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Podcast 586: Toxic Shock Syndrome
Contributor: Don Stader, MD Educational Pearls: Toxic shock syndrome (TSS) is a rare cause of shock typically caused by Staph aureus or Strep pyogenes, that produces a toxin that...
Podcast 585: You Sure You Want Colchicine for Gout?
Contributor: Don Stader, MD Educational Pearls: Gout is an arthritis caused by the deposition of urate crystals into the joint space Colchicine works by disrupting microtubules and prevents white...
Podcast 582: Gadolinium – The Contrast of MRI
Contributor: Michael Hunt, MD Educational Pearls: Contrast agents are commonly used for X-rays and CT’s to better characterize disease, but contrast doesn’t work with MRI. That’s where the element...
Podcast 581: Alcohol Complications
Contributor: Don Stader, MD Educational Pearls: Altered mental status/confusion are major symptoms associated with both alcohol use and withdrawal. Wernicke’s encephalopathy is a triad of symptoms of confusion, internuclear...
On The Streets #6: Artificial Intelligence Detection for LVOs
Meet Michelle Whaley, Clinical Nurse Specialist and Stroke Program Coordinator at Sky Ridge Medical Center in Lone Tree, Colorado. Jordan and Michelle discuss advances in Artificial Intelligence technology in...
Podcast 580: Origin of PPE
Contributor: Michael Hunt, MD Educational Pearls: PPE, or personal protective equipment, has become a major talking point since the emergence of the novel coronavirus (COVID 19). While ubiquitous now,...
Podcast 579: Yersinia Pestis
Contributor: Don Stader, MD Educational Pearls: Yersinia Pestis is the bacteria that caused the black plague. It was first discovered to be the cause of the bubonic plague in...
Podcast 578: Brown-Sequard Syndrome
Author: Eric Miller, MD Educational Pearls: Brown-Sequard Syndrome is a neurological deficit that results from hemisection of the spinal cord This is usually from traumatic injury (blunt or penetrating),...
Podcast 577: Immunotherapies
Contributor: Don Stader, MD Educational Pearls: Checkpoint inhibition normally helps our body detect abnormal cells and terminate it but cancerous cells often are able to avoid this countermeasure Monoclonal...
UnfilterED #9: Dr. Steven Bradley
Dr. Steven Bradley is an active duty U.S. Naval officer practicing as a Staff Anesthesiologist in Virginia where also resides on the Medical Ethics Committee for his hospital. He...
Podcast 576: Status Epilepticus Drugs
Author: Charlene Gnisci Melton, PharmD Educational Pearls: Status Epilepticus is defined as continuous seizure activity for >5 minutes, or 2 or more seizures without full return to consciousness between...
Podcast 575: Light on the Sedation
Contributor: Aaron Lessen, MD Educational Pearls: Studies have shown that patients who are under deeper sedation in the ICU have worse outcomes. Recent study compared lighter vs heavier sedation...
Epidemic Meets Pandemic #4: The Patient Perspective
This limited series will investigate how the nation’s opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm...
Epidemic Meets Pandemic #3: The Law Enforcement Perspective
This limited series will investigate how the nation’s opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm...
Epidemic Meets Pandemic #2: The Addiction Medicine Perspective
This limited series will investigate how the nation’s opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm...
Epidemic Meets Pandemic #1: The Harm Reductionist Perspective
This limited series will investigate how the nation’s opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm...
UnfilterED Clips: A Toxicologist’s Perspective on COVID-19. Biological Warfare and the Need for Disaster Preparedness
Taken from ‘UnfilterED #8: Dr. Christopher Hoyte’. “This current sars-coV-2 / COVID-19 situation should really be a wake-up call for not just a pandemic, but for a biological attack…One...
UnfilterED #8: Dr. Christopher Hoyte
Dr. Chris Hoyte is an ED physician, toxicologist and researcher based in Denver, CO. He was featured in Bring Em’ All: Chaos. Care. Stories from Medicine’s Front Line, a...
