Medical Minute Archives - Page 3 of 66 - The Emergency Medical Minute

Medical Minute

Podcast 647: INR and Liver Failure

Contributor:  Erik Verzemnieks, MD Educational Pearls: INR measures the clotting cascade including factors II, VII, IX, and X Coumadin most commonly elevates the INR, and it is used to monitor the anticoagulant’s effectiveness Liver failure can cause a similar elevation in the INR due to lack of synthesis of factors II, VII, IX, X An…

Read More

Podcast 646: Thunderclap Headache, Think…RCVS?

Contributor:  Aaron Lessen, MD Educational Pearls: When evaluating a thunderclap headache, don’t forget RCVS! RCVS: reversible cerebral vasoconstriction syndrome Due to reversible spasms of cerebral blood vessels Can sometimes be seen on CTA or MRA, but often the imaging is normal and formal angiograms only occasionally show it It can be caused by medications, intense…

Read More

Podcast 645: Necrotizing Enterocolitis and More

Contributor:  Peter Bakes, MD Educational Pearls: Necrotizing Enterocolitis (NEC) Presents in the first few days of life (often in the NICU) to 3 weeks old Risk factors include prematurity, excess feeding, neonatal sepsis Pneumatosis Intestinalisis on abdominal xray caused by bacterial translocation into the bowel wall Treated with NG tube, bowel rest and surgical resection…

Read More

Podcast 644: Covid Outcomes

Contributor:  Aaron Lessen, MD Educational Pearls: Meta-analysis of 57,420 COVID+ patients evaluated mortality after intubation 45% mortality rate for all patients in the study 84.4% mortality in patients over 80 years old POSITIONED Trail assessed need for intubation in patients awake self-proning compared to not Risk of intubation and mortality was lower for those self-proning…

Read More

Podcast 643: Convulsions with Gastroenteritis

Contributor:  Jared Scott, MD Educational Pearls: Differential Diagnosis: non-accidental trauma, febrile seizure, meningitis, hyponatremia, epilepsy Convulsions with gastroenteritis is a known entity to cause seizures in infancy Predominantly occurs in ages 6 months to 3 years Occur with diarrheal episodes No electrolyte abnormalities associated with the seizure nor severe dehydration Seizures tend to come in…

Read More

Podcast 642: Vasopressors

  Contributor:  Nick Tsipis, MD Educational Pearls: Epinephrine: alpha-1, alpha-2, beta-1, and beta 2 agonist – used in cardiac arrest with positive effects on ROSC in prehospital and peri-hopsital setting Norepinephrine: alpha-1 and beta-1 agonist – used in septic shock to increase cardiac output and peripheral vasoconstriction Phenylephrine: alpha-1 adrenergic agonist – used in spinal/neurogenic…

Read More

Podcast 641: Leadless Intracardiac Pacemaker

Contributor: Jared Scott, MD Educational Pearls: Small capsule pacemaker (2.5 cm, 1 ml volume) resides in the heart without any associated wires or leads like a traditional pacemaker The new version has a 6 year battery life, after which it can be deactivated and a traditional pacemaker put in place Cost is around 2-4 times…

Read More

Podcast 640: Kawasaki’s Disease

Contributor: Peter Bakes , MD Educational Pearls: Pediatric Fever + Rash Differential: scarlet fever, measles, rubella, chicken pox, fifth’s disease, HHV-6, adenovirus, anaphylaxis, Kawasaki’s disease Kawasaki’s is diagnosed clinically with prolonged fever (>7 days fever in <6 months > 5 days of fever >6 months with 4 of the following:  Strawberry tongue/fissured lips Bilateral conjunctival…

Read More

Podcast 639: Rib Fractures in the Elderly

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective review of 5,021 patients over 65 with 2 or more  rib fractures recently published 3577 (78 %) were admitted to non-ICU setting 1.1% of these patients had unexpected intubation or ICU transfer Findings raise questions regarding current guidelines for ICU admission in elderly patients with isolated rib fractures…

Read More

Podcast 638: Pyogenic Liver Abscess

Contributor: Aaron Lessen, MD Educational Pearls: Pyogenic liver abscesses can be caused by Intra-abdominal infection progressing to peritonitis which then drains into liver Bacteremia leading to hematogenous spead and seeding Local biliary infection with contiguous spread Patients typically present with signs of sepsis or septic shock and the abscess can be diagnosed using ultrasound or…

Read More

 

Stay up to date by
joining our mailing list!