In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UNLIKELY tool for pulmonary embolism... The post EM Quick Hits 47 HFNC, Dissection Drugs, ADJUST-UNLIKELY for PE, Antibiotic Course Duration, Skin Glue Hacks, ESP Block, Learner Oversight appeared first on Emergency Medicine Cases.

In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes? What are the common ways in which we misinterpret the Rumack-Matthew nomogram? What are indications for fomepizole and dialysis after acetaminophen poisoning? Is hyperphosphatemia the best predictor of need for liver transplant in acetaminophen poisoning? and many more... The post Ep 180 Acetaminophen Poisoning – Pitfalls in Assessment and Management appeared first on Emergency Medicine Cases.

ED recognition and management of some commonly missed or mismanaged hand inuries including finger tip avulsions and amputations, nailbed injuries, PIP dislocations, metacarpal fractures, hand tendon lacerations, Stener lesions, Seymour fractures, mallet fingers, jersey fingers, skier's thumb, Bennet fractures and Rolando fractures with masters Dr. Arun Sayal and Dr. Matt Distefano... The post Ep 179 Hand Injuries – Finger Tip Injuries, Jersey Finger, PIP Dislocations, Metacarpal Fractures, Thumb Injuries, Tendon Lacerations appeared first on Emergency Medicine Cases.

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing... The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on Emergency Medicine Cases.

In this Part 3 of our 3-part podcast series on management of lacerations Dr. Haley Cochrane joins Anton and Justin to explore laceration aftercare and the evidence for keeping wounds dry or wet, wound dressings, topical antibiotics, prophylactic oral antibiotics, Vitamin E oil, aloe vera cream and UV protection with regards to cosmetic outcomes and infection rates. What may be the most important aspect of aftercare is educating the patient what to expect as the laceration heals and when they should seek medical attention... The post JJ 23 Laceration Aftercare – Dressings, Antibiotics, Improving Cosmesis, Preventing Infection appeared first on Emergency Medicine Cases.

The hand is anatomically complex. Having an anatomical-based approach to the assessment of patients who present to the Emergency Department is important to preserve quality of life following a hand injury. Hand injuries are the second most common injury leading to days without work. It is no surprise then that open finger injuries land in the top 10 most common diagnoses that end up in court. In this first part of our two-part series on hand injuries Dr. Matt Distefano and Dr. Arun Sayal guide us through the principles and pitfalls of assessment and management of hand injuries and answer questions such as: what is the differential diagnosis of a globally swollen hand? What is the intrinsic minus hand position? When should we suspect compartment syndrome of the hand? How should we best locate retracted lacerated tendons of the hand? What are the best ways to control bleeding of a finger tip amputation? What are the best analgesic choices? How large of a skin avulsion hand injury should we let heal by secondary intention rather than recommend a flap/skin graft? and many more... The post Ep 178 Hand Injuries – Pitfalls in Assessment and Management appeared first on Emergency Medicine Cases.

In this Part 2 of our 3-part Journal Jam series on Laceration Management we dive into the evidence for the choice of material to close lacerations. Which is best for which kind of laceration? Surgical skin glue? Wound adhesive strips? Surgical staples? Absorbable sutures? Nonabsorbable sutures?... The post JJ 22 Laceration Repair – Glue vs Strips vs Staples vs Sutures appeared first on Emergency Medicine Cases.

Understanding why ETCO2 is recommended in cardiac arrest with Swami, practical steps to organ donation in the ED with Dr. Andrew Healy, using your hospital food court to treat paraphimosis, rectal prolapse and food bolus obstruction with Dr. Sarah Foohey, QI Corner with Dr. Tahara Bhate, 4 Medicolegal Myths with Dr. Jennifer C. Tang on this month's EM Quick Hits podcast... The post EM Quick Hits 45 ETCO2 in Cardiac Arrest, Organ Donation, Paraphimosis, Medicolegal Myths, QI Corner appeared first on Emergency Medicine Cases.

