Podcasts about cjem

In this episode, Dr Kat Ralston chats with Dr Emma Phillips about clinical debriefing. They talk about what clinical debriefing is (and isn't) and why we should be incorporating this into our everyday work. They explore when and how to facilitate a clinical debrief and share tips on how we can embed clinical debriefing into our practice. Dr Phillips is an Anaesthetic Registrar working in South-East Scotland. She completed a simulation fellowship at Scottish Simulation Center in 2018 and maintains active role in simulation based education. Dr Phillips completed a Master's in 2022 with a dissertation examining attributes and evidence for use of clinical debriefing tools. She has also published and presented on a number of topics including non-technical skills in simulation, clinical debriefing, educational innovations and airway management. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members' Committee, currently working in Edinburgh. -- Useful Links -- Kolbe M, Schmutz S, Seelandt J C, Eppich W J, Schmutz J B. Team debriefings in healthcare: aligning intention and impact BMJ 2021; 374 :n2042 - https://doi.org/10.1136/bmj.n2042 Phillips EC, Smith SE, Tallentire V, et al. Systematic review of clinical debriefing tools: attributes and evidence for use BMJ Quality & Safety Published Online First: 28 March 2023. - https://doi.org/10.1136/bmjqs-2022-015464 Petrosoniak A, Gabriel J, Purdy E. Stop asking if it works, start making it happen: exploring barriers to clinical event debriefing in the ED. CJEM. 2022;24(7):673-674. - https://doi.org/10.1007/s43678-022-00396-9 Walker CA, McGregor L, Taylor C, Robinson S. STOP5: a hot debrief model for resuscitation cases in the emergency department. Clin Exp Emerg Med. 2020;7(4):259-266. - https://doi.org/10.15441/ceem.19.086 Wolfe et al. (2014) Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes - https://doi.org/10.1097/CCM.0000000000000327 Rose & Cheng (2018) Charge nurse facilitated clinical debriefing in the emergency department - https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/charge-nurse-facilitated-clinical-debriefing-in-the-emergency-department/CC224433937ACBA849491A66EBC9593D Ralston et al. (2024) Overcoming barriers to clinical event debriefing through simulation - https://doi.org/10.1111/medu.15359 Recording Date: 16 February 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: November 8, 2018 A patient comes into the emergency department. They've got a headache. You get some basic labs, a chest x-ray, and a CT scan. And then you get a drug screen. But does this information even help you? And could it hurt the patient? This week on the BrainWaves podcast, Dr. Emily Rosenthal shares her experience with Dr. Kelley Humbert on the ethics of toxicology "screening" and how she manages patients with a substance use disorder. Produced by Emily Rosenthal, Kelley Humbert, and Jim Siegler. Music by Montplaisir, Lee Rosevere, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817Eisen JS, Sivilotti ML, Boyd KU, Barton DG, Fortier CJ, Collier CP. Screening urine for drugs of abuse in the emergency department: do test results affect physicians' patient care decisions? CJEM 2004;6(2):104-11. PMID 17433159Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med 2010;363(24):2320-31. PMID 21142534Lager PS, Attema-de Jonge ME, Gorzeman MP, Kerkvliet LE, Franssen EJ. Clinical value of drugs of abuse point of care testing in an emergency department setting. Toxicol Rep 2017;5:12-17. PMID 29270362Silver B, Miller D, Jankowski M, et al. Urine toxicology screening in an urban stroke and TIA population. Neurology 2013;80(18):1702-9. PMID 23596074Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med 2010;170(13):1155-60. PMID 20625025Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol (Phila) 2009;47(4):286-91. PMID 19514875 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

The Zurich Tongue Scheme may help you in assessing tongue lacerations in kids.     Check out the papers mentioned. Seiler M, Massaro SL, Staubli G, Schiestl C. Tongue lacerations in children: to suture or not? Swiss Med Wkly. 2018 Oct 28;148:w14683. doi: 10.4414/smw.2018.14683. PMID: 30378089. https://doi.org/10.4414/smw.2018.14683   Sibley AK, Atkinson P, Lobay K. Just the facts: Pediatric Dental and Oral Injuries. CJEM. 2020 Jan;22(1):23-26. doi: 10.1017/cem.2019.440. PMID: 31727193. https://caep.ca/wp-content/uploads/2020/01/just_the_facts_pediatric_dental_and_oral_injuries.pdf    www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Jon's chosen article explores the information-gathering techniques of residents by analyzing their initial visual fixation patterns in a simulated resuscitation environment. Authors:  Szulewski et al., Publication details:  A new way to look at simulation-based assessment: the relationship between gaze-tracking and exam performance CJEM. 2019 Jan;21(1):129-137. Epub 2018 Jun 21. 

