Emergency Medicine Cases – Where the Experts Keep You in the Know. For show notes, quizzes, videos and more learning tools please visit emergencymedicinecases.com
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Help me fill in the blanks of the practice of ED Critical Care. In this podcast, we discuss all things related to the crashing, critically ill patient in the Emergency Department. Find the show notes at emcrit.org.
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Meet 'em, greet 'em, treat 'em and street 'em
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Stimulus | Helping Doctors overcome burnout, excel in leadership, and unlock their most fulfilling careers
Rob Orman, MD
We break down ideas, strategies, and tactics to help you improve your mindset, overcome burnout, excel in leadership, prioritize your well-being, get unstuck, de-stress, and thrive in your career. If you are a doctor, nurse, paramedic, medical student, physician assistant, nurse practitioner, administrator, or even tangentially related to healthcare, this show is made for you. Hosted by emergency physician and executive coach Rob Orman, MD. Don't just suck it up, think differently.
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Emergency Medicine podcasts based on evidence based medicine focussed on practice in and around the resus room.
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The aim of this podcast is to discuss and debate prehospital and retrieval medicine--its current practice and controversies. In many ways the philosophy espoused will be that of prehospital critical care. Whereas EMCrit brings upstairs care, downstairs; I aim to bring it out of the hospital. Many prehospital providers are doing this already.
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Your Boot Camp Guide to Emergency Medicine
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EMCrit 381 - Penetrating Neck Trauma - Get Out of the Zones!
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By Scott D. Weingart, MD FCCM
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SGEM#449: Bad Boys What’cha Gonna Do – Patient Perceptions of Behavioral Flags in the ED
36:53
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Date: July 31, 2024 Reference: Gonzales RE, Seeburger EF, Friedman AB, and Agarwal AK. Patient perceptions of behavioral flags in the emergency department: A qualitative analysis. AEM July 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Departmen…
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The UK REBOA trial left many with doubts over its utility for trauma patients in ED. The time from injury to its use was around 90 minutes and the trial was stopped when it didn't reduce and maybe even increased mortality compared to standard care alone. But what effect does REBOA have when used prehospitally and how feasible is it? Our first paper…
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EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma
1:11:42
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In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast …
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EMCrit 380 - Acid Base Part VIII - Tris-Hydroxymethyl Aminomethane (THAM) for Acidosis
38:10
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By Scott D. Weingart, MD FCCM
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Are You Betting On Yourself? | How locus of control makes all the difference
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Success and happiness are often determined by where we place our focus: within ourselves or on external factors. Mastery lies in asking the right questions, and understanding the locus of control is a key part of this. Those who focus on what they can influence are generally happier and more successful. In this episode, we explore the philosophy be…
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SGEM#448: More than A Feeling – Gestalt vs CDT for Predicting Sepsis
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Reference: Knack et al. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Date: July 25, 2024 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: Your hospital is running Morbidit…
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SGEM#447: Just What I Needed – Preoxygenation Prior To Intubation
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Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career …
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EMCrit ShadowBoxing - Casey Parker Rural Medicine Critical Care Case
57:01
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By Scott D. Weingart, MD FCCM
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Acute Kidney Injury is common, complicated and holds significant morbidity and mortality. But...if we recognise it, we can make a real difference to our patients' outcomes. In this episode we run through the anatomy, physiology and aetiologies. We have a think about the multitude of definitions of AKI and then take each of the pre renal, renal and …
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Medical debt has a strange and storied history in America. Stretching back to colonial times, physicians and patients alike have grappled with its harsh realities. In recent years, hospitals have resorted to selling medical debt to third parties, who then aggressively pursue patients. In today’s episode, medical historian Luke Messac, MD, PhD, guid…
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SGEM#446: Finding Pneumo…nia in Febrile Infants
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Reference: Florin TA, et al. Radiographic pneumonia in young febrile infants presenting to the emergency department: secondary analysis of a prospective cohort study. Emerg Med J. 2023 Date: May 29, 2024 Guest Skeptic: Dr. Christina Lindgren is a Pediatric Emergency Medicine Attending at Children’s National Hospital and Assistant Professor of Pedia…
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EMCrit 379 - Procedural Sedation Part IV - the Critically Ill Patient and MidaKet
15:12
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By Scott D. Weingart, MD FCCM
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Ep 196 Pediatric Meningitis Recognition, Workup and Management
1:28:57
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In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various age…
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SGEM#445: Why Can’t We Be Friends – Conflict in Emergency Medicine
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Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She co-founded FOAMcast and is a pulmonary embolism and implementation science re…
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EMCrit Wee - Don't be so Quick to Blow-Off New-Onset Atrial Fibrillation (A-Fib)
