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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

01:55

Podcast 547: Capsaicin Cream to the Rescue

Emergency Medical Minute ·

2020/03/09

Author: Aaron Lessen, MD Educational Pearls: A recent retrospective study looked capsaicin cream in treating cannabinoid hyperemesis syndrome in regards to length of stay, cost analysis, use of rescue therapies, and adverse events Results showed a trend towards reduced length of stay but did not reach statistical significance Use of opioids was reduced in the capsaicin group Capsaicin remains a potential treatment option in this often difficult disease References Samantha Wagner, Jason Hoppe,

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03:57

Podcast 546: Complete Heart Block

Emergency Medical Minute ·

2020/03/03

Author: Jared Scott, MD Educational Pearls: Differentiating symptomatic bradycardia from asymptomatic may be essential in determining workup and treatment Airway, breath, circulation always hold true Symptoms may include dizziness, syncope, or weakness An EKG is essential in the majority of cases Complete heart block can be a cause of symptomatic bradycardia and requires immediate attention Complete heart block can be caused by drugs (beta-blockers, calcium channel blockers), Lyme disease,

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01:39

Podcast 545: So You Quit Smoking… Now What?

Emergency Medical Minute ·

2020/03/02

Author: Aaron Lessen, MD Educational Pearls: New data shows within 5 years of smoking cessation, the risk of cardiovascular disease becomes half of those who continue to smoke After 10-15 years of cessation, cardiovascular disease rates return to rates seen in non-smokers. Lung disease, COPD, and cancer rates do not decrease quite as rapidly, but do decrease It’s important to remind patients of the long-term health benefits associated with smoking cessation when counseling them. References Duncan

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33:54

UnfilterED #5: Dr. Lisa Zwerdlinger

Emergency Medical Minute ·

2020/02/26

Recorded remotely in the highest hospital in the world, Nick sits down to talk with Dr. Lisa Zwerdlinger, a small-town physician who's worn many different hats both in the hospital and her community. Intro Music: Backbay Lounge Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/

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02:30

Podcast 544: C is for Sepsis

Emergency Medical Minute ·

2020/02/25

Author: Aaron Lessen, MD Educational Pearls: Previously, trials had shown promising evidence that vitamin C may improve mortality rates in patients with sepsis or septic shock. A 2017 retrospective before-after study gave a “cocktail” of hydrocortisone, vitamin C, and thiamine to patients with severe sepsis or in septic shock and reported a decrease in mortality from 40% to 8%. A 2020 randomized controlled trial demonstrated that giving patients hydrocortisone, vitamin C, and thiamine showed

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03:57

Podcast 543: Scoring Blunt Traumatic Aortic Injury

Emergency Medical Minute ·

2020/02/24

Author: Nick Tsipis, MD Educational Pearls: Aortic injury caused by blunt trauma is very rare Chest x-ray findings might include widening of the mediastinum Ligamentum arteriosum (remnant of the ductus arteriosus) tethers the aorta to the chest wall, potentially causing injury with abrupt decelerations and motion XR lacks significant sensitivity (around 75%) to be utilized in many cases CT angiogram (CTA) of the chest is typically the preferred test but comes with potential risks including

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11:45

Mental Health Monthly #2: Non-Epileptic Seizures (NES)

Emergency Medical Minute ·

2020/02/19

Non Epileptic Seizures (NES) is perhaps one of the most misunderstood and overlooked disorders that emergency medicine professionals encounter. Dr. Randi Libbon & Dr. Laura Strom, both experts on NES, explain the ongoing research surrounding the topic as well as how to best manage patients with NES in the emergency setting. To learn more about Dr. Randi Libbon: https://www.cudoctors.com/Find_A_Doctor/Profile/25375 To learn more about Dr. Laura Strom:

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04:17

Podcast 542: Nasogastric Tubes

Emergency Medical Minute ·

2020/02/18

Author: Don Stader, MD Educational Pearls: Nasogastric tubes (NGT) are very uncomfortable for all those involved but some simple tricks and tips may help: Topical lidocaine can be inserted into the nasal passage for local analgesia Afrin may help shrink the mucosal tissue of the nasal turbinates as well Molding the tube with cold/ice water can help - putting it in an ice bath with an endotracheal tube stylet will allow you to mold the tip to your preference References Lor YC, Shih PC, Chen HH, et

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03:19

Podcast 541: Needle Thoracostomy

Emergency Medical Minute ·

2020/02/17

Author: Aaron Lessen, MD Educational Pearls: Traditional technique of needle thoracostomy for tension penumothorax is along the 2nd intercostal space at the midclavicular line Inserting a large angiocatheter along the 4th or 5th intercostal space at the mid-axillary line may provide a thinner area that is more easily identified, overcoming many of the obstacles of the traditional approach The 10th Edition of ATLS now recommends this location as well A finger thoracostomy, where a scalpel and then

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25:23

On the Streets #1: The Art of the Handoff Report

Emergency Medical Minute ·

2020/02/12

EMM is proud to present the pilot episode of our new monthly series, “On the Streets”. This will be an informative podcast for all of our listeners, but this one was designed specifically for our EMS listeners. Each month, we will consult medical experts on topics pertinent to prehospital care: Identifying a posterior circulation stroke in the field; Knowing when to do a 12-lead and what to look for; How to use capnography for a variety of datapoints; How to give an effective handoff report. And

