Podcast 845: Hyperkalemic Cardiac Arrest
Emergency Medical Minute
by Emergency Medical Minute
2w ago
Contributor: Aaron Lessen, MD Educational Pearls: Hyperkalemia may cause cardiac arrest  Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including high-quality CPR, defibrillation if appropriate, and resuscitation medications  Administer calcium products to stabilize cardiac membrane and potassium shifting medications  If ROSC is achieved, initiate dialysis  There are several case reports of patients being dialyzed while CPR is ongoing, with some success   Dialysis during resuscitation may be an appropriat ..read more
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Podcast 844: Dental Infections
Emergency Medical Minute
by Emergency Medical Minute
2w ago
Contributor: Meghan Hurley, MD Educational Pearls: Educational Pearls: Dental infections can be categorized into two main groups Infections of the gums Pericoronitis Tooth eruption leading to inflammation/irritation Can progress to an infection Requires pain control, no antibiotics Gingivitis Inflammation of the gums Can lead to an infection requiring antibiotics Abscess (gums) If an infection develops in the gums it can progress to an abscess May require drainage Acute necrotizing ulcerative gingivitis (ANUG) aka Trench Mouth Filmy, grayish discoloration of the gums with “p ..read more
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Podcast 843: Commotio Cordis
Emergency Medical Minute
by Emergency Medical Minute
2w ago
Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest  A national registry, US Commotio Cordis Registry, reports an average of 10-20 cases annually  95% of reported cases occur in males, indicating possible genetic component  Average age of patient in registry is 15  Most cases occur during sporting events (baseball in particular), in addition to physical altercations and industrial accidents  Treatment is high quality CPR and early defibrillation  Survival rate is ..read more
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Podcast 841: History of Wound Care
Emergency Medical Minute
by Emergency Medical Minute
3w ago
Contributor: Aaron Lessen, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided properties of being antimicrobial, absorption and moisturization, respectively  Ancient Greeks irrigated wounds with clean water and applied wine and vinegar  One of the first synthetic topical antimicrobials was a dye researched by scientist Gerhard Domagk and later produced by Bayer under the name Prontosil  Some current wound care methods include wet-to-dry dressings, Dankin’s So ..read more
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Podcast 840: Abnormal Pediatric Vitals at Discharge
Emergency Medical Minute
by Emergency Medical Minute
1M ago
Contributor: Aaron Lessen, MD Educational Pearls: Pediatric patients frequently have vital signs considered abnormal for age at discharge Large multicenter study recently evaluated if pediatric patients discharged with abnormal vital signs have worse outcomes  97,824 pediatric discharges were included in the study 18.1% were discharged with vitals considered abnormal for age No significant difference in readmission rates at 48 hours (2.28% in abnormal cohort vs. 2.45% in normal cohort) No significant adverse outcomes in those discharged with abnormal vital signs (4 total PICU admission ..read more
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Podcast 839: Causes of Pancreatitis
Emergency Medical Minute
by Emergency Medical Minute
1M ago
Contributor: Travis Barlock, MD Educational Pearls: The causes of pancreatitis can be remembered with the mnemonic: “GET SMASHED”  G: Gallstones (Most common cause of pancreatitis overall)  E: Ethanol (Alcohol consumption is the most common cause of chronic pancreatitis) T: Trauma  S: Steroids M: Malignancy A: Autoimmune  S: Scorpion Sting H: Hypertryglyceridemia  E: ERCP D: Drugs (e.g. Valproate, Antiretrovirals)    References Beyer G, Habtezion A, Werner J, Lerch MM, Mayerle J. Chronic pancreatitis. Lancet. 2020;396(10249):499-512. doi:10.1016/S0140-6 ..read more
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Podcast 838: Sternoclavicular Septic Arthritis
Emergency Medical Minute
by Emergency Medical Minute
1M ago
Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis of the sternoclavicular joint is uncommon accounting for ..read more
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Podcast 837: Snakebites
Emergency Medical Minute
by Emergency Medical Minute
1M ago
Contributor: Meghan Hurley, MD Educational Pearls: Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae In prehospital setting, elevate the bitten extremity and transport to hospital immediately Do not attempt interventions with the bite site  Monitor for progression of swelling past any joint line, systemic symptoms or lab abnormalities for 8-12 hours  Symptoms may present up to hours after bite   Crotalinae venom has heme toxicity and may present with lab pattern of DIC  Treatment for all symptoms is antiveno ..read more
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Podcast 836: Humming to get EJ
Emergency Medical Minute
by Emergency Medical Minute
1M ago
Contributor: Jared Scott, MD Educational Pearls: Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg’s position and Valsalva’s maneuver by patient  One study compared ultrasound visualization of cross sections of EJ and common femoral vein at baseline and with patients in Trendelenburg's position, Valsalva's maneuver, and while humming The study found all three conditions distended the veins from baseline, but there was no significant difference in diameter between the conditions   Humming may be a viable technique in distended EJ for ..read more
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Podcast 834: Peds Buckle Fractures
Emergency Medical Minute
by Emergency Medical Minute
2M ago
Contributor: Aaron Lessen, MD Educational Pearls: Torus (Buckle) fractures are a commonly encountered pediatric fracture pattern Typically presents as wrist pain secondary to a child falling on outstretched hand One edge of the bone “buckles” or bends because children’s bones are softer and more pliable Management Older studies have shown that short term immobilization with a velcro splint and primary care follow up is sufficient Recent randomized trial compared immobilization with Velcro splint with as needed wrist support using a gauze wrap No significant differences noted in outcomes ..read more
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