Do you have a similar program where you work, or are you interested in learning more about how to start one? Share your experiences and questions with us on social media, @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Terry Klassen, Professor, Pediatrics & Child Health, University of Manitoba Resources: “Wraparound” EM Pulse Podcast published June 17, 2021. https://ucdavisem.com/2021/06/17/wraparound/ Snider CE, Jiang D, Logsetty S, Chernomas W, Mordoch E, Cochrane C, Mahmood J, Woodward H, Klassen TP. Feasibility and efficacy of a hospital-based violence intervention program on reducing repeat violent injury in youth: a randomized control trial. CJEM. 2020 May;22(3):313-320. doi: 10.1017/cem.2019.406. PMID: 31645229.  https://pubmed.ncbi.nlm.nih.gov/31645229/  *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Contributor:  Ricky Dhaliwal, MD, JD Educational Pearls: Glucagon administered intravenously has a high rate of adverse events (nausea/vomiting) with very weak evidence NItroglycerin too has very limited evidence but a much better adverse event profile Mix 0.4 mg (1 sublingual tablet) nitro in 10 mL of water and administer orally Nothing beats upper endoscopy for effectiveness but in settings where GI is not immediately available, nitroglycerin may be worth an attempt given its better safety profile to other medications References  Arora S, Galich P. Myth: glucagon is an effective first-line therapy for esophageal foreign body impaction. CJEM 2015;11:169–71 Schimmel J, Slauson S. Swallowed Nitroglycerin to Treat Esophageal Food Impaction. Ann Emerg Med. 2019 Sep;74(3):462-463.  Summarized/Edited by Erik Verzemnieks, MD The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.  Donate to EMM today!

