Emergency Medicine Cases

Dr. Anton Helman
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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. 12 THG 11

    Ep 199 Trauma Airway and Airway Trauma

    In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma? Dr. George Kovacs and Dr. Andrew Petrosoniak answer this and other questions such as: how should we re-sequence the trauma resuscitation depending on immediate life-threats? When is immediate vs delayed intubation recommended? How useful are the Zones of the neck in penetrating neck trauma? What is the optimal dosing of airway medications in the sick trauma patient? How should we modify our airway strategy for the severely head injured patient and/or agitated patient? When should we consider ketamine facilitated fiberoptic intubation in the trauma patient? and many more... 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 November, 2024 Cite this podcast as: Helman, A. Petrosoniak, A. Kovacs, G. Trauma Airway & Airway Trauma. Emergency Medicine Cases. November, 2024. https://emergencymedicinecases.com/trauma-airway. Accessed November 21, 2024 Résumés EM Cases Case study: Penetrating neck trauma Consider a 25-year-old woman who presents with a stab wound to the anterior neck. She arrives with a heart rate of 145, oxygen saturation at 90%, and audible gurgling sounds, indicating potential airway compromise. This is a high-stakes scenario where every decision, especially regarding airway management, could have life-altering consequences. The injury, located just off the midline in the anterior neck, immediately raises concerns about airway obstruction, major vascular injury, or both. Re-sequencing the trauma airway: A paradigm shift While working through the standard ATLS approach of A then B then C can be a helpful memory tool, our trauma resuscitations often require simultaneous assessment and management of all three or a total re-ordering of priorities. Some traumas may require a CAB approach or a CBA approach. Intubation is not always the first priority in trauma and, in fact, it may worsen outcomes if done prior to adequate resuscitation. Instead of focusing on letters, we should be focusing on identifying and managing the most immediate threat to life for each patient. Look for and immediately manage the following: * Massive hemorrhage: For example, a spurting artery that needs immediate management/compression or an unstable pelvis that needs binding. * Severe airway compromise: * Dynamic airway: If you wait even minutes, you may miss the opportunity to secure an airway. For example, expanding neck hematoma. * Critical hypoxia: Despite maximum noninvasive ventilation, O2 saturation is still 90%. * Obstructive shock: * Tension pneumothorax/ hemothorax: Consider bilateral finger thoracostomies/ chest tube before airway management. * Cardiac tamponade: Very high-risk intubations, should likely be done in the OR if patient still has a BP. If cardiac arrest, consider thoracotomy if your resources allow. The decision to intubate the trauma patient

    1 giờ 44 phút

  2. 22 THG 10

    EM Quick Hits 60 Post-Tonsillectomy Hemorrhage, Post-CABG Infections, Bougie Tips, Pelvic Fracture Bleeds, Debriefing: Why, When & How

    Topics in this EM Quick Hits podcast Kevin Wasko on post-tonsillectomy hemorrhage management (1:06) Brit Long on assessment and management of post-CABG surgical incision infections (15:40) Anand Swaminathan on evidence, pitfalls and tips on using Bougies (23:07) Leah Flannigan on when to suspect vascular injury in patients with low energy mechanism pelvic fractures (31:05) Andrew Petrosoniak on debriefing after cases: why, when and how (38:35) Podcast production, editing and sound design by Anton Helman Podcast content, written summary & blog post by Anton Helman, October, 2024 Cite this podcast as: Helman, A. Wasko, K. Long, B. Swaminathan, A. Flannigan, L. Petrosoniak, A. EM Quick Hits 60 - Post-Tonsillectomy Hemorrhage, Post-CABG Infections, Bougie Tips, Pelvic Fracture Bleeds, Debriefing: Why, When & How. Emergency Medicine Cases. October, 2024. https://emergencymedicinecases.com/em-quick-hits-october-2024/. Accessed November 21, 2024. Post-Tonsillectomy Hemorrhage Management Best of University of Toronto EM * Primary vs. Secondary post-tonsillectomy hemorrhage: * Primary post-tonsillectomy hemorrhages occur within the first 24 hours post-op, usually related to intraoperative factors like surgical technique or undiagnosed coagulopathies (e.g., von Willebrand disease). These bleeds are more likely in the immediate post-op period. * Secondary post-tonsillectomy hemorrhages occur after 24 hours, typically around post-op days 5 to 7, but can occur up to 14 days. They are caused by the sloughing off of the fibrin clot, exposing underlying tissue, which can lead to ongoing oozing or trickling bleeding. These are more insidious and can escalate quickly into life-threatening hemorrhages. * Key point: * Even if the bleeding is minor, like a small trickle, it should be considered a potential herald bleed—a precursor to a larger, more dangerous bleed. In these cases, early ENT consultation is crucial as definitive source control is needed, especially if bleeding persists for several hours. * Management approach (3-pronged): * Resuscitation: * Ensure the patient is sitting upright in a comfortable position to prevent aspiration and make visualization easier. * Establish IV access and consider starting IV TXA 1-2g in adults, 15mg/kg in children if appropriate. * Get help early: * Contact ENT early, especially if you’re in a rural or resource-limited setting where transfer may be delayed. * Arrange for transport to a tertiary care center if no ENT is available locally. * Temporizing measures (until definitive management in the operating room): * Direct pressure with gauze and topical medications: Use lidocaine spray for local analgesia, and gauze soaked in epinephrine and/or TXA * Tranexamic Acid (TXA) options: * Nebulized TXA: Consider while other preparations are made. It’s a low-risk, easy intervention. * Topical TXA: Soak gauze in TXA and apply it directly to the bleeding site. * IV TXA: 15 mg/kg in children or 1-2 grams in adults over 10 minutes. * While evidence is limited, it is a reasonable adjunct in these cases, given the low risk of harm. * Airway Management in the post-tonsillectomy bleed * If the patient starts to aspirate blood, or if bleeding becomes severe enough to cause respirat...

    52 phút

  3. 1 THG 10

    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 November 21, 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.

    1 giờ 29 phút

  4. 10 THG 9

    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 November 21, 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.

    59 phút

  5. 19 THG 8

    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 November 21, 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

    1 giờ 15 phút

  6. 30 THG 7

    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 November 21, 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...

    1 giờ 12 phút

  7. 8 THG 7

    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 November 21, 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)

    1 giờ 29 phút

  8. 18 THG 6

    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 November 21, 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 infectio...

    58 phút
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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/

Thông Tin

  • Nhà sáng tạo
    Dr. Anton Helman
  • Năm hoạt động
    2010 - 2024
  • Tập
    366
  • Xếp hạng
    Sạch
  • Bản quyền
    © Medicine Cases
  • Trang web chương trình
    Emergency Medicine Cases

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