November 30, 2019 @ 10:40 am

November 2019 - Celebrating Dr. Peter Rosen

Happy November everyone!

We hope your Thanksgiving was wonderful, that your time off was long and your shifts were short.

This month we celebrate Dr. Peter Rosen who passed away earlier this month. Dr. Rosen was a great friend to our little podcast. Many organizations and institutions around the country will be memorializing him over the next several months and we would like to contribute our thanks as well. Please enjoy some excerpts from previous interviews with Dr. Rosen on this month’s episode.

I hope his wisdom and love for EM will continue to inspire others for years to come. Of all the quotable lines from Peter, my favorite and the one that best encompasses his passion for EM and the people he mentored is how he signed every email. 

“Love, Peter.” 

The AZEMCast Team 

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October 28, 2019 @ 2:44 pm

October 2019 - Safety and Procedural Sedation

Happy October everyone!

You know the EM stereotype about adrenaline junkies who love taking risks and shooting from the hip? Apparently, that kind of behavior can get you in trouble. Who knew? And when it comes to procedural sedation, it can get your patient in trouble. Safety is a huge concern with ED procedural sedation because it's easy to put a patient to sleep. The hard part is making sure they wake up.

Several years ago ACEP came out with a clinical policy on procedural sedation to ensure that we not only keep our privilege to do sedation but that we show we can do it right. So this month, we comb through that policy and tell you everything you need to be certain you are prepped and ready to sedate.

The AZEMCast Team 

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September 30, 2019 @ 4:01 pm

September 2019 - Intro to Procedural Sedation

Happy September everyone!

As the days get shorter and pumpkin spice infiltrates every part of our lives, we decided to talk about the closest thing we get to do in the ED to be master bakers and chefs: procedural sedation. A cup of propofol, a dollop of ketamine and a pinch of fentanyl all added to a heavy base of pre-procedure safety checklists is the perfect receipt for a happy, sleepy patient who will never remember the awful things we discussed regarding abscesses over the summer. Sedations are fun if done well. Done poorly, they're like pumpkin-spiced Spam (real product, can't make this stuff up).

So we're starting from the beginning with the why, the who and the how on procedural sedation in the ED.

The AZEMCast Team 

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August 31, 2019 @ 10:59 am

August 2019 - Cutaneous Abscesses - Part 2

Happy August everyone!

We left off last month’s saga of purulence with an epic cliff hangar. Why do we try so many methods to get the pus out when cold, hard steel works best? PAIN! These things hurt! It’s the pain inflicted that makes use go from watching Dr. Pimple Popper in our spare time to picking up as many abdominal pains as possible to avoid the abscess I&D. So this month we end our series on abscesses with a discussion of how to get the pain controlled. I don’t have the best answer to this, but fortunately, we have several smarted and more experienced people who can give you their best advice on how to get the pus out and still feel like a decent human being afterwards. Plus our peer review on the entire series by UA alumnus Dr. Grant Roper so you can see how much we are consistent with the community and how much we are blowing smoke.

The AZEMCast Team

Peer Review by Dr. Grant Roper

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July 31, 2019 @ 11:31 am

July 2019 - Cutaneous Abscesses - Part 1

Happy July everyone!

First off, welcome to the new interns here and around the country. This podcast is intended to be a supplement to your education and by NO MEANS is it enough to train you how to be a good doctor. Instead we hope to teach you the ways of evidence-based emergency medicine in a way that is practical and applicable to your next shift.

Fortunately interns, you missed missed a rousing discussion on pilonidal and bartholin gland abscesses! But have no fear for there is still plenty of pus to discuss. This month we tackle the ins and outs of cutaneous abscesses or as they’re better known in the ED, “spider bites.” Not sure what poor spiders did to be confused with these awful boils. At any rate, these things are painful and full of purulent badness and it’s our job to get it out. This month we’ll discuss the good, the bad and the ugly methods of getting the pus out leading to a cliffhanger ending of what works best!

To be continued . . .

