Podcasts about emnerd

We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessons

Join the nerds as they talk nerd news and shoot the breeze

Join the guys as they shoot the breeze about video games, movies, and nerd news!

The EM Cases Team is very excited to bring you not only a new format for the Journal Jam podcast but a new member of the team, Dr. Rory Spiegel, aka @EM_Nerd an Emergency Medicine physician from The