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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

04:50

Podcast 532: SVC Syndrome

Emergency Medical Minute ·

2020/01/14

Contributor: Jared Scott, MD Educational Pearls: Superior vena cava (SVC) syndrome is caused by physical compression of the SVC and can present with facial swelling, upper extremity swelling, flushing, and parasthesias Common causes of SVC syndrome include lung cancer, lymphoma, and thymoma Keep SVC syndrome on the differential for all patients with facial or upper extremity swelling References The superior vena cava syndrome: clinical characteristics and evolving etiology. Rice TW, Rodriguez RM,

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03:04

Podcast 531: Migraine Cocktail

Emergency Medical Minute ·

2020/01/13

Contributor: Don Stader, MD Educational Pearls: The classic migraine cocktail includes: Reglan (or other dopamine antagonist), Benadryl, Toradol, Decadron, and IV fluids. The most effective agent in the cocktail is a dopaminergic agent Routine IV fluids have not shown efficacy There is no evidence for pre-treatment of akathisia with diphenhydramine (Benadryl) Decadron reduces rebound headache Consider trigger point injections for those with migraine attributable to cervical neck pain.

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04:47

Podcast 530: Anion Gap Acidosis + Metformin Toxicity

Emergency Medical Minute ·

2020/01/08

Contributor: Don Stader, MD Educational Pearls: The common causes of anion gap metabolic acidosis include (MUDPILES) Metformin, Methanol Uremia DKA Paraldehyde INH/Iron Lactate Ethylene Glycol Salicylate Metformin is a very common drug used to treat type 2 diabetes, however in the right setting, it can cause a profound lactic acidosis. There is a very high mortality rate. Treatment of metformin toxicity includes fluids, bicarb, and dialysis Most commonly, metformin toxicity is in the

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03:17

Podcast 529: Hemophilia

Emergency Medical Minute ·

2020/01/08

Contributor: Aaron Lessen, MD Educational Pearls: Hemophilia is characterized by bleeding (A /B) A is is 8, B (chrstmas, 9) Hemophilia refers to a group of bleeding disorders caused by a deficiency in a certain clotting factor. The two most common are hemophilia A (caused by a lack of factor VIII), and B (caused by a lack of factor 9) Most cases are inherited in an X-linked recessive manner. Therefore, males are the most commonly affected. However, spontaneous cases do occur in all sexes. People

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04:33

Podcast 528: Decompensated Liver Failure

Emergency Medical Minute ·

2020/01/06

Contributor: Michael Hunt, MD Educational Pearls: Cirrhosis is the end stage of chronic structural damage to the liver. This is most commonly due to alcohol but other causes viral hepatitis and hepatotoxic drugs Cirrhotic patients are very prone to GI bleeding and infections, partially due to the role the liver plays in producing immune and clotting factors These patients can easily become “sick”. Use the shock index (heart rate / systolic blood pressure) as a rapid assessment of hemodynamic

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02:01

Podcast 527: Knee Dislocations

Emergency Medical Minute ·

2020/01/03

Contributor: Erik Verzemnieks, MD Educational Pearls: Knee dislocations are most common in high energy trauma, such as a motor vehicle accident The knee may appear grossly normal on initial inspection since dislocations can spontaneously reduce - Look for such findings as hemarthrosis, instability, or ecchymosis, as clues to an occult dislocation. Knee dislocations are often associated with damage to the popliteal artery that runs behind the knee. Assess for pulse deficit on exam. If you are

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03:34

Podcast 526: Desmopressin for Intracranial Hemorrhage

Emergency Medical Minute ·

2019/12/30

Contributor: Charleen Melton, PharmD Educational Pearls: Desmopressin (DDAVP) is an analogue of anti-diuretic hormone (ADH) that has been used for the treatment of intracranial hemorrhage. It works by increasing the release of Von Willebrand factor, helping to stabilize clots. The use of DDAVP for intracranial hemorrhage in patients on antiplatelet agents (mainly Aspirin and Plavix) was recently reviewed In this retrospective review, they found an 88% decreased likelihood of hemorrhage expansion,

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03:24

Podcast 525: Enjoyable Epistaxis?

