Podcast From St Mungo's

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Right heart failure is often misunderstood and underappreciated. It is more common than we think and presents in a number of common conditions such as sepsis. Using anatomic principles, this talk demystifies RV Failure and applies some basic principles to guide practice.

Skin infections are a common presenting complaint to the emergency department. This talk provides an overview of animal bites, other infected skin infections, abccesses and necrotising facsciitis.

Asthma management is a critical skill for ED clinicians. Rapid assessment and application of appropriate interventions can quickly improve patient status. The key is in understanding where on the spectrum of disease the patient lies and, whatinterventions are appropriate based on disease severity. In this talk, we will review the presentation of mild, moderate and severe asthma and focus on the interventions that have benefit depending on the patient's severity.

A review of key literature and best practice in trauma management, with tips and pearls from Chris Colwell.

Finbar McGrady is a Northern Irish GP, Skin Specialist, international triathlon champion with a passion for wellness. In this episode we discuss mind, body and spirit and the need to address each of these to achieve effective and lasting contentment.

Acute kidney injury is a common finding in patients in the emergency department. The vast majoreity of these can be reversed by a foley catheter and a bag or two of crystalloids, however understanding what to do for the remainder is an important and often confusing topic. Dr. Topf boils down the science to present acute kidney injury with a practical bent. He covers the common causes as well as the less common diagnosis with an emphasis of what to look for in order to dig deeper, rather than presenting a comprehensive diagnostic algorithm. He also discusses the recent data of the treatment of metabolic acidosis, the initiation of dialysis and how to use and interpret the furosemide stress test.

This talk will serve as an introduction to the term "frailty" and how the assessment of frailty is an underutilized and important part of acute care medicine. The increased adverse outcomes associated with increased frailty will be discussed, and the differentiation between advanced age and frailty will be highlighted. There are many existing tools for frailty assessment, so after a brief overview of their historical roots, notable and well-studied assessment tools for the emergency department will be presented. The lecture concludes with implementation ideas and initial steps for investing in frailty-aware care.

This talk explores the acute management of traumatic brain injury (TBI) with a focus onsevere traumatic brain injured patients. We review the global burden of TBI and societalimpact. We discuss characterizing TBI severity. We review the imaging to obtain basedon various factors related to the injury. We discuss the critical role of the provider inpreventing secondary injury in brain injured patients and how to manage a brain injuredpatient in the acute setting. Throughout the presentation, we review evidence-basedguidance.

Status epilepticus is a life-threatening emergency. However, there are different forms of status epilepticus: focal to bilateral tonic-clonic status epilepticus and focal status epilepticus. Focal status epilepticus may have prominent motor symptoms, often with impaired awareness, or may be nonconvulsive. The implications of this are important: the treatment of focal to bilateral tonic-clonic seizures requires immediate action. Evidence for first-line therapy is clear that benzodiazepines should be administered in adequate doses we will review those studies. New evidence for second-line treatment has emerged, as well. In those with focal status epilepticus, urgent treatment is still indicated but the approach is more nuanced and less likely to require an escalation to third-line agents, such as anesthetics. We review these concepts and provide some guidance for clinical practice.

A review of oxygenation in the context of critical illness and Rapid Sequence Intubation. What are the historical recommendations, how has this changed over time, and what does the evidence support currently?

This talk goes over the most common causes of inhirted bleeding disorders. There are two major types of hemophilia – deficiency in factor VIII and IX – which predominant occur in men. Hemophilia A is deficiency of factor VIII and is the most common form of hemophilia treated with factor concentrate. Hemophilia B is less common but treatment principles are the same. There are multiple types of von Willebrand Disease as this is a complex molecular that both carries factor VIII and forms large multimers essential for platelet function. Mild forms of vWD can be treated by desmopressin but von Willebrand factor is needed for more severe types.

Pain is one of the most common reasons for patients to visit the emergency department and other acute care settings. Due to the extensive number of visits related to pain, ED clinicians across the globe and should be aware of the various therapeutic options available to them to treat patients with a variety of acute and chronic painful syndromes. With a huge improvement in understanding of the neurobiological aspect of pain by utilizing channels/enzymes/receptors concept, ED clinicians should consider patient-centered, pain syndrome-specific approach by using multimodal approach that include non-pharmacological modalities and pharmacological ones that include non-opioid and opioid analgesics. Additionally, availability and cost -effectiveness of analgesics need to be factored in treatment plan across the globe.

This talk highlights how a quick scroll through a non contrasted head CT can provide important information about the severity of illness. We review normal anatomy and easily recognized distorsions of neuroanatomy that suggest severe brain injury and impending herniation. The talk focuses on how these brain injured patients can be managed to prevent further injury and how simple bedside exams findings coupled with neuroradiologic findings can guide bedside management.

