EM Basic (general)

This is the first of two episodes on procedural sedation. In the ED we need to provide safe and effective procedural sedation and analgesia whenever we do painful procedures. It is our job to relieve anxiety and pain in our patients and we need to know how to do this right. This episode will focus on how to prepare for a procedural sedation. We will talk about how to make the decision as to who is an appropriate candidate for procedural sedation in the ED, the depth of sedation, and how to prepare all of our equipment so that we leave nothing to chance. This will be in preparation for the second episode where we will talk about the medications that we use in procedural sedation.

Direct download: 22_Procedural_Sedation_Part_1-_Preparation.mp3
Category:general -- posted at: 1:41pm EDT

Since I refer to the neuro exam from the headache episode, I decided to take that part of the episode and make a supplement so you can easily review the "5 minute ED neuro exam." Let me know if there are any other topics that you would like me to make into a supplement like this.

Direct download: Neuro_exam_supplement.mp3
Category:general -- posted at: 1:38pm EDT

We're back with a podcast on...dizziness!  While weak and dizzy is almost never the most exciting chart in the rack, we see it a lot in the ED. This is a chief complaint where we have to be on the lookout for the serious causes of dizziness among the avalanche of not-so-serious causes of dizziness. First- what does the patient mean by "I feel dizzy"? This seems like a silly question because just about everyone has felt "dizzy" before but if you get it wrong, you'll go down the completely wrong diagnostic path.

One small self-promotion- The new academic year is just about to start so if you like the podcast, please tell your colleagues, classmates, and especially the new medical students and interns.

Direct download: 21_Dizziness.mp3
Category:general -- posted at: 10:21pm EDT

For the second part of trauma resuscitation, we'll discuss the various interventions that you may have to accomplish in the trauma bay. The first part is a continuation from the first episode and talks about the EFAST exam- a vital part of the secondary survey. The second part discusses the control of massive extremity hemorrhage and how to intervene on any airway, breathing, or circulation issue in the trauma bay.

Direct download: 20_Trauma_resuscitation_part_2-_interventions.mp3
Category:general -- posted at: 4:17pm EDT

Being able to run an effective trauma resuscitation is a necessary skill for any emergency medicine provider. In part 1 of this 2 part series, I'll go over how to properly assess a trauma patient who arrives to the ED. We'll go over how to prepare for the patient's arrival, how to perform the primary and secondary surveys, how to make sure we get a good report from the EMS crew, and how to avoid the pitfalls during these first few crucial minutes in the care of a trauma patient.

The bonus section is a rant on why you should get your trauma patients off the backboard as soon as possible.

Direct download: Trauma_Resuscitation_Part_1-_the_evaluation.mp3
Category:general -- posted at: 10:23am EDT

A week ago, I posted an airway review paper by Scott Weingart and Richard Levitan that I think is a must read. Today I decided to do a podcast reviewing the paper in order to really get it out there and talk about the major points. The best part of the paper is the description of the NO DESAT technique which virtually eliminates hypoxia during RSI and will make your next intubation a lot easier. While this podcast is a lot more advanced than the usual "basic" topics that I usually talk about, its important to know about these techniques. My 0.02- they will become the new standard of care in the near future but you can hear about them now.

Direct download: 18_Airway_update.mp3
Category:general -- posted at: 9:48pm EDT

Being able to give a good ED patient presentation will not only help you get a good grade on your EM rotation, it will also make sure that nothing is missed in the patient's care.  In this episode, I'll discuss the nuts and bolts of forming and delivering a solid ED patient presentation that is complete and concise at the same time.  I'll also give a few example presentations so you can put it all together.  The show notes here are condensed down so you can carry them around with you on shift so you don't forget anything.  There is even a card sized version in the show notes for even further portability.  Feel free to take the Word format show notes and re-format them to fit your needs.

Direct download: 17_How_to_give_a_good_ED_patient_presentation.mp3
Category:general -- posted at: 11:43am EDT

Shortness of breath is a chief complaint that we encounter each day in the ED.  This chief complaint encompasses a huge differential and this is a long podcast.  As always, I'll break this chief complaint down into the diagnoses that we can't miss and how to treat the underlying causes of shortness of breath for both kids and adults.

Direct download: 16_Shortness_of_Breath.mp3
Category:general -- posted at: 4:58pm EDT

By popular demand, this episode will be dedicated to talking about prehospital issues. I've had several people write me and ask for my 0.02 on how EMS can better be our "eyes and ears" in the field so here's my take on this question. I'll also talk about how the ED staff can better interact with our EMS colleagues so we can both work together to deliver optimal care to our patients. Hopefully this will serve as a starting point for conversations between EMS providers and ED staff and I encourage anyone to post comments on these issues to the blog.

Direct download: 15_Prehospital_episode.mp3
Category:general -- posted at: 5:44pm EDT

Syncope (or "passing out") is a chief complaint that we deal with a lot in the emergency department. While most causes of syncope are benign and need nothing more than reassurance, we need to be on the lookout for the serious causes of syncope. This episode will focus on the definition of syncope, how to get a complete history, catch the red flags, perform a targeted workup that doesn't keep the patient in the ED forever, and how to scrutinize an EKG for the deadly arrhythmias that we can't miss.

In addition, per a request from a podcast listener, there is a bonus section on how to effectively rehydrate patients in the ED. You may be surprised that there are other options besides putting an IV in everyone.

Direct download: 13_Syncope.mp3
Category:general -- posted at: 6:30pm EDT