14 episodes

Founded and created by Dr. Ankur Verma, The DESI EM PROJECT is an endeavour to bring before you discussions on everything emergency medicine, daily EM work, cases, myths, dogmas, concepts, evidence based approaches, conferences, and much more. We would also be focusing on the Indian emergency medicine scenario. EM guests from India and across the globe would be invited to chat with regarding EM in India. This is the 1st Emergency Medicine podcast coming from India. You can DM me on twitter with suggestions and feedbacks - @anksv25

THE DESI EM PROJECT Ankur Verma

    • Health & Fitness
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Founded and created by Dr. Ankur Verma, The DESI EM PROJECT is an endeavour to bring before you discussions on everything emergency medicine, daily EM work, cases, myths, dogmas, concepts, evidence based approaches, conferences, and much more. We would also be focusing on the Indian emergency medicine scenario. EM guests from India and across the globe would be invited to chat with regarding EM in India. This is the 1st Emergency Medicine podcast coming from India. You can DM me on twitter with suggestions and feedbacks - @anksv25

    DESI EM PROJECT - EPISODE 14 - THE ONE WITH "THE PHYSIOLOGICALLY DIFFICULT AIRWAY"

    DESI EM PROJECT - EPISODE 14 - THE ONE WITH "THE PHYSIOLOGICALLY DIFFICULT AIRWAY"

    A very Happy Doctors' Day to you all! In this episode I discuss some salient points regarding the physiologically difficult airway. There are many physicians I know who are still not aware regarding this concept that can kill patients as soon as we try and save them. Also - EZECON is being organised in Kolkata from 16-17th July,22 and it is going to be an academic feast for the residents. So do register for it. 

    The references for reading up more on the physiologically difficult airways are as follows - 

    1. Mosier JM, Joshi R, Hypes C, Pacheco G, Valenzuela T, Sakles JC. The Physiologically Difficult Airway. West J Emerg Med. 2015 Dec;16(7):1109-17. doi: 10.5811/westjem.2015.8.27467. Epub 2015 Dec 8. PMID: 26759664; PMCID: PMC4703154.

    2. Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559.

    3. https://www.acepnow.com/article/crash-a-mnemonic-for-the-physiological-difficult-airway/

    4. Myatra SN, Divatia JV, Brewster DJ. The physiologically difficult airway: an emerging concept. Curr Opin Anaesthesiol. 2022 Apr 1;35(2):115-121. doi: 10.1097/ACO.0000000000001102. PMID: 35165233.

    5. Cai SR, Sandhu MRS, Gruenbaum SE, Rosenblatt WH, Gruenbaum BF. Airway Management in an Anatomically and Physiologically Difficult Airway. Cureus. 2020 Sep 24;12(9):e10638. doi: 10.7759/cureus.10638. PMID: 33123451; PMCID: PMC7584327.

    6. Kornas RL, Owyang CG, Sakles JC, Foley LJ, Mosier JM; Society for Airway Management’s Special Projects Committee. Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesth Analg. 2021 Feb 1;132(2):395-405. doi: 10.1213/ANE.0000000000005233. PMID: 33060492.

    7. Mosier, Jarrod M. “Physiologically Difficult Airway in Critically Ill Patients: Winning the Race between Haemoglobin Desaturation and Tracheal Intubation.” British Journal of Anaesthesia 125, no. 1 (July 2020): e1–4. https://doi.org/10.1016/j.bja.2019.12.001.

    8. Scott Weingart, MD FCCM. EMCrit 325 – The Hypoxemic Difficult Airway and Preox Discussion with Jarrod Mosier. EMCrit Blog. Published on June 5, 2022. Accessed on June 30th 2022. Available at [https://emcrit.org/emcrit/hypoxemic-difficult-airway/ ].

    9. Salim Rezaie, "An Emergency Difficult Airway Predictor Would be From HEAVEN", REBEL EM blog, January 31, 2018. Available at: https://rebelem.com/emergency-difficult-airway-predictor-heaven/.