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02:44

Podcast 540: Zyprexa

Emergency Medical Minute ·

2020/02/11

Contributor: Don Stader, MD Educational Pearls: Olanzapine (Zyprexa) is an atypical antipsychotic that can be used in a similar fashion to haloperidol for pain and nausea, including that with abdominal pain and headaches Olanzapine can be administered as an oral disolving tablets, intramuscular or intravenous injection Because Zyprexa is an atypical antipsychotic, it has a lower risk for tardive dyskinesia and akathisia Olanzapine may cause transient rises in glucose and should be considered when

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03:13

Podcast 539: Coricidin Abuse

Emergency Medical Minute ·

2020/02/10

Contributor: Rachel Beham, PharmD Educational Pearls: Coricidin HBP Cough & Cold (dextromethorphan and chlorpheniramine) is one of the more commonly abused over-the-counter medications Dextromethorphan, binds to multiple receptors, particularly at high doses Opioid receptors, causing respiratory depression, CNS depression NMDA receptors, causing agitation and hallucinations Serotonin-reuptake inhibition, which may lead to serotonin syndrome, especially when combined with other agents

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02:43

Podcast 538: Low Maintenance Boxer’s Fracture

Emergency Medical Minute ·

2020/02/04

Contributor: Jared Scott, MD Educational Pearls: A distal 5th metacarpal neck fracture is often referred to as a “boxer’s fracture” and a common fracture encountered in the emergency department Splinting with an ulnar gutter splint is the typical management of uncomplicated boxer’s fractures A recent study randomized patients to buddy taping or ulnar gutter splint for uncomplicated Boxer’s fractures. Similar functional and pain outcomes were found at follow-up, and those in the buddy taping group

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05:15

Podcast 537: Thoughts on Cardiac Arrest

Emergency Medical Minute ·

2020/02/03

Contributor: Don Stader, MD Educational Pearls: High-quality compressions are an essential, and probably one of the most important, part of cardiac arrest Actual evidence for drugs in cardiac arrest included in ACLS are limited, including epinephrine, bicarbonate, amiodarone, etc. Early defibrillation for ventricular tachycardia (VT) or ventricular fibrillation (VF) has a plethora of supporting evidence Double-sequential defibrillation (nearly simultaneous defibrillation using 2 machines) may be

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45:30

UnfilterED #4: Dr. Vivek Tayal

Emergency Medical Minute ·

2020/01/29

Dr. Vivek Tayal of Carolinas Medical Center, a pioneer of using ultrasound in the emergency department, reflects on his role in establishing ultrasound use in emergency medicine and much more! Ultrasound Program Management: https://www.amazon.com/Ultrasound-Program-Management-Point-Care/dp/3319631411 Intro Music: Backbay Lounge Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/

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08:13

Podcast 536: Epistaxis 101

Emergency Medical Minute ·

2020/01/28

Contributor: Dylan Luyten, MD Educational Pearls: Clear the nasal passages - have the patient, if stable, blow their nose to dislodge any clot that might be in the way Searching for the source of bleeding can be tough. Majority of anterior bleeding is from Kesselbach’s plexus Placing a clamp to provide direct pressure is a mainstay of treatment Application of a topical agent, which may include lidocaine epinephrine tetracaine (LET), tranexamic acid (TXA), or oxymetazoline Nasal packing with a

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02:53

Podcast 535: A Prescription for Falls

Emergency Medical Minute ·

2020/01/28

Contributor: Aaron Lessen, MD Educational Pearls: Emergency department evaluation of falls, particularly in the elderly, should include an assessment of risk factors Common causes of falls in the elderly include medications. Review medication list for sedating medications amongst others Consult with your hospital physical therapist to discuss fall prevention techniques with the patient One study has shown that a comprehensive interdisciplinary approach to geriatric falls in the ED can

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10:10

Mental Health Monthly #1: Decision Making Capacity

Emergency Medical Minute ·

2020/01/22

In the first episode of this new series, the complexities of decision making capacity are discussed. References and Further Reading: [1] Appelbaum, P. S. (2007). Assessment of patients' competence to consent to treatment. New England Journal of Medicine, 357(18), 1834-1840. [2] Etchells, E., Darzins, P., Silberfeld, M., Singer, P. A., McKenny, J., Naglie, G., ... & Strang, D. (1999). Assessment of patient capacity to consent to treatment. Journal of general internal medicine, 14(1), 27-34.

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05:04

Podcast 534: Nerve Agents

Emergency Medical Minute ·

2020/01/21

Author: Michael Hunt, MD Educational Pearls: Organophosphate “nerve agents” were developed in the 1930’s These agents have cholinergic effects, which can be remembered by the mnemonic “SLUDGE” Salivation Lacrimation Urination Defecation GI cramping Emesis The “SLUDGE” toxidrome is mediated through the muscarinic acetylcholine receptors. Nerve agents also affect the nicotinic acetylcholine receptors, which leads to muscle paralysis Death in these cases is from respiratory collapse due to

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04:42

Podcast 533: Hypoglycemia

Emergency Medical Minute ·

2020/01/20

Contributor: Dylan Luyten, MD Educational Pearls: Insulin related hypoglycemia can vary from a brief transient effect from short-acting forms (i.e. insulin lispro) to prolonged from long acting (i.e. insulin glargine), and will require different treatment and/or observation Of oral glycemic agents, sulfonylureas are a common culprit while metformin is rarely a cause Sulfonylureas also deserve attention because in pediatric patients, they can be lethal even with a single ingestion, but also can

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