April 29, 2018 @ 11:03 pm

April 2018 - Cervical Spine Injury - Part 1

Happy April everyone!

This month we are getting back to the nitty gritty science of emergency medicine. Something everyone loves to talk about, worry about and argue about: the cervical spine. That’s right, a topic so important that it’s not even part of the ABC’s of trauma management because it is assumed you already took care of it! We will cover everything from assessment to management, imaging to NOT imaging, cervical collars to towel rolls and most everything in between. We have SOO much stuff to cover that we had to break the podcast in two . . . sorry, FRACTURE the podcast in two with our peer review by another great UofA community alumnus. 

So give yourself a hug and squeeze your butt cheeks as we log roll you into this month’s episode of AZEMCast on cervical spine injury.  
 

The AZEMCast team

Peer Review coming next month
 
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March 31, 2018 @ 10:39 pm

March 2018 - ED Flow

Happy March Everyone!

Have you found your mojo in the ED yet? Things seems to be clicking along, you can anticipate your labs, get your patients dispo-ed and still have time to go to the bathroom! Enjoy the luxury of the spring while you can because the times they are a-changing. Come July, the well-oiled machine you have developed will have a monkey wrench thrown into it as everyones moves on to the next phase of training and life. So as you progress to junior, senior or attending (or the incredible nurses and medics that have to deal with our crazy transitions), we want you to be the best you can for your patients and your sanity. 

This month we take a break from the science of medicine and get practical in our discussion of managing ED flow. Take the tips you can and beware of flying turkeys!

 

The AZEMCast team

Peer Review by Dr. Amol Desai
 
Twitter: @arizonaemcast
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February 26, 2018 @ 11:42 pm

February 2018 - Influenza

Happy February everyone!

Flu season is in full effect . . . and has been for quite a while. Long enough for us to put together a lengthy discussion on the diagnosis and management of your favorite wintertime ailment. But this is more than just a review of the literature. Brian Drummond takes deep dive into the Mariana Trench of oseltamivir and where the recommendations for this drug have come from.

 

Summer come quickly . . . 

 

The AZEMCast team

Peer Review by Dr. Kathy Hiller
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February 1, 2018 @ 12:36 am

January 2018 - Renal/GU Board Review

 

Happy 2018 everyone!

Some of you are very disappointed NOT to see an episode on influenza but don't worry it's coming. Before we do that we need to pack our residents' brains with as much information as possible before their exam next month. So we have th next best thing: Brian and I talking about kidneys and genitalia! In preparation for the EM resident in-training exam, we give you a survey of all things renal, genital and urinaty that you may encounter in the ED, but even more concerning, on your test!

Happy studying!

The AZEMCast Team

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December 31, 2017 @ 8:21 pm

December 2017 - International Emergency Care

Happy December Everyone (Even though it'll be 2018 by the time anyone listens to this)!

 

I recently had a great discussion with on international emergency care with Dr. Joseph Kalanzi and Dr. Brad Dreifuss on Dr. Kalanzi's personal experiences in creating an Emergency System in Uganda. Fortunately, the microphone in my office is always on (spooky, I know). It was a very interesting discussion on the evolution of emergency care in developing countries and our role as Western healthcare providers when we volunteer our time. So using Uganda as an example we hope to convey how individual countries will define their own needs and how we as US emergency providers can support them in that endeavor. 

Happy New Year,

The AZEMCast

Peer Review by Dr. Chris Williams
 
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November 28, 2017 @ 7:30 pm

November 2017 - Pediatric Minor Head Injury

Happy November Everyone!

 
Now that the tryptophan has worn off from Thanksgiving, it’s time to have some PECARN pie (not a typo, just a bad pun) and discuss Pediatric Head Trauma. Head bonks are to children what  . . . youth is to children. It happens all day, every day and it’s your job to distinguish between the worried well and the walking time bombs. The good news is most all medical providers know about the landmark PECARN head injury decision rule to help you risk stratify these patients. The bad news is that our patients’ parents are usually not medical providers and have centuries of folklore and medical mythology telling them their child will die without a CT scan. 
 
