Synopsis
www.tamingthesru.com - Free. Open-Access. Focused on Emergency Medicine, critical care and prehospital medicine, as well as practice algorithms and decreasing knowledge translation in Med Ed.
Episodes
-
Qi/KT - Acute Liver Failure
01/09/2023 Duration: 16minDrs. Wilson and Arnold discuss the latest research that went into their development of a protocol for managing Acute Liver Failure
-
Hunting for Invasive Bacterial Illness in Infants with a Positive UA
03/07/2023 Duration: 12minDr Marlena Wosiski-Kuhn recaps a recent journal club covering the paper by Mahajan and colleagues: Serious Bacterial Infections in Young Febrile Infants with Positive Urinalysis Results.
-
Sick or Not Sick through a Sniff - EtCO2 at Triage
11/06/2023 Duration: 09minBoarding of admitted patients in the ED and subsequent overcrowding of ED’s continues to plague hospitals in the United States and Internationally. The Covid-19 pandemic exacerbated an already growing problem regarding capacity management and patient flow. In this current climate, the Emergency Physician’s responsibilities continue to shift toward the front-end of the process, mainly patients waiting to be seen in the lobby. As such, identifying sick patients in a timely manner and utilizing additional resources to predict patients at risk of clinical deterioration will be paramount moving forward. This recap covers a paper that looks to see if EtCO2 can play a bigger and better role in the triage process
-
IV Metoprolol vs Diltiazem for A fib with Concomitant Heart Failure
22/04/2023 Duration: 09minThe management of atrial fibrillation with rapid ventricular response is often complicated by the presence of heart failure with reduced ejection fraction. The presence of HFrEF limits pharmacologic options for rate control. This podcast will cover a retrospective study looking at the use of metoprolol vs diltiazem in patients with A fib with RVR and concomitant heart failure
-
Diastolic Shock Index
30/03/2023 Duration: 13minEarly recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. Many clinical decision-making tools have been developed and validated in their use to identify and define those who are in sepsis or septic shock, as well as predict a patient’s overall risk of morbidity and mortality, including tools like the SIRS criteria and SOFA score. The diastolic blood pressure is determined by vascular tone, and thus it can be assumed that a decrease in the diastolic blood pressure should correlate with the pathologic vasodilation in septic shock. As a result, the authors of this study hypothesized that the relationship between heart rate and the diastolic blood pressure (i.e. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes.
-
CTs in SAH - Does Time Even Matter
02/02/2023 Duration: 06minIn this podcast, Dr. Justin Milligan covers a recently published retrospective review that could inform our future practice. We all rely on a negative CT within 6 hours for diagnosing SAH, but what if we could through the time limits out the window?
-
What Drip After the Drop - Post Cardiac Arrest Hypotension
18/11/2022 Duration: 04minDuring a cardiac arrest resuscitation, finally palpating a pulsatile flow beneath your gloved fingertips brings a sense of satisfaction like no other. But just as you go to finally breathe a sigh of relief and wipe the beading sweat off your brow, your now widening pupils focus on the patient’s steadily plummeting blood pressure. As you begin to sense your own heart palpitating, you think about medications to utilize in hopes of staving off another round of chest compressions. Since you’ve already given four doses of code-dose epinephrine, maybe an epinephrine infusion is best? You also recall that norepinephrine seems to be a popular choice in patients with shock, so maybe you should start that instead?
-
Family Presence During Cardiac Arrest Resuscitations
11/11/2022 Duration: 03minCardiac arrests are an inevitable reality for emergency medicine providers. There is often a debate on whether family members presence during CPR will lead to more emotional burdens on the family members who witnessed these resuscitations. Dr Melanie Yates summarizes this recent study that aimed to determine if there are increased rates of PTSD-related symptoms of close relatives who witnessed CPR of a family member.