Podcast 574: Cyanide Toxicity
Contributor: Nick Tsipis, MD Educational Pearls: Significant cyanide exposure most commonly occurs from fire/smoke exposure particularly when plastics are involved Cyanide binds to cytochrome oxidase leading to the use...
Podcast 573: Arsenic Toxicity
Contributor: Nick Tsipis, MD Educational Pearls: Arsenic is a heavy metal that binds to multiple cellular enzymes and inhibits aerobic metabolism It is primarily absorbed through the skin, respiratory...
Podcast 572: Locked In Syndrome
Contributor: Aaron Lessen, MD Educational Pearls: Locked in syndrome results typically from an infarct of the basilar artery leading to infarction of the brainstem but typically preservation of the...
Podcast 571: Digital Blocks
Contributor: Jared Scott, MD Educational Pearls: Traditional digital block involves dorsal approach on either side of the digit, injecting local anesthetic along each side to numb all four nerves...
Podcast 570: Oh no no no to O2
Contributor: Aaron Lessen, MD Educational Pearls: Supplemental oxygen is not a completely benign intervention. A recent meta-analysis found that O2 saturations above 96% while on supplemental O2 were associated...
Podcast 569: The eFAST Exam
Contributor: Aaron Lessen, MD Educational Pearls:. Focused assessment with Sonography for Trauma (FAST) exam and the extended-FAST (eFAST) are essential components of current trauma care and evaluation There has...
Podcast 568: Shock ‘em!
Contributor: John Winkler, MD Educational Pearls: Unstable ventricular tachycardia (VT) typically manifests with syncope, shortness of breath, diaphoresis and/or chest pain with hemodynamic instability Electrical cardioversion of unstable ventricular...
Podcast 567: Mechanical CPR….Not So Fast
Contributor: Aaron Lessen, MD Educational Pearls: Mechanical CPR (machine assisted compression devices) remains a hot topic of debate in emergency medicine Machine assisted CPR has been advocated to provide...
Selected Audio from ‘UnfilterED #7: Russell J. Ledet, Ph.D.’
“Go unafraid! And also know that you got to reach out to the right people and hold on to those people no matter what they look like, no matter...
UnfilterED #7: Russell J. Ledet, Ph.D.
Russell J. Ledet hails from Lake Charles, Louisiana. After serving in the U.S. Navy, he attended Southern University and A&M College for his undergraduate degrees in biology and chemistry....
Podcast 566: The Cholera Pandemic
Contributor: Jared Scott, MD Educational Pearls: Cholera has been responsible for 6 previous global pandemics and currently the world is in the seventh pandemic of cholera, ongoing since 1961....
Podcast 565: Cesarean Scar Pregnancies
Contributor: Nick Hatch, MD Educational Pearls: A cesarean scar ectopic pregnancy occurs when the pregnancy implants along the scar tissue deep in the myometrium from a prior cesarean surgery,...
On the Streets #5: Trauma during COVID-19
Jordan sits down to discuss trauma with Dr. Kaysie Banton, the Trauma Services Medical Director at Level 1 Trauma Center Swedish Medical Center in Englewood, Colorado. In this laid...
Podcast 564: Cardiac Ischemia Management Update
Contributor: Nick Tsipis, MD Educational Pearls: Recent randomized controlled trial compared early intervention (PCI/CABG) to medical management for those diagnosed with moderate to severe cardiac ischemia on stress testing...
Podcast 563: DC ACs
Contributor: Nick Hatch, MD Educational Pearls: An AC (acromioclavicular joint) separation in the shoulder is a common traumatic injury XRs can help rule out other injuries as well as...
Podcast 562: COVID-19 Occlusions*
*(A shorter and more clinically focused follow up piece to our COVID Digest released on 5/1/20) Contributor: Nick Tsipis, MD Educational Pearls: Case series reported 5 cases of generally...
Podcast 561: Give Bup
Contributor: Don Stader, MD Educational Pearls: Buprenorphine has been shown to decrease morbidity and mortality in opioid use disorder Buprenorphine used in naloxone-induced withdrawals can displace naloxone at opioid...
