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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

05:54

Podcast 507: Who gonna crump?

Emergency Medical Minute ·

2019/10/07

Contributor: Nick Tsipis, MD Educational Pearls: Communication proves time and time again to be most helpful in preventing surprises after patient admission Frequent re-evaluations and repeat vital signs can be important to evaluating a patient’s risk for deterioration once admitted as well as selecting the proper level of care at admission Broad categories of patients who most commonly have a change in condition after admission are septic patients and those admitted for respiratory complaints

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01:00:01

UnfilterED #1: Dr. Michael Hunt

Emergency Medical Minute ·

2019/10/07

On the first installment of this new series, Dr. Michael Hunt shares stories, lessons and advice as he reflects on his 35 year career as an emergency physician. 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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02:23

Podcast 506: Seymour Fracture

Emergency Medical Minute ·

2019/10/03

Contributor: Don Stader, MD Educational Pearls: Seymour fracture is an eponym for a Salter-Harris I/II fracture of the distal phalanx of the finger or toe in children, associated with a nailbed inury These may present and subtle as a subungal hematoma with a fracture on x-ray but carry a significant risk of complications While in adults a hammer-finger deformity indicates an avulsion injury of the extensor tendon, in children it can indicate disruption of the growth plate. This is coupled with

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03:41

Podcast 505: Sleep on Strep Throat

Emergency Medical Minute ·

2019/10/01

Contributor: Don Stader, MD Educational Pearls: Only 10% of patients receiving antibiotics for strep throat actually have the diesease Treatment of strep with antibiotics only slightly reduces the duration of illness. Most studies say the reduction is between 16 and 24 hours Antibiotic treatment may reduce complications such as peritonsilar abscess and otitis media but antibiotics also increase the risk of diarrhea and yeast infection Rheumatic fever is caused by a specific serotype of strep that

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03:23

PREVIEW: UnfilterED

Emergency Medical Minute ·

2019/09/28

...coming October 2019 Music: emotional by Barradeen | https://soundcloud.com/barradeen Music promoted by https://www.free-stock-music.com Creative Commons Attribution-ShareAlike 3.0 Unported https://creativecommons.org/licenses/by-sa/3.0/deed.en_US

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03:22

Podcast 504: Ocular Compartment Syndrome

Emergency Medical Minute ·

2019/09/26

Contributor: Don Stader, MD Educational Pearls: The eye is surrounded by relatively inflexible tissues such as the bone of the orbit and the fibrous tissue of the eye. This makes it relatively susceptible to damage from outside compression, which is most common from trauma. This phenomenon is called ocular compartment syndrome (OCS) Look for OCS when patients have face, head or direct eye trauma OCS will present with a swollen, bulging eye associated with pain and blurry vision. Typically

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08:31

Podcast 503: Magical Magnesium

Emergency Medical Minute ·

2019/09/23

Contributor: Dylan Luyten, MD Educational Pearls: Those that are hypokalemic are often hypomagnesemic, and should receive magnesium (Mg) supplementation if repleting potassium Mg levels are typically not necessary - if someone is suspect to have hypomagnesemia, just given them Mg Mg increases the AV node refractory period and therefore may be helpful as an adjunct to those in atrial fibrillation with a rapid ventricular response Mg is the preferred treatment for seizure prophylaxis in preeclampsia

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02:41

Podcast 502: EMS Psych Clearance

Emergency Medical Minute ·

2019/09/20

Contributor: Aaron Lessen, MD Educational Pearls: Patients with psychiatric complaints are often complicated to disposition from the main ED, and many will require inpatient psychiatric stays Some health systems have dedicated psychiatric ED’s that are specialized in taking care of these patients For example, in Oakland, CA, EMS are permitted to “clear” a patient for transport to a psych-only facility. 5-year retrospective study of this system showed 40% of psych patients were cleared by EMS for

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03:20

Podcast # 501: Take Down Potions

Emergency Medical Minute ·

2019/09/16

Author: Jared Scott, MD Educational Pearls: Study from Hennepin County EM studied the efficacy of different drugs for agitation, which included 737 patients Most patients in this study were male and *surprise* drunk Compared doses of common sedatives with primary outcome of sedation at 15 minutes (all intramuscular) haloperidol 5 mg ziprasidone 20 mg olanzapine 10 mg midazolam 5 mg haloperidol 10 mg with the main outcome of agitation at 15 minutes Intramuscular midazolam resulted in the lowest

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01:05:53

Colorado MAT Part 4: Buprenorphine in the Emergency...