-
Doppler US For Pulse Checks
04/11/2022 Duration: 04minPalpating a pulse during a resuscitation can be more challenging than it seems. Digital palpation of femoral pulses may lack sensitivity and specificity needed to accurately detect the presence of a pulse. In this Journal Club recap, Dr Martina Diaz summarizes a recently published paper looking at the use of Doppler ultrasound for pulse checks.
-
A Life Saving Bolus? Fluids at the Time of Intubation
31/08/2022 Duration: 09minIn this podcast, Dr. Courtney Kein breaks down a recently published article examining the effects of a bolus of IVF at the time of intubation. Does a push of fluid prevent peri-intubation hemodynamic collapse?
-
Bougie so Bougie
24/08/2022 Duration: 04minIn this Journal Club paper breakdown, Dr Bailee Stark recaps the findings of a recently published study by Driver et al looking at the effect of bougie aided intubation vs standard stylet intubation.
-
Tube Thoracostomy - Tiny Tubes for Bloody Effusions
17/08/2022 Duration: 19minIn this Journal Club podcast, PGY-3 Tony Fabiano breaks down a paper from the Journal of Trauma comparing the effectiveness and patient perception of pigtail catheters versus standard chest tubes for hemothorax in the setting of trauma. Is a tiny tube effective at all in draining blood from the chest?
-
ECG to Activation
26/05/2021 Duration: 07minTime is myocardium, and minimizing door-to-activation time improves outcomes in patients with acute coronary occlusion. There are a number of existing quality metrics used to help drive improvements in the time-based care of STEMI patients. Could a new quality metric help the decision making time of Emergency Physicians?
-
The Danger of the OMI
19/05/2021 Duration: 08minThe paradigm of STEMI vs NSTEMI is one of the most well known in Emergency Medicine. Could a change in thinking shift this paradigm to OMI vs NOMI and result in a more complete identification of patients with significant morbidity and mortality?
-
How Good is a Post-ROSC EKG?
12/05/2021 Duration: 13minOne of the first tests ordered for a patient with ROSC following cardiac arrest is an EKG. Many of these EKGs are profoundly abnormal. Current practice is to evaluate for STEMI and to activate the cardiac cath lab if one is found. But, the test characteristics (sensitivity and specificity) of post-ROSC EKGs are likely different than the test characteristics for patients presenting to the ED with complaints of chest pain/symptoms concerning for ACS. This meta-analysis looked to pull together the existing literature and determine those test characteristics for this critically ill patient population. Read the summary after the link and listen to the podcast to hear a breakdown of this study.
-
Droperidol for Agitation - Part 3
19/04/2021 Duration: 09minThis is part 3 of 3 recapping our most recent journal club where we looked at the evidence for the safety and efficacy of droperidol for treating acute agitation in the ED. In this final episode, Dr. Christa Pulvino will share her summary of the DORM trial done by Isbister et al which looked at IM droperidol vs midazolam for violence and acute behavioral disturbance in the ED.
-
Droperidol for Agitation in the ED - Part 2
12/04/2021 Duration: 11minThis is our second in a 3 part series looking at the evidence for the safety and efficacy of droperidol for acute agitation in the ED. In this episode, Dr. Shawn Hassani leads us in a discussion of an article by Taylor et al which was a randomized trial of droperidol vs droperidol + midazolam vs olanzapine.
-
Droperidol for Agitation - Part 1
06/04/2021 Duration: 09minThis is part 1 of our 3 part series recapping our most recent journal club. In this podcast, Dr Jeff Hill leads a discussion of a paper by Calver et al which was a multicenter prospective trial looking at the safety and efficacy of droperidol for acutely agitated patients in the ED
-
Hold the Bicarb?
10/02/2021 Duration: 10minThis is the final of 3 podcasts recapping our most recent journal club. In this podcast Dr. Olivia Urbanowicz walks us through a meta-analysis by Wu et al published in the Journal of Emergency Medicine in 2020. We tackle the question as to whether or not there is evidence that supports the routine use of sodium bicarbonate in patients with cardiac arrest.