In this main episode podcast Anton discusses with world expert and bronchiolitis researcher Dr. Suzanne Schuh, the challenges of the diagnosis and management of bronchiolitis during a time of crisis in pediatric emergency medicine and offers some evidence-based solutions to improving outcomes while minimizing valuable resources, as part of our 'Best of University of Toronto EM' series... The post Ep 177 Bronchiolitis – Diagnostic Challenges and Management Pitfalls appeared first on Emergency Medicine Cases.

In this Journal Jam podcast Anton and Justin welcome special guest Dr. Haley Cochrane. We dive deep into the evidence for timing of closure and infection rate, fluid choice, volume and pressure of irrigation of lacerations, glove type and infection rate, how eversion of wound edges effects cosmetic outcomes and much more. You might be surprised to discover that the evidence for many things we do for lacerations that are considered "standard of care", is either weak or non-existent. But do not fret - we deliver practical bottom line practical recommendations to help improve outcomes, save time and decrease resource utilization... The post Journal Jam 21 Laceration Management – Does Timing of Closure, Irrigation, Gloves Type, Eversion Matter? appeared first on Emergency Medicine Cases.

In this EM Quick Hits podcast: Justin Morgenstern on fluids in pancreatitis, Leeor Sommer on nasal fractures, Christina Shenvi on delirium, Sheldon Cheskes and Rohit Mohindra on Dose VF, and Noor Khatib and Kari Sampsel on intimate partner violence... The post EM Quick Hits 44 Fluids in Pancreatitis, Nasal Fractures, Delirium, DOSE VF, Intimate Partner Violence appeared first on Emergency Medicine Cases.

Do not let a negative X-ray rule the day! Like almost all medical tests X-rays are far from perfect and should be ordered and interpreted only in the context of a thorough history and physical exam. In this 2nd part of our 2-part series on orthopedic x-rays with Dr. Arun Sayal and Dr. Yatin Chadha we discuss the pitfalls of obtaining and interpreting orthopedic X-rays, when orthopedic X-ray decision tools lead us astray, how understanding the concept of central ray helps dictate how we should order X-rays and interpret them, how the ring structure concept of the forearm and lower leg can remind us where to look for a second injury, when we need 3 views vs 2 views, when extra views like the clenched fist view and weight bearing views are indicated, why we should always look at the lateral view first, the limitations of ultrasound and CT in long bone and joint injuries and more... The post Ep 176 Orthopedic X-rays Master Class – Pitfalls in Obtaining and Interpreting MSK X-rays appeared first on Emergency Medicine Cases.

In this main episode podcast, Dr. Arun Sayal creator of the CASTED course and Dr. Yatin Chadha a radiologist with a fellowship in MSK radiology, join Anton for Part 1 of 2 podcasts on Emergency Orthopedic Injuries. This episode focuses on a differential diagnosis of MSK injuries that are occult to X-ray with the help of the SCARED OF mnemonic. It ensures we pick up all the “can’t miss” diagnoses that can be easily overlooked when we do not integrate a pointed history and physical exam with the X-ray in front of us. Essentially, we discuss ‘when X-rays lie’ and offer up a variety of clinical pearls and pitfalls in assessing patients in the ED with MSK presentations… The post Ep 175 Emergency Orthopedics Differential: SCARED OF Mnemonic – When X-rays Lie appeared first on Emergency Medicine Cases.

On this month's EM Quick Hits podcast: Best of University of Toronto EM with Yaron Finkelstein on pediatric cannabis poisoning pitfalls, Brit Long on recognition and management of esophageal perforation, Jesse McLaren on 3 questions to diagnose Brugada Syndrome, Tahara Bhate on QI Corner, Constance Leblanc on maintaining wellness in career transitions from CAEP 2022... The post EM Quick Hits 43 Pediatric Cannabis Poisoning, Esophageal Perforation, Brugada, Career Transitions in EM appeared first on Emergency Medicine Cases.

