185 episodes

Core EM is dedicated to bringing Emergency Providers all things core content Emergency Medicine. In the true spirit of Emergency Medicine our content is available to anyone, anywhere, anytime.

Core EM - Emergency Medicine Podcast Core EM

    • Medicine
    • 4.7 • 133 Ratings

Core EM is dedicated to bringing Emergency Providers all things core content Emergency Medicine. In the true spirit of Emergency Medicine our content is available to anyone, anywhere, anytime.

    Episode 179.0 – Precipitous Breech Deliveries

    Episode 179.0 – Precipitous Breech Deliveries

    EM management of the rare but potentially complicated precipitous vaginal breech delivery.

    Hosts:

    Audrey Bree Tse, MD

    Masashi Rotte, MD MPH







    https://media.blubrry.com/coreem/content.blubrry.com/coreem/Breesashi_Breech_CoreEM.mp3







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    Tags: Obstetrics, Precipitous Deliveries, Pregnancy











    Show Notes

    Frank Breech Presentation:



    Complete Breech Presentation:



    Incomplete Breech (“Footling”) Presentation:



     

    Pinard Maneuver:

     

    Mauriceau Maneuver:



    References:



    Cunningham FG et al.  Breech Presentation and Delivery.  Williams Obstetrics, 22nd ed. 2005.

    Desai S, Henderson SO. Labor and Delivery and Their Complications. Rosen’s Emergency Medicine, 8e. 2014. Chapter 181.

    Gabbe SG et al.  Obstetrics: Normal and Problem Pregnancies, 2nd e. 1991. p.479.

    Stitely ML, Gherman RB. Labor with abnormal presentation and position. Obstet Gynecol Clin North Am. 2005; 32: 165.

    VanRooyen MJ, Scott J.  Emergency Delivery.  Tintanelli’s Emergency Medicine, 7th e.  2011.  Chapter 105.

    http://www.emdocs.net/the-complicated-delivery-what-do-you-do/#:~:text=Deliveries%20that%20occur%20in%20the,in%20denial%20of%20their%20pregnancies.

    https://ranzcog.edu.au/womens-health/patient-information-resources/breech-presentation-at-the-end-of-your-pregnancy

    https://wikem.org/wiki/Breech_delivery







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    • 14 min
    Episode 178.0 – Graduation Speech by Dr. Goldfrank

    Episode 178.0 – Graduation Speech by Dr. Goldfrank

    The speech given by Dr. Goldfrank at the 2020 NYU / Bellevue Emergency Medicine Graduation Ceremony







    https://media.blubrry.com/coreem/content.blubrry.com/coreem/Goldfrank_Graduation_Speech_2020.mp3







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    Tags: Graduation. Goldfrank











    Show Notes

    Graduation 2020

    Lewis R. Goldfrank, MD

    June 17, 2020



    WELCOME TO THE GRADUATES

    Congratulations to a wonderful group of physicians. It is a pleasure to recognize your great accomplishments in the presence of your friends, families, loved ones and the residents and faculty who have learned so much from and with you. I would first like to recognize those of you who are members of the Gold Humanism Honor Society.

    There are a remarkable number of awardees in our graduating class of 2020.



    CLASS OF 2020

    Joe Bennett (R)

    Max Berger (R)

    Ashley Miller (R)

    Leigh Nesheiwat (S)

    Kristen Ng (R)

    Emily Unks (S)

    AND

    Arie Francis (R)

    Nisha Narayanan (S)

    FUTURE PGY-4

    Elena Dimiceli (S)

    Kamini Doobay (S)

    Mark Iscoe (R)

    FUTURE PGY-3

    Stasha O’Callaghan (S)

    Nicholus Warstadt (S)

    FUTURE PGY-1

    Aaron Bola (S)

    Alison (Ali) Graebner (S)

    Aron Siegelson (S)

    Melissa Socarras (S)

    Sarah Spiegel (S)

    Thomas Sullivan (S)

    Christy Williams (S)



    GOLD HUMANISM CORE VALUES

    Integrity, Excellence, Compassion, Altruism, Respect, Empathy, Service

    These are the values you want as a doctor for yourself or a loved one,



    * to have outstanding listening skills with patients

    * to be at your side during a medical emergency,

    * to have exceptional interest in service to the community,

    * to have the highest standards of professionalism

    * to integrate a humanistic approach in patient care.