    10. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/.

    11. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.

    • 9 min
    DESI EM PROJECT - EPISODE 13 - THE ONE WITH "INDIA IN MELBOURNE 2022"

    DESI EM PROJECT - EPISODE 13 - THE ONE WITH "INDIA IN MELBOURNE 2022"

    So the International Conference on Emergency Medicine 2022 is on in Melbourne. There is quite a bit of representation from India at the biggest EM conference! In today's episode, I talk about how India emergency physicians are contributing to the academic fest in Melbourne. Enjoy!

    • 8 min
    DESI EM PROJECT - EPISODE 12 - THE ONE WITH "RECOMMENDATIONS AND TRAUMA MYTHS"

    DESI EM PROJECT - EPISODE 12 - THE ONE WITH "RECOMMENDATIONS AND TRAUMA MYTHS"

    In this episode I bid farewell to my passing out residents and discuss some trauma myths like Manual in line stabilization and the use of steroids in acute spinal cord injuries. You all can go through the following articles to learn more - 

    1. Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Ann Emerg Med. 2007 Dec;50(6):653-65. doi: 10.1016/j.annemergmed.2007.05.006. Epub 2007 Aug 3. PMID: 17681642.

    2.Manoach S, Paladino L. Manual in-line stabilization for acute airway management of suspected cervical spine injury: historical review and current questions. Ann Emerg Med. 2007 Sep;50(3):236-45. doi: 10.1016/j.annemergmed.2007.01.009. Epub 2007 Mar 6. PMID: 17337093.

    3. Thiboutot F, Nicole PC, Trépanier CA, Turgeon AF, Lessard MR. Effect of manual in-line stabilization of the cervical spine in adults on the rate of difficult orotracheal intubation by direct laryngoscopy: a randomized controlled trial. Can J Anaesth. 2009 Jun;56(6):412-8. doi: 10.1007/s12630-009-9089-7. Epub 2009 Apr 24. PMID: 19396507.

    4. Kapp JP. Endotracheal intubation in patients with fractures of the cervical spine [technical note]. J Neurosurg. 1975;42:731-732.

    5. Hachen HJ. Idealized care of the acutely injured spinal cord in Switzerland. J Trauma. 1977;17:931-936

    6. Bohlman HH. Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am. 1979;61:1119-1142.

    7. Podolsky S, Baraff LJ, Simon RR, et al. Efficacy of cervical spine immobilization methods. J Trauma. 1983;23:461-465.

    8. Hugenholtz H, Cass DE, Dvorak MF, Fewer DH, Fox RJ, Izukawa DM, Lexchin J, Tuli S, Bharatwal N, Short C. High-dose methylprednisolone for acute closed spinal cord injury--only a treatment option. Can J Neurol Sci. 2002 Aug;29(3):227-35. doi: 10.1017/s0317167100001992. PMID: 12195611.

    9. Suberviola B, González-Castro A, Llorca J, Ortiz-Melón F, Miñambres E. Early complications of high-dose methylprednisolone in acute spinal cord injury patients. Injury. 2008 Jul;39(7):748-52. doi: 10.1016/j.injury.2007.12.005. Epub 2008 Jun 9. PMID: 18541241.

    10. Bracken MB, Shepard MJ, Collins WF, Holford TR, Young W, Baskin DS, Eisenberg HM, Flamm E, Leo-Summers L, Maroon J, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med. 1990 May 17;322(20):1405-11. doi: 10.1056/NEJM199005173222001. PMID: 2278545.

    11. Bracken MB, Collins WF, Freeman DF, Shepard MJ, Wagner FW, Silten RM, Hellenbrand KG, Ransohoff J, Hunt WE, Perot PL Jr, et al. Efficacy of methylprednisolone in acute spinal cord injury. JAMA. 1984 Jan 6;251(1):45-52. PMID: 6361287.

