Best Emergency Medical Minute Podcasts (2024)

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Episode 910: Cellulitis Recovery Timeline 1:45

2h ago1:45

1:45

Contributor: Aaron Lessen, MD Educational Pearls: How fast does cellulitis recover? A recent prospective cohort study took a look at this question. The study included 300 adults with cellulitis (excluding those with peri-orbital cellulitis or abscesses) in two emergency departments in Queensland, Australia. They collected data from initial and foll…

1
Season 4 Episode 6 Talking Tyranny with Margaret Anna Alice of Through the Looking Glass 48:03

2h ago48:03

48:03

Send us a Text Message. The times are fraught with lies and confusion. I am excited to be speaking to Margaret Anna Alice who is another truth seeker and teller. Smart, unabashed, she tells it like it is without fear. She is very good with words like philanthropath - a psychopath masquerading as a philanthropist. An example of this is Bill Gates. B…

1
Hydrogen Ions as a H&T Reversible Cause of Cardiac Arrest 4:38

5h ago4:38

4:38

Hydrogen ions is on one of the Hs in ACLS's H&T reversible causes of cardiac arrest. When considering hydrogen ions as a cause, what we’re looking at is the patient’s pH, or acid/base balance, and conditions that affect it. The body's normal pH. Using patient history, ABGs, & labs to determine acidosis or alkalosis. Common conditions/causes that ma…

1
Code Flow Using the Adult Cardiac Arrest Algorithm 8:11

1d ago8:11

8:11

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such …

1
Aspirin Use in ACLS’s ACS & Stroke Algorithms 4:25

3d ago4:25

4:25

For patients exhibiting symptoms consistent with myocardial ischemia, Aspirin is the first medications we should consider along with morphine, oxygen, and nitroglycerine; if indicated & safe. Aspirin's mechanism of action & benefits for Acute Coronary Syndrome (ACS) patients. Contraindications and considerations for aspirin’s use. The dose and rout…

1
Review of First & Third Degree AV Blocks 7:26

3d ago7:26

7:26

To pass ACLS, you will need to be able to identify common rhythms on a monitor during your mega code and ECG strips on your written exam. If you don't normally monitor patients as part of your job, I suggest two things: 1. Find a system for ECG interpretation that works well for you; and 2. Practice reading ECGs every day for a few weeks before you…

1
Antiarrhythmics: Lidocaine & Amiodarone 6:46

3d ago6:46

6:46

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine. The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine. Review of Lidocaine dosing and administration …

1
Episode 909: Prehospital Blood Pressure Management in Suspected Stroke 2:08

4d ago2:08

2:08

Contributor: Aaron Lessen MD Educational Pearls: A recent study assessed EMS treatment of high blood pressure in the field 2404 patients randomized to prehospital treatment (1205) vs. usual care (1199) Included patients with prehospital BP greater than 150 mm Hg The treatment arm’s BP goal was 130-140 mm Hg The primary efficacy outcome was function…

1
Nasopharyngeal Airway (NPA) Review 4:57

7d ago4:57

4:57

The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA). Examples of when a NPA should be considered. Contraindica…

1
Tamponade as an H&T Reversible Cause of Cardiac Arrest 5:23

8d ago5:23

5:23

When blood, or other fluids, accumulate in the sac around the heart it’s called a cardiac tamponade or pericardial tamponade. The effects of tamponade on the electrical system and chambers of the heart. Cardiac tamponade can be acute or chronic and caused by traumatic, iatrogenic, or pathological etiologies. Common traumatic events, medical procedu…

1
The Team Leader Role and Use of Quick Reference Cards 5:04

9d ago5:04

5:04

Two things have changed in recent years to aid students that don't use ACLS in their daily practice. The role of the team leader; and The ability to use your quick reference cards. The team leader is responsible for assigning tasks and overall direction of the team but can & should ask team members for help. Using closed-loop communication to ensur…

