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Rank #165 in Medicine category

Health & Fitness
Medicine

Core EM Podcast

Updated 5 days ago

Rank #165 in Medicine category

Health & Fitness
Medicine
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Core Emergency Medicine

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Core Emergency Medicine

iTunes Ratings

97 Ratings
Average Ratings
84
5
8
0
0

Quick, efficient and practical review

By Sher Ali Khan - Jul 30 2018
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Very ice Job. I am intense medicine and I enjoy listening to it for my Hospital based practice in residency

PA-c

By cs1245 - Nov 10 2017
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I really enjoy concise info on pertinent topics for ER providers. Thanks

iTunes Ratings

97 Ratings
Average Ratings
84
5
8
0
0

Quick, efficient and practical review

By Sher Ali Khan - Jul 30 2018
Read more
Very ice Job. I am intense medicine and I enjoy listening to it for my Hospital based practice in residency

PA-c

By cs1245 - Nov 10 2017
Read more
I really enjoy concise info on pertinent topics for ER providers. Thanks
Cover image of Core EM Podcast

Core EM Podcast

Updated 5 days ago

Rank #165 in Medicine category

Read more

Core Emergency Medicine

Rank #1: Episode 133.0 – Initial Trauma Assessment

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This week we dive in to the initial trauma assessment. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_133_0_Final_Cut.m4a Download Leave a Comment Tags: ABCDEs, Trauma

Show Notes

Take Home Points
  1. Development of a systematic approach is essential to rapidly assessing the wide diversity of trauma patients and minimizes missed injures
  2. Prepare with whatever information is available before the patient arrives and remember to get a good handoff from the pre-hospital team
  3. Complete the primary survey (ABCDEs) and address immediate life threats
  4. Round out your assessment with a good medical history and remember to complete a comprehensive head-to-toe exam

Read More

Shlamovitz GZ, et al. Poor test characteristics for the digital rectal examination in trauma patients. Ann Emerg Med. 2007;50(1):25-33, 33.e1. PMID: 17391807

ER Cast: Gunshot to the Groin with Kenji Inaba

EM:RAP: Do We Still Need The C-Collar?

YouTube: Death of the Dinosaur: Debunking Trauma Myths by Dr. S.V. Mahadevan

REBEL EM: Is ATLS wrong about palpable blood pressure estimates?

Life in the Fast Lane: Digital rectal exam (DRE) in trauma


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Feb 19 2018
18 mins
Play

Rank #2: Episode 31.0 – Rocuronium vs. Succinycholine

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This podcast is a recorded lecture from our conference on why Rocuronium should be the go to drug for RSI in the ED. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_31_0_Final_Cut.m4a Download 2 Comments Tags: Airway, Rocuronium, RSI, Succinycholine

Show Notes

[caption id="attachment_2583" align="aligncenter" width="558"] Sydney HEMS Sux Contraindications[/caption] Read More: Strayer RJ. Rocuronium versus succinylcholine: Cochrane synopsis reconsidered. Ann Emerg Med 2011; 58(2): 217-8 Strayer RJ. Rocuronium vs. succinylcholine revisited. Ann Emerge Med 2010; 39(3): 345-6. Mallon WK et al. Response to Rocuronium vs. succinylcholine revisited. Ann Emerge Med 2010; 39(3): 346-7. Strayer RJ. (2010, January 14). Screencast: Rocuronium vs. Succinylcholine in 8 minutes. Retrieved from http://emupdates.com/2010/01/14/rocuronium-vs-succinylcholine/ References
  1. Sluga M, Ummenhofer W, Studer W, Siegemund M, Marsch SC. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: a prospective, randomized trial in emergent cases. Anesth Analg 2005; 101:1356 – 61.
  1. McCourt KC, Salmela L, Mirakhur RK, et al. Comparison of rocuronium and suxamethonium for use during rapid sequence induction of anaesthesia. Anaesthesia 1998;53:867–71.
  1. Laurin EG, Sakles JC, Panacek EA, Rantapaa AA, Redd J. A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients. Acad Emerg Med 2000;7:1362–9.
  1. Herbstritt A. BET 3: Is rocuronium as effective as succinylcholine at facilitating laryngoscopy during rapid sequence intubation. Emerg Med J 2012; 29(3): 256-9.
  1. Taha SK et al. Effect of suxamethonium vs rocuronium on onset of oxygen desaturation during apnoea following rapid sequence induction. Anaesthesia 2010; 65: 358-61.
  1. Tang L et al. Desaturation following rapid sequence induction using succinylcholine vs. rocuronium in overweight patients. Acta Anaesthesiol Scand 2011; 55: 203-8.