    These values are what brought all of you to NYU-Bellevue and that you have honed throughout your training. The remainder of this talk shows how all of you have been successful and demonstrated these values some of you were elected to the Gold Humanism—all of you have achieved humanistic success.

    Your personal efforts in the face of uncertainty of the evolution of the pandemic, the inadequate supplies, the hospital and governmental problematic decisions are remarkable. In our country, the President did not mourn the loss of more than a 100,000 human beings and the needs of society. Nor did he provide the leadership and moral support that the country desperately needed to optimally handle this unprecedented crisis. You, in contrast, demonstrate unflappable commitment to address and overcome obstacles to care for your patients, assist your peers, educate and care for your families and friends, while also caring for yourselves. This is a tribute to your humanism. You created essential ways to help patients who were isolated from families and friends during the critical phases of COVID-19.

    • 5 min
    Hemoptysis

    Hemoptysis

    An overview and management tips of hemoptysis in the ED.

    Hosts:

    Brian Gilberti, MD

    Audrey Bree Tse, MD







    https://media.blubrry.com/coreem/content.blubrry.com/coreem/Hemoptysis.mp3







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    Tags: Critical Care, Pulmonary











    Show Notes

    OVERVIEW:



    Definition:



    expectoration/ coughing of blood originating from tracheobronchial tree





    Sources:



    Bronchial arteries (90%): under systemic circulatory pressure to supply supporting structures of the lung → heavier bleeding

    Pulmonary arteries (5%): under low pressure to supply alveoli → milder bleeding

    Nonbronchial arteries (5%): intercostal arteries, coronary arteries, thoracic/ upper/ inferior phrenic arteries





    Quantification:



    Mild: 300mL-1L/ 24hr

    Mortality: 38% for massive (>500mL/ 24hr) vs 4.5% for nonmassive









    Etiology (in adults):



    Infectious (most common):



    Bronchitis

    PNA (necrotizing, lung abscess)

    TB

    Viral

    Fungal

    Parasitic





    Malignancy:



    Primary lung cancer vs metastatic disease





    Pulmonary:



    Bronchiectasis

    COPD

    PE/ infarction

    Bronchopleural fistula

    Sarcoidosis





    Cardiac:



    Mitral stenosis

    Tricuspid endocarditis

    CHF





    Rheumatological:



    Goodpasture Syndrome

    SLE

    Vasculitis (Wegener’s, HSP, Behcet)

    Amyloidosis





    Hematological:



    Coagulopathy/ thrombocytopenia/ platelet dysfunction

    DIC





    Vascular:



    Pulmonary HTN

    AA

    Pulmonary artery aneurysm

    Aortobronchial fistula

    Pulmonary angiodysplasia





    Toxins:



    Anticoagulation/ aspirin/ antiplatelets

    Penicillamine, amiodarone

    Crack lung

    Organic solvents





    Trauma:



    Tracheobronchial rupture

    Pulmonary contusion





    Other:



    bronchoscopy/ lung biopsy

    Pulmonary artery or central venous catheterization

    Foreign body aspiration

    Pulmonary endometriosis (catamenial hemoptysis)

    Idiopathic (up to 25% of cases)





    Pseudohemoptysis: 



    Sinusitis

    Epistaxis

    Rhinorrhea

    Pharyngitis

    URI

    Aspiration

    GIB











    WORKUP:



    HPI:



    CP, SOB

    B symptoms: fever, weight loss, chills, night sweats

    Lymphadenopathy

    Timeframe: acute vs chronic

    Prior lung/ renal/ cardiac disease

    Recreational drug/ cigarette/ chemical exposures

    travel/ infectious exposure

    Medications

    Any other sites of bleeding

    Precipitating factors

    Description of blood clots

    • 14 min
    Episode 176.0 – Pneumonia Updates

    Episode 176.0 – Pneumonia Updates

    We go over the recent updates in the workup and management of pneumonia.