So how do you use PECARN correctly? What do you do with the intermediate risk patients? And how do you reassure the parents that what you are saying is true?
 
Excellent questions that we intend to answer on this month’s episode of AZEMCast! 
 
The AZEMCast Team
 
Peer Review by Dr. Ilene Claudius
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October 13, 2017 @ 11:50 am

October 2017 - Health Care Policy 2 - The Peer Review

Happy October everyone!

Health care policy strikes back for part 2 of our discussion . . . now with actual experience and knowledge of the subject matter!!!

We knew we had stepped out of our comfort zone a bit last month but felt it was important to cover this topic, in spite of our limited experience or knowledge. We are very fortunate to have Dr. Seth Trueger from University of Chicago and Dr. Arthur Smolensky from the University of Tennessee who have both of those. And they don’t mind disagreeing with us or outright correcting us on points that truly matter. The peer review is an important part of what we do, which is why we dedicated this entire episode to polishing out the rough edges from the episode. 
 
Thanks Arthur and Seth!

The AZEMCast Team

Twitter: @arizonaemcast
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September 30, 2017 @ 1:10 pm

September 2017 - Health Care Policy

Happy September everyone!

Here in Tucson, the air is thick with pumpkin spiced lattes, influenza and tension over health care policy decisions. Jarrod had the bright idea to discuss healthcare policy which I fought tooth and nail  . . . until I realized that I was being an ignorant coward and avoiding an incredibly important topic that affects us all.

Couple of ground rules: 

1) Our aim is to DEFINE 10 healthcare policy terms that we felt were important for all EM docs to know

2) We did our best to remain impartial and leave our personal opinons out of this.

3) We failed horribly at goal #2. While there is some evidence that we cite and some Turkey's flocking about, there is a TON of opinion, presumption and guessing throughout the episode.

Fortunately we have TWO peer reviewers with opposite opinions about health care policy and whether or not our podcast is any good. They will be on next month because they had so much to offer that we split it into its own episode. They did both agree that this is an important topic that most providers get very little training on so I hope we can at least start a converstaion which they can steer in the right direction next month.

Listen, but take each word with a pound of salt and look into these terms and how they affect you and your patients.

The AZEMCast Team

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August 30, 2017 @ 11:13 pm

August 2017 - NIPPV

Happy August Everyone!

 
The ED is full of fun technology: ultrasounds, video laryngoscopes, the Playstation that’s supposed to be “just for sick children.” But there’s a whole group of toys that ED docs need to know how to work: the bipap vent and high flow nasal cannula. These toys can help optimize your airway before intubation or even replace intubation all together, in the right circumstance. But what are those right circumstances? Who is at risk failure? Can’t I just do whatever the respiratory therapists tells me to do? Never fear, Dr. Jarrod Mosier is here to explain how these new-fangled machines work and who you should be using them on. 
 
Don’t forget to take your screen shots and read up!
 
The AZEMCast Team
 
Peer Review by Dr. Raj Joshi and Dr. Ian Butler
 
Twitter: @arizonaemcast
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July 31, 2017 @ 12:03 pm

July 2017- Chronic Pain in the ED

Happy July everyone!
 
We thought we’d start off the new year with an exciting and high acuity condition . . . chronic pain! 
 
Ok, I know it’s not the sexiest thing we do in the ED but it’s incredibly important to figure out how you’re going to manage this daily issue. To say that the practice variation is broad is an understatement. Some people bleed opioids while others keep a vice grip on the script pad. Whoever you are and however you decide to practice, an evidence-based and consistent approach to chronic pain is important. We are joined this month by Dr. Howard Roemer, an EM doc who now seeks to mitigate this issue as the medical director for Cenpatico behavioral health here in Tucson. He has some interesting experience and ideas on how to help this issue and how to help us as providers in the ED. 
 
While listening to this discussion I encourage you to separate in your mind the  chronic pain patient from the drug seeking patient, although I admit this can be tough to do. Don’t forget to take your screen shots and read up!

The AZEMCast Team

Peer Review by Dr. Amol Desai
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