1
Why Early CPR & Defibrillation is Important 5:33

10d ago5:33

5:33

Two factors to cardiac arrest survivability that have been clearly shown to make the biggest difference is continuous, high-quality CPR and early defibrillation. The most common dysrhythmia present during the first few minutes of cardiac arrest is ventricular fibrillation. The chance of successful defibrillation decreases every minute that passes. …

1
Episode 908: Sympathomimetic Drugs 7:54

11d ago7:54

7:54

Contributor: Taylor Lynch MD Educational Pearls: Overview: Sympathomimetic drugs mimic the fight or flight response, affecting monoamines such as dopamine, norepinephrine, and epinephrine Limited therapeutic use, often abused. Types: Amphetamines: Methamphetamine, Adderall, Ritalin, Vyvanse MDMA (Ecstasy) Cocaine (Both hydrochloride salt & free bas…

1
Quantitative Waveform Capnography in ACLS 5:02

11d ago5:02

5:02

Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care. We can use waveform capnography with, and without, an advanced airway in place. Monitoring end tidal CO2 during rescue breathing. Use of capnography to…

1
Vagal Maneuvers for Stable Tachycardia Patients 5:38

14d ago5:38

5:38

Patients with a narrow complex tachycardia with a rate over 150 BPM are in SVT. Unstable patients in SVT, or V-Tach with a pulse, should be cardioverted with a synchronized shock. Assessment & treatment of stable tachycardic patients. Commonly used vagal techniques. A less common technique to stimulate the vagus nerve is the dive reflex. Indication…

1
Defibrillation & Synchronized Cardioversion Energy Settings 5:34

15d ago5:34

5:34

Remembering all the different energy setting needed for synchronized cardioversion and defibrillation used to be confusing for a lot of people. Defibrillators can be broken down into three basic categories: 1. Automated External Defibrillator (AED); 2. Biphasic defibrillators; and 3. Monophasic defibrillators. Use of an AED to rapidly deliver a sho…

1
Identification and Treatment of Unstable Bradycardia 5:19

16d ago5:19

5:19

Patients with a heart rate less than 60 are bradycardic. Some people can have a resting heart rate in the 40s without any compromise. For others, a heart rate of 50 or less could signify the need for immediate intervention and warrants additional assessment. Signs & symptoms that indicate a bradycardic patient is unstable. Monitoring oxygen saturat…

1
Episode 907: Wide-Complex Tachycardia 3:46

16d ago3:46

3:46

Contributor: Travis Barlock MD Educational Pearls: Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds Wide-complex tachycardia of supraventricular origin is known as SVT with aberrancy Aberrancy is due to bundle branch blocks Mostly benign Treated with adenosine or diltiazem Wide-complex tachycardia of…

1
Post-Arrest Care & Targeted Temperature Management (TTM) 5:14

17d ago5:14

5:14

The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved. Post-arrest care and recovery are the final two links in the chain of survival. Identification of ROSC during CPR. Initial patient management goals after identifying ROSC. The patient’s GCS/LOC should be evaluated to determine …

1
The Chain of Survival for Cardiac & Stroke Emergencies 5:05

18d ago5:05

5:05

The chain of survival for ACLS is the same as was learned in your BLS class. The beginning steps of the Cardiac Emergency and Stroke chain of survival. ACLS's timed goals for first medical contact to PCI for STEMI and door-to-needle for ischemic stroke. Characteristics of areas that have significantly better stroke and out-of-hospital cardiac arres…

1
Hypokalemia & Hyperkalemia as a H&T Reversible Cause 4:32

24d ago4:32

4:32

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes. When a patient’s potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively. Two things that may lead us to suspect hypo or hyperkalemia. Medical conditions & medications that can ca…

51
Episode 906: Case Study of Hypernatremia 3:46

26d ago3:46

3:46

Contributor: Aaron Lessen MD Educational Pearls: The case: A gentleman came in from a nursing home with symptoms concerning for sepsis. He was hypotensive, hypoxic, febrile, and mentally altered. His past medical history included previous strokes which had left him with deficits for which he required a feeding tube. Initial workup included some poi…

