Emergency Medicine Cases

Dr. Anton Helman
  • 5,0 (9)
  • MEDICINA
  • DUAS VEZES/SEMANA
Emergency Medicine Cases

In-depth round table discussions with North America's brightest minds in Emergency Medicine on practical practice-changing EM topics since 2010, plus our EM Quick Hit series for a variety of short EM knowledge nuggets, and our Journal Jam series for EBM deep dives. World class Free Open Access Medical Education (FOAMed). For archived podcast episodes, show notes, quizzes, videos, discussions and an entire EM learning system, visit emergencymedicinecases.com. For donations, please visit https://emergencymedicinecases.com/donation/

  1. HÁ 4 DIAS

    Ep 198 Understanding and Improving Culture in Emergency Medicine: Key Insights

    There is a culture problem in medicine. 70% of us are disengaged, more than 50% contribute nothing to our departments and more than 15% actively work against a healthy culture in our departments. What makes an Emergency Department run like a well-oiled machine with staff that find meaning in their work and who are grateful for serving the public? There are individual skills; there are team skills; there is the admin, and then there is the oh-so-important culture which permeates all of these and can make them great or can drive them into the ground. The culture of an ED can make it or break it. 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... Podcast production, sound design & editing by Anton Helman Written Summary and blog post by Anton Helman October, 2024 Cite this podcast as: Helman, A. Byker, L. Brindley, P. Episode 198 Understanding and Improving Culture in Emergency Medicine: Key Insights. Emergency Medicine Cases. October, 2024. https://emergencymedicinecases.com/improving-culture-emergency-medicine. Accessed October 5, 2024 Résumés EM CasesWhat is culture in medicine? Culture in medicine integrates values, beliefs, behaviors, and interpersonal dynamics. Gert Hofstede’s framework outlines five key indices to evaluate cultural health in organizations: power distance, individualism vs. collectivism, assertiveness, uncertainty avoidance, and long vs. short-term orientation. Understanding where your department stands on these scales can illuminate pathways for cultural improvement. Hofstede’s 5 Dimensions of Culture * Power differential – the degree of inequality that exists and is accepted between people with and without power * Individualism vs collectivism – the strength of the ties that people have to others within their community * High IVD – high value placed on people’s time and need for privacy and freedom, an enjoyment of challenges, and expectation of individual rewards for hard work – in these communities should encourage debate and expression of people’s ideas and don’t mix work life with social life too much * Low IVD – emphasis on building skills and becoming a master of something, people work for intrinsic rewards, maintaining harmony among group members is important, wisdom is important, avoid giving negative feedback in public * Uncertainty avoidance index – how well people can cope with anxiety * Long vs short-term orientation * Indulgence vs restraint Why culture in medicine matters The culture of an ED shapes every aspect of its operation, from teamwork to patient care. It is critical for fostering a supportive environment that allows medical professionals to thrive. Culture is often intensified in high-pressure situations typical of Emergency Medicine, making it imperative to assess and enhance cultural dynamics actively. It can be a challenge to foster teamwork in a culture that often prioritizes individualism and status.

    1h29min

  2. 10 DE SET.

    EM Quick Hits 59 Traumatic Coronary Artery Dissection, Proper Use of Insulin, Mesenteric Ischemia, Exercise Associated Hyponatremia, AI for OMI