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Jan 25 2016
Play

Rank #3: Episode 2.0 – Sepsis, Ebola, Endocarditis and More!

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This podcast highlights pearls, pitfalls and take home points from our conference on ID emergencies as well as a sepsis update for 2015 https://media.blubrry.com/coreem/content.blubrry.com/coreem/Core_EM_Podcast_Episode_2.mp3 Download Leave a Comment Tags: Ebola, Endocarditis, Infectious Diseases, Myocarditis, Sepsis

Show Notes

[caption id="attachment_717" align="alignleft" width="1800"] SIRS Criteria[/caption] Read More REBELCast: Sepsis Care in 2015 References Tattevin P et al. Does this patient have Ebola virus disease? Intensive Care Med 2014; 40(11): 1738-41. PMID: 25183574 Rivers E et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. NEJM 2001; 345(19): 1368-77. PMID: 11794169 The ProCESS Investigators. A randomized trial of protocol-based care for early septic shock. NEJM 2014; 370(18): 1683-93. PMID: 24635773 ARISE Investigators. Goal-directed resuscitation for patients with early septic shock. NEJM 2014; 371(16): 1496-506. PMID: 25272316 Mouncey PR et al. Trial of early, goal-directed resuscitation for septic shock. NEJM 2015; 327(14): 1301-11. PMID: 25776532
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Jun 29 2015
21 mins
Play

Rank #4: Episode 61.0 – Hypokalemia

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This week we discuss the presentation and treatment of hypokalemia. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_61_0_Final_Cut.m4a Download Leave a Comment

Show Notes

Take Home Points

  1. Hypokalemia has a wide variety of presentations ranging from generalized weakness, to paralysis, to cardiac arrhythmia or cardiac arrest.
  2. When you discover hypokalemia, be sure to check and EKG. Think about underlying causes of hypokalemia, because it is rarely a solo event.
  3. Treat with oral potassium supplementation of 40-60 orally every 4-6 hours for mild hypokalemia and 10-20 mEq/hour IV for severe or symptomatic hypokalemia.

Additional Reading

LITFL: Hypokalemia

LITFL: Hypokalemic Periodic Paralysis

Core EM: Hypokalemia


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Aug 29 2016
Play

Rank #5: Episode 71.0 – Acute Pulmonary Edema

Nov 07 2016
22 mins
Play

Rank #6: Episode 23.0 – SBO

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Nov 23 2015
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Rank #7: Episode 17.0 – Asthma and COPD

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Pearls from our weekly conference discussing severe asthma and COPD exacerbations. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_17_0_Final.m4a Download 4 Comments Tags: Asthma, BPAP, COPD, NIPPV, Respiratory

Show Notes

Shownotes

EMCrit: Delayed Sequence Intubation

REBEL EM: The Crashing Asthmatic

EM:RAP: The Rule of 2s

Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Critical Care 16(5):323. PMID: 23106947
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Oct 12 2015
Play

Rank #8: Episode 121.0 – Pancreatitis

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This week we dive into the diagnosis and management of pancreatitis in the ED https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_121_0_Final_Cut.m4a Download Leave a Comment Tags: Gastroenterology, GI, Pancreatitis

Show Notes

[caption id="attachment_6188" align="aligncenter" width="593"] Ranson's Criteria for Pancreatitis-Associated Mortality (Rosen's)[/caption]

Take Home Points

  • Pancreatitis is diagnosed by a combination of clinical features (epigastric pain with radiation to back, nausea/vomiting etc) and diagnostic tests (lipsae 3x normal, CT scan)
  • A RUQ US should be performed looking for gallstones as this finding significantly alters management
  • The focus of management is on supportive care. IV fluids, while central to therapy, should be given judiciously and titrated to end organ perfusion
  • Patients will mild pancreatitis who are tolerating oral intake and can reliably follow up, can be discharged home

Read More

Hemphill RR, Santen SA: Disorders of the Pancreas; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 91: p 1205-1226

PulmCrit: The Myth of Large-Volume Resuscitation in Acute Pancreatitis

PulmCrit: Hypertriglyceridemic Pancreatitis: Can We Defuse the Bomb?