Theme: POCUS. Participants: Oliver Archer (ED resident and previous cardiac sonographer), Hung Diep (ED advanced trainee), Dr Richard McNulty, Dr Kenny Yee, Dr Pramod Chandru, Kit Rowe, Shreyas Iyer, Caroline Tyers and Samoda Wilegoda Mudalige.Discussion 1:Presenter - Oliver Archer.Starting - 02:00. Atkinson, P., Beckett, N., French, J., Banerjee, A., Fraser, J., & Lewis, D. (2019). Does Point-of-care Ultrasound Use Impact Resuscitation Length, Rates of Intervention, and Clinical Outcomes During Cardiac Arrest? A Study from the Sonography in Hypotension and Cardiac Arrest in the Emergency Department (SHoC-ED) Investigators. Cureus. https://doi.org/10.7759/cureus.4456.Take-Home Points: This study showed that visualizing cardiac activity on ultrasound resulted in increased duration and effort of resuscitation, and was associated with improved clinical outcomes.  It is difficult to know whether the improved clinical outcomes were secondary to increased resuscitation efforts or due to identification (with ultrasound) of those with a better prognosis.  Ultimately, ultrasound should be used as an adjunct to your clinical decision-making, but should not get in the way of the established standard ALS protocol.  The COACHRED protocol (referenced below) assists in incorporating POCUS into the arrest algorithm. Discussion 2:Presenter - Hung Diep.Starting - 29:10.Daley, J., Dwyer, K., Grunwald, Z., Shaw, D., Stone, M., & Schick, A. et al. (2019). Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. Academic Emergency Medicine, 26(11), 1211-1220. https://doi.org/10.1111/acem.13774.Take-Home Points: This study shows that focused cardiac ultrasound (FOCUS): involving right ventricular dilation, McConnell's sign, septal flattening, tricuspid regurgitation, and tricuspid annular plane systolic excursion (TAPSE), maybe a useful adjunct in the workup of patients with a high pre-test probability of PE. The most sensitive component of the FOCUS was TAPSE.  The most specific components of the FOCUS were McConnell's sign and septal flattening.  However, it is important to remember that illnesses associated with chronic right heart strain such as COPD would also yield a positive FOCUS. At this stage, there is not enough evidence for FOCUS in diagnosing PE to alter clinical decision-making.  Discussion 3:Presenter - Pramod Chandru.Starting - 01:03:35.  Chartier, L., Bosco, L., Lapointe-Shaw, L., & Chenkin, J. (2016). Use of point-of-care ultrasound in long bone fractures: a systematic review and meta-analysis. CJEM, 19(2), 131-142. https://doi.org/10.1017/cem.2016.397Take-Home Points: This study looked at the use of POCUS to assist with both the diagnosis and reduction of long bone fractures (radius, ulna, humerus, tibia, fibula, and femur).  POCUS use had reasonable sensitivity and specificity in the diagnosis of fractures, particularly paediatric forearm fractures and adult ankle fractures - however, it may not provide all the information required regarding a fracture once identified.  In the absence of fluoroscopy, using POCUS to delineate the satisfactory nature of a reduction in ED (such as of the wrist) may reduce the risks associated with recurrent reductions and the need for operative fixation, however, further research with randomized controlled trials is needed. All in all, it is hard to see how ultrasound would replace x-ray as the imaging modality of choice for fractures, but there is an argument to be made for the use of ultrasound in assessing for the adequacy of reduction particularly in specific populations and this would be an interesting area for future studies.  Interlude Segment:Starting - 56:10.Ioannidis, J. (2005). Why Most Published Research Findings Are False. PLoS Medicine, 2(8), e124. https://doi.org/10.1371/journal.pmed.0020124.Other References:Finn, T., Ward, J., Wu, C., Giles, A., & Manivel, V. (2019). COACHRED: A protocol for the safe and timely incorporation of focused echocardiography into the rhythm check during cardiopulmonary resuscitation. Emergency Medicine Australasia, 31(6), 1115-1118. https://doi.org/10.1111/1742-6723.13374.Credits:The discussions were mediated by ED consultant and ultrasound guru Dr Kenny Yee, ED consultant and clinical toxicologist Dr Richard Mc Nulty, and ED consultant Dr Pramod Chandru.This episode was produced by the ­­­­Emergency Medicine Training Network 5 with the assistance of Dr Kavita Varshney, Deepa Dasgupta, Cynthia De Macedo Franco, and Paul Scott.Music/Sound Effects Another Time by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.  Cross Over by Sapajou | https://soundcloud.com/sapajoubeats, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US Esperanza by Roa Music | https://soundcloud.com/roa_music1031, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US Medical Examination by MaxKoMusic | https://maxkomusic.com/, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution-ShareAlike 3.0 Unported, https://creativecommons.org/licenses/by-sa/3.0/deed.en_US.  Mega Epic by Alexander Nakarada | https://www.serpentsoundstudios.com, Music promoted by https://www.free-stock-music.com, Attribution 4.0 International (CC BY 4.0), https://creativecommons.org/licenses/by/4.0/ Nightswim by Scandinavianz | https://soundcloud.com/scandinavianz, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Piano Rock Instrumental by Hyde - Free Instrumentals | https://soundcloud.com/davidhydemusic, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Ragga Groove by Peyruis | https://soundcloud.com/peyruis, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.  Sea Current by Vlad Gluschenko | https://soundcloud.com/vgl9, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US Smile by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Sound effects from https://www.free-stock-music.com. Wasting Time by Sapajou & Yorgo H | https://soundcloud.com/sapajoubeats, Music promoted by https://www.free-stock-music.comCreative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US.  ~Thank you for listening!Please send us an email to let us know what you thought.You can contact us at westmeadedjournalclub@gmail.com.See you next time,Caroline, Kit, Pramod, Samoda, and Shreyas.

Core Questions List key historical red flags in a patient presenting with back pain. (Box 32.1)  List red flags on physical examination of a patient with back pain. (Box 32.1)  List key critical differential diagnoses for a patient presenting with acute back pain (Box 32.2) Describe an approach to the rapid assessment of a patient with acute lower back pain (Fig 32.1)  Describe an approach to ancillary testing and imaging for critical causes of acute back pain (table 32.1)  List the sensory, motor, and screening tests for the lumbar nerve roots L3-S1 (table 32.2)  Describe an overview of the management of acute low back pain (Fig 32.2)  Wisecracks What are 4 variables associated with serious outcomes in patients with back pain (p. 276)  Differentiate between conus medullaris syndrome and cauda equina syndrome.  What physical exam/ancillary findings are most predictive of cauda equina? (CJEM 2020;22(5):652–654)  How does Rosen’s differentiate between disc herniation and radiculopathy?