    Topics in this EM Quick Hits podcast Ian Chernoff on traumatic coronary artery dissection (1:05) Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia (15:50) Brit Long & Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management (21:47) Dave Jerome on managing exercise-associated hyponatremia and heat illness (33:47) Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG (50:50) Podcast production, editing and sound design by Anton Helman Podcast written summary & blog post by Brandon Ng, edited by Anton Helman, September, 2024 Cite this podcast as: Helman, A. Chernoff, I. Swaminathan, A. Long, B. Rosenberg, H. Jerome, D. McLaren, J. EM Quick Hits 59 Traumatic Coronary Artery Dissection, Proper Use of Insulin, Mesenteric Ischemia, Exercise Associated Hyponatremia, AI for OMI. Emergency Medicine Cases. September, 2024. https://emergencymedicinecases.com/em-quick-hits-september-2024/. Accessed October 5, 2024. Traumatic Coronary Artery Dissection - Best of University of Toronto EM Traumatic coronary artery dissection is a rare, but often fatal injury that is challenging to diagnose and requires specific knowledge of it's clinical features. Clinical clues for traumatic coronary artery dissection include: * History of blunt force chest trauma ranging from low to high energy mechanisms (direct blow to the chest, high speed motor vehicle crash) * Possible delayed presentation by many hours to days to weeks * Typical angina symptoms in young patient with no cardiac risk factors * Wall motion abnormalities on cardiac PoCUS * Elevated troponin * ECG ischemic changes Why is traumatic coronary artery dissection difficult to diagnose? * Cardiac injuries ranging from contusions to dissections occur in 5-15% of blunt chest trauma; traumatic coronary artery dissection comprises a small proportion of these patients * Symptoms may not present for days to weeks after inciting event * May occur even with low energy mechanisms * Most often occur in young patients who are not at risk for cardiac ischemia – 82% under age 45 and have been reported in as young as age 14 * Often overlooked due to low index of suspicion in the context of other concurrent traumatic injuries Traumatic coronary artery dissection vs SCAD (Sontaneous Coronary Artery Dissection) * There are some corollaries with SCAD and traumatic CAD in that both have historically been under-recognized;h owever, whereas SCAD has now belatedly been recognized as the leading cause of MI in women under age 50, traumatic CAD continues to be under appreciated Workup of traumatic coronary artery dissection * Patients complaining of chest pain after sustaining blunt chest trauma should undergo prompt cardiovascular workup * Current Eastern Association for the Surgery of Trauma (EAST) guidelines propose an ECG as well as cardiac markers should be performed on any patient in which one suspects blunt cardiac injury; doing so appears practitioner dependent A key pitfall in chest trauma is assuming that a borderline ECG and positive troponin is due only to cardiac contusion, which does not warrant activation of the cath lab.

    59min

  3. 19 DE AGO.

    Ep 197 Acute Heart Failure Risk Stratification and Disposition

    We’d like to think that we’re getting better at identifying acute heart failure and making good disposition decisions. But the facts are, ED physicians are only about 80% accurate diagnosing acute heart failure, and 30-day mortality outcomes and readmission rates for acute heart failure have been about the same in North America for the last few decades – plus we often send home patients who should be admitted and admit patients who should be sent home. This is because there are many challenges for EM docs when it comes to acute heart failure. First, the diagnosis can be tough, and often is only made once the patient is admitted. There is no one clinical feature that is a slam dunk for the diagnosis, and even combinations of features are not great. There are many flavours of heart failure – diastolic, systolic, right-sided, left-sided, SCAPE, cardiogenic shock - just too complicate things further. Even if we’ve made an accurate diagnosis, the decision of whether to admit or send home can be challenging. We have risk stratification decision scales to help, but are they good enough? Are we using them appropriately? In this podcast, with the help of Dr. Doug Lee, cardiologist and researcher at Sunnybrook Hospital in Toronto and Dr. Clare Atzema, our go to EM Atrial fibrillation expert, an EM doc and researcher also from Sunnybrook Hospital, with a special appearance by Ian Chernoff on the role of PoCUS in the diagnosis and risk stratification of acute heart failure, we’ll dig into how to improve our diagnostic accuracy of acute heart failure in the ED and how to improve our disposition decision making so that just the right number of people are admitted and just the right number of people of sent home safely... Podcast production, sound design & editing by Anton Helman Written Summary and blog post by Ryan O'Reilly and Anton Helman August, 2024 Cite this podcast as: Helman, A. Episode 197 Acute Heart Failure Risk Stratification and Disposition. Emergency Medicine Cases. August, 2024. https://emergencymedicinecases.com/acute-heart-failure-risk-stratification-disposition. Accessed October 5, 2024 Résumés EM CasesAccuracy of initial evaluation findings in the diagnosis of acute heart failure  Source: King M, Kingery J, Casey B. Diagnosis and evaluation of heart failure. Am Fam Physician. 2012 Jun 15;85(12):1161-8. Value of NT-pro-BNP in risk stratification of acute heart failure remains controversial Based on our in depth review of the world's literature in 2018 in this Journal Jam podcast, and as detailed on First10EM, BNP has limited, if any, value in risk stratification of acute heart failure in the ED. However, a subsequent study and guidelines suggest that NT-pro-BNP is highly accurate at the extremes (NT-pro-BMP 450 * 50-75 - >900