Podcast 560: Imaging in a COVID world
Contributor: Don Stader, MD Educational Pearls: COVID-19 commonly appears as a bilateral patchy infiltrate on chest radiograph, but this is a non-specific finding Sensitivities range from 17-70% for COVID-19...
Mental Health Monthly #3: Maintaining Mental Health and Wellness for Healthcare Professionals
In this timely installment of Mental Health Monthly, mental health expert Lexi Eliades shares useful tips for identifying burnout and mental health decline as well as ways to maintain...
Podcast 558: Rapid ARDS Review
Contributor: Don Stader, MD Educational Pearls: Acute respiratory distress syndrome (ARDS) is a catch all term for when lung injury leads to fluid collection in the air spaces of...
Podcast 557: COVID-19 Lab Trends
Contributor: Don Stader, MD Educational Pearls: COVID-19 is diagnosed with a nasopharyngeal swab (q-tip). This unfortunately can be painful, but if the swab doesn’t go deep into the nasal...
Podcast 556: CSF – What is it good for?
Contributor: Eric Miller, MD Educational Pearls: A cell count is performed on tubes 1 and 4 to account for changes that may occur from blood entering the first sample...
Podcast #555: Anticoagulation vs. Antiplatelet
Contributor: Don Stader, MD Educational Pearls: When do we give antiplatelet drugs or anti-coagulation drugs? Arterial issues get antiplatelet therapy Venous issues, or slow flow states, get anticoagulation therapy....
UnfilterED #6: Dr. Anton Helman
In this organic conversation, Nick and Dr. Helman establish a warm rapport early on as they discuss musical beginnings, life-changing mentors and the origins of Emergency Medicine Cases. Their...
On the Streets #4: Posterior Circulation Strokes
In part 2 of our interview with Dr. Adam Graham, Jordan takes a deep dive into posterior circulation strokes and how to identify them in the field.
Podcast 554: Sleeping Away Alzheimer’s
Contributor: Dave Rosenberg, MD Educational Pearls: White noise is all the surrounding sound frequencies mixed together that your brain tunes down so you don’t get distracted while you’re sleeping...
Podcast 553: Airway Management in the Hypoxic COVID-19 Patient(Recorded 4/3/20)
Contributor: Dylan Luyten, MD Educational pearls: Clinical management of COVID-19 is rapidly evolving, relying on case reports and clinical experience In just a month, the consensus around management of...
Podcast 552: PE Management and Risk Stratification
Contributor: Dylan Luyten, MD Educational Pearls: After you diagnose a pulmonary embolism (PE) via CT or VQ scan, we need to categorize the PE as massive, sub-massive, or just...
Podcast 551: PPIs are Not Benign
Contributor: Don Stader, MD Educational Pearls: PPIs (Proton pump inhibitors) reduce stomach acid levels and are commonly prescribed in patients with GERD or peptic ulcer disease Stopping a...
On the Streets #3: COVID-19
In this special edition of our On the Streets podcast, we discuss COVID-19 as well as what first responders and emergency providers need to know to keep themselves and...
Podcast 550: Good ol’ Versed
Contributor: Sam Killian, MD Educational Pearls: Agitation can be due to a number of causes, but regardless of the cause, sedation often plays a key role in patient and...
Podcast 549: Just Use Epineprhine
Contributor: Sam Killian, MD Educational Pearls: Classic dogma teaching that epinephrine should not be used in the fingers, nose, penis, and toes when performing local anesthesia due to concerns...
On the Streets #2: Neurological Deficits
Part 1 of 2: Dr. Adam Graham dishes out the essentials of identifying concerning neurological deficits on the scene, predicting what they mean and how to best care for...
Podcast 547: Capsaicin Cream to the Rescue
Author: Aaron Lessen, MD Educational Pearls: A recent retrospective study looked capsaicin cream in treating cannabinoid hyperemesis syndrome in regards to length of stay, cost analysis, use of rescue...
Podcast 546: Complete Heart Block
Author: Jared Scott, MD Educational Pearls: Differentiating symptomatic bradycardia from asymptomatic may be essential in determining workup and treatment Airway, breath, circulation always hold true Symptoms may include dizziness,...