Airway management in the ED and other acute care settings has followed the ‘ABC' priority paradigm. Open the airway, apply oxygen then support oxygenation and ventilation with a ‘definitive' airway A.K.A a tracheal tube. The challenge and focus of airway management in emergencies has been on the technical imperative of laryngoscopy and intubation and therefor success is usually referenced by correct placement of the tube. First pass success (FPS) has been the primary outcome in a majority of publications examining airway management. This reverse rationalization is supported by numerous publications in every setting demonstrating an association between increasing number of attempts and patient morbidity and mortality. The focus of airway management is to support oxygenation and ventilation while maintaining physiologic homeostasis. The tube provides neither benefit nor harm airway management and success should therefor, be defined by a broader contextual surrogate for patient outcomes. Clinicians should strive for FPS rates >90%, without critical hypoxemia or hypotension performed in a timely manner.

Eoghan and Alasdair discuss the current dilemmas in fluid resuscitation in septic patients. Despite many research studies over the past 15 years, many questions still exist: what are the ideal endpoints for volume resuscitation?; what are the best fluids to give?; and when and how to start vasopressors?. Alasdair covers what we know and what we don't, and how we might get the right answers.

Dr Arun Sayal is an Emergency Physician from Toronto with a keen interest in orthopaedics. He has run a fracture clinic in his hospital for 12 years and assists the orthopaedic surgeons in theatre. In this episode, Arun shares some of the tips and pearls he has learned from the orthopaedic specialists, which will guide emergency physicians to better manage cases that are ‘common, commonly missed, and commonly mismanaged’.

Dr Jim Ducanto is an anaesthetist from the USA and founder of the SALAD technique, a stepwise approach to intubating the heavily soiled/bloody airway. In this episode, Eoghan and Jim discuss the background to, and the fundamentals of, the procedure. Plus, there’s a special offer for St Mungo’s listeners at the end.

In this episode, Eoghan discusses all things ‘Tissue Donation in the Emergency Dept’ with Neil Healy and Dr Sonja Allen: when to consider; what can be donated; steps to take; communication with families; what happens after the body leaves the ED; and a whole lot more

In this episode, Eoghan discusses all things ‘Tissue Donation in the Emergency Dept’ with Neil Healy and Dr Sonja Allen: when to consider; what can be donated; steps to take; communication with families; what happens after the body leaves the ED; and a whole lot more

The law around organ and tissue donation in Scotland is changing to an opt out system on 26 March 2021 to help save and improve lives. Mrs Lesley Logan is the Opt-Out Implementation Lead for NHS Scotland. In this episode Lesley and Eoghan discuss what this means for healthcare professionals.

Dr Alisdair MacConnachie is a Consultant in Infectious Diseases in Glasgow. Eoghan and Alisdair discuss the latest understanding of the disease and what has changed since the previous podcasts. This was recorded on February 26th 2021. Information is changing quickly, so please check the latest guidance from Public Health England, or Health Protection Scotland.

Dr Alisdair MacConnachie is a Consultant in Infectious Diseases in Glasgow. Eoghan and Alisdair discuss the latest understanding of the disease and what has changed since the previous podcasts. This was recorded on February 26th 2021. Information is changing quickly, so please check the latest guidance from Public Health England, or Health Protection Scotland.

Professor Robin Taylor discusses Treatment Escalation Plans (TEPS) which help to reduce patient harm and avoid futile treatments.

Dr Alisdair MacConnachie is a Consultant in Infectious Diseases in Glasgow. Eoghan and Alisdair discuss the latest understanding of the disease and what has changed since the previous podcasts. This was recorded on October 1st 2020. Information is changing quickly, so please check the latest guidance from Public Health England, or Health Protection Scotland.

Dr Erin Kilborn is an Emergency Medicine trainee who has worked around the world on a variety of medical missions. The aim of the podcast is to learn about Erin, her motivations, her experiences, and her tips and suggestions for those interested in Humanitarian Medicine. Prepare to be inspired!

Dr Erin Kilborn is an Emergency Medicine trainee who has worked around the world on a variety of medical missions. The aim of the podcast is to learn about Erin, her motivations, her experiences, and her tips and suggestions for those interested in Humanitarian Medicine. Prepare to be inspired!

Dr Erin Kilborn is an Emergency Medicine trainee who has worked around the world on a variety of medical missions. The aim of the podcast is to learn about Erin, her motivations, her experiences, and her tips and suggestions for those interested in Humanitarian Medicine. Prepare to be inspired!

Dr Alisdair MacConnachie is a Consultant in Infectious Diseases in Glasgow. Eoghan and Alisdair discuss the latest understanding of the disease and what has changed since the previous podcasts. This was recorded on April 10th 2020. Information is changing quickly, so please check the latest guidance from Public Health England, or Health Protection Scotland.

Eoghan and Stephen discuss performance under pressure. In this episode, they discuss how to prepare for high-pressure situations and how to ‘CALM DOON’ in moments of frazzle!

