Let’s Talk Nerdy: 5 papers you need to know.

Welcome back to the blog site!  It’s summer and it feels hotter than the surface of the sun again,  so I hope you’re finding ways to beat the heat and enjoy the upcoming holiday. I’m happy to have another production completed for you, and this time it’s all about critical care topics.

This discussion focuses on five important papers that have been published in the last few months, and that will have an immediate impact on your practice when you go in for your next shift.  Our topics this time around include drugs and airway management for cardiac arrest, administration of vasopressors via a peripheral IV for shock, and a discussion of blood pressure management in patients with acute intracerebral hemorrhage.  If you want an hour of CME, just click on the link above to get to the CME quiz page.  I promise that it’s relatively painless.  🙂

If you are interested in any of the papers,  feel free to contact me and I will gladly send you the paper to read.  Have a happy summer!

 

A Potpourri of Papers to Improve your Practice

Hello, and happy new year!  I apologize that this latest post has taken so long to come out; between technical difficulties with new recording hardware and a family illness, it took longer than expected to get this one edited and published.  But I hope you enjoy this month’s video as much as I enjoyed producing it for you.

Rather than doing a deep dive into one topic, I thought it would be fun to change things up a bit and make this post a bit more of a mix of topics; hence the “potpourri” of papers.  There are some really important papers included in here, like the PATCH trial reviewing the evidence for platelet transfusion for intracranial hemorrhage, and the recent ALPS trial: a NEJM paper on antiarrhythmics in cardiac arrest.

If you’d like to go into greater depth on any of these topics, here are some great links to get you started:

http://rebelem.com/patch-trial-hold-platelets-spontaneous-intracerebral-hemorrhage/

http://www.emlitofnote.com/?p=3144

https://emergencymedicinecases.com/amiodarone-vs-lidocaine-vs-placebo-alps-trial/

http://rebelem.com/alps/

As always, there is a CME quiz that you can get to by following the link above.  And please leave me feedback so I can continue to bring you the clinical knowledge you need!

The Difficult Airway: Updated

Hello, and Happy fall!  Welcome back to the blog for some more Emergency Medicine goodness.  I hope you are all safe and well, and enjoying the cooler fall weather that has finally arrived.

This month’s topic focuses on one of the cornerstone skills of Emergency Medicine: Airway Management.  And specifically, what do you do do and how do you prepare to manage the anticipated (and unanticipated) difficult airway scenario?  While we could talk about this for hours . . . or days . . . and still not cover every possible scenario, this talk is designed more to help you develop a mental framework for management of the difficult airway with a more structured and controlled approach.

Since it would be impossible to cover all the topics we’ll touch on in enough depth without making the presentation six hours long, here are some additional resources we mention in the discussion for your reference and further perusal:

The 2015 Difficult Airway Society Guidelines: das-2015-guidelines

Delayed Sequence Intubation: A Prospective, Observational Trial: dsi

Links to the debate over Video laryngoscopy vs Direct laryngoscopy:
EMCrit blog post: Has video laryngoscopy killed direct laryngoscopy?
Life in the Fast Lane Blog: Video vs. Direct Laryngoscopy
R.E.B.E.L EM Blog: Video vs Direct Laryngoscopy for trainees

And as always, please feel free to post comments and leave feedback.  Thanks, and have a happy Halloween!

Sepsis 3.0: The good, the bad, and the . . . different

Hi everybody!  It’s great to be back with you again.  It’s been too long between posts again . . . somehow life and work are always there to keep me from getting to this like I should.  You’d think that I would know by now that these always take longer to produce than I think they will.  I’m sorry for the wait.  🙂

This month’s topic is sepsis 3.0 . . . it’s a little discussion about the new definition of sepsis that was published in JAMA this spring.  I think there’s both some good and some bad in the new definition, so I thought it would be a good topic to talk about.   And as always, please feel free to post comments, leave feedback, or start a discussion in the comments section.  There is a link to a CME quiz at the top of the page, and this talk is good for an hour of AMA category 1 CME!

AS you might imagine, sepsis is a complicated topic, and there is no way to do it justice in one 40 minute talk.  There are some great resources out there, and here are some links to some of the resources I used when I was just starting to do my research for this discussion:

R.E.B.E.L. EM: http://rebelem.com/sepsis-3-0/

EMCrit blog: http://emcrit.org/podcasts/sepsis-3/ and http://emcrit.org/wee/wee-cliff-deutschman-additional-thoughts-sepsis-3-0/

PulmCrit blog: http://emcrit.org/pulmcrit/problems-sepsis-3-definition/

Transfusion: Is Less More?

