Emergency Medicine Cases

On this EM Quick Hits podcast: Tick Borne Illness Update with Dr. Issac Bogoch, Pediatric ECG Interpretation with Dr. Kathleen Stephanos, Nailbed Repair with Dr. Matthew McArther, Closed Loop Communication with Dr. Shawn Segeren, ESRD with Dr. Brit Long, Leaders in EM Dr. Catherine Varner...

In this update to the 7 T’s of Massive Hemorrhage Protocols with Dr. Jeannie Callum and Dr. Andrew Petrosoniak, we explore the most current, evidence-informed strategies for bleeding patients, from polytrauma to obstetrical, drawing on the latest clinical trial data and real-world experience. We answer the questions: What is the evidence based alternative to FFP in EDs where FFP is not readily available? How accurate are decision scores in helping decide the trigger for MHP activation? Why is testing fibrinogen levels and giving fibrinogen concentrates so important in massive hemorrhage? How should we tailor our MHP to the GI bleed patient? To the obstetrical patient? and many more... Please donate to EM Cases to ensure ongoing Free Open Access Medical Education at https://emergencymedicinecases.com/donation/.

On this EM Quick Hits podcast: Pediatric Torticollis with Dr. Deb Shconfeld, Approach to Stable Wide Complex Tachydysrhythmias with Dr. Anand Swaminathan, Post-intubation Neurocritical Care 5 best practices with Dr. Andrew Petrosoniak, Hyponatremia Correction Rates with Dr. Justin Morgenstern, Paronychia Management with Dr. Andrew Tagg, and Women in EM Leader Series with Judith Tintinalli and Dr. Victoria Myers...Donate to EM Cases to help ensure continued Free Open Access Medical Education in the future here: https://emergencymedicinecases.com/donation/

In this podcast, with Dr. Thom Mayer, Dr. Carolyn Snider and Dr. Howard Ovens, on leading from the inside out, we cover foundational principles, practical habits, and transformative insights that can make any member of an ED team a more effective, compassionate, and adaptive leader. Here, you’ll find tools, philosophy, and stories that just might transform how you think about your role in the ED to make your work more satisfying, make your teams work together better and improve patient outcomes... Please consider a donation to EM Cases to help ensure we continue to provide high quality Free Open Access medical education into the future https://emergencymedicinecases.com/donation/

On this month's EM Quick Hits podcast: Dr. Mathew MacArther on Occipital Nerve Block, Dr. Ian Chernoff on PoCUS in Pulmonary Embolism, Dr. Hans Rosenberg on Myelopathy, Dr. Shawn Segeren on Team Resuscitation, Dr. Brit Long on Incidental Neutropenia and Dr. Kylie Booth on Peer Programs. Please help ensure continued Free Open Access of the entire EM Cases Learning System by donating here: https://emergencymedicinecases.com/donation/

There are many nuances in the management of patients with pulmonary embolism in cardiac arrest, peri-arrest or simply in shock: We need to optimize oxygenation and airway management, hemodynamic support, acid/base management, thrombolysis and/or catheter-directed therapies that Anton dives into with guest experts Dr. Lauren Westafer, Dr. Bourke Tillmann and Dr. Justin Morgenstern... EM Cases is proudly FOAMEd - Please consider a donation: https://emergencymedicinecases.com/donation/

In this month's EM Quick Hits podcast: Zafar Qasim & Andrew Petrosoniak on whole blood transfusion in trauma, Justin Morgenstern on calcium pre-treatment to prevent diltiazem-induced hypotension, Kiran Rikhraj on dynamic LV outflow tract obstruction, Anand Swaminathan on resuscitative thoracotomy, Andrew Tagg on uterine casts, and Jesse McLaren on scale & proportionality in occlusion MI ECG interpretation. **Please support EM Cases to continue to be free open access by making a donation: https://emergencymedicinecases.com/donation/

How do you predict which intermediate-risk patients will suddenly deteriorate? What role do risk scores, biomarkers, imaging, and hemodynamics play in decision-making? Should these patients receive anticoagulation alone, or is thrombolysis warranted? When should you consider catheter-directed or surgical interventions? This podcast focuses us to think critically about risk stratification, early interventions and escalation in care in PE. We include an algorithm in the show notes. Not all patients fit neatly into classification boxes, making clinical judgment crucial. Join Dr. Lauren Westafer, Dr. Justin Morgenstern, Dr. Bourke Tillman and Anton as they explore the key decision points, pitfalls, and lifesaving strategies for managing intermediate-risk PE in the ED...

