Total Em - Tools Of The Trade And Academic Learning In Emergency Medicine

Acutely decompensated CHF can be a highly dangerous condition and one that needs immediate management.  Previous Resuscitation Leadership Academy (RLA) student Michelle Perkins comes on for her debut to discuss management of this condition.

This week's podcast is all about hypertension. Like a previous podcast, #13 on abscess management, this podcast is in response to a recent Skeptic's Guide to Emergency Medicine (SGEM) post that TOTAL EM was featured on. We want to add to that discussion by expanding on clinically important hypertension in the emergency department. This primer will most likely only be the start to future discussions on deeper reviews about hypertension that we need to be concerned about in emergencies.

We are back for our first ever trio podcast!  We have two previous PA guests, Patrick Bafuma and Frank Norman, to discuss a new paper regarding dyspnea and POCUS.  At this time, the paper has not received much publicity but we agreed it was important to cover.  Like our last podcast, this one is a bit longer but it is well worth your time so please look over the blog and listen to the podcast.  A quick apology though as to the audio quality, especially in the second half.  Due to a technical issue, it could not be refined to the same extent but it is still worth the listen.

Kris Maday is back for another podcast which is also available at the PAINE Podcast this time to discuss complications of chemotherapy.  We review some of the most common conditions that also possess a risk to be life threatening for those fighting cancer.  Since chemotherapy is designed to kill rogue cancer cells (some by sniper, some by nuke), there is bound to be collateral damage.  The detailed show notes provided are in large part from Kris Maday's review of the literature.

Reading the title you may be concerned that this interview is broken up into multiple parts but fear not for this is a new series we are starting!  Greg Schmor, a critical care paramedic in Canada is our first guest in a series of podcasts that we plan to have on Rural Mass Casualty Incidents (MCIs).  In any system, MCIs are a challenge but there are unique difficulties that are seen in the rural/remote environment or at least are exacerbated by such an environment.  This series can be of benefit for anyone who may become involved in MCIs but we focus especially on those in the rural and remote settings.

It may feel like we have been talking about a lot on imaging recently, but in emergency medicine, we do a lot of imaging!  More specifically, CTs are a cornerstone in the emergency department and contrast is frequently used.  However, there have been concerns about the use of contrast in higher risk populations which we have also discussed before.  In patients at higher risk, is prophylactic hydration beneficial?  We discuss that on today's podcast with a new randomized control trial.

We have Frank Norman back on the podcast to talk a little more about the Society of Physician Assistants in Clinical Ultrasound (SPACUS) but also to discuss integrating an ultrasound program into an already busy PA school curriculum or getting it into the work place.  Especially in rural or remote settings, this can be a significant challenge, but we cover it in today's podcast.

Frank Norman joins the podcast today to discuss the Society of Physician Assistants in Clinical Ultrasound (SPACUS) and point of care ultrasound (POCUS) competency.  The conversation also includes teasing out competency versus certification.  Listening to this podcast is great not only for those who are new to ultrasound but also for those with experience and looking to help out others interested in POCUS.

With Physician Assistants (PAs) starting to celebrate 50 years of the profession, there is still debate as to the quality of care provided by PAs. There have been studies on the topic, but very little in the field of emergency medicine and the paper we discuss today helps address this issue. Today with our guest Patrick Bafuma we tackle that very question along with a discussion of PAs in emergency medicine in general.

Contrast has been hotly debated in the radiology and emergency medicine world.  Many of these contrast medications have demonstrated safety and efficacy.  However, a deep dive has been sorely needed on this subject and with recent relevant papers over the last year this felt like the right time.  Joined by Dr. Paul Schunk, we explore the mysteries and evidence that exists for contrast safety in CTs for acute kidney injury and contrast induced nephropathy.

Soft collars are being supported more with a growing body of literature.  There is growing support for the change from semi-rigid (hard) collars to soft collars by a number of organizations, especially prehospital, in nations such as Australia.  After our initial primer podcast on this subject, we review some of the finer points to this debate on this podcast.  Details on the pros and cons are mentioned more extensively in the podcast itself so take a listen.

How have you taken ACLS?  Most of us will have taken a course in person but what if you are not able to do the course in person before your license expires?  Do you take an online course and if so which one?  In this podcast we review one option, HeartCode ACLS, and discuss the pros/cons of the course.  As always, there is nothing to disclose as any of the courses and organizations mentioned do not have any financial ties with this author.

To some, the rightful place for a rigid cervical collar is in a trash bin, but is it really that easy?  Parts of Australia seem to think so and have made a hard push in that direction.  To prepare us for the debate, this podcast is devoted to an introduction of the issue.  A primer if you will.  Minh Le Cong helps explain more in the podcast.

Dexamethasone is commonly used in the treatment of asthma exacerbations both in adults and children. It is growing popularity with new research that supports its role over traditional alternatives such as prednisone. One key difference is its longer lasting effect. However, this new paper demonstrates some potential limitations as discussed in this review.

Although a lot good and bad has happened around the world in 2016, this year marked the first year for TOTAL EM.  This project has been beneficial for many and continues to get very positive feedback.  The message continues though and this podcast talks about the past year along with the future of this podcast.

Fritz Fuller, PA-C is back for another great podcast this time for our inaugural Rural Rants which features a discussion on night shift as well as early adopters.  With Rural Rants we talk about the unconventional or at least approach it in a way that many do not want to talk about in your traditional academic setting.  Not only do we rant though, but we come up with ways to improve and develop solutions.

We have had many recent firsts on the podcast, and this is the first of two new concepts coming up with a new regular guest, Fritz Fuller.  Fritz is a PA practicing in emergency medicine.  He plans on coming on regularly for such discussions as these "Tales from the Holler" as well as "Rural Rants" which will be our next type of new podcast.  Until next week, enjoy this first episode of "Tales from the Holler."

Rule out criteria can be our biggest friends or our worst enemies depending on how we use them.  They are not perfect, but can save us from a lot of over-testing.  In this blog and podcast, we talk about the good and the bad along with how to use rule out criteria appropriately.

Anaphylaxis is a life-threatening condition.  It needs to be identified quickly and treated appropriately to save a patient's life.  Today marks our first ever "Patient and Provider" podcast.  This means that although the podcast itself is still meant to provide more of the basics, the blog will also be helping educate patients in the relevant condition.  Check both the blog and the podcast for all the details.

Sometimes we have to go back to the basics.  Airway management has its many advanced methods but with all the great FOAMed out there, very little of it covers the basic approach.  We wish to remedy this with guest Kris Maday, PA-C.  He is another PA with a podcast.  His is called the PAINE Podcast and can be easily found.