    12. Evaniew N, Noonan VK, Fallah N, Kwon BK, Rivers CS, Ahn H, Bailey CS, Christie SD, Fourney DR, Hurlbert RJ, Linassi AG, Fehlings MG, Dvorak MF; RHSCIR Network. Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Propensity Score-Matched Cohort Study from a Canadian Multi-Center Spinal Cord Injury Registry. J Neurotrauma. 2015 Nov 1;32(21):1674-83. doi: 10.1089/neu.2015.3963. Epub 2015 Jul 17. PMID: 26065706; PMCID: PMC4638202.

    • 11 min
    DESI EM PROJECT - EPISODE 11 - THE ONE WITH "MYTHS IN EMERGENCY MEDICINE PART 2"

    DESI EM PROJECT - EPISODE 11 - THE ONE WITH "MYTHS IN EMERGENCY MEDICINE PART 2"

    In this episode of myths in emergency medicine, I talk about Oxygen in STEMI patients, Epinephrine in digital anaesthesia, C- line for CVP monitoring and MILS in trauma patients. You can go through some of the following papers and decide what you want to do with your EM practice - 

    1. Stub D, Smith K, Bernard S, Nehme Z, Stephenson M, Bray JE, Cameron P, Barger B, Ellims AH, Taylor AJ, Meredith IT, Kaye DM; AVOID Investigators. Air Versus Oxygen in ST-Segment-Elevation Myocardial Infarction. Circulation. 2015 Jun 16;131(24):2143-50. doi: 10.1161/CIRCULATIONAHA.114.014494. Epub 2015 May 22. PMID: 26002889.

    2. Hofmann R, Befekadu Abebe T, Herlitz J, James SK, Erlinge D, Yndigegn T, Alfredsson J, Kellerth T, Ravn-Fischer A, Völz S, Lauermann J, Jernberg T, Lindahl B, Langenskiöld S. Routine Oxygen Therapy Does Not Improve Health-Related Quality of Life in Patients With Acute Myocardial Infarction-Insights From the Randomized DETO2X-AMI Trial. Front Cardiovasc Med. 2021 Mar 15;8:638829. doi: 10.3389/fcvm.2021.638829. PMID: 33791349; PMCID: PMC8006541.

    3. Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol. 2004 Nov;51(5):755-9. doi: 10.1016/j.jaad.2004.05.028. PMID: 15523354.

    4. Mohan, P P. “Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Epinephrine in digital nerve block.” Emergency medicine journal : EMJ vol. 24,11 (2007): 789-90. doi:10.1136/emj.2007.053793

    5. Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008 Jul;134(1):172-8. doi: 10.1378/chest.07-2331. PMID: 18628220.

    6. Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Ann Emerg Med. 2007 Dec;50(6):653-65. doi: 10.1016/j.annemergmed.2007.05.006. Epub 2007 Aug 3. PMID: 17681642.

    7. Santoni BG, Hindman BJ, Puttlitz CM, Weeks JB, Johnson N, Maktabi MA, Todd MM. Manual in-line stabilization increases pressures applied by the laryngoscope blade during direct laryngoscopy and orotracheal intubation. Anesthesiology. 2009 Jan;110(1):24-31. doi: 10.1097/ALN.0b013e318190b556. PMID: 19104166.

    8. Manoach S, Paladino L. Manual in-line stabilization for acute airway management of suspected cervical spine injury: historical review and current questions. Ann Emerg Med. 2007 Sep;50(3):236-45. doi: 10.1016/j.annemergmed.2007.01.009. Epub 2007 Mar 6. PMID: 17337093.

    9. Wiles MD. Manual in-line stabilisation during tracheal intubation: effective protection or harmful dogma? Anaesthesia. 2021 Jun;76(6):850-853. doi: 10.1111/anae.15472. PMID: 33939842.

