EM Basic
Febrile Seizures

In this episode we are going to talk about febrile seizures.  We see this chief complaint a lot in the ED so it's important that we know this topic really well.  Today's script was written by Dr. Andrea Sarchi and will review how to do a good history and physical, how to rule out serious pathology without overtesting, and how to talk with parents.  While simple febrile seizures don't cause any harm to the child, they are very scary for parents so it's important that we know the facts so we can re-assure them and prevent future worry.

Category:general -- posted at: 9:15pm EST

Ebola has been in the news for the past few months and it has taken on more urgency in the US as cases have arrived from outside the country  Within the past week, transmission to two healthcare workers outside of Africa has been reported.  Dr. Prabu Selvam, an intern at the Wright-Pratt Emergency Medicine Residency, provided the resources for today's episode on Ebola.  In this short episode we will discuss appropriate screening for Ebola, it's signs and symptoms, lab abnormalities, how to confirm infection with laboratory testing, treatment of Ebola, and how to properly isolate patients with this disease.  While now is not the time to panic and think that every fever and sniffle is Ebola, we should certainly be aware of how to properly screen, diagnose, and treat this deadly disease.

Category:general -- posted at: 10:00pm EST

Psychiatric Emergencies Part 2

Today's episode is the second and final part of Dr. Sheyna Gifford's interview with Dr. Les Zun on psychiatric emergencies.  This episode will talk more about treating depressed patients, what you can do for patients who board in your ED for hours to days to even a week, and medications used for treatment of acute agitation in the ED.

Category:general -- posted at: 4:30am EST

Psychiatric Emergencies Part 1

Today's episode is another installment in the EM Basic Project.  Dr. Sheyna Gifford took on the task of interviewing Dr. Les Zun, a nationally known speaker on the topic of psychiatric emergencies.  While we did an episode on psychiatric medical screening before, this episode will focus on some of the tougher situations we encounter in the ED.  For example- What do we do about the patient who is depressed but not suicidal?  How do we calm down agitated patients without reaching for medications?  These are tough questions but Dr. Zun goes througha methodical way of thinking about these issues and offers some real world practical advice that you can use on your next shift. 

Category:general -- posted at: 4:30am EST

Hepatic Emergencies from FOAMcast

Today I am handing over the podcast to FOAMcast by Drs. Lauren Westafer and Jeremy Faust.  A little more than a month ago, Dr. Nick Genes challenged twitter to create core content FOAM for hepatic emergencies.  Lauren and Jeremy did an excellent episode on this topic on FOAMcast so here it is- re-broadcasted on EM Basic.  They'll review common hepatic emergencies and their managementi in the ED and point you in the right direction to learn even more on this topic.  I haven't edited their episode at all- it's all Lauren and Jeremy's episode.  If you like what you hear, go to foamcast.org or look for FOAMcast on iTunes.

Category:general -- posted at: 4:30am EST

Today is the third anniversary of the EM Basic podcast.  To celebrate this milestone, this is a screencast titled "Airway Update".  I first prepared this lecture about two years ago for a conference but the topics are still relevant today.  This will be most useful for medical students and EM interns who may not have been exposed to these airway topics.  This screencast will help catch you up on what we have been talking about over the last two years on social media and FOAMed.  We'll review apenic oxygenation, delayed sequence intubation, how to effectively use ketamine in your practice, awake cricothyrotomy, and more.

Direct download: Airway_Update_Screencast.mp4
Category:general -- posted at: 1:04pm EST

Salicylate Overdose

Today's episode is another installment for the EM Basic Project by Dr. Andrea Sarchi.  Salicylate overdose is a toxidrome that we have to be on the lookout for in the ED.  While some cases are obvious because the patient or EMS can tell us what they took, some cases are subtle and require vigilance to make the diagnosis.  In this episode we'll review the important history and physical points, how to order the right tests, manage the toxicity, and properly disposition the patient.

Category:general -- posted at: 4:30am EST

Acetaminophen overdose

Today's episode talks about the diagnosis and management of Acetaminophen overdose.  This is another addition to the EM Basic Project written by Andrea Sarchi.

We encounter acetaminophen overdose frequently in the ED and we need to be on the look out for this because patients can be completely asymptomatic.  If we don't catch it, acetaminophen overdose can result in liver failure requiring transplant or even death unless we interevene early.  This episode will review how to properly workup a patient with a known or suspected acetaminophen overdose, what tests to order, and how to decide who needs antidote therapy.

Category:general -- posted at: 4:30am EST

Documentation

In today's episode we are going to talk about documentation in the ED.  It is very important that we are complete but concise in our documentation in order to provide an accurate record for the patient's ED patient to protect them and ourselves from problems down the road.  Good documentation is good patient care so we need to know how to do this efficiently.  We will review each part of the chart starting with the triage note and ending how to give good discharge instructions.  We'll also review some tips and tricks of the trade regarding abbreviations that will make your charting faster, how to document interactions with our consultants, and even what to do when you have to document a difficult situation with a consultant.

Category:general -- posted at: 4:30am EST

Asymptomatic Hypertension

The patient's blood pressure is 190/80 but they feel fine...how do we treat these patients in the ED?  Labs?  EKG? BP meds?  Admission???...but they are here for an ankle sprain!  Asymptomatic hypertension is a challenging complaint to deal with in the ED because of so many conflicting opinions and worries but it doesn't have to be difficult.  In this episode, we'll discuss a systematic and rational way to evaluate patients with asymptomatic HTN, do limited and targeting testing, and get them the right followup while calming the patient's fears and avoiding harm.

Category:general -- posted at: 4:30am EST