Minute ·

2020/11/27

Contributor: Rachael Duncan, PharmD Educational Pearls: ED visits nationwide declined by 42% in April 2020 compared to the same time in 2019 largely due to the fear of the COVID-19 pandemic. The biggest decline was seen in pediatrics less than 14, women and emerging COVID hotspots like the Northeast. In recent weeks, this trend has reversed, showing a record-breaking number of COVID cases, hospitalizations, and deaths. As hospitals reach capacity, critically ill COVID patients are being held in

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18:17

Mental Health Monthly #5: Borderline Personality...

Emergency Medical Minute ·

2020/11/25

For this episode of Mental Health Monthly, EMM is honored to collaborate with the hosts of Millennial Mental Health Channel podcast to explain Borderline Personality Disorder and tips to manage patients with this diagnosis in the Emergency Department. Dr. Justin Romano is a third year psychiatry resident in Omaha, Nebraska and Eddie Carrillo is a licensed mental health therapist currently working at partial hospitalization and IOP eating disorder program in Portland, Oregon. Their podcast Millennial

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03:12

Podcast 616: MDIs for the Win

Emergency Medical Minute ·

2020/11/24

Contributor: Aaron Lessen, MD Educational Pearls: Contrary to many assumptions, meter-dose inhalers (MDIs) are as effective as nebulizers in pediatric and adult patients Nebulizers are associated with higher rates of tremor, tachycardia; they cost more and are associated with longer ED stays Though it may take some convincing, in a patient that is physically able, using an MDI with spacer appears to be the better option - and that was even before COVID. References Snider MA, Wan JY, Jacobs J, Kink

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05:08

Podcast 615: Pediatric DKA

Emergency Medical Minute ·

2020/11/23

Contributor: Ryan Circh, MD Educational Pearls: Diabetic ketoacidosis (DKA) can be the initial presenting condition of undiagnosed diabetes type I in pediatric patients Unlike adults, children typically need less fluid (i.e. 10 mL/kg bolus for those in shock followed by maintenance) Cerebral edema is a concern from rapid administration of fluids An insulin drip at 0.1 units/Kg/hr should be started but a bolus isn’t required Editor’s note: While conceptually similar, treatment for pediatric DKA is

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04:26

Podcast 614: Perichondritis

Emergency Medical Minute ·

2020/11/17

Contributor: Nick Tsipis, MD Educational Pearls: Perichondritis involves infection of not only the connective tissue of the ear but typically the cartilage as well Symptoms include erythema, ear pain, and fevers The most common bacterial cause is Pseudomonas. Perichondritis often occurs after a wound or piercing, but trauma is not necessary for the infection to occur Anti-pseudomonal coverage is essential with typically oral agents for milder disease and IV antibiotics for severe infections Can

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04:16

Podcast 613: Spontaneous Bacterial Peritonitis

Emergency Medical Minute ·

2020/11/16

Contributor: Sam Killian, MD Educational Pearls: Spontaneous bacterial peritonitis (SBP) is an infection of peritoneal fluid that typically occurs in cirrhotic patients Symptoms may include abdominal pain, fever, and/or altered mental status Paracentesis is diagnostic test of choice. Diagnostic criteria includes > 250 polymorphonuclear cells (PMNs) or a positive gram stain/culture Treatment is typically a 3rd generation cephalosporin ·30-40% of SBP patients will go into renal failure and SBP

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16:22

Pharmacy Phriday #3: Drug Shortages in COVID

Emergency Medical Minute ·

2020/11/13

Contributor: Rachael Waterson, PharmD Educational Pearls: Drug shortages have been an ongoing issue since the 2000’s. Improvement was being made; however, several factors have exacerbated the drug supply more recently. According to the US Food and Drug Administration (FDA) Report there are 163 drugs currently on the drug shortage list. Of the 40 drugs critical to treating COVID-19, 18 are on this list. In comparison, according to the American Society of Health-Systems Pharmacists (ASHP), the

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40:05

UnfilterED #11: Dr. Ricky Dhaliwal

Emergency Medical Minute ·

2020/11/11

Dr. Tsipis sits down with colleague Dr. Ricky Dhaliwal for some insightful conversation regarding the differences between academic and community settings as well as the various roles of advocacy in medicine. Time Stamps 00:23 Banter and introductions 2:41 upbringing in 1st generation immigrant Indian household 14:30 losing culture as 2nd gen immigrant 7:32 Balancing family and work with a two doc family 8:32 President of EMRA 10:42 Working in academia vs community 13:29 New job advice 15:55 Nick

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04:09

Podcast 612: Origin of Vaccines

Emergency Medical Minute ·

2020/11/10

Contributor: Dave Rosenberg, MD Educational Pearls: The potential of vaccinations was first observed in the late 1600s when Jenner observed people who had cowpox never contracted smallpox, so he inoculated people with cowpox to see if it prevented smallpox, and… Years later, Louis Pasteur inoculated chickens with cholera after his assistant accidently created the first live attenuated vaccine by creating a weakened bacteria when he left the bacteria out while he went on vacation Pasteur observed