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Nov 13 2017
13 mins
Play

Rank #10: Episode 22.0 – Extra-Abdominal Causes of Abdominal Pain

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This week we'll discuss some common causes of abdominal pain that originate in extra-abdominal pathology. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_22_0_Abdominal_Pain_Final_Cut.m4a Download Leave a Comment Tags: Abdominal Pain

Show Notes

Life in the Fast Lane: Metabolic Causes of Abdominal Pain
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Nov 16 2015
Play

Rank #11: Episode 88.0 – Simplified Approach to Tachydysrhythmias

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This week, we review a simplified approach to determining the rhythm on an EKG with a tachydysrhythmia. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_88_0_Final_Cut.m4a Download One Comment Tags: Atrial Fibrillation, AVNRT, SVT, Tachycardias, Tachydysrhythias, Ventricular Tachycardia

Show Notes

Take Home Points

  1. When looking at a tachy rhythm that isn’t sinus tach, quickly differentiate by determining if the QRS complexes is narrow or wide and then determine if the rhythm is regular or irregular. This approach quickly drops the rhythm into 1 of 4 boxes and makes rhythm determination much easier
  2. Each of those 4 categories has a small set of rhythms included. Narrow and irregular - AF, Aflutter with variable block or MFAT. Narrow and regular - SVT or Aflutter. Wide and irregular - Torsades, VF, AF with aberrancy or a BBB. Wide and regular - VTach, SVT with aberrancy or SVT with a BBB.
  3. If you see wide and regular, the top 3 diagnoses are VT, VT and VT. Assuming VT and treating for that will almost never send you astray

Read More

EM: RAP: Episode 84 - Tachycardia

Core EM: A Simplified Approach to Tachydysrhythmias

Core EM: Atrioventricular Nodal Reentry Tachycardia

Core EM: Ventricular Tachycardia

Core EM: Recent-Onset Atrial Fibrillation

[caption id="attachment_1697" align="aligncenter" width="1003"] Simplified Approach to Tachydysrhythmias Diagnosis[/caption] [caption id="attachment_1700" align="aligncenter" width="1543"] Tachydysrhythmias Therapeutic Algorithm[/caption] [caption id="attachment_4740" align="aligncenter" width="904"] Torsades de Pointes[/caption] [caption id="attachment_4741" align="aligncenter" width="865"] Torsades de Pointes[/caption]
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Mar 13 2017
Play

Rank #12: Episode 46.0 – Grand Rounds (Ilene Claudius) – Pediatric SOB

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This week, the podcast features a full length talk from our Grand Rounds series. This talk was given by Ilene Claudius on pediatric SOB https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_46_0_Final_Cut.m4a Download Leave a Comment Tags: Asthma, Atropine, Bronchiolitis, Croup, Magnesium, RSI

Show Notes

Irazuzta JE et al. High-dose magnesium sulfate infusion for severe asthma in the emergency department: efficacy study. Crit Care Med 2016; 17: e29-e33. PMID: 26649938
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May 09 2016
Play

Rank #13: Episode 82.0 – ED Management of Seizures

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This week we discuss the ED management of seizures focusing on treatment and workup particularly of a 1st seizure episode. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_82_0_Final_Cut.m4a Download Leave a Comment Tags: Neurology, Seizure, Status Epilepticus

Show Notes

Take Home Points

  1. Get a detailed history to tease out whether the patient had a seizure or a syncopal event. Regardless, get an EKG on 1st time seizures in case it was actually syncope.
  2. BZDs are first line therapy for seizure termination. If you don’t have IV access, go with 10 mg of midazolam or 2-4 mg of lorazepam IM
  3. Always review the 5 main categories for causes of seizures in order to make sure you’re not missing anything. Those categories once again are vital sign abnormalities, CNS infections, toxic/metabolic issues, CNS space occupying lesions including masses and bleeds and finally epilepsy.
  4. In patients with a first time seizure without a particular cause and return to baseline neurologic status, there’s unlikely to be any benefit to a NCHCT or to starting an AED. Scheduling close follow up with a neurologist is very reasonable. The key is to do a thorough examination and make sure you’re not missing a subtle abnormality.
  5. Finally, in status epilepticus hit the patient with 2-3 hefty doses of BZDs and if the seizure is still ongoing, strongly consider moving to propofol and intubation in order to rapidly control the seizure activity.

Read More

Core EM: Parenteral Benzodiazepines

LITFL: Seizure

EMCrit: Podcast 155 - Status Epilepticus with Tom Bleck

First10EM: Management of Status Epilepticus in the Emergency Department

Huff SJ et al. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Seizures. Ann Emerg Med 2014; 43(5): 605-25. PMID: 15111920


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Jan 30 2017
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Rank #14: Episode 144.0 – Acute Rhinosinusitis

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This week we dive into rhinosinusitis exploring the recommendations of who needs antibiotics and who doesn't. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_144_0_Final_Cut.m4a Download Leave a Comment Tags: Acute Bacterial Sinusitis, ENT, Sinusitis

Show Notes

Take Home Points

  • Acute rhinosinusitis is a clinical diagnosis
  • The vast majority of acute rhinosinusitis cases are viral in nature and do not require antibiotics
  • Consider the use of antibiotics in select groups with severe disease or worsening symptoms after initial improvement.