Emergency Medicine has undergone many changes over the last couple of decades and especially during the COVID pandemic. Most of these changes have been very positive, but increasing volumes, staff shortages, aging populations, increasing breadth of responsibilities and better access to more imaging have made some of us question how we should define the scope of our practices. In this main episode podcast, highlights from CAEP 2022 conference, Anton discusses the article 'Saving EM: Is Less More?' with Dr. Paul Atkinson and Dr. Grant Innes and offer some solutions to this current state of affairs in EM. In another CAEP highlight, trauma team leader Dr. Mathieu Toulouse delivers the latest on management of traumatic pneumothorax. He answers such questions as: Do all patients with a traumatic pneumothorax require tube thoracostomy? How do CXR and CT differ in determining which patients require a chest tube? Do all patients receiving positive pressure ventilation require a chest tube for their traumatic pneumothorax? Does the presence of hemothorax necessitate placement of a chest tube? Are 14Fr pigtail catheters adequate for all traumatic pneumothoraces? and many more... The post Ep 174 Is Less More? Saving EM and Traumatic Pneumothorax – Highlights from CAEP 2022 appeared first on Emergency Medicine Cases.

In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain management in the polytrauma, Nour Khatib on a rural EM case on management of near-drowning patient, Sara Reid delivers a polio primer, Anand Swaminathan on head-up CPR... The post EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Drowning, Polio, Head-up CPR appeared first on Emergency Medicine Cases.

In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant? How do the PECARN, Step-by-Step and Aronson decision tools for identifying febrile infants at low risk for IBI and SBI? Can EM Cases incorporate all these decision tools and the upcoming Canadian Pediatric Society position statement on febrile infants recommendations into one concise algorithm? and many more... The post Ep 173 Febrile Infant – Risk Stratification and Workup appeared first on Emergency Medicine Cases.

In this EM Quick Hits podcast: Anand Swaminathan on limitations and practical tips on intraosseus access,Tahara Bhate QI corner on missed ectopic pregnancy, Sarah Reid from EM Cases Summit on oxygen saturation monitoring in bronchiolitis and management of infant gastro-esophageal reflux, Brit Long on the value of rectal exam in diagnosis of cauda equina syndrome, Hans Rosenberg & Ariel Hendin on withdrawal of life-sustaining care in the ED... The post EM Quick Hits 41 – IO Limitations, Missed Ectopic Pregnancy, Bronchiolitis O2 Monitoring, DRE in Cauda Equina Syndrome, Withdrawal of Life Sustaining Care appeared first on Emergency Medicine Cases.

In this main episode podcast, Dr. David Carr joins Anton to give us his simplified approach to syncope based solely on history, physical and ECG to help guide disposition decisions. We answer questions such as: What features have the best likelihood ratios to help distinguish syncope from seizure? What key clinical features on history and physical exam can help us distinguish orthostatic and reflex syncope from the more sinister cardiac syncope? What is the best approach to ECG interpretation for the patient who has presents with syncope? Are syncope clinical decision tools any better than physician gestalt? and many more.... The post Ep 172 Syncope Simplified with David Carr appeared first on Emergency Medicine Cases.

In this month's EM Quick Hits podcast: Anand Swaminathan on GI balloon tamponade preparation and indications, Jesse McLaren on why troponin is rarely useful in SVT, Christina Shenvi on why we should not use the term "mechanical fall" in older patients, Nour Khatib & Jonathan Wallace on rural vertical vertigo case and Reuben Strayer on VAFEI - Video-Assisted Flexible Endoscopic Intubation for the anatomically challenging airway... The post EM Quick Hits 40 – GI Balloon Tamponade, SVT and Troponin, Falls in Older Patients, Vertical Vertigo, VAFEI Airway appeared first on Emergency Medicine Cases.