Core Questions List key historical red flags in a patient presenting with back pain. (Box 32.1)  List red flags on physical examination of a patient with back pain. (Box 32.1)  List key critical differential diagnoses for a patient presenting with acute back pain (Box 32.2) Describe an approach to the rapid assessment of a patient with acute lower back pain (Fig 32.1)  Describe an approach to ancillary testing and imaging for critical causes of acute back pain (table 32.1)  List the sensory, motor, and screening tests for the lumbar nerve roots L3-S1 (table 32.2)  Describe an overview of the management of acute low back pain (Fig 32.2)  Wisecracks What are 4 variables associated with serious outcomes in patients with back pain (p. 276)  Differentiate between conus medullaris syndrome and cauda equina syndrome.  What physical exam/ancillary findings are most predictive of cauda equina? (CJEM 2020;22(5):652–654)  How does Rosen’s differentiate between disc herniation and radiculopathy?

On this, the season finale of EPIC Podcast (Emergency Preparedness in Canada), we do our part to put 2020 firmly in the rearview mirror by reviewing one of the most eventful years for emergency management ever. From record breaking snowfalls, to the most expensive hailstorm ever, to the deadliest shooting in Canadian history, 2020 had it all. Oh, and also there was a Pandemic.... Help us say good riddance to 2020 while celebrating some of the advancements in our profession which so often accompany disaster in this very special episode of EPIC Podcast: Current, Relevant, Canadian. Show Notes: Check out the inaugural issue of CJEM: https://cdnjem.ca/ Participate in EM research: https://scharr.eu.qualtrics.com/jfe/form/SV_b3Dv0y3pQIsMbLD?Q_CHL=social&Q_SocialSource=linkedin Learn from Ontario's false alarm: https://www.mcscs.jus.gov.on.ca/english/Publications/InvestigationemergencyalertssentJanuary122020.html

This month we discussed Calhoun, Aaron W. Pian-Smith, May. Shah, Anjan et. al. Guidelines for the Responsible Use of Deception in Simulation, Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: August 2020 - Volume 15 - Issue 4 - p 282-288 We were also joined by Ian Summers, Director of Monash Simulation, who contributed as our expert commentator this month. Ben and Vic summarised the article and online discussion, and our trio then went deep on the definition of deception, and the concept of ‘fair’ in simulation design, drawing on the article and personal experience. And we reviewed 2 extra papers  Lin Y, Hecker K, Cheng A, et al. Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training BMJ Simulation and Technology Enhanced Learning Published Online First: 29 September 2020 Caners, K., Baylis, J., Heyd, C., & Chan, T. (2020). Sharing is caring: How EM Sim Cases (EMSimCases.com) has created a collaborative simulation education culture in Canada. CJEM, 1-3. And finally – Ben gave us an invitation for the September Journal Club. Kerrey, Benjamin, MD, MS, Boyd, Stephanie, et al. Developing a Profile of Procedural Expertise: A Simulation Study of Tracheal Intubation Using 3-Dimensional Motion Capture. Simul. healthc.. 2020;15(4):251-258.   Please come along and join the conversation …  

Salim Rezaie on HALT-IT trial for TXA in unstable GI bleed, Sarah Reid on pediatric DKA update in fluid management and cerebral edema, Hans Rosenberg on POCUS in shoulder dislocations via CJEM, Arun Sayal on Lisfranc injury pearls and pitfalls, Justin Morgenstern on RECOVERY Trial for Dexamethasone in COVID pneumonia, Walter Himmel on getting what you need from consultants... The post EM Quick Hits 21 TXA in GI Bleed, Pediatric DKA, POCUS for Shoulder Dislocations, Lisfranc Injuries, Dexamethasone for COVID Pneumonia, Consultation Tips appeared first on Emergency Medicine Cases.