Hello, and happy spring!  It’s great to be back with you again this month.  I apologize that this is coming out a little bit later than planned, but between cold and flu season and a few technical difficulties, it took a little bit longer for some of the processing to happen than expected.  This month’s talk is on transfusion . . . . I know, it’s not the most sexy topic in the world.  But we do a lot of transfusions in the ED, so it’s something we need to dust off and look at from time to time – especially now that the new guidelines have come out with some new changes.  This one is a pretty quick view, so please enjoy this months video blog  . . . and as always, please feel free too leave feedback or comments!

Stuff you learned that’s just plain wrong

Hey folks, and happy new year!  I’m happy to be posting again, and wishing all of you a happy, safe, and healthy 2016.  This month’s talk is another one of my favorite things to post about . . . we’re busting some more medical myths this month.  These myths all have something in common: they’re all imaging-related myths.  So sit back, and let’s get to more medical mythbusting!  And as always, please feel free to leave comments or feedback.

8 Awesome Critical Care Papers

It’s been a while since I’ve posted anything to the site, but I wanted to get this up in time to wish you all a very happy holiday season!   It’s going up a little later in the month than intended, largely due to a virus that decided to set up shop in my larynx for a week.  There are a few comments from the peanut gallery (my 7-month-old kitten) in the audio, so I apologize for the occasional meows.

I just got back from ACEP a few weeks ago, and I wanted to share some of the great stuff that has just come out in the literature regarding the management of the critically ill patient in the ED.  So I picked 8 of the papers that I thought you could all apply immediately to your practice, so please enjoy!  As always, please feel free to leave thoughts or feedback, and if you’d like to get an hour of CME for watching this, go get the CME quiz from the link above and send it on in.

A few shout outs this month . . . for the great Christmas tune, the group is the very talented Straight no Chaser, a professional men’s a cappella group that started out at my own Indiana University.  And for his fantastic ED critical care blog and podcast, Dr Scott Weingart.  I highly recommend his podcast, and there is a link to the EMCrit site in the “Useful EM links” below.  But here is a link to the podcast on DSI: http://emcrit.org/dsi/

Choosing Wisely 2.0 (Part 2)

Hi folks!  I hope you’re all enjoying the summer and finding ways to escape the heat!  As promised, here is the second half of last month’s topic: an in-depth discussion of the last 3 Choosing Wisely items from the American College of Emergency Physicians.   A few folks have asked for more information about the Choosing Wisely Campaign, so I’m adding a link to the Choosing Wisely site under my list of “Useful EM Links” on the main page . . . feel free to check them out!  There are a lot of different societies that have made great recommendations that apply to our practice in the ED.  I hope you find this helpful . . . if you have any thoughts or suggestions, please leave a comment for me!   And of course, the CME quiz is also available by following the link at the top of the page.

Choosing Wisely 2.0, Part 1

Hi everybody!  I hope you’re all having a great summer, and staying cool now that the heat is upon us.  Thanks for checking in for the latest educational morsel . . . in this case, a discussion about the first 2 recommendations for Emergency Medicine from the Choosing Wisely campaign.  I apologize for being a little late publishing this for the second time in a row . . . between working shifts and an unfortunate episode of losing my voice for a couple days, I’m afraid it took longer than planned to get this posted.  There is a new CME quiz for this presentation up as well.  Please feel free to leave comments or feedback!

Updates in Anticoagulation 2015

Hi!  I apologize for the delay in publishing this presentation . . . . the plan was actually to publish this last month, but due to life, work, and technical Snafus, it was a bit later in production than I had hoped to be.  There are still one or two small audio glitches, and the audio seems to contain a few comments from a certain geriatric feline who insistently wanted attention while I was trying to produce this video.  🙂

Before we begin, I’d like to be clear that the viewpoints expressed in this presentation are my own opinions.  Feel free to disagree or leave comments.  I have no financial ties or conflicts of interest with any of the companies that make any of these drugs or products.  I just have some strong opinions, and one of those strong opinions is that I hate warfarin, and would love nothing more than to see this drug disappear from our clinical practice.    With that said, please enjoy this update!  CME is available to Dignity Health Providers, and the link to this month’s CME quiz is under the “CME Quiz” link at the top of this page.

I have also made a little “cheat sheet” for all the novel oral anticoagulant drugs, and I have uploaded it below for you to open and save.

Novel Oral Anticoagulant Cheat Sheet