    1h15min

  4. 30 DE JUL.

    EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma

    Topics in this EM Quick Hits podcast Megan Landes on providing HIV PEP and PrEP in the ED (1:05) Justin Morgenstern and George Kovacs on evidence for pre-oxygenation with NIPPV before intubation in RSI (19:05) Brit Long on recognition and management of blast crisis in the ED (41:31) Leah Flanagan and Liam Loughrey on the rise of nitrous oxide toxicity (50:40) Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient (59:55) Podcast production, editing and sound design by Anton Helman Podcast content, written summary & blog post by Brandon Ng and Brit Long, edited by Anton Helman, July, 2024 Cite this podcast as: Helman, A. Morgenstern J. Landes, M. Kovacs, G. Long, B. Flanagan L. Loughrey, L. Petrosoniak, A. EM Quick Hits 58 - HIV PEP and PrEP, PREOXY Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma. Emergency Medicine Cases. July, 2024. https://emergencymedicinecases.com/em-quick-hits-month-year/. Accessed October 5, 2024. HIV Post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) This is part 2 of our 2-part EM Quick Hits series on HIV. We suggest reviewing part 1 if you haven't already - Part 1 of this 2-part EM Quick Hits series on HIV * PEP is an effective method for reducing the risk of transmission for persons who have been exposed to HIV. It needs to be given less than 72 hours from initial exposure to be maximally effective and is prescribed as a 28-day course of Anti-retroviral therapy (ART). * PEP reduces the relative risk of a single exposure event to HIV by 80% (reduces risk of percutaneous exposure and mucocutaneous exposure to HIV positive blood to 0.3% and 0.09%, respectively). * Note that every risk of exposure to HIV is relatively low, and PEP reduces that to an even more minuscule risk. HIV post-exposure risk stratification and indications for post-exposure prophylaxis (PEP)? 1.Determine the source risk for transmissible HIV, which can be categorized into substantial, low but nonzero, and negligible/none: Source: Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis by Tan et al. EMAJ 2017 * Concomitant STIs increase the risk of transmitting HIV through methods such as breaking down mucosal barriers and increasing inflammatory states. 2.Determine the type of transmission: Source: Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis by Tan et al. EMAJ 2017 * There is no good data on the risk of HIV transmission via mucocutaneous splash. Refer to your local occupational health policies. Who should we advise to start PEP? * Consider PEP if the source risk is in the substantial category and the type of exposure is high/moderate risk. * PEP is not recommended if the source’s risk is negligible/none and the exposure type is low risk. Indications for pre-exposure prophylaxis for HIV (PrEP)? * PrEP is ARTs (e.g. Truvada®) on an ongoing basis due to expecting repeated high-risk exposures to HIV. * There is a relative risk reduction of 44% and a NNT of 15. * People who should consider taking PrEP include: sexually active adults who have ongoing exposure (e.g. ongoing condomless sex with known HIV exposure), patients with recent STI, and those presenting to ED for recurrent PEP. * There are also current studies and ongoing evidence for adding doxycycline t...

    1h12min

  5. 8 DE JUL.