Podcast 545: So You Quit Smoking… Now What?
Author: Aaron Lessen, MD Educational Pearls: New data shows within 5 years of smoking cessation, the risk of cardiovascular disease becomes half of those who continue to smoke After...
UnfilterED #5: Dr. Lisa Zwerdlinger
Recorded remotely in the highest hospital in the world, Nick sits down to talk with Dr. Lisa Zwerdlinger, a small-town physician who’s worn many different hats both in the...
Podcast 544: C is for Sepsis
Author: Aaron Lessen, MD Educational Pearls: Previously, trials had shown promising evidence that vitamin C may improve mortality rates in patients with sepsis or septic shock. A 2017...
Podcast 543: Scoring Blunt Traumatic Aortic Injury
Author: Nick Tsipis, MD Educational Pearls: Aortic injury caused by blunt trauma is very rare Chest x-ray findings might include widening of the mediastinum Ligamentum arteriosum (remnant of the...
Mental Health Monthly #2: Non-Epileptic Seizures (NES)
Non Epileptic Seizures (NES) is perhaps one of the most misunderstood and overlooked disorders that emergency medicine professionals encounter. Dr. Randi Libbon & Dr. Laura Strom, both experts on...
Podcast 542: Nasogastric Tubes
Author: Don Stader, MD Educational Pearls: Nasogastric tubes (NGT) are very uncomfortable for all those involved but some simple tricks and tips may help: Topical lidocaine can be inserted...
Podcast 541: Needle Thoracostomy
Author: Aaron Lessen, MD Educational Pearls: Traditional technique of needle thoracostomy for tension penumothorax is along the 2nd intercostal space at the midclavicular line Inserting a large angiocatheter along...
On the Streets #1: The Art of the Handoff Report
EMM is proud to present the pilot episode of our new monthly series, “On the Streets”. This will be an informative podcast for all of our listeners, but this...
Podcast 540: Zyprexa
Contributor: Don Stader, MD Educational Pearls: Olanzapine (Zyprexa) is an atypical antipsychotic that can be used in a similar fashion to haloperidol for pain and nausea, including that with...
Podcast 539: Coricidin Abuse
Contributor: Rachel Beham, PharmD Educational Pearls: Coricidin HBP Cough & Cold (dextromethorphan and chlorpheniramine) is one of the more commonly abused over-the-counter medications Dextromethorphan, binds to multiple receptors, particularly...
Podcast 538: Low Maintenance Boxer’s Fracture
Contributor: Jared Scott, MD Educational Pearls: A distal 5th metacarpal neck fracture is often referred to as a “boxer’s fracture” and a common fracture encountered in the emergency department...
Podcast 537: Thoughts on Cardiac Arrest
Contributor: Don Stader, MD Educational Pearls: High-quality compressions are an essential, and probably one of the most important, part of cardiac arrest Actual evidence for drugs in cardiac arrest...
UnfilterED #4: Dr. Vivek Tayal
Dr. Vivek Tayal of Carolinas Medical Center, a pioneer of using ultrasound in the emergency department, reflects on his role in establishing ultrasound use in emergency medicine and much...
Podcast 536: Epistaxis 101
Contributor: Dylan Luyten, MD Educational Pearls: Clear the nasal passages – have the patient, if stable, blow their nose to dislodge any clot that might be in the way...
Podcast 535: A Prescription for Falls
Contributor: Aaron Lessen, MD Educational Pearls: Emergency department evaluation of falls, particularly in the elderly, should include an assessment of risk factors Common causes of falls in the...
Mental Health Monthly #1: Decision Making Capacity
In the first episode of this new series, the complexities of decision making capacity are discussed. References and Further Reading: [1] Appelbaum, P. S. (2007). Assessment of patients’ competence...
Podcast 532: SVC Syndrome
Contributor: Jared Scott, MD Educational Pearls: Superior vena cava (SVC) syndrome is caused by physical compression of the SVC and can present with facial swelling, upper extremity swelling, flushing,...