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03:06

Podcast 611: Flu Season in the time of COVID

Emergency Medical Minute ·

2020/11/09

Contributor: Chris Holmes, MD Educational Pearls: During a typical flu season positive rates of flu tests run around ~20% Surveillance data from Australia, South Africa, and Chile showed remarkably low rates of flu during their typical high season - only 51 total cases were reported This overlapped with COVID, meaning extensive social distancing and other measures likely have benefit with flu Editor’s note: at 35 cases, we are over half way there! References

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03:01

Podcast 610: Swimmers Itch

Emergency Medical Minute ·

2020/11/03

Contributor: John Winkler, MD Educational Pearls: Swimmers itch is due to a flatworm parasitic infection that causes an itchy rash after the worm burrows into the skin The flatworm is passed between bird and snail hosts The itch is due to the death of the parasite under the skin which leads to an extremely itchy reaction. The rash can be difficult to identify, often erythematous and macular but can develop papules and vesicles eventually scaling The treatment is diphenhydramine for milder cases and

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04:29

Podcast 609: Kratom

Emergency Medical Minute ·

2020/11/02

Contributor: Nick Hatch, MD Educational Pearls: Kratom is derived from the evergreen tree sharing the same name, found in Southeast Asia Kratom is legal is most regions Adverse effects of this substance are increasing in prevalence as its use becomes more widespread At lower doses kratom has a stimulatory effect Higher doses of kratom can cause opioid-like and psychotropic effects Documented instances of more severe acute liver toxicity do exists References LiverTox: Clinical and Research

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05:04

Podcast 608: Another Elevated Lactate?

Emergency Medical Minute ·

2020/10/27

Contributor: Jared Scott, MD Educational Pearls: Lactate is a byproduct of anaerobic metabolism or tissue hypoperfusion Though typically associated with severe sepsis, hyperlactatemia can be caused by vigorous exercise, seizures, liver failure, asthma exacerbations, albuterol, metformin, antiretroviral drugs, and propofol Liver failure can lead to an inability to clear lactate, or convert it back to glucose byproducts, instead of an overproduction of lactate Always remember the other causes of

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05:42

Podcast 607: Is Pain the Enemy?

Emergency Medical Minute ·

2020/10/26

Contributor: Don Stader, MD Educational Pearls: Pain is ubiquitous in the emergency department but it is not the enemy - suffering is Nociception is the ability to feel noxious stimuli which usually causes a reaction, like pulling a limb away when you feel something painful. Nociception is really a brainstem reflex. Pain is nociception plus cognition, meaning we process the noxious stimuli in our frontal cortex but it is not necessarily suffering. Pain can be associated with euphoria, such as with

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19:41

Pediatric Emergencies Brewcast: Common Respiratory...

Emergency Medical Minute ·

2020/10/21

Emergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies geared towards mid-level providers at a local Denver brewery for our latest Brewcast. Pediatric patients require special considerations compared to adults when receiving medical care, and that remains true when dealing with respiratory illnesses across different age ranges. Dr. Parisa Jamshidi, Pediatric Emergency Physician, reviews common respiratory illnesses including

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03:45

Podcast 606: The Oxygen Wars

Emergency Medical Minute ·

2020/10/20

Contributor: Aaron Lessen, MD Educational Pearls: The use of oxygen is controversial when treating patients with certain conditions, like MI’s, stokes, or ARDS because adverse outcomes have been demonstrated with using high oxygen concentrations. The Oxygen ICU trial looked at using higher and lower oxygen levels in treating intubated ARDS patients and found that mortality was improved when less oxygen was given allowing oxygen saturations to sit around 95% versus using high oxygen levels to obtain

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05:43

Podcast 605: Acute Limb Ischemia

Emergency Medical Minute ·

2020/10/19

Contributor: Peter Bakes, MD Educational Pearls: Classically presents with the 6Ps: Pain, pallor, paresthesia, pulseless, poikilothermia (cold), and paralysis Acute limb ischemia occurs by embolic or thrombotic causes Thrombotic causes are now more common due to aging populations and advancements in vascular surgery like stents which can be a nidus for thrombosis. Sudden onset of pain without prior symptoms is more typical of embolic causes Preceding symptoms leading to acute ischemia are more

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01:11:44

On the Streets #9: Advanced Applications of Capnography

Emergency Medical Minute ·

2020/10/14

Capnography is the measurement of the partial pressure of exhaled CO2 and is an indirect measurement of your cellular respiration. It is displayed visually as a block-like waveform during the exhalation phase of respiration and monitors ventilation in real-time. Capnography is the gold standard for monitoring sedated and intubated patients in the hospital and the field and can be used in many other situations to discern more information about your patient. Our host Jordan Ourada is joined by Dr

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02:42

Podcast 604: Baclofen Withdrawal

Emergency Medical Minute ·

2020/10/13

Contributor: Erik Verzemnieks, MD Educational Pearls: Baclofen is used to treat muscle spasms or spasticity. Baclofen comes in two forms: oral and intrathecal Withdrawal is much more common with those receiving intrathecal administration from a Baclofen pump, which is typically spinal cord patients Withdrawal symptoms usually start within 1-3 days after stopping baclofen Symptoms include altered mental status, muscle rigidity, and fevers, which can mimic other severe illnesses It is nearly

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