19:22
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By Scott D. Weingart, MD FCCM
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Impatience, Anger, and the Guilt of Abundance | Insights from the Dalai Lama’s Doctor
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It's natural to feel guilt or shame when living in abundance while much of the world faces hardship. In this episode, Dr. Barry Kerzin, the Dalai Lama's personal physician and a Buddhist monk, shares his approach to managing these emotions with a simple yet powerful tool. He also discusses his journey to becoming a monk, life within the Dalai Lama'…
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There's a huge paper to talk about this month in the PREOXI trial, a multi centre RCT looking at the pre oxygenation strategy in critically unwell patients undergoing RSI, with patients either getting high flow oxygen through a facemask or NIV. The results are pretty remarkable and may well be practice changing as we'll discuss in the podcast! Next…
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SGEM Xtra: When I’m 64 – Old Fashioned Doctors
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Date: June 29, 2024 Reference: Herbert L. Fred M.D. (1998) Old-Fashioned Doctors, Hospital Practice. This is an SGEM Xtra episode. I was honoured to be invited by Dr. Fernada Bellolio to the Mayo Clinic and present to the Department of Emergency Medicine. They were kind enough to allow me to speak about any topic. I […] The post SGEM Xtra: When I’m…
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EMCrit 378 - So NSTI - Necrotizing Fasciitis & Life Threatening Soft Tissue Infections
17:05
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By Scott D. Weingart, MD FCCM
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EMCrit Wee - Adaptive Support Ventilation (ASV)
39:22
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By Scott D. Weingart, MD FCCM
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SGEM#444: I Need Oxygen…But How Much Oxygen for Critically Ill Children
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Reference: Peters MJ, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-picu): a UK multicentre, open, parallel-group, randomised clinical trial. Lancet. December 2023 Guest Skeptic: Dr. Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicin…
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EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments
58:03
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In this month's EM Quick Hits podcast: Megan Landes on the importance of diagnosing HIV in the ED, Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion, Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient, Brit Long and Hans Rosenberg on the identification, wor…
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So this month we’re looking at major incidents and specifically the triage process that is now coming into play in the UK and further afield that you need to know about! We normally stick pretty strongly to clinical topics; they’re pretty easy to focus on because you can imagine how extra knowledge in a certain clinical area could make a difference…
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Are Non-Compete Clauses About To Be History? | And what to consider before accepting a signing bonus
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Non-compete clauses have plagued contracts for decades. It’s been analogous to asymmetric warfare, with employers holding the upper hand. All of that may soon be a thing of the past. In this episode, we explore the Federal Trade Commission's recent ruling to ban these clauses and its implications for doctors and the healthcare industry. We'll also …
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EMCrit Wee - Additional Thoughts on the PREOXI Trial
11:30
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By Scott D. Weingart, MD FCCM
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SGEM#443: Don’t Stop Me Now – REBOA for Hemorrhage Control in Trauma Patients?
46:25
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Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also ser…
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EMCrit 377 - Break News - The PREOXI Trial changes everything about Preoxygenation for Intubations in the Critically Ill
52:12
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By Scott D. Weingart, MD FCCM
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SGEM#442: I’m on the Right Track Baby I Was Born This Way
39:05
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Reference: Kruse et al. Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People Recommendations for Immediate Action to Improve Care. WJEM December 2023 Date: May 30, 2024 Guest Skeptic: Dr. Kay Dingwell is a rural emergency physician working in Prince County, PEI wit…
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EMCrit Wee - Controlled Automated Reperfusion of the Whole Body (CARL) ECPR / ECLS Yields Amazing Results
42:22
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By Scott D. Weingart, MD FCCM
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Why Cultural Context Matters in Patient Care and Clinician Burnout
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Understanding cultural context in healthcare can seem overwhelming, especially when time and resources are limited. Why should clinicians invest energy in learning about different cultures? In this pod, we break down the differences between cultural competence and cultural safety, explaining why the latter is essential for patient care. We share pr…
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SGEM#441: Searching Searching for the best Clinical Decision Rule to Detect Pediatric C-Spine Injury
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Reference: Tavender E, et al. Triage tools for detecting cervical spine injury in paediatric trauma patients. Cochrane Database Syst Rev. 2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washin…
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Welcome back to June's Papers of the month! We kick off this month looking at the work up of patients with a first episode of psychosis. With these patients there is a chance of a psychosis secondary to an underlying structural cause. Getting neuro-imaging to look for this prior to psychiatric assessment is tricky though, often with a need for seda…
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Ep 195 Management of Subarachnoid Hemorrhage
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Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast s…
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EMCrit 376 - Do We Need ETCO2 (Capnography) for Procedural Sedation in the ED?
17:56
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By Scott D. Weingart, MD FCCM
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By Scott D. Weingart, MD FCCM
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SGEM#440: I’m Gonna Need Someone To Help Me – GRACE4 AUD and CHS Management in the ED
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Reference: Borgundvaag et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. AEM May 2024 Date: May 22, 2024 Guest Skeptic: Dr. Bjug Borgundvaag is the Founding Director of the Schwartz/Reisman Emergency Medicine …
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Kicking The Can Down The Road | How to break up with deciding not to decide
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"Kicking the can down the road" is a common behavior that manifests in various ways, from delaying difficult patient decisions to avoiding complex tasks. We explore the reasons behind on-shift procrastination and strategies for overcoming it. Our discussion includes practical steps to recognize and address decision deferral, techniques for managing…
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SGEM Xtra: Yeah, Might Be All that You Get – How Ted Lasso Made Us Better
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Date: May 13, 2024 Guest Skeptics: Dr. Rebecca Szabo is an obstetrician/gynecologist and medical educator specializing in simulation from Melbourne, Australia working at The Royal Women’s Hospital and The University of Melbourne. This is her first time as a guest skeptic on the SGEM, she has created FOAMed content through various media, including t…
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EMCrit 375 - Vasopressors for Early Hemorrhage?
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By Scott D. Weingart, MD FCCM
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Cardiac Arrest, Start With The End In Mind; Roadside to Resus
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We’ve covered Cardiac Arrest management (as in the medical delivery of it) in a previous Roadside to Resusepsiode. Since then we've had some updates with Paramedic-2, Refractory VF, Airways-2 and a whole host of other papers. But what we haven't talked much about is the art of creating the environment, space & workflow to deliver the best medical c…
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Ep 194 Subarachnoid Hemorrhage – Recognition, Workup and Diagnosis Deep Dive
1:21:50
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Anton is joined by the world's leading EM researcher in subarachnoid hemorrhage diagnosis Dr. Jeff Perry and EM-Stroke team clinician Dr. Katie Lin for a deep dive into why we still miss this life-threatening diagnosis, the key clinical clues, proper use of decision tools, indications for CT, indications for CTA, indications for LP and CSF interpre…
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EMCrit Wee - Intraosseous Device Burr Holes (Craniotomy) with Marc Grossman
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By Scott D. Weingart, MD FCCM
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SGEM #439: Go Ninja Go Ninja Go…Home without Replacing the Fingernail
21:11
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Reference: Jain A, et al. Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. Br J Surg. March 2023 Date: May 7, 2024 Guest Skeptic: Dr. Brian Lee is a pediatric emergency medicine attending at the Children’s Hospital of Philadelphia and Assistant Professor of Pediatric…
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EMCrit 374 - ShadowBoxing - An AMAXimally Sick Patient
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By Scott D. Weingart, MD FCCM
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Welcome back to the podcast and three great papers for May's episode! First up we take a pretty deep look into refractory VF. This follows on from our our review of DOSE-VF in December '22's papers of the month and our recent Roadside to Resus on the topic. In that we discussed the possibility that many of the cases we see at pulse checks as being …
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SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?
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Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. February 2024. Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community Col…
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EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality
1:04:36
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In this month's EM Quick Hits podcast: Justin Morgenstern on the first RCT of high dose nitroglycerin in SCAPE, Andrew Neill on Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) indications and evidence, Brit Long on indications for CT in suspected diverticulitis, Tahara Bhate on Central Retinal Artery Occlusion (CRAO) and diagnosti…
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SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures
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Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM. Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta. She is an Assistant…
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EMCrit 373 - Mike Weinstock with another Critical Care Bounceback: "Asymptomatic Hypertension"
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By Scott D. Weingart, MD FCCM
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