The AZEMCast Team

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June 30, 2019 @ 6:46 pm

June 2019 - “Special” Abscesses

Happy June everyone!

June is the end of an era for us in academics. We say goodbye to our seniors and welcome another crop of interns to the fold. To our seniors, thank you for your exceptional work over the years. We are proud to have worked with you and are excited to see what you accomplish in your careers. To our interns, welcome to the family. We are eager to work with you and see you transform into amazing emergency physicians.

Ok, enough of the sappy melodrama, on to the pus. And not just any pus, this month we focus on the pus that dare not speak its name. The pus down below. Butt pus. From pilonidal cysts to perianal abscesses to bartholin gland abscesses, we cover the down and dirty of how to care for some serious infection in sensitive areas. We even sometimes manage to do it with a straight face and a professional demeanor! So strap on your face shields and breathe through your mouth for this month's episode of AZEMCast.

The AZEMCast Team


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May 31, 2019 @ 10:56 pm

May 2019 - Febrile Neonates Part 2

Happy May everyone!

We conclude our saga of 90’s EBM nostalgia with a look at the recent PECARN article that proposes a new method for the evaluation of the febrile neonate. Dr. Chan Lowe and I continue the discussion with a deep dive into the study and a deep discussion of what it means for clinical practice. They always say you never want to be the first or the last to adopt new evidence into your practice. But this is a truly unique situation where a decades old paradigm of EM and pediatric practice is really made anew. Now that it’s out there, what are you going to do about it?
This and more on this month's AZEMCast.
The AZEMCast Team
Peer Review by Dr. Anna McFarlin
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April 28, 2019 @ 4:43 pm

April 2019 - Neonatal Fever - Part 1

Happy April everyone!

We interrupt our series of Skin and Soft Tissue Infections (right before the pus starts!) to bring you a timely review of neonatal fever. There is some great, exciting new research coming on our evaluation of febrile neonates to help us do the most for these kids with less. This is field that has had multiple breakthroughs in treatment but few changes in the evaluation for almost 25 years! 
But before we bring out the new, we need a brief history lesson on why febrile neonates are traditionally so scary. Dr. Chan Lowe, Pediatrics hospitalist extraordinaire, joins us for a discussion of why we do the blood-urine-csf-antibiotics-admit dance for all these febrile neonates when most of them are viruses. 
So, grab your hyper-color T-shirt and your Gameboy as we travel back to the 90’s to learn why you should take proceed with caution with febrile neonates.
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March 26, 2019 @ 6:11 pm

March 2019 - Skin and Soft Tissue Infections Part 2

Happy March everyone!

Did you listen to the last episode and say to yourself, “Wow, thanks for the great education on identifying SSTIs but you never told me what to do with them! So now I have an ED full of boarded SSTIs because it’s taken you a month to publish the part two on treatment and management!!!”
Ok, probably not, but it’s still worth a listen to this month’s episode on the treatment of SSTIs. In it, we highlight a great example of when guidelines clash with evidence and we decide to do whatever we want anyway. Are you a cephalexin fan or maybe you’re more a clindamycin aficionado. We pit the therapies against the evidence to help provide you the options you need to care for your patients.
So, empower yourselves with some knowledge and send your patients home with the right antibiotics and, more importantly, the right discharge instructions and return precautions. 
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February 28, 2019 @ 11:24 pm

February 2019 - Skin and Soft Tissue Infections Part 1

Happy February everyone!

First, congrats to the residents who just finished their in-training exam!  
Second, the four words every healthcare provider fears: Does this look infected? Is it oozing? Are you gonna send me a picture? Skin and soft tissue infections are a common complaint from patients and co-workers alike (ahem, Ryan) but it never looks like it does in the book. That’s why we have thrown out the book (doesn’t translate well on an audio podcast anyway) and gathered a panel of experts to discuss the diagnosis of the ITIS. With our typical AZEMCast taste and decorum, we discuss the fun part of staring at a stranger’s red skin and making a gues . . . I mean, diagnosis.


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