Core IM | Internal Medicine Podcast Core IM Team

What is your approach to trach complications? What do all the words in the one liner of a trach patient mean? What are best practices for airway clearance? When is a patient ready for a speaking valve? What is the process for decannulation?
Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im 
Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E10
Show notes, Transcript and References: 
https://www.coreimpodcast.com/2023/03/08/trac/
Time stamps
2:56 Trach Components
12:47 Trach Complication Management
27:48 Airway Clearance
34:53 Speaking Valve
38:54 Decannulation
Tags: IM Core, CoreIM, pulmonary, critical care, ICU, nursing care, respiratory therapy, pharmacy


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Why are safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care?
Show notes, Transcript and References:
https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/
Timestamps:
0:00 Hahnemann University Hospital
4:36 What is a Safety Net Hospital?
11:11 The Origins and Paradox of the Safety Net Hospital
Links to other episodes:
A Complex Patchwork of Supplemental Payments:
https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/
The Future of Safety Net Hospitals & Payment Policies:
https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/
Tags: IM Core, CoreIM, health policy, health disparities, insurance, medicare and medicaid


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How does your problem representation change as we get more history in this episode? How can we use Oxaam's razor & Hickman's dictum as powerful diagnostic tools IF used properly?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/15/25438/Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim (https://glass.health/coreim) Time stamps* 01:51 Intro* 07:57 Case * 13:09 Differential* 16:15 Diagnosis* 22:20 Problem Representation Tags: IM Core, CoreIM, diagnostic tools, Occam's razor, Hickam's dictum, data collection, mental model, clinical reasoning, rheumatology

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How do you approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this?Show notes, Transcript and References:  https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/ (https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/)Time stamps* 04:45 What do we mean by “futility”?* 11:20 Definitions* 20:23 Ethical Analysis* 39:13 RecommendationsTags: IM Core, CoreIM, ATS, autonomy, justice, values, emotions, communication, medical humanities, ethics

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What does the duration of afib tell you about the thromboembolic risk? When do you start anticoagulation for post-op afib? What do the most recent guidelines recommend for perioperative anticoagulation management? How many devices do you know that can be useful in post-discharge cardiac monitoring in new atrial fibrillation? How can we improve our communication regarding afib management?Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im  (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im%C2%A0)Show notes, Transcript and References: https://www.coreimpodcast.com/2023/01/18/diagnosis-of-atr…-matters-segment/Time stamps* 01:12 Intro* 03:51 Deep Dive 1* 08:16 Deep Dive 2* 15:25 Deep Dive 3* 21:05 Deep Dive 4* 27:07 Deep Dive 5Tags: IM Core, CoreIM, Devices, cardiac, risk, perioperative, stroke, surgery, anticoagulation

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Is it enough to look at LDL-C? What is Apo-B? How do you use TG/HDL ratio to understand your patients cardiovascular risk? Do you need to get a fasting lipid panel? How does it affect the triglycerides and LDL?Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/12/15/reimagining-the-…-the-gap-segment/ (https://www.coreimpodcast.com/2022/12/15/reimagining-the-lipid-panel-mind-the-gap-segment/)Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E8 (https://go.amboss.com/CoreIM-E8)Time stamps* 01:24 Intro * 03:37 Fasting vs. Nonfasting Lipid Panel* 05:11 Current guidelines* 07:43 Pathophysiology Overview* 09:04 Pathophysiology of Apo-B vs. LDL-C with traffic analogy* 11:23 Apo-B* 15:40 TG-to-HDL ratio* 17:06 Takeaways* Tags: IM Core, CoreIM, risk, USPSTF, ACC/AHH, family medicine, cardiology, primary care

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