1
Time Goals for Assessment & Treatment of Stroke 4:59

25d ago4:59

4:59

When treating patients having an MI or stroke, more minutes equals more dead cells. Because the majority of strokes are the ischemic type, the treatment for stroke is similar to an MI; to reestablish perfusion to the ischemic tissues. Review the first four steps in the Stroke Chain of Survival. Time criteria for the administration of tPA or EVT of …

1
Season 4 Episode 5 Grieving 31:28

29d ago31:28

31:28

Send us a Text Message. This episode talks about grieving and how and why an approach using both naturopathic medicine and the expressive arts can keep you balanced and sane, literally in this difficult but precious time. Grieving the loss of a loved one is not easy work. This is why it's so important to do whatever you can on your own to balance y…

1
Medication Review: Adenosine 5:51

1M ago5:51

5:51

Adenosine is the first IV medication given to stable patients with sustained supraventricular tachycardia (SVT) refractory to vagal maneuvers. Symptoms indicating a stable vs unstable patient. Common causes of tachycardia. Cardiac effects of Adenosine. Indications for use in the ACLS Tachycardia algorithm. Considerations and contraindications. Aden…

1
Emergency Minute - Crazy Medical Scenes in Famous Movies 32:34

1M ago32:34

32:34

Send us a Text Message. Ever wonder if the medical scenes in movies are realistic? Is it possible to jump start someone's heart by stabbing them in the chest with a big needle full of adrenalin? Is it possible to treat a collapsed lung by putting a giant needle in the chest with a valve? If someone collapses and loses their pulse should you punch t…

1
Recognition of Second Degree Heart Blocks and Possible Interventions 7:21

1M ago7:21

7:21

To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block. One method of ECG rhythm identification is to ask a series of questions such as: What's the rate (<60, 60-100, 101-149, or >150); Is the rhythm regular or irregular; What's the shape, width,…

1
Episode 905: Oseltamivir (Tamiflu) for Influenza 2:37

1M ago2:37

2:37

Contributor: Aaron Lessem MD Educational Pearls: Oseltamivir (Tamiflu) is an antiviral medication used commonly to treat influenza Trials show that the medication reduces the duration of illness by less than 1 day (~16 hours in one systematic review) Benefit only occurs if taken within 48 hours of symptom onset Must be taken for 5 days A 2024 meta-…

1
SaO2 and Oxygen Administration 4:42

1M ago4:42

4:42

When treating patients with Acute Coronary Syndrome (ACS), MONA is an acronym sometimes used to help us remember the initial interventions. The O in MONA is Oxygen. When we should administer oxygen to ACS patients. When O2 administration is unnecessary based on an accurate pulse ox. Monitoring patient's oxygen saturation (SaO2) using a pulse oximet…

1
Objective Measures of Good CPR 6:42

1M ago6:42

6:42

Along with early defibrillation, high quality CPR with minimal interruptions is one of the two factors that has been shown to improve cardiac arrest outcomes. How do we know if high quality, effective CPR is being performed? Objective measures of high-quality CPR include: Compression rate; Compression depth & recoil; ETCO2; and Chest Compression Fr…

1
Bradycardia Dosing for Atropine & Dopamine 5:57

1M ago5:57

5:57

When we should consider using the bradycardia algorithm. The signs & symptoms of unstable bradycardia. Atropine's dose and maximum. The use of atropine when a patient is in a second degree type II or third degree heart block. ECG changes that indicate subsequent doses of atropine are likely to be ineffective. The dose of Dopamine. The use of Dopami…

1
Oropharyngeal Airway (OPA) Review 5:58

1M ago5:58

5:58

The tongue is the most common airway obstruction in an unconscious patient. Insertion an oropharyngeal airway helps keep the patient’s tongue from falling to the back of the pharynx, causing an airway obstruction. The oropharyngeal airway is sometimes called an OPA or simply an oral airway. Indications for using an oral airway. Contraindication for…