    Ep 196 Pediatric Meningitis Recognition, Workup and Management

    In this EM Cases main episode podcast with Dr. Shannon MacPhee and Dr. Jeanette Comeau we discuss the recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis including antibiotic choices and dexamethasone. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages? How does one differentiate between meningitis and retropharyngeal abscess on physical exam? How do the Canadian and American guidelines on work up of well-appearing febrile infants compare when to it comes to indications for lumbar puncture? Which patients with suspected meningitis require imaging prior to lumbar puncture? Which patients with febrile seizure require a workup for meningitis? How do we best interpret the various CSF tests to help distinguish between viral and bacterial meningitis? What are the indications and timing of administering dexamethasone in the pediatric patient with suspected meningitis? and many more.... Podcast production, sound design & editing by Anton Helman; Voice editing by Braedon Paul Written Summary and blog post by Matthew McArthur, edited by Anton Helman July, 2024 Cite this podcast as: Helman, A. Comeau, J. MacPhee, S. Pediatric Meningitis Recognition, Workup and Management. Emergency Medicine Cases. July, 2024. https://emergencymedicinecases.com/pediatric-meningitis-recognition-workup-management. Accessed October 5, 2024 Résumés EM CasesWhile pediatric bacterial meningitis is rare, it is predicted to be on the rise due to decreasing vaccination use Thanks in large part to vaccination programs, meningitis is a rare diagnosis. Its rarity and potential serious sequelae if untreated make it challenging but important to recognize when it occurs. The estimated incidence of bacterial meningitis is only 0.4/100,000 in adolescents but increases to 81/100,000 in neonates with a mortality rate of 20% in infants and 2% in older children. Most pediatric meningitis is caused by an enterovirus. The earlier the diagnosis of bacterial meningitis is made and the sooner treatment is initiated, the better the outcomes. One of the reasons we chose this topic is because there is a trend of decreasing use of childhood vaccinations in the last decade, which experts predict is likely to increase the rates of meningitis from vaccine preventable pathogens including Hemophilus Influenzae, Streptococcus Pneumoniae, Neisseria Meningiditis in the coming years.  Understanding the pathophysiology of and knowing the risk factors for bacterial meningitis helps guide recognition and management Sequence of steps leading to bacterial meningitis: Bacterial colonization (most often respiratory tract/oropharynx - bacterial meningitis may be preceded by a viral infection which increase the likelihood of bacterial colonization) Invasion of bloodstream (risk factors to consider in the pre-test probability of bacterial meningitis include: recent viral illness, smoking history, alcohol use disorder, immune suppression/immune deficiency, no or incomplete vaccinations against S pneumoniae, N meningitides, H influenza) Survive intravascularly and interact with BBB to penetrate into subarachnoid space (main risk factors are duration and degree of bacteremia, antibiotics that penetrate the BBB are required - see below) Relative lack of immunity within CSF space, bacterial proliferation and immune/inflammatory response (dexamethasone for inflammation - see below)

    1h29min

  6. 18 DE JUN.

    EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments

    Topics in this EM Quick Hits podcast Megan Landes on the importance of diagnosing HIV in the ED (1:10) Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion (22:33) Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient (29:25) Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis (37:32) Matt Poyner on the most lucrative side-gig, DIY investing (46:34) Podcast production, editing and sound design by Anton Helman Written summary & blog post by Shaila Gunn & Megan Landes, edited by Anton Helman Cite this podcast as: Helman, A. Landes, M. McLaren, J. Swaminathan, A. Long, Rosenberg, H. B. Pointer, M.  EM Quick Hits 57 - HIV diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments. Emergency Medicine Cases. June, 2024. https://emergencymedicinecases.com/em-quick-hits-june-2024/. Accessed October 5, 2024. HIV diagnosis and why it's important in EM HIV is a commonly missed diagnosis. 1 in 7 HIV+ Canadians are unaware of their diagnosis. For many people at high risk for HIV, the ED is the only accessible place to get tested. An early diagnosis saves lives by initiating early treatment, thus preventing transmission of the infection by 96% (undetectable = untransmissible). In whom should we consider testing for HIV in the ED? 1a) Major risk factor for HIV - persons who inject drugs (PWID), indigenous people, and people from endemic areas, suspect TB plus 1b) Clinical condition associated with HIV * Acute retroviral syndrome: an influenza like illness that happens within the first month of seroconversion. Influenza like illness + risk factor = think HIV. * Opportunistic infections: may include angular cheilitis, aphthous ulcers, oral candida, and hairy leukoplakia (from left to right in image below). The clues are in the mouth, so examine it! Be suspicious of unexpected weight loss and chronic diarrhea. Opportunistic infections of the mouth in people with HIV, from left to right, angular cheilitis, aphthous ulcers, oral candida, and hairy leukoplakia * AIDS defining illnesses: severe wasting, esophageal candida, and PCP/PJP pneumonia (may be identified by characteristic 'bag wing' bilateral pneumonia) are the most common. Also consider unusual CNS presentations including altered mental status, meningitis, and encephalitis. 2.Anyone who requests a test 3. Unexplained pancytopenia * Other risk factors for HIV: People presenting with any STI,  people with multiple sexual partners and people with recurrent presentations for post-exposure prophylaxis (PEP). => Integrating IVDU and sexual history into your history for all adult patients presenting with a fever will improve your diagnostic pick up rate of HIV Testing should be done through whatever means you have access to at your institution. This may include point of care testing, self-testing with oral swabs, or lab-based antigen-antibody tests. Note, if the test if negative and you have high suspicion, repeat testing in 1-3 months as false negatives are common early in the natural history of HIV. Other illnesses to be aware of in HIV+ patients * Immune reconstitution inflammatory syndrome: This is a paradoxical worsening of any pre-existing infectious...

    58min

  7. 28 DE MAI.

    Ep 195 Management of Subarachnoid Hemorrhage

    Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr. Katie Lin and Dr. Jeff Perry we answer questions such as: what are the 4 critical priorities in the initial stabilization of the patient with a suspected massive subarachnoid hemorrhage? When is a CT plus CTA of the head indicated up front in the management of patients with suspected subarachnoid hemorrhage? What is the evidence for oral nimodipine in improving outcomes in patients with subarachnoid hemorrhage and how does it work? What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage? What are the simplest and best prognostic tools available for spontaneous subarachnoid hemorrhage to help counsel families and patients? and more... Podcast production, sound design & editing by Anton Helman; Voice editing by Braedon Paul Written Summary, algorithm and blog post by Hanna Jalali, edited by Anton Helman May, 2024 Cite this podcast as: Helman, A. Perry, J. Lin, K. Management of Spontaneous Subarachnoid Hemorrhage. Emergency Medicine Cases. May, 2024. https://emergencymedicinecases.com/ed-management-subarachnoid-hemorrhage. Accessed October 5, 2024 Résumés EM Cases  Go to part 1 of this 2-part podcast on subarachnoid hemorrhage Management of the undifferentiated crashing brain: Management of the patient with a suspected subarachnoid hemorrhage prior to CT imaging Clinical features on their own have shown to not be reliable in distinguishing ischemic versus hemorrhagic CNS insult. While patients with head bleeds are more likely to complain of headache, nausea and vomiting compared to patients with ischemic strokes, a significant minority of patients with ischemic strokes do have these symptoms. Definitive management requires neuroimaging however we need to be able to empirically resuscitate the sick neurological patient keeping in mind important factors for the crashing brain. 4 critical priorities in the first 10 minutes: * Check and correct the glucose or empirically give an amp of D50W * Perform a rapid neurological exam prioritizing GCS, eyes (reaction to light, discongugate gaze, deviation), and motor response * Avoid hypotension and hypoxia at all costs considering early airway management/capture if needed * Resuscitate to get to the scanner so targeted treatment can be initiated after diagnosis is made Initial imaging for suspected subarachnoid hemorrhage: Non-contrast CT vs CT plus CTA upfront? In the crashing neurological patient we need more information than a plain CT head can offer to drive definitive management. The delay to definitive management can mean loss of brain viability. If available at your center, consider CT + CTA as the initial imaging modality of choice patients who: * Have neurological deficits: speech or motor deficit, vision loss, decreasing or low GCS. * Pre-existing intracranial vascular abnormality * Have a contraindication to LP * With shared decision-making >6 hours post headache onset (see SAH Part 1 a href="https://emergencymedicinecases.