Contributor: Aaron Lessen, MD Educational Pearls:.   Focused assessment with Sonography for Trauma (FAST) exam and the extended-FAST (eFAST) are essential components of current trauma care and evaluation There has been an accumulation of research to provide an estimate of effectiveness of identifying certain injuries with ultrasound: For identifying a pneumothorax, the sensitivity ~70% and specificity ~99%. For pericardial effusions, sensitivity 90% and specificity ~ 94%. For hemoperitoneum, sensitivity ~74% and the specificity ~98%. While ultrasound is excellent for identifying many injuries, it may not be adequate alone to rule out serious injuries if the clinical suspicion is high based on these pooled studies References Netherton S, Milenkovic V, Taylor M, Davis PJ. Diagnostic accuracy of eFAST in the trauma patient: a systematic review and meta-analysis. CJEM. 2019;21(6):727‐738. doi:10.1017/cem.2019.381 Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Sarah Reid on pediatric appendicitis risk calculator, Sheldon Cheskes & Mark Ramzy on double defibrillation for refractory ventricular fibrillation, Hans Rosenberg & Krishan Yadav on cellulitis clinical pearls, Anand Swaminathan on serratus anterior block, Brit Long on recognition of toxic shock syndrome, Justin Morgenstern on tranexamic acid in head injury and CRASH-3... The post EM Quick Hits 10 – TXA CRASH-3, CJEM Cellulitis, Double Defib, Serratus Anterior Block, PARC score, Toxic Shock Syndrome appeared first on Emergency Medicine Cases.

Listen as author, Dr. Paul Atkinson, discusses the use of point-of-care ultrasound in Emergency Medicine and Resuscitation. Dr. Paul Atkinson is Professor in Emergency Medicine at Dalhousie University and Saint John Regional Hospital, New Brunswick, Canada. He is the current chair of the provincial Emergency Medicine research committee. Paul is also deputy editor of CJEM, Chief Medical Officer at WorkSafeNB, and is currently VP for ultrasound research for the International Federation for Emergency Medicine (IFEM). He is co-director of the Emergency Critical Care Ultrasound (ECCU) course. His international training included Royal North Shore Hospital in Sydney, Australia, and Cambridge University Hospitals in the UK. He is the principal investigator and chair of the SHoC ultrasound research network. He has over 80 peer-reviewed publications, as well as being the lead editor on two textbooks, Emergency Medicine an Illustrated Colour Text, 2010; and Point of Care Ultrasound in Emergency Medicine and Resuscitation, 2019. Awards include the inaugural “Best in Class” undergraduate teaching award from Dalhousie University in 2012, and the national Grant Innes Award for Emergency Medicine research in 2014, and the Ian Stiell Researcher of the Year Award from the Canadian Association of Emergency Physicians, 2019. Current research interests include PoCUS in critical illness, occupational stress injury, medical education, trauma systems, and prevention, as well as quality in medicine. Paul enjoys cycling and hiking in the wide-open spaces of New Brunswick.

Jon's chosen article explores the information-gathering techniques of residents by analyzing their initial visual fixation patterns in a simulated resuscitation environment. Authors:  Szulewski et al., Publication details:  A new way to look at simulation-based assessment: the relationship between gaze-tracking and exam performance CJEM. 2019 Jan;21(1):129-137. Epub 2018 Jun 21.  View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME? Click here!

A patient comes into the emergency department. They've got a headache. You get some basic labs, a chest x-ray, a CT scan. And then you get a drug screen. But does this information even help you? And could it hurt the patient? This week on the BrainWaves podcast, Dr. Emily Rosenthal shares her experience with Dr. Kelley Humbert on the ethics of toxicology "screening" and how she manages patients with a substance use disorder. Produced by Emily Rosenthal, Kelley Humbert, and Jim Siegler. Music by Montplaisir, Lee Rosevere, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Bates GP, Dorsey R, Gusella JF, Hayden MR, Kay C, Leavitt BR, Nance M, Ross CA, Scahill RI, Wetzel R, Wild EJ and Tabrizi SJ. Huntington disease. Nat Rev Dis Primers. 2015;1:15005. Silver B, Miller D, Jankowski M, Murshed N, Garcia P, Penstone P, Straub M, Logan SP, Sinha A, Morris DC, Katramados A, Russman AN, Mitsias PD and Schultz LR. Urine toxicology screening in an urban stroke and TIA population. Neurology. 2013;80:1702-9. Eisen JS, Sivilotti ML, Boyd KU, Barton DG, Fortier CJ and Collier CP. Screening urine for drugs of abuse in the emergency department: do test results affect physicians' patient care decisions? CJEM. 2004;6:104-11. Smith PC, Schmidt SM, Allensworth-Davies D and Saitz R. A single-question screening test for drug use in primary care. Archives of internal medicine. 2010;170:1155-60. Lager PS, Attema-de Jonge ME, Gorzeman MP, Kerkvliet LE and Franssen EJF. Clinical value of drugs of abuse point of care testing in an emergency department setting. Toxicol Rep. 2018;5:12-17. Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol (Phila). 2009;47:286-91. Jones HE, Kaltenbach K, Heil SH, Stine SM, Coyle MG, Arria AM, O'Grady KE, Selby P, Martin PR and Fischer G. Neonatal abstinence syndrome after methadone or buprenorphine exposure. The New England journal of medicine. 2010;363:2320-31.