On this month's EM Quick Hits podcast: Stephen Freedman on pediatric bloody diarrhea, S-TEC and hemolytic uremic syndrome, Justin Morgenstern on the evidence for IM epinephrine in out of hospital cardiac arrest, Matthew McArther on recognition and ED management of dengue fever, Andrew Petrosoniak on imaging decision making in trauma in older patients, Brit Long & Michael Gotlieb on recognition and management of TTP...Please consider a donation to EM Cases to help ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Only one in 246 patients who screen positive for an eating disorder at triage have a chief complaint suggesting it. These patients don’t always fit the stereotype—many appear “healthy,” have normal BMI, or present with vague GI, cardiac, or neurological symptoms. Missing the diagnosis has important consequences. The earlier an eating disorder is identified and the earlier that appropriate treatment is initiated the better the long term outcomes. In this episode, with the expertise of Dr. Samantha Martin and Dr. Jennifer Tomlin, we’ll break down the essential clinical clues, screening questions, red flags, and subtle exam findings that can help Emergency Physicians diagnose eating disorders early and initiate treatment to decrease mortality and long term morbidity in these young patients. Eating disorders need to be thought of as both a psychiatric condition and medical condition to optimize the pick up rate and appropriate management. Missing or mismanaging eating disorders in the ED means missing an opportunity to save a life and prevent long term morbidity... Please consider a donation to EM Cases to ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

On this month's EM Quick Hits podcast: Anand Swaminathan on optimizing RSI medication timing, Brittany Ellis on ED boarding challenges in older patients and solutions to ED crowding and flow, Dave Jerome on managing prolonged tourniquet application, Nour Khatib and Phil Gillick on a rural peer support case, Jesse McLaren on ECG reciprocal changes in acute coronary occlusion, and Melody Ng on practical nutrition tips for shift workers...

In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine? How can we best streamline thorough data gathering for each case so that we don't miss key data points? How do the master EM clinicians perform an efficient and targeted history and physical exam? How can the concept of heuristic cycling help you avoid outdated or faulty thinking? How can we document our clinical encounter in a way that considers a differential diagnosis that prioritizes dangerous conditions and improve our thinking around cases? How can we use the 2-10% rule for pre-test probabilities and the concept of preferred error to guide our decision making for tests and treatments in the ED? What strategies can we use to avoid anchoring bias and keep your mind open to all possibilities? What’s the role of shared decision-making when navigating diagnostic uncertainty? How does understanding the vigilance pendulum help us assess our risk tolerance better? How can post-shift decision journaling, conducting pre-mortems and meditation improve our decision making and boost our emotional resilience on shift? and many more... Please consider a small donation to EM Cases to ensure ongoing high quality FOAMed: https://emergencymedicinecases.com/donation/

Which elements of your current pre-shift preparation contribute most to your mental clarity and performance, and what new practices might further optimize your readiness? With interruptions shown to increase task errors and decision fatigue, how can you strike a balance between being approachable to colleagues and safeguarding your focus for patient care? When confronted with a particularly challenging or emotionally charged case, what strategies have you found most effective for maintaining professionalism and clear decision-making under pressure? How often do you debrief after high-stakes scenarios, and what impact has debriefing—whether formal or informal—had on your team’s learning, emotional recovery, and future preparedness? What strategies do you use to foster open communication and ensure all team members feel empowered to provide input during high-stakes situations? How do you mentally and emotionally shift from managing a critical resuscitation to treating lower-acuity patients without compromising your focus or energy? When faced with a complex case where diagnostic clarity is elusive, how do you prioritize your next steps while maintaining confidence in your decision-making process? How can apps, personalized workflows, or EMR tools be better utilized to minimize cognitive load and enhance clinical decision-making during shifts? These are just some of the questions we pose in this 2-part podcast series on How the Experts Think with Dr. Reuben Strayer, Dr. Scott Weingart and Dr. Mike Betzner... Please consider a donation to ensure EM Cases continues to provide you high quality Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips...

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma? Dr. George Kovacs and Dr. Andrew Petroniak answer this and other questions such as: how should we re-sequence the trauma resuscitation depending on immediate life-threats? When is immediate vs delayed intubation recommended? How useful are the Zones of the neck in penetrating neck trauma? What is the optimal dosing of airway medications in the sick trauma patient? How should we modify our airway strategy for the severely head injured patient and/or agitated patient? When should we consider ketamine facilitated fiberoptic intubation in the trauma patient? and many more... Please consider a donation to EM Cases to ensure ongoing Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

On this month's EM Quick Hits podcast: Kevin Wasko on post-tonsillectomy hemorrhage management, Brit Long on assessment and management of post-CABG surgical incision infections, Anand Swaminathan on evidence, pitfalls and tips on using Bougies, Leah Flannigan on when to suspect vascular injury in patients with low energy mechanism pelvic fractures, Andrew Petrosoniak on debriefing after cases: why, when and how... Do you learn a lot from EM Cases? Please consider a donation to ensure EM Cases continues to provide you high quality Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

In this EM Cases podcast Anton chats with Dr. Peter Brindley and Dr. Leon Byker who have a deep interest in the Culture of Medicine to explore what culture in medicine is, why culture is so important, and then drive home 10 strategies to improving the culture in our departments emphasizing the importance of human connection, empathy, open communication, and a willingness to learn from mistakes in creating a positive and fulfilling work environment, so that we love our work, we love our department, we love taking care of our patients and our patients have better outcomes... Support EM Cases and Free Open Access Medical Education by making a donation now: https://emergencymedicinecases.com/donation/

On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

We over-admit low risk acute heart failure patients and under-admit high risk heart failure patients. In this podcast we discuss the diagnostic accuracy of various clinical features, lab tests and imaging modalities for acute heart failure, the 3 validated risk stratification tools and a simple approach to PoCUS for the diagnosis and prognostication of acute heart failure in the ED to improve our diagnostic accuracy and disposition decisions for patients with acute heart failure... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

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 crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/