    Hosts:

    Brian Gilberti, MD

    Audrey Tse, MD







    https://media.blubrry.com/coreem/content.blubrry.com/coreem/Pneumonia_Updates.mp3







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    Tags: Infectious Diseases, Pulmonary











    Show Notes







    2007 Infectious Diseases Society of America/American Thoracic Society Criteria for Defining Severe Community-acquired Pneumonia

    Validated definition includes either one major criterion or three or more minor criteria



    * Minor criteria



    * Respiratory rate > 30 breaths/min PaO2/FIO2 ratio 20 mg/dl)

    * Leukopenia* (white blood cell count , 4,000 cells/ml)

    * Thrombocytopenia (platelet count , 100,000/ml)

    * Hypothermia (core temperature , 368 C) Hypotension requiring aggressive fluid

    * resuscitation





    * Major criteria



    * Septic shock with need for vasopressors

    * Respiratory failure requiring mechanical ventilation









    A special thanks to our Infectious Diseases Editor:

    Angelica Cifuentes Kottkamp, MD

    Infectious Diseases & Immunology

    NYU School of Medicine











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    • 10 min
    Episode 175.0 – Posterior Circulation Stroke

    Episode 175.0 – Posterior Circulation Stroke

    Diagnosing and managing one of our critical diagnoses - posterior stroke.

    Hosts:

    Mukul Ramakrishnan, MD

    Audrey Bree Tse, MD







    https://media.blubrry.com/coreem/content.blubrry.com/coreem/final_posterior_stroke_podcast_post_edit.mp3







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    Tags: Neurology, Posterior Stroke











    Show Notes

    See Dr. Newman-Toker demonstrate the HINTS exam here

    Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009 Nov;40(11):3504-10

     





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    • 15 min
    Episode 174.0 – Homelessness

    Episode 174.0 – Homelessness

    We discuss one of the most complex problems we face – Homelessness

    Hosts:

    Kelly Doran, MD

    Audrey Tse, MD

    Brian Gilberti, MD







    https://media.blubrry.com/coreem/content.blubrry.com/coreem/Homelessness.mp3







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    One Comment











    Tags: Social Emergency Medicine











    Show Notes

    Special Thanks To:

    Dr. Kelly Doran, MD MHS

    Ronald O. Perelman Department of Emergency Medicine at NYU Langone Health, NYC Health + Hospitals/ Bellevue

    ___________________________

    References:

    Doran, K.M.  Commentary: How Can Emergency Departments Help End Homelessness?  A Challenge to Social Emergency Medicine. Ann Emerg Med. 2019;74:S41-S44.

    Doran, K.M., Raven, M.C. Homelessness and Emergency Medicine: Where Do We Go From Here? Acad Emerg Med. 2018;25:598-600.

    Salhi, B.A., et al. Homelessness and Emergency Medicine: A Review of the Literature. Acad Emerg Med. 2018;25:577-93.

    U.S. Department of Housing and Urban Development, Annual Homeless Assessment Report to Congress. Available at: https://www.hudexchange.info/resource/5783/2018-ahar-part-1-pit-estimates-of-homelessness-in-the-us/

    U.S. Interagency Council on Homelessness. Home, Together Federal Strategic Plan to Prevent and End Homelessness. https://www.usich.gov/resources/uploads/asset_library/Home-Together-Federal-Strategic-Plan-to-Prevent-and-End-Homelessness.pdf





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    • 21 min

Customer Reviews

4.7 out of 5
133 Ratings

133 Ratings

Hfvubcdjm ,

Not just for medical students!

I am in emergency room nurse and this has definitely helped my practice and ability to communicate with residents and attending MDs about patient presentations and interventions.

Sher Ali Khan ,

Quick, efficient and practical review

Very ice Job. I am intense medicine and I enjoy listening to it for my Hospital based practice in residency

Kristy5150 ,

Free and Fabulous!

I absolutely love this short free podcast. It is easy listening and chock full of good up-to-date information. I’ve been following Swami for quite some time and he has a way of making emergency medicine exciting even for this old APC.

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