Join the EMGuideWire team as they explore the use of Point-of-Care Ultrasound for the evaluation of patients with possible COVID-19 infection . Dr. Patrick Lam , from the Carolinas Medical Center Department of Emergency Medicine Department Division of Ultrasound , will guide us on the techniques and pro-tips for this application.
Join EMGuideWire team as they listen in to EM Residency Conference at Carolinas Medical Center (in Charlotte, NC) and learn from Emily MacNeill, MD as she discusses " What Happens When a Disease Management System Crashes into a Public Health Crisis ."
Join the EMGuideWire team as they learn from one of the world's foremost experts in neurologic emergencies, Dr. Andrew Asimos. This episode will address the Neurologic Manifestations and Complications of the COVID-19 Infection.
Join the EMGuideWire team as they listen to Dr. Geib discuss how to recognize and manage Hydroxychloroquine toxicity, which may become more prevalent during the current COVID-19 pandemic .
Join the EMGuideWire team as they learn from Critical Care fellow, Dr. Russell Trigonis while he addresses the important aspects of managing ARDS in patients with COVID-19 infections .
OB Trauma Core Concepts Physiologic changes of pregnancy : physiologic anemia, decreased SVR, increased HR, increased RR, and pelvic vessel engorgement Traumatic complications : placental abruption, preterm labor (PTL), uterine rupture, and pelvic fx Abruption triad = abd pain, large for dates uterus, vaginal bleeding Perform cervical check to eval for PTL Obtain Type and Screen and KB test Give Rhogam if mom is Rh neg . 50 mcg if <12 wks, 300mcg if > 12 wks Check fetal HR after E-FAST , n...
Join the EMGuideWire Crew from CMC EM Residency Program as they discuss Ludwig's Angina and the management Priorities!!! BACKGROUND Angina = “Strangling” Bilateral infection of submental, submandibular, and sublingual spaces 70-85% of cases arise from odontogenic source Periapical abscesses of mandibular molars Piercings (frenulum) URI more common cause in children Source of infection often polymicrobial Most commonly viridans ; also Staphylococcus and Bacteroides species Patients usually 20-60 ...
Join the EMGuideWire team as they discuss Superior Vena Cava Syndrome! Shownotes: Definition : Any condition leading to obstruction of blood flow through the SVC Pathophysiology : Pathology in adjacent anatomy (lung, lymph node, thymus, mediastinum) or within the SVC itself obstructs venous return to the right atrium. As the SVC is compressed, venous collaterals form alternative pathways returning blood to the right atrium which can dilate over several weeks. As a result, upper body venous press...
October was Domestic Violence month and in an effort to help highlight this very important topic, join Drs. Salzman, Dragoo, and Richardson from Carolinas Emergency Medicine Residency while they discuss the very important presentation of Strangulation . This is not a mere gesture of power, it may be our last opportunity to save this patient's life! Pearls Strangulation victims are 750% more likely to become a homicide victim. Strangulation is not choking. Call it what it is. External exam findin...
Join the EMGuideWire crew as they discuss some tips and pearls on how to skillfully run a medical resuscitation . Pearls Preparation is everything. Get your staff, and get your stuff! Call out names, be redundant, and say what you are thinking out loud . Don’t go for the tube! Supraglottic airways are quicker and safer! High quality compressions are life saving. V-tach and V-fib are usually ischemic. PEA is usually non-cardiac . PEA? Is it Wide or Narrow? Narrow - think procedural. Wide - think ...
The EMGuideWire Team is visited by a prior crew member, Russell Trigonis, MD ! Join them as they discuss how the patient diagnosed with Sepsis in your ED has their care continued in the ICU ! Pearls Start pressors with IVF (30-40cc/kg). NE at 7mcg/min peripherally can always be stopped, but better earlier than later. Increase NE until at 20mcg/min, if still hypotensive, then add a 2nd pressor like Vasopressin at 0.03units/min and 100mg Hydrocortisone Q8h. Start antibiotics early and identify sou...
It it the end of Sepsis Awareness Month , but there is a BONUS Monday (Sept. 30th), so why not a BONUS episode ! Join the EMGuideWire Team as they explore the challenges the children bring to this clinical condition. Let's review Pediatric Sepsis ! Pearls: Screening should be age adjusted. Identify severe sepsis. Treat w/early antibiotics, balanced fluid administration, and EPI if needed. SIRS in children must be age-adjusted. HR & RR > 2 standard deviations of nml; WBC age adjusted. Scre...