Ben and Vic discuss the paper of the month, which provoked controversy about the interplay of feeling and facts in clinical debriefing. Rose, S. & Cheng, A. (2018). “Charge nurse facilitated clinical debriefing in the emergency department.” CJEM, 1-5. doi:10.1017/cem.2018.369.   And we talked about a few other sim papers across a range of topics and research methods, including simulation educators’ qualifications and transformative experiences, and sim for improving telephone conversations in healthcare   Gardner, Aimee K. et al. Entrustable Professional Activities (EPAs) for Simulation Leaders: The Time Has Come. Journal of Surgical Education, 2018 Dieckmann, M. Birkvad Rasmussen, S. B. Issenberg, E. Søreide, D. Østergaard & C. Ringsted (2018): Long-term experiences of being a simulation-educator: A multinational interview study, Medical Teacher, DOI: 10.1080/0142159X.2018.1471204 Walter J. Eppich, Jan-Joost Rethans, Timothy Dornan & Pim W. Teunissen. (2018): Learning how to learn using simulation: Unpacking disguised feedback using a qualitative analysis of doctors’ telephone talk, Medical Teacher, DOI: 10.1080/0142159X.2018.1465183   So we’ll be back with journal club in July – join the discussion   Victoria

Ben and Vic discuss the paper of the month.  Eppich, W. and Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS). Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 10(2), pp.106-115.    And a few other sim papers across a range of topics and research methods.  1. Snelgrove H, Fernando A Practising forethought: the role of mental simulation BMJ Simulation and Technology Enhanced Learning Published Online First: 29 January 2018. doi: 10.1136/bmjstel-2017-000281 Lorello, G., Hicks, C., Ahmed, S., Unger, Z., Chandra, D., & Hayter, M. (2016). Mental practice: A simple tool to enhance team-based trauma resuscitation. CJEM, 18(2), 136-142. doi:10.1017/cem.2015.4   McNaughten B, Hart C, Gallagher S, et al. Clinician’s gaze behaviour in simulated paediatric emergencies. Archives of Disease in Childhood Published Online First: 07 March 2018. doi: 10.1136/archdischild-2017-314119   Greenwood K, Ewell S. Faculty development through simulation-based education in physical therapist education. Advances in Simulation 2018 3:1 https://doi.org/10.1186/s41077-017-0060-3   Note – for a better discussion of phenomenology than I provide on the podcast….. https://icenetblog.royalcollege.ca/2018/02/13/appliedmededmethods101-phenomenography-to-understand-how-something-can-be-understood/    Next month Ben Invites us to join the April discussion of an evaluation paper   Kumar A, Sturrock S, Wallace EM, et al. Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick’s framework: a mixed methods study. BMJ Open 2018;8:e017451. doi:10.1136/bmjopen-2017-017451    Looking forward to another great discussion   Vic 