Podcast 529: Hemophilia
Contributor: Aaron Lessen, MD Educational Pearls: Hemophilia is characterized by bleeding (A /B) A is is 8, B (chrstmas, 9) Hemophilia refers to a group of bleeding disorders caused...
Podcast 528: Decompensated Liver Failure
Contributor: Michael Hunt, MD Educational Pearls: Cirrhosis is the end stage of chronic structural damage to the liver. This is most commonly due to alcohol but other causes viral...
Podcast 527: Knee Dislocations
Contributor: Erik Verzemnieks, MD Educational Pearls: Knee dislocations are most common in high energy trauma, such as a motor vehicle accident The knee may appear grossly normal on initial...
Podcast 526: Desmopressin for Intracranial Hemorrhage
Contributor: Charleen Melton, PharmD Educational Pearls: Desmopressin (DDAVP) is an analogue of anti-diuretic hormone (ADH) that has been used for the treatment of intracranial hemorrhage. It works by increasing...
Podcast 525: Enjoyable Epistaxis?
Contributor: Jared Scott, MD Educational Pearls: The ED is full of painful procedures. One of the most commonly dreaded procedures is nasal packing for epistaxis, as it is quite...
Podcast 523: A Dizzying Diagnosis
Contributor: Don Stader, MD Educational Pearls: It can be difficult to distinguish between central and peripheral causes of vertigo. Cerebellar stroke should be considered with any dizzy patient. Signs...
UnfilterED #3: Dr. Katie Bakes & Dr. Pete Bakes
Husband and wife Pete and Katie Bakes, both emergency physicians in the Denver-Metro area, reflect on their upbringings, the many lessons learned over their twenty year careers, and how...
Podcast 522: e-Cigarette and Vaping Related Lung Injury
Contributor: John Winkler, MD Educational Pearls: Vaping-related lung injury initially presents with flu-like symptoms and can progress to respiratory failure requiring aggressive resuscitation including ECMO It is thought to...
Podcast 521: Traumatic Hyphema
Author: Jared Scott, MD Educational Pearls: A hyphema is blood in the anterior chamber of the eye, typically caused by trauma While there is a spectrum of disease, blurred...
Podcast 520: Approach to the arresting patient
Contributor: Peter Bakes, MD Educational Pearls: Peri-arrest patients present a particular challenge to ED providers, as the differential is broad and time is critical The differential for near cardiac...
Podcast 519: Malaria Drug Resistance
Contributor: John Winkler Educational Pearls: There is increasing resistance to antimalarial drugs, especially in P. falciparum. This trend started with chloroquine, but is now spreading to the other first-line...
Podcast 518: Professional Complications
Contributor: Jared Scott, MD Educational Pearls In a 4 yr period at 2 hospital systems, unprofessional behavior of surgeons was monitored via a complaint system. Number of complaints was...
Podcast 517: It’s all about the PEEP
Contributor: Dylan Luyten, MD Educational Pearls: Bag-valve masks (BVM) typically have a port to connect O2 to. Unfortunately room air becomes entrained in the mask, reducing the FiO2 delivered...
UnfilterED #2: Lisa Raville & Dr. Josh Blum
Lisa Raville and Dr. Josh Blum, two pioneers of harm reduction in Denver, discuss the addiction crisis, the current state of harm reduction and how it will evolve in...
Podcast 516: Narcan and Pulmonary Edema
Contributor: Erik Verzemnieks, MD Educational Pearls: Important to realize complications can occur in the post-opioid overdose patient regardless of cause Narcan administration has been associated with non-cardiogenic pulmonary edema,...
Podcast 515: Non-Accidental Trauma
Contributor: Jared Scott, MD Educational Pearls: Non-accidental trauma (NAT) to children is commonly missed by medical providers Try to remember TEN-4-FACES as a useful aide for concerning patterns that...
Podcast 514: Pain Control While on Naltrexone
Author: Don Stader, MD Educational Pearls: Suboxone, methadone, and naltrexone are commonly used as treatments for opiate use disorder. Naltrexone is a full mu-opiate receptor antagonist, making acute pain...