Join the EMGuideWire Crew as they continue to explore the High Yield management points for Sepsis! This week's Episode's Pearls : Early fluids save lives. Give 40cc/kg bolus in first 3 hours. But don’t fluid overload the patient! U/S the heart and lungs: A plethoric IVC, immobile mitral valve, and B lines on the lungs should urge you to be more cautious with fluids. Goal in all patients is to establish an adequate MAP ASAP! Fluids + Vasopressors! Vasopressor titration algorithm: First low dose N...
Join the EMGuideWire crew once again for this month's series on Sepsis in honor of Sepsis Awareness month . Episode 3 will cover antibiotic use and selection. Antibiotics for Sepsis Take a history and perform a chart biopsy first! Consider past infections, bug susceptibilities, healthcare acquired vs. community acquired infection, foreign travel, and comorbidities. Always check local antibiogram and prior culture results . Septic shock - Start broad spectrum antibiotics within 1 hour . Stable pa...
Sepsis Awareness Month continues! Join the EMGuideWire Team as they dive into the issues of Fluid selection for resuscitation. 1) Fluids are not all created equal. Use balanced fluids for large volume resuscitation. 2) Lactated Ringers is likely the best choice available in the ED. Plasmalyte is also a good option, if you have it. 3) You can start low dose vasopressors peripherally if you need to, rather than continuing to flood patients with fluids for hypotension....
Join the EMGuideWire Team, from Carolinas Emergency Medicine Residency Program in Charlotte, NC, as they explore the critical core concepts on the important topic of Sepsis. In this first episode, the team will discuss the definitions of Sepsis. Pearls: Sepsis is a dysregulated systemic inflammatory response to infection causing intravascular inflammation, tissue ischemia, cytopathic injury, and dysregulated apoptosis. SIRS terminology is now outdated. Current terminology is “Sepsis” (SIRS, susp...
Join the EMGuideWire Team, from Carolinas Emergency Medicine Residency Program in Charlotte, NC, as they explore the critical core concepts on the important topic of Sepsis. Over the course of September, Sepsis Awareness Month, the group will cover a variety of high-yield points to help make us all better at recognizing, evaluating, and managing Sepsis. This is the Intro to the month. Follow us every week for more information... and maybe even get a Bonus 5th episode as a reward!...
Join the EMGuideWire team from Carolinas Medical Center Emergency Medicine Residency Program as they discuss the challenging condition of thyrotoxicosis and thyroid storm! From evaluation to management, this critical state requires our respect and attention!
Join the EMGuideWire crew as they explore the various skin and soft tissue infections that are commonly encountered and considered in the Emergency Department. While some may be minor, like furuncles, others can be life-threatening, like necrotizing fasciitis.
Join the EMGuideWire Team as they explore the Basic Principles that must be considered when managing a pediatric airway. Knowledge of the anatomic and physiologic differences that exist between adults and children is paramount! Assuming that all pediatric airways are going to be "difficult" may help keep us prepared.
Join the EMGuideWire Team as they discuss some of the tips for having a successful and safe Sign-Out in the ED . Hear from recent graduates from the Carolinas Medical Center Emergency Medicine Program as they discuss their perspectives on Transition of Care in the ED.
Join the EMGuideWire Team as they are joined by two Pediatric EM experts (Drs. Simone Lawson and Pat Morgan) to discuss the very important and challenging topic of Pediatric Non-Accidental Trauma (NAT) . Let's discover ways to remain help pick up on the subtle and sentinel cases to help protect our most vulnerable patients.
Join Dr. Driscoll from the EMGuideWire crew as he enters the Sports Medicine Corner once again. Today, he covers some of the issues with athlete cardiac screening and sudden cardiac death in athletes .
Join the EMGuideWire Team as they discuss the evaluation and management of Myasthenia Gravis and a Myasthenic Crisis ! Learn about the means to assess a patient's ability to maintain her/his own airway.
Join the EMGuidewire team from CMC EM program as they discuss a potentially critical condition, HyperKalemia. Review the important HyperKalemia EKG Changes and be ready to take action!
Join the Ped EM Fellows from Carolinas Medical Center and the EMGuideWire as they discuss the seemingly simple issue of Pediatric Urinary Tract Infections. Who needs to be test and how do we do so? Let's review this less than simple topic.
Join Drs. Trigonis and Murray from the EMGuideWire team as they discuss use and selection of Vasopressors in the ED .
Join the EMGuideWire Team , from the CMC EM program, as they enter the TOXIDome once again to wrestle with Aspirin (ASA) Toxicity !
The patient is agitated and combative and a danger to everyone in the ED. What do you give? Haloperidol and lorazepam? Maybe there are better choices. Join the EMGuideWire crew as they enter the TOXIDome to discuss a better approach to the management of the Agitated Patient .
Join the EMGuideWire team as they enter the TOXIDome once again and review Toxidromes with Dr. Kopec !