Emergency Medical Minute ·

2019/08/26

Treatment with buprenorphine is easier, less time consuming and far more effective for management of opioid withdrawal and OUD than standard care with clonidine, IVF, haldol and other symptomatic therapies. Induction with buprenorphine is easy, requires no IV or labs, and is usually accomplished in 1-2 hours. It requires a chair, not a hospital bed. To identify patients who are candidates, be sure they’re in sufficient opioid withdrawal using clinical impression or the COWS scale, obtain a

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27:01

Colorado MAT Part 3: Medications for MAT in the ED

Emergency Medical Minute ·

2019/08/26

There are three MAT drugs available to treat addiction: naltrexone (brand name Vivitrol), methadone (brand names Dolophine or Methadose) & buprenorphine (brand name Suboxone, Subutex, and Sublicade). The only MAT drug appropriate for initiation in the ED is buprenorphine. Buprenorphine is a semi-synthetic opioid which acts as partial agonist at the mu receptor. Buprenorphine does not produce as much euphoria or as much of the respiratory depression seen with other opioids. It has a quick onset and

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28:02

Colorado MAT Part 2: Medication Assisted Treatment

Emergency Medical Minute ·

2019/08/26

Medication Assisted Treatment or (Medication for Addiction Treatment) is an important frontier in ED care of patients with Opioid Use Disorder. Naltrexone, methadone and buprenorphine are the medications approved for the treatment of OUD. Addiction is a disease that is widely misunderstood and rarely taught in medical school. It is a dangerous myth that the best treatment of all addictions is simply abstinence. The evolving consensus around OUD is that is best treated with medication. An opioid

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39:24

Colorado MAT Part 1: Understanding Addiction & Opioid...

Emergency Medical Minute ·

2019/08/26

Addiction is widely misunderstood by the public and by many healthcare providers. It is not taught in most medical schools. Combating the opioid epidemic will require providers to understand Opioid Use Disorder (OUD) and its treatment. Addiction is a chronic, relapsing disease with extraordinarily high morbidity and mortality. It is the transition from controlled to impulsive and compulsive drug intake. Physiologic dependence is just one aspect of addiction. The behavioral and social derangements

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14:21

Podcast #500: 2018-19 Rapid Fire EM Literature Review

Emergency Medical Minute ·

2019/08/24

Author: Dave Saintsing Educational Pearls: Poor sleep is an independent risk factor for development of health problems such as type 2 diabetes. A 2019 study, randomized participants to 3 groups: 9 hours of sleep, 5 hours of sleep with weekend catch-up sleep, and 5 hours of sleep without catch-up sleep. In the sleep deprived (5 hour) groups, there was significantly more insulin resistance, calorie intake, and weight gain regardless of catch-up sleep. Tramadol is prescribed 25 million times a year

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12:13

Podcast #499: Posterior Circulation Ischemia

Emergency Medical Minute ·

2019/08/22

Podcast # 499: Posterior Circulation Strokes Contributor: Neal O’Connor, MD Educational Pearls: Dizziness is a very common complaint in the emergency department, but how can we find patients with a dangerous cause of their symptoms, namely a posterior circulation stroke? Consider a posterior circulation stroke in those with an abrupt onset of headache with neck pain, balance problem, blurred vision, or dysphagia Thorough cranial nerve exam can be important to screen for posterior circulation

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12:42

Podcast # 498: Ortho Tips

Emergency Medical Minute ·

2019/08/19

Author: Susan Ryan, DO Educational Pearls: General orthopedic principles: Examine above and below the injury Document neurovascular status X-ray imaging typically requires three different views Fracture description should include name the bone, location of fracture, degree of displacement, and if it is closed or open Osgood-Schlatter (tibia) and Sever’s (calcaneus) disease are apophyseal injuries caused by ligaments that are “stronger” than the bones they attach to When looking for scaphoid

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15:00

Podcast #497: Does my patient with CP have ACS?

Emergency Medical Minute ·

2019/08/15

Author: Dylan Luyten, MD Educational Pearls: While certain aspects of the history, exam, and EKG may increase likelihood of ACS, there is no one element that performs well on its own Elements of the history have been found to have different likelihood ratios, which can increase or decrease the probability of a patient having ACS Likelihood ratios greater than one increase the chance of the patient having the disease. Ratios less than one decrease it Bilateral arm radiation is one of very few

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07:18

Podcast # 496: Hallucinogens

Emergency Medical Minute ·

2019/08/12

Author: David Holland, MD Educational Pearls: Hallucinogenics have been used for a variety of cultural and religious reasons for thousands of years In the 1960’s a Harvard professor began experimenting with psilocybin mushrooms. There was resulting public outcry, eventually leading to all hallucinogens being listed as schedule I drugs Common hallucinogens include: LSD (acid), Mescaline (peyote), DMT (ayahuasca), Psilocybin (mushrooms), MDMA (ecstacy) Effects vary by specific drug but may include

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06:53

Podcast # 495: Trauma in the Elderly

Emergency Medical Minute ·

2019/08/06

Author: Rachel Brady, MD Educational Pearls: Elderly patients (>65 years old) have a higher trauma mortality compared to younger patients, even though they have lower mechanisms of injury Elder trauma is often under-triaged due to low-energy mechanisms and lack of physiologic response due to age and medications such as beta-blockers. Do not be reassured by normal vital signs. Image elderly patients with head injury aggressively since they are at high risk of intracranial bleeds Be sure to ask

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07:09

Podcast #494: A Standard Toxicology Approach

Emergency Medical Minute ·

2019/08/02

Contributor: JP Brewer, MD Educational Pearls: Obtaining collateral is often vital to determine the potential drugs accessible to the patient - this may include After this, use ancillary sources such as EMS, family/friends, and police to determine the patient’s last normal, PMH and medications To help separate toxidromes, pupillary exam and skin exam are helpful Important physical exam clues in toxicology include the pupils and the skin Adjunct laboratory evaluation may include liver function

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