Eoghan and Stephen discuss the art of performing well in high-stress situations. In this episode they discuss performance pressure: what it is, why it occurs, how it impacts on our performance, and a whole lot more.

Dr Alisdair MacConnachie is a Consultant in Infectious Diseases in Glasgow. Eoghan and Alisdair discuss what we know about Coronavirus and the new strain COVID-19. In this episode, they cover testing, treatments, management, predictions for the future and a whole lot more.

Dr Alisdair MacConnachie is a Consultant in Infectious Diseases in Glasgow. Eoghan and Alisdair discuss what we know about Coronavirus and the new strain COVID-19: why the concern, what we know, how to manage suspected cases, and a whole lot more.

Rebecca Metcalfe is a Consultant in Sexual Health with a specialist interest in HIV and sexual health. In this episode, Eoghan and Rebecca discuss a number of sexual health-related problems that can present to ED and how to manage them. Topics include sexual assault, male urethritis, herpes, and emergency contraception.

Rebecca Metcalfe is a Consultant in Sexual Health with a specialist interest in HIV, the topic of this episode. Eoghan and Rebecca run through a number of cases and discuss the assessment of risk, what to ask, treatment, advice, follow-up and a whole lot more.

Rebecca Metcalfe is a Consultant in Sexual Health with a specialist interest in HIV, the topic of this episode. Eoghan and Rebecca discuss the current state of HIV infection and treatment, the recent spike in Prevalence in Glasgow, and a whole lot more.

Marcus McMillan is a consultant obstetrician in Princess Royal Maternity in Glasgow. He has a special interest in abnormally invasive placentas and coordinates care for people with this in Glasgow. He works with the Scottish Multiprofessional Maternity Development Programme for teaching obstetric emergencies and management to maternity staff and other departments. Eoghan and Marcus discuss obstetric emergencies, and in this episode they cover Cardiovascular Collapse, Resuscitative Hysterotomy, and a lot more.

Marcus McMillan is a consultant obstetrician in Princess Royal Maternity in Glasgow. He has a special interest in abnormally invasive placentas and coordinates care for people with this in Glasgow. He works with the Scottish Multiprofessional Maternity Development Programme for teaching obstetric emergencies and management to maternity staff and other departments. Eoghan and Marcus discuss obstetric emergencies, and in this episode, they focus on Pre-Eclampisa/Eclampsia, Chest pain in Pregnancy and APH.

Marcus McMillan is a consultant obstetrician in Princess Royal Maternity in Glasgow. He has a special interest in abnormally invasive placentas and coordinates care for people with this in Glasgow. He works with the Scottish Multiprofessional Maternity Development Programme for teaching obstetric emergencies and management to maternity staff and other departments. Eoghan and Marcus discuss obstetric emergencies, and in this episode they focus on normal and problematic deliveries.

Mark Dunn is a consultant in Pre-hospital medicine, Emergency medicine and Intensive Care Medicine, who spent 18 months away from work battling severe depression. Mark discusses this time openly and honestly in the hope that his experience will help others to address their own mental health issues.

Mark Dunn is a consultant in Pre-hospital medicine, Emergency medicine and Intensive Care Medicine, who spent 18 months away from work battling severe depression. Mark discusses this time openly and honestly in the hope that his experience will help others to address their own mental health issues.

Eoghan and Kath discuss Gender-Based Violence - why it’s important, how it can present, how to tackle it, and a whole lot more.

Eoghan and Kath discuss Gender-Based Violence - why it’s important, how it can present, how to tackle it, and a whole lot more.

Eoghan discusses Damage Control Resuscitation with Pete Davis, a Consultant in Emergency Medicine and Prehospital Medicine, and an Army Medic who has served in multiple conflicts around the world. Find out what this concept is and how to apply it to your sickest trauma patients.

Eoghan discusses Damage Control Resuscitation with Pete Davis, a Consultant in Emergency Medicine and Prehospital Medicine, and an Army Medic who has served in multiple conflicts around the world. Find out what this concept is and how to apply it to your sickest trauma patients.

This is the fifth and final episode in a multi-part series on the interface between healthcare and the legal system. We aim to cover all the main essentials including:the structure of the legal systemhow to provide statements and prepare for courtconduct within court (and what to expect)We have 3 incredible guests giving expert advice for health professionals called to court.This episode covers the giving of testimony in court - who will ask questions, what they will ask (and how they will ask it) and how to conduct yourself appropriately.

This is the fourth in a multi-part series on the interface between healthcare and the legal system. We aim to cover all the main essentials including:the structure of the legal systemhow to provide statements and prepare for courtconduct within court (and what to expect)We have 3 incredible guests giving expert advice for health professionals called to court.This episode covers preparation for court, what will happen when you arrive, what to expect inside the court and some recommendations on court behaviour.