    49min

  8. 13 DE MAI.

    Ep 194 Subarachnoid Hemorrhage – Recognition, Workup and Diagnosis Deep Dive

    Spontaneous subarachnoid hemorrhage is bad: Fifty percept mortality rate with half the survivors suffering from significant chronic disability. A whole one quarter of patients die in the field. Of those who make it to the ED, a few will be crashing in our resuscitation rooms, but most will just have a headache. So, the problem we face in the ED with SAH is two-fold: First, the clinical manifestations range from just a headache alone – maybe a sentinel leak, to comatose and death. The second problem is that once we identify a subarachnoid bleed, secondary bleeding and ischemia snowball fast leading to delayed badness. It follows that our job in the ED is two-fold: We need to find the needle in the haystack of headache-alone patients who have a SAH. That sentinel leak, that if you pick up now, can prevent a giant bleed and death later. And the literature suggests we’re not great at this – rates of misdiagnosis have been estimated to be as high as 7%. In this part 1 of our 2-part podcast series on subarachnoid hemorrhage, world-renowned EM researcher Dr. Jeff Perry and EM-stroke team clinician Dr. Katie Lin join Anton in a deep dive on SAH decision tools, key clinical clues, indications for CT/CTA, indications for LP, CSF interpretation so that we can safely improve our diagnostic accuracy and save lives... Podcast production, sound design & editing by Anton Helman; Voice editing by Braedon Paul Written Summary and blog post by Sara Brade, edited by Anton Helman May, 2024 Cite this podcast as: Helman, A. Lin, K. Perry, J. Episode 194 Subarachnoid Hemorrhage Recognition, Workup and Diagnosis. Emergency Medicine Cases. May, 2024. https://emergencymedicinecases.com/subarachnoid-hemorrhage-recognition-workup-diagnosis. Accessed October 5, 2024 Résumés EM Cases  Go to part 2 of this 2-part podcast on subarachnoid hemorrhage Traumatic vs atraumatic/spontaneous subarachnoid hemorrhage The most common cause of SAH is head trauma. Trauma can cause SAH, but SAH can also cause trauma (ie. SAH causes syncope and patient falls or crashes their car, etc). Etiology (traumatic or atraumatic) dictates the work-up and management. Features to help distinguish the two: Spontaneous subarachnoid hemorrhage is missed up to 7% of the time - why? In 73% of cases of missed spontaneous SAH, the most common mistake was not considering the diagnosis and not ordering a non-contrast CT head (NCCTH). Spontaneous SAH has a spectrum of disease presentation. We can’t rely on the “classic presentation” as our only trigger for ordering imaging. We also have to understand the limitations of NCCTH and pursue additional follow-up testing when appropriate (ie. LP and/or CTA). More on work-up below. “Thunderclap” headache - is it accurate for subarachnoid hemorrhage diagnosis? “Thunderclap” headache can mean different things to different people. In the Ottawa SAH Rule for headache evaluation, “thunderclap” headache is defined as abrupt onset severe headache that peaks instantly at onset. While most patients with SAH experience headaches that peak in far less than 1 hour, in order to capture all patients with SAH we should still be concerned about SAH in patients with a severe headache peaking up to 1 hour after onset. When patients experience a sentinel bleed and t...

    1h22min
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In-depth round table discussions with North America's brightest minds in Emergency Medicine on practical practice-changing EM topics since 2010, plus our EM Quick Hit series for a variety of short EM knowledge nuggets, and our Journal Jam series for EBM deep dives. World class Free Open Access Medical Education (FOAMed). For archived podcast episodes, show notes, quizzes, videos, discussions and an entire EM learning system, visit emergencymedicinecases.com. For donations, please visit https://emergencymedicinecases.com/donation/

Informações

  • Criado por
    Dr. Anton Helman
  • Anos de atividade
    2010 - 2024
  • Episódios
    364
  • Classificação
    Livre
  • Copyright
    © Medicine Cases
  • Site do podcast
    Emergency Medicine Cases

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