927 episodes

Our near daily podcasts move quickly to reflect current events, are inspired by real patient care, and speak to the true nature of what it’s like to work in the Emergency Room or Pre-Hospital Setting. Each medical minute is recorded in a real emergency department, by the emergency physician or clinical pharmacist on duty – the ER is our studio and everything is live.

Emergency Medical Minute Emergency Medical Minute

    • Health & Fitness
    • 4.7 • 174 Ratings

Our near daily podcasts move quickly to reflect current events, are inspired by real patient care, and speak to the true nature of what it’s like to work in the Emergency Room or Pre-Hospital Setting. Each medical minute is recorded in a real emergency department, by the emergency physician or clinical pharmacist on duty – the ER is our studio and everything is live.

    Podcast 795: Lithium Toxicity

    Podcast 795: Lithium Toxicity

    Contributor: Peter Bakes, MD
    Educational Pearls:
    Lithium remains a commonly used medication for treating bipolar disorder Lithium toxicity can be acute, acute-on-chronic, or chronic  Measuring blood lithium level Therapeutic range of lithium is around 1.6-1.8 mEq/L >2 mEq/L is likely to cause significant toxicity >4 mEq/L necessitates lifesaving treatment The lethal dose of lithium is 700 mg/kg Lithium can have delayed absorption resulting in levels increasing during hospitalization Symptoms associated with acute lithium toxicity Gastrointestinal Nausea, vomiting, abdominal pain Neurological Tremor, nystagmus, CNS depression (late finding) Cardiovascular Bradycardia, QT prolongation, EKG changes Treatment for lithium toxicity ABCs Get a good history GI Decontamination: Whole bowel irrigation if patient ingested extended-release tablets Dialysis Most effective treatment for lithium toxicity References
    Baird-Gunning J, Lea-Henry T, Hoegberg LCG, Gosselin S, Roberts DM. Lithium Poisoning. J Intensive Care Med. 2017;32(4):249-263.
    Hedya SA, Avula A, Swoboda HD. Lithium Toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC.; 2022.
    McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721-728.
     
    Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD
     
    The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 
    Donate to EMM today!

    • 4 min
    Podcast 793: Postintubation Sedation and Analgesia

    Podcast 793: Postintubation Sedation and Analgesia

    Contributor: Peter Bakes, MD
    Educational Pearls:
    When intubating a patient, it is important to consider what medications will be used for post-intubation sedation and analgesia The common non-benzodiazepine sedating medications are propofol, precedex, and ketamine Propofol is frequently used in the emergency department, and it lowers ICP and MAP making it the preferred sedative for patients with intracranial bleeds Precedex is a milder sedative used in the ICU because it decreases time to extubation and reduces the risk of complications associated with long term intubation  Ketamine should be used in hypotensive patients because it does not lower blood pressure, and its bronchodilatory effect is beneficial for asthmatic patients  Versed and ativan are the most commonly encountered benzodiazepine sedatives, but they are infrequently used because they increase the risk of delirium and delay extubation Benzodiazepines are useful for sedation in patients with delirium tremens For post intubation analgesia, fentanyl is the drug of choice since it has a lower risk of hypotension than is seen in other narcotics In the emergency department, intubated and sedated patients should initially be sedated to a RASS of -2 while obtaining imaging, but aim for a RASS of -1 after to decrease side effects and promote earlier extubation References
    Ely EW, Truman B, Shintani A, et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289(22):2983-2991.
    Garner O, Ramey JS, Hanania NA. Management of Life-Threatening Asthma: Severe Asthma Series. Chest. 2022.
    Keating GM. Dexmedetomidine: A Review of Its Use for Sedation in the Intensive Care Setting. Drugs. 2015;75(10):1119-1130.
    McKeage K, Perry CM. Propofol: a review of its use in intensive care sedation of adults. CNS Drugs. 2003;17(4):235-272.
    Ramos-Matos CF, Bistas KG, Lopez-Ojeda W. Fentanyl. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC.; 2022.
     
    Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD
    Emergency Medical Minute's Palliative screening event is tonight! There is still time to buy tickets to this intimate evening diving into the nuance of pediatric palliative care, purchase tickets on eventbrite!

    • 6 min
    Podcast 792: Rectal Prolapse

    Podcast 792: Rectal Prolapse

    Contributor: Jarod Scott, MD
    Educational Pearls:
    Rectal prolapse is an evagination of the rectal tissue through the anal opening Factors that weaken the pelvic floor muscles increase the risk of rectal prolapse These include age > 40, female, multiple pregnancies, constipation, diarrhea, cystic fibrosis, prior pelvic floor surgeries, or other pelvic floor abnormalities Noninvasive treatment options include increasing fluid and fiber intake to soften stools as well as using padding/taping to reinforce the perineum Surgery is an option to repair the prolapse so long as the patient is a good surgical candidate Medical sugar can be used as a desiccant to dry out and shrink the prolapse thus allowing for easier manual replacement References
    Coburn WM, 3rd, Russell MA, Hofstetter WL. Sucrose as an aid to manual reduction of incarcerated rectal prolapse. Ann Emerg Med. 1997;30(3):347-349.
    2Gachabayov M, Bendl R, Flusberg M, et al. Rectal prolapse and pelvic descent. Curr Probl Surg. 2021;58(9):100952.
    Segal J, McKeown DG, Tavarez MM. Rectal Prolapse. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC.; 202
     
    Summarized by Mark O’Brien, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD
     
    The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 
    Donate to EMM today!