Read More

Core EM: Acute Rhinosinusitis

TheNNT.com: Antibiotics for Clinically Diagnosed Acute Sinusitis in Adults

TheNNT.com: Antibiotics for Radiologically-Diagnosed Acute Maxillary Sinusitis


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May 07 2018
9 mins
Play

Rank #15: Episode 20.0 – AVNRT

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On this podcast we review some background on AVNRT and focus on Emergency Department management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_20_0_Final.m4a Download 2 Comments Tags: AVNRT, PSVT, REVERT Trial, Tachydysrhythmias

Show Notes

AVNRT with Aberrancy vs. VT

REBEL EM: SVT with Aberrancy Versus VT

Amal Mattu’s ECG Case of the Week: August 26th, 2013

Valsalva Maneuver

ALiEM: Tricks of the Trade: Valsalva Maneuver By Using a 10cc Syringe

St. Emlyn’s: JC The REVERT Trial

Adenosine in AVNRT

Larry Mellick: Treating SVT with Adensoine

ALiEM: Trick of the Trade: Combining Adenosine with the Flush

Verapamil in AVNRT

RAGE Podcast: Rage Session Two

ERCast Podcast: How to run a code

Appleboam A et al. Postural mdodification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised trial. Lancet 2015. PMID: 26314489


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Nov 02 2015
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Rank #16: Episode 8.0 – Chest Pain

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Recapping pearls from our weekly conference. This week, we discussed pearls on chest pain. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Core_EM_Podcast_Episode_8.m4a Download Leave a Comment Tags: ACS, Chest Pain

Show Notes

How to Build a Great Talk

Chest Pain Workshop

[caption id="attachment_1587" align="aligncenter" width="510"] The HEART Pathway (Mahler 2015)[/caption]

Journal Update

  • Goldberg H et al. Oral steroids for actue radiculopathy due to a herniated disk - a randomized clinical trial. JAMA 2015; 313(19): 1915-23. PMID: 25988461

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Aug 10 2015
Play

Rank #17: Episode 24.0 – Hepatic Encephalopathy

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This podcast is a brief discussion on hepatic encephalopathy: How it presents, the utility of ammonia levels and what else to look out for. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_24_0_Final_Cut.m4a Download Leave a Comment Tags: Ammonia, AMS, Hepatic Encephalopathy
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Nov 30 2015
Play

Rank #18: Episode 93.0 – Meningitis

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This week we cover a workshop from our conference on CNS infections focusing on meningitis. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_93_0_Final_Cut.m4a Download 3 Comments Tags: Bacterial Meningitis, CNS Infections, Infectious Diseases, Meningitis, Neurology

Show Notes

[caption id="attachment_5041" align="aligncenter" width="948"] CSF Analysis (LITFL)[/caption]

EM Lyceum: Viral Meningitis “Answers”

EM RAP: Meningitis

LITFL: Bacterial Meningitis

LITFL: CSF Analysis

The NNT: Glucocorticoid Steroids for Bacterial Meningitis

References

Attia J et al. Does this adult patient have acute meningitis. JAMA 1999; 281(2): 175-81. PMID: 10411200

Brouwer MC et al. Corticosteroids for acute bacterial meningitis (review). Cochrane Database Syst Rev 2015. PMID: 26362566

Cooper DD, Seupaul RA. Is adjunctive dexamethasone beneficial in patients with bacterial meningitis? Ann Emerg Med 2012; 59(3): 225-6. PMID: 22088494

de Gans J et al. Dexamethasone in adults with bacterial meningitis. NEJM 2012; 347(20): 1549-57. PMID: 12432041

Hasbun R et al. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. NEJM 2001; 345(24): 1727-34. PMID: 11742046

Sakushima K et al. Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis. J Infection 2011; 62: 255-62. PMID: 21382412

Tunkel AR et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004; 39: 1267-84. PMID: 15494903


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Apr 17 2017
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Rank #19: Episode 58.0 – Hyponatremia

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This week we discuss severe hyponatremia - presentation and treatment. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_58_0_Final_Cut.m4a Download Leave a Comment Tags: Electrolytes, Hypertonic Saline, Hyponatremia

Show Notes

EM Cases: Podcast 60: Emergency Management of Hyponatremia

References

Adrogue HJ, Maidas NE. Hyponatremia. NEJM 2000; 342(21): 1581-9. PMID: 10824078

Moritz ML, Ayus JC. 100 cc 3% sodium chloride bolus: a novel treatment for hyponatremic encephalopathy. Metab Brain Dis 2010; 25: 91-6. PMID: 20221678


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Aug 08 2016
Play

Rank #20: Episode 7.0 – Hyperkalemia + Rate Control in AFib

Aug 03 2015
Play

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