In this EM Cases episode with Dr. Nazanin Meshkat, multinational ED doc and Dr. Matthew Muller, infectious disease specialist, we discuss the most common tropical disease killers that we see in patients who present with Fever in the Returning Traveler. Every year an increasing number of people travel abroad, and travelers to tropical destinations are often immunologically naïve to the regions they're going to. It's very common for travelers to get sick. In fact, about 2/3 of travelers get sick while they're traveling or soon after their return, and somewhere between 3 and 19% of travelers to developing countries will develop a fever. Imported diseases, like Malaria, Dengue, Ebola, and Zyka can be acquired abroad and brought back to your ED in unsuspecting individuals. This is serious stuff - you might be surprised to learn that Malaria is responsible for more morbidity and mortality worldwide than any other illness. According to a study in CJEM most emergency physicians have minimal or no specific training in tropical diseases and emergency physicians indicated an unacceptably low level of comfort when faced with patients with tropical disease symptoms. In fact, 40% of the cases were incorrectly diagnosed or managed. And Canadian ED docs aren't the only ones who's skill isn't stellar in this department - a similar 2006 study of UK physicians showed a 78% misdiagnosis rate. This misdiagnosis rate isn't wholly because of lack of knowledge – it almost certainly also has to do with the vague presentations and huge amount of overlap between so many tropical disease. You might be thinking that it's impossible to learn all the thousands of details of the dozens of different tropical diseases - true. However, in the ED, while we don't need to know every detail of every tropical disease, and don't necessarily need to make the exact diagnosis right away, we do need to have a rational, organized approach to diagnosing and managing fever in the returning traveler, so that we can identify some of the more common serious illnesses like Malaria, Dengue and Typhoid fever, and start timely treatment in the ED. The post Episode 77 Fever in the Returning Traveler appeared first on Emergency Medicine Cases.

In this EM Cases episode with Dr. Nazanin Meshkat, multinational ED doc and Dr. Matthew Muller, infectious disease specialist, we discuss the most common tropical disease killers that we see in patients who present with Fever in the Returning Traveler. Every year an increasing number of people travel abroad, and travelers to tropical destinations are often immunologically naïve to the regions they’re going to. It’s very common for travelers to get sick. In fact, about 2/3 of travelers get sick while they’re traveling or soon after their return, and somewhere between 3 and 19% of travelers to developing countries will develop a fever. Imported diseases, like Malaria, Dengue, Ebola, and Zyka can be acquired abroad and brought back to your ED in unsuspecting individuals. This is serious stuff - you might be surprised to learn that Malaria is responsible for more morbidity and mortality worldwide than any other illness. According to a study in CJEM most emergency physicians have minimal or no specific training in tropical diseases and emergency physicians indicated an unacceptably low level of comfort when faced with patients with tropical disease symptoms. In fact, 40% of the cases were incorrectly diagnosed or managed. And Canadian ED docs aren’t the only ones who’s skill isn’t stellar in this department - a similar 2006 study of UK physicians showed a 78% misdiagnosis rate. This misdiagnosis rate isn’t wholly because of lack of knowledge – it almost certainly also has to do with the vague presentations and huge amount of overlap between so many tropical disease. You might be thinking that it’s impossible to learn all the thousands of details of the dozens of different tropical diseases - true. However, in the ED, while we don’t need to know every detail of every tropical disease, and don’t necessarily need to make the exact diagnosis right away, we do need to have a rational, organized approach to diagnosing and managing fever in the returning traveler, so that we can identify some of the more common serious illnesses like Malaria, Dengue and Typhoid fever, and start timely treatment in the ED. The post Episode 77 Fever in the Returning Traveler appeared first on Emergency Medicine Cases.

BEST CASE EVER 20: CPR in Trauma?!?! Closed Chest Compressions in Traumatic Arrest?!?! Is CPR ever successful in the trauma patient? Dr. Dave MacKinnon, Trauma Team Leader at St. Michael's Hospital in Toronto, gives you his Best Case Ever in the cardiac arrest trauma patient. The literature is full of case series of zero survival in trauma patients requiring CPR. For example, this report in CJEM. Normally, we should not be thinking of CPR in traumatic arrests, but instead, ED thoracotomy as Scott Weingart of emcrit describes in his podast 36 - Traumatic Arrest. But just wait until you here Dave's Best Case Ever.......... The post Best Case Ever 20: CPR in Trauma appeared first on Emergency Medicine Cases.

BEST CASE EVER 20: CPR in Trauma?!?! Closed Chest Compressions in Traumatic Arrest?!?! Is CPR ever successful in the trauma patient? Dr. Dave MacKinnon, Trauma Team Leader at St. Michael's Hospital in Toronto, gives you his Best Case Ever in the cardiac arrest trauma patient. The literature is full of case series of zero survival in trauma patients requiring CPR. For example, this report in CJEM. Normally, we should not be thinking of CPR in traumatic arrests, but instead, ED thoracotomy as Scott Weingart of emcrit describes in his podast 36 - Traumatic Arrest. But just wait until you here Dave's Best Case Ever.......... The post Best Case Ever 20: CPR in Trauma appeared first on Emergency Medicine Cases.