Emergency Medical Minute ·

2019/12/24

Contributor: Jared Scott, MD Educational Pearls: The ED is full of painful procedures. One of the most commonly dreaded procedures is nasal packing for epistaxis, as it is quite uncomfortable for the patient. A recent study compared TXA with compression, saline with compression, and traditional nasal packing for the treatment of epistaxis. Hemostasis was achieved in 91% with TXA and compression, 93% with nasal packing, and 71% with saline and compression. There was no statistically significant

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03:33

Podcast 524: Bacterial Endocarditis

Emergency Medical Minute ·

2019/12/20

Contributor: Sue Chilton, MD Educational Pearls: More intracardiac devices and injection drug abuse are thought to be increasing incidence of endocarditis Classic signs of endocarditis have included: Osler nodes (painful hemorrhagic lesions on hands and feet), Janeway lesions (painless hemorrhagic lesions on the hands and feet), and splinter hemorrhages in the nail beds Other classic findings like fever and murmur are variable More non-specific symptoms can include flu-like symptoms Patients who

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02:20

Podcast 523: A Dizzying Diagnosis

Emergency Medical Minute ·

2019/12/17

Contributor: Don Stader, MD Educational Pearls: It can be difficult to distinguish between central and peripheral causes of vertigo. Cerebellar stroke should be considered with any dizzy patient. Signs and symptoms that suggest stroke as the cause of vertigo include: ataxia, cranial nerve deficits, and rapid onset of symptoms When cerebellar stroke is being considered, MRI is the imaging modality of choice since CT does not adequately visualize the posterior fossa. References Kim J, Lee H

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01:43:52

UnfilterED #3: Dr. Katie Bakes & Dr. Pete Bakes

Emergency Medical Minute ·

2019/12/14

Husband and wife Pete and Katie Bakes, both emergency physicians in the Denver-Metro area, reflect on their upbringings, the many lessons learned over their twenty year careers, and how they've evolved as physicians and as a couple in this very special episode of UnfilterED. Time Stamps: 00:25 - Intros 03:05 - How did you two meet? 08:20 - (P) How have you seen Katie develop and change over the course of her medical career? 12:00 - (K) As a young woman, how did you balance your professional

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02:41

Podcast 522: e-Cigarette and Vaping Related Lung Injury

Emergency Medical Minute ·

2019/12/10

Contributor: John Winkler, MD Educational Pearls: Vaping-related lung injury initially presents with flu-like symptoms and can progress to respiratory failure requiring aggressive resuscitation including ECMO It is thought to be related to the contents of homemade vaping fluid, mostly in THC-containing products (“brands” include DankVapes, PaxPen) Ask patients with vague constitutional or respiratory symptoms about their vape use References What are the respiratory effects of e-cigarettes? Gotts

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02:20

Podcast 521: Traumatic Hyphema

Emergency Medical Minute ·

2019/12/05

Author: Jared Scott, MD Educational Pearls: A hyphema is blood in the anterior chamber of the eye, typically caused by trauma While there is a spectrum of disease, blurred vision and eye pain are common presenting complaints after direct trauma to the eye Hyphema are graded between Grade 1 and Grade 5, depending on the amount of blood in the anterior chamber. Higher grades are associated with worse outcomes and more complications Other important diagnoses to consider include globe rupture and

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07:37

Podcast 520: Approach to the arresting patient

Emergency Medical Minute ·

2019/12/03

Contributor: Peter Bakes, MD Educational Pearls: Peri-arrest patients present a particular challenge to ED providers, as the differential is broad and time is critical The differential for near cardiac arrest includes the “H’s and T’s”, just as in true cardiac arrest The 6 H’s include: hypoxia, hypo/hyperkalemia, hypovolemia (including shock states), hydrogen (acidosis), hypothermia The 6 T’s include: tension pneumothorax, cardiac tamponade, thrombus (PE/MI), toxins, trauma Use your history

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56:57

CBHW Summit: The Cycle of Drug-Related Stigma -...

Emergency Medical Minute ·

2019/11/27

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Michael Miller, Strategic Initiatives Coordinator, Jefferson County Public Health

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45:14

CBHW Summit: A Strategic Framework for Addiction...

Emergency Medical Minute ·

2019/11/27

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributors: Judith Shlay, MD, MSPH, Associate Director, Denver Public Health, and Brooke Bender, MPH, Center for Addiction Medicine Planner, Denver Health

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01:08:24

CBHW Summit: Safe Prescribing 101/201

Emergency Medical Minute ·

2019/11/27

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Christopher Urbina, MD, MPH, Colorado Consortium for Prescription Drug Abuse Prevention

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52:41

CBHW Summit: Male Mental Health - A Crisis in Public...

Emergency Medical Minute ·

2019/11/27

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Jason Vitello, MSW, Behavioral Health Coordinator, Denver Public Health/CPHA

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01:06:29

CBHW Summit: Children's Mental Health

Emergency Medical Minute ·

2019/11/27

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributors: Sarah Davidon, EdD, Director of Research & Child and Adolescent Strategy, Mental Health Colorado, and Sarah Younggren, LCSW, Child & Adolescent Specialist, Mental Health Colorado

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23:16

CBHW Summit: Positive Psychology and Well-Being

Emergency Medical Minute ·

2019/11/27

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Carl Clark, MD, President & Chief Executive Officer, Mental Health Center of Denver

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