    • 4 min
    Podcast 791: Hyperglycemic Hyperosmolar State

    Podcast 791: Hyperglycemic Hyperosmolar State

    Contributor: Aaron Lessen, MD
    Educational Pearls:
    Hyperglycemic Hyperosmolar State (HHS) is less common than Diabetic Ketoacidosis (DKA) but is associated with a mortality rate up to 10 times greater than that seen in DKA Typically seen in elderly patients with severely elevated blood glucose levels (>1000 mg/dL) and an increased plasma osmolality Unlike in DKA, patients with HHS do not have elevated ketones Treatment of HHS includes insulin administration along with correcting fluid and electrolyte abnormalities When treating HHS, it is important to monitor and follow osmolality regularly because over-rapid correction can result in the development of cerebral edema References
    Fayfman M, Pasquel FJ, Umpierrez GE. Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Med Clin North Am. 2017;101(3):587-606.
    Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc. Copyright © 2000-2022, MDText.com, Inc.; 2000.
    Long B, Willis GC, Lentz S, Koyfman A, Gottlieb M. Diagnosis and Management of the Critically Ill Adult Patient with Hyperglycemic Hyperosmolar State. J Emerg Med. 2021;61(4):365-375.
     
    Summarized by Mark O’Brien, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD
     
    The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 
    Donate to EMM today!

    • 3 min
    On the Streets #14: Trauma Activations in the Field

    On the Streets #14: Trauma Activations in the Field

    The Emergency Medical Minute is excited to announce that we our upcoming event, Palliative. Check out our event page for more information and to buy tickets: Palliative Eventbrite Page

    • 18 min
    Podcast 790: Opioids vs OTC Pain Meds

    Podcast 790: Opioids vs OTC Pain Meds

    Contributor: Aaron Lessen, MD
    Educational Pearls:
    NSAIDs are a potential alternative to opioids for pain management and are associated with decreased rates of adverse effects A recent study evaluated the effectiveness of ibuprofen and oxycodone for pain management in pediatric patients with isolated, acute-limb fractures Participants were discharged home with either ibuprofen or oxycodone and followed for six weeks  There was no difference in pain scores between those taking ibuprofen and those taking oxycodone indicating that they had comparable analgesic effects Those in the ibuprofen group experienced significantly less adverse events compared to those taking oxycodone The participants in the ibuprofen group showed quicker return to their normal activities and improved quality of life In pediatric patients with fracture-related pain, ibuprofen is a safer alternative to oxycodone that is equally effective for pain control References
    Ali S, Manaloor R, Johnson DW, et al. An observational cohort study comparing ibuprofen and oxycodone in children with fractures. PLoS One. 2021;16(9):e0257021.
    Cooney MF. Pain Management in Children: NSAID Use in the Perioperative and Emergency Department Settings. Paediatr Drugs. 2021;23(4):361-372.
    Yin X, Wang X, He C. Comparative efficacy of therapeutics for traumatic musculoskeletal pain in the emergency setting: A network meta-analysis. Am J Emerg Med. 2021;46:424-429.
    Summarized by Mark O’Brien, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD
     
    The Emergency Medical Minute is excited to announce that we our upcoming event, Palliative. Check out our event page for more information and to buy tickets: Palliative Eventbrite Page
    Donate to EMM today!
     

    • 3 min

Customer Reviews

4.7 out of 5
174 Ratings

174 Ratings

Diana Salha ,

Amazing podcast

I want to start off by saying that this podcast was extremely interesting and helpful to listen to. After listening to this podcast, I believe that I will continue to listen to more podcast similar to this. It was extremely informative which is what I love and educational. I love how it isn’t too long which made listening even more interesting to listen to.

Yuli Ibarra ,

Nice podcast

I got to listen to the episode about fentanyl because I’ve been hearing more about it in the news. I learned that there is a lot more money in the fentanyl business compared to the heroine industry. People are more willing to take pills because of the psychological aspects, they’re more likely to take a pill rather than cutting it up and sniffing it. Fentanyl is also cheaper and has easier access to get, withdrawal is also sleeping. This podcast is very informative, they give the information needed for a listener to understand the topic they’re talking about. They list the background information necessary and even talk about the actions needed after. Highly recommend this to people who are interested in the healthcare field.

qrjeanty ,

Great episode

This was really interesting.

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