Podcast 513: Plague
Author: John Winkler, MD Educational Pearls: The plague (black death) is caused by the Yersinia Pestis bacteria. This bacteria is spread by fleas and carried by rats. It is...
Podcast 512: Abstinence is Bad, mmmkay?
Author: Don Stader, MD Educational Pearls: Abstinence from substances such as tobacco or alcohol are effective strategies to achieve long term sobriety However, abstinence is not an effective strategy...
Podcast 511: Ebola Treatment
Author: Rachel Beham, PharmD Educational Pearls: There are currently many Ebola vaccines that are being studied, and one (recombinant VZV-Ebola vaccine) is currently being used in Africa. This vaccine...
Podcast # 510: Ebola
Author: John Winkler, MD Educational Pearls: There is a new outbreak of Ebola in The Congo. This is likely due to civil war and rebel attacks on healthcare workers...
Podcast 509: Circadian Rhythm and Shift Work, From Z to Z
Contributor: Jared Scott, MD Educational Pearls: Sleep deprivation and disturbed sleep cycles increases the risk of many acute and chronic medical issues such as motor vehicle accidents, diabetes, cardiovascular...
Podcast 508: Are you with child?
Contributor: Chris Holmes, MD Educational Pearls: In ancient Egypt, pregnant women would urinate over barley and wheat seeds to help determine the sex of thier fetus, as well as...
Podcast 507: Who gonna crump?
Contributor: Nick Tsipis, MD Educational Pearls: Communication proves time and time again to be most helpful in preventing surprises after patient admission Frequent re-evaluations and repeat vital signs can...
UnfilterED #1: Dr. Michael Hunt
On the first installment of this new series, Dr. Michael Hunt shares stories, lessons and advice as he reflects on his 35 year career as an emergency physician. ...
Podcast 506: Seymour Fracture
Contributor: Don Stader, MD Educational Pearls: Seymour fracture is an eponym for a Salter-Harris I/II fracture of the distal phalanx of the finger or toe in children, associated with...
Podcast 505: Sleep on Strep Throat
Contributor: Don Stader, MD Educational Pearls: Only 10% of patients receiving antibiotics for strep throat actually have the diesease Treatment of strep with antibiotics only slightly reduces the duration...
Podcast 504: Ocular Compartment Syndrome
Contributor: Don Stader, MD Educational Pearls: The eye is surrounded by relatively inflexible tissues such as the bone of the orbit and the fibrous tissue of the eye. This...
Podcast 502: EMS Psych Clearance
Contributor: Aaron Lessen, MD Educational Pearls: Patients with psychiatric complaints are often complicated to disposition from the main ED, and many will require inpatient psychiatric stays Some health systems...
Podcast # 501: Take Down Potions
Author: Jared Scott, MD Educational Pearls: Study from Hennepin County EM studied the efficacy of different drugs for agitation, which included 737 patients Most patients in this study were...
Colorado MAT Part 4: Buprenorphine in the Emergency Department
Treatment with buprenorphine is easier, less time consuming and far more effective for management of opioid withdrawal and OUD than standard care with clonidine, IVF, haldol and other symptomatic...
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Colorado MAT Part 3: Medications for MAT in the ED
There are three MAT drugs available to treat addiction: naltrexone (brand name Vivitrol), methadone (brand names Dolophine or Methadose) & buprenorphine (brand name Suboxone, Subutex, and Sublicade). The only...
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Colorado MAT Part 2: Medication Assisted Treatment
Medication Assisted Treatment or (Medication for Addiction Treatment) is an important frontier in ED care of patients with Opioid Use Disorder. Naltrexone, methadone and buprenorphine are the medications approved...
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Colorado MAT Part 1: Understanding Addiction & Opioid Use Disorder
Addiction is widely misunderstood by the public and by many healthcare providers. It is not taught in most medical schools. Combating the opioid epidemic will require providers to understand...
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Podcast #500: 2018-19 Rapid Fire EM Literature Review
Author: Dave Saintsing Educational Pearls: Poor sleep is an independent risk factor for development of health problems such as type 2 diabetes. A 2019 study, randomized participants to 3...
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