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EM:RAP for Max Hockstein

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A monthly emergency medicine podcast heard by over 14,000 of your colleagues. EM:RAP is filled with superb educational content, lectures, in-studio productions, reviews and perspectives all in a fun filled, tongue-in-cheek format.




Expired Subscription on April 1, 2016

Max Hockstein, your subscription expired on April 1, 2016. Renew now for continued access to the best content in emergency medicine. https://www.emrap.org/subscribe

New Venous Thromboembolism Guidelines

Hot off the press Antithrombotic Therapy for VTE Disease: CHEST Guideline published in February 2016 addresses the clinical quagmire debated in this month’s show: Should we anticoagulate patients with subsegmental pulmonary embolism?New Venous Thromboembolism GuidelinesMel Herbert, MD MBBS FAAEM • Rob Orman, MD

It’s Time to Renew Emrap!

Max Hockstein, your subscription expires on April 1, 2016. Renew now for continued access to the best content in emergency medicine. https://www.emrap.org/subscribe

Spring Forward Into PE

Spring is here and what a perfect time to talk PE. It’s a two for one special with a subsegmental PE battle for the ages between Tom Deloughery and Jeff Kline. Jeff returns later in the show for some PE in pregnancy mythbusting. Jess Mason and burn surgeon Chuck Yowler give us the skinny on second degree burns. Remember Icatibant, the miracle drug for ACE-I angioedema? There is some new data on it that may shock you. It seems like we talk low risk chest pain every month, but what does it...

C3 - Altered Mental Status - Part 2

Stuart and Mizuho continue their discussion about AMS, and discuss less common but interesting causes of AMS, including clinical findings, workup and management of these various diagnoses.

Duration: 00:57:02

EM:RAP Special Report: Concussion

On this episode we discuss concussions, the sequelae that happen as a result of concussions, and the long term effects of repeated head trauma. We seek answers from “Captain Cortex”, Prof. Stuart Swadron. Medical team physician for the Cleveland Indians, Dr Tom Waters, explains the process of assessing when an injured player in the NFL can go back in the game. Dave’s personal trainer, Steven Yates, talks about his experience with concussions, as a former college football player, and Jess...

C3 - Altered Mental Status - Part 1

The differential diagnosis for altered mental status is extremely broad. Stuart Swadron MD and Mizuho Spangler DO discuss the most common causes of AMS and review a practical approach to initially assessing a patient with undifferentiated AMS.

Duration: 00:43:34

A Fib Gets The Royal Treatment

It’s deep winter in the northern hemisphere which can only mean one thing… Cam Berg is back with a new treatment pathway. This time, it’s all about atrial fibrillation. Out of hospital cardiac arrest, using two defibrillators? It’s a real thing. Bryan Hayes puts NSAIDS, tramadol, and antidepressants under his jaundiced eye and the results may surprise you. We’ve got a trauma double feature - a new decision instrument for chest CT and thinking about retirement for the C-Collar. Reuben...

Just How Good is CT in Diagnosing Subarachnoid Hemorrhage?

Hot off the press, Sensitivity of Early Brain Computed Tomography to Exclude Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-AnalysisJust How Good is CT in Diagnosing Subarachnoid Hemorrhage?Mel Herbert, MD MBBS FAAEM • Rob Orman, MD • Salim Rezaie, MD FAAEM

Vascular Injury in Extremity Trauma

A trauma patient rolls in the door following a gunshot wound to the leg. Do they need to go straight to the OR? Can they wait for a CT angiography? Are they just fine and not in need of any surgical management? Jess Mason reviews the hard and soft signs of extremity vascular injury.Vascular Injury In Extremity TraumaJessica Mason, MD

C3 - Headache

A unique approach to the patient with headache with an emphasis on “Red Flag” symptoms and signs

Duration: 00:36:46

Cracking The Chest

Happy New Year and welcome to the thoracotomy extravaganza! Kenji Inaba breaks down not only the indicators for, but a how to guide on, emergency department thoracotomy. When is a UTI not a UTI? When there are no symptoms (at least in adults). Amiodarone is becoming as ubiquitous as Mel saying “buttocks”, but patients on this drug are at risk for some serious complications. Should all agitated mental health patients get immediate high dose sedation? Dan Mccollum says we can be more...

Holiday Sepsis Special

What says ‘happy holidays” more than sepsis? Probably a lot of things, but just in time for the new year, Cam Berg is back to answer your sepsis questions.Holiday Sepsis SpecialCameron Berg, MD FAAEM • Mel Herbert, MD MBBS FAAEM • Rob Orman, MD

Top 5 ACLS Updates

At the 2015 AHA meeting, ACLS got a few updates and some may surprise you!Top 5 ACLS UpdatesRob Orman, MD • Sheldon Cheskes, MD • Zach Shinar, MD

The Psychiatry of Peds C-Spine

2015 is about to come to a close but not before an EM:RAP Master Class. You know the long angiocath in a central line kit? Ever wonder what it’s for? Reuben Strayer shows us how to use it to make central line placement easier and safer. Clearing the peds c-spine can cause stress, debate, and consternation. Probably because there are no validated decision instruments. Mizuho and Kenji clear the air and break down the evidence. Is the emergency department your tribe? Sometimes that’s a good...

Sexual Healing

Sexual intercourse for the treatment of ureteral colicSexual HealingAnand Swaminathan, MD FAAEM • Rob Orman, MD

New Xa Inhibitor Reversal Agent

Dabigatran now has a reversal agent, so it was only a matter of (short) time that one would come along for the oral Xa inhibitors.New Xa Inhibitor Reversal AgentRob Orman, MD

How To Use An MDI

Rarely a shift goes by that we don’t see someone with an asthma exacerbation. Most of these patients will have the discharge instruction to use a metered dose inhaler at home. But are they using it correctly? Probably not. Jess Mason breaks down the steps of proper MDI use (and how to teach it to patients).How To Use An MDIJessica Mason, MD

Codes and Cath Labs

It’s time for November EMRAP. Rob and Swami cut through the complexity and give their basic approach to vasopressors. Andy Sloas is back and he is mad about something. This time it’s NPO sedation rules in kids. Should all post arrest patients with ROSC go to the cath lab? Amal Mattu gives some guidance on making the decision. Intrathecal pumps can seem like alien implants that are impossible to understand. The LIN sessions cut through the mystery. Traumatic cervical artery dissection in...

Can you feel the HEAT?

Should we treat febrile patients in whom we suspect infection? The HEAT trial, just published in NEJM, studied 700 ICU patients with fever (and either infection or suspected infection). Half got acetaminophen and half placebo. Primary outcome was ICU free days and there was no significant difference in this outcome between the two groups. So should we treat fever, should we not? Swami sums it up like this: Fever need not always be treated in patients with suspected infectious causes. It...
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