1
Hypoxia: An H&T Reversible Cause of Cardiac Arrest 5:54

1M ago5:54

5:54

Hypoxia is a state of low oxygen levels in the blood. Determining hypoxia using a pulse oximeter or arterial blood gasses (ABGs). A goal of ACLS is to recognize signs of hypoxia and provide timely treatment to prevent an arrest. Examples of some things that might lead us to think of hypoxia as a cause of cardiac arrest. Why we should not rely on pu…

51
Episode 904: Cardiovascular Risks of Epinephrine 2:11

1M ago2:11

2:11

Contributor: Aaron Lessen MD Educational Pearls: Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective? A 2024 study in the Journal of the American College of Emergency Physicians Open sought to answer this question. Methods: Retrospective observational study at a Tennessee quaterna…

1
Sinus Tachycardia vs. Supraventricular Tachycardia (SVT) 6:08

1M ago6:08

6:08

ECG characteristics of supraventricular tachycardia (SVT) vs. sinus tachycardia. Signs & symptoms that indicate a patient is unstable. Delivery of a synchronized shock for the treatment of unstable SVT using a biphasic vs monophasic defibrillator. Consideration for team safety while performing synchronized cardioversion. Actions to take immediately…

1
Season 4 Episode 4 Hospital Error - How My Husband Died - Part 2 32:23

1M ago32:23

32:23

Send us a Text Message. This episode completes the tragic story of Avi's passing by hospital error. This is Part 2. Although the cause of his original problem was TDap vaccine we did get him well after two heart attacks and a stroke. There was nothing wrong with his brain and his heart and body were healing after we initially got him well with home…

1
Administration of Epinephrine During Cardiac Arrest 5:12

1M ago5:12

5:12

When working to resuscitate a patient in sudden cardiac arrest, Epinephrine is the first IV medication we administer. When we give the first dose of epinephrine depends on whether the patient is in a shockable or non-shockable rhythm. When to give the first dose of epinephrine and its frequency for patients in asystole or PEA following the right si…

1
Identification & Treatment of Common Conditions That Can Mimic a Stroke 6:01

1M ago6:01

6:01

If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it’s possible they could be having a stroke. The Cincinnati Prehospital Stroke Scale. There are several conditions that can mimic a stroke. Identification & Treatment of hypoglycemia or hyperglycemia. Identification &…

1
Medication Administration Via Intraosseous or Endotracheal Tube Route 5:59

1M ago5:59

5:59

Most ACLS medications are given IV push. But, what happens if we can't get an IV? Why IO is better than ETT as an alternative route. The locations we should place an IO when running a code and a location we should avoid. The ACLS medications that can be given intraosseous. Where you can find more information about intraosseous access during resusci…

1
Prehospital Capabilities and EMS Destination Protocols for STEMI & Stroke 5:53

2M ago5:53

5:53

The chain of survival for a cardiac emergency and stroke start the same: 1. preparedness & recognition of an emergency; 2. activation of EMS; 3. delivery of Advanced Life Support; and 4. transporting to the most appropriate facility. ALS ambulances are staffed with paramedics who have training in ACLS skills. Why EMS "Destination Protocols" for sus…

1
Episode 903: Treating Precipitated Opioid Withdrawal 2:47

2M ago2:47

2:47

Contributor: Aaron Lessen MD Educational Pearls: Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients Treatment of opioid use disorder with buprenorphine can also precipitate withdrawal Opioid withdrawal symptoms include nausea, vomiting, diarrhea, and agitation Bupreno…

1
Review of Automated External Defibrillator (AED) 6:26

2M ago6:26

6:26

Performing good CPR and delivering a shock as soon as possible to a patient in Ventricular Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest. Studies have demonstrated significantly better out-of-hospital cardiac arrest survival outcomes in communities with …

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