    • 7 min
    DESI EM PROJECT - EPISODE 10 - THE ONE WITH "MYTHS IN EMERGENCY MEDICINE PART 1"

    DESI EM PROJECT - EPISODE 10 - THE ONE WITH "MYTHS IN EMERGENCY MEDICINE PART 1"

    In today's episode, I've discussed some myths that are still prevalent in emergency medicine practices across the world. They are still taught even if some clinicians do not practice it. do you own research. Don't take my word for it. Change your practice accordingly. You can go through some of the following references - 



    1. SELLICK BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet (London, England). 1961; 2(7199):404-6. PMID:13749923

    2. Birenbaum A, Hajage D, Roche S, et al. Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial. JAMA surgery. 2018; PMID:30347104

    3. Allman KG. The effect of cricoid pressure application on airway patency. Journal of clinical anesthesia. 1995; 7(3):197-9. PMID:7669308

    4. Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Annals of emergency medicine. 2007; 50(6):653-65. PMID:17681642

    5. Neilipovitz DT, Crosby ET. No evidence for decreased incidence of aspiration after rapid sequence induction. Canadian journal of anaesthesia = Journal canadien d’anesthesie. 2007; 54(9):748-64. PMID:17766743

    6. Palmer JH, Ball DR. The effect of cricoid pressure on the cricoid cartilage and vocal cords: an endoscopic study in anaesthetised patients. Anaesthesia. 2000; 55(3):263-8. PMID:10671846

    7. Byrne AL, Bennett M, Chatterji R, Symons R, Pace NL, Thomas PS. Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta-analysis. Respirology. 2014 Jan 3. PMID: 24383789.

    8. Kelly AM, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. Emerg Med J. 2001 Sep;18(5):340-2. PMID 11559602

    9. Middleton P, Kelly AM, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J. 2006 Aug;23(8):622-4. PMID16858095

    10. Klein LR, Cole JB. Ketamine: Focusing on the Facts and Forgetting the Fiction. Ann Emerg Med. 2021 Jul;78(1):132-139. doi: 10.1016/j.annemergmed.2021.03.039. PMID: 34167728.

    11. Godoy DA, Badenes R, Pelosi P, Robba C. Ketamine in acute phase of severe traumatic brain injury "an old drug for new uses?". Crit Care. 2021 Jan 6;25(1):19. doi: 10.1186/s13054-020-03452-x. PMID: 33407737; PMCID: PMC7788834.

    12. Schofer JM. Premedication during rapid sequence intubation: a necessity or waste of valuable time? Cal J Emerg Med. 2006 Dec;7(4):75-9. PMID: 20505811; PMCID: PMC2872531.

    13. Robinson N, Clancy M. In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature. Emerg Med J 200;8:453-7.

    • 9 min
    DESI EM PROJECT - EPISODE 9 - THE ONE WITH "LOW SODIUM LEVELS - HYPONATREMIA 2.0"

    DESI EM PROJECT - EPISODE 9 - THE ONE WITH "LOW SODIUM LEVELS - HYPONATREMIA 2.0"

    In today's episode, I invite Drs Sanjay and Shivani back to the show to discuss the 6 steps to manage hyponatremia in your ED in a little bit more detail. This will be a learning curve for the young (and the old) emergency physicians. Later on, I would have them back to discuss real life cases that have been managed in our department using the 6 cases. Enjoy! For any questions you can DM us on our twitter handles -  @anksv25 (Ankur), @drshivanisarda (Shivani) and @drbobby71sanjay (Sanjay) 

    • 14 min

Customer Reviews

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puneet99914 ,

Great podcast for everyone! Eye opener!

Dr Ankur Verma beautifully unravels the mystery of emergency medicine for his listeners. Very engaging conversations and great learning for everyone. Knowing what to do in an emergency should be a human right and this podcast brings us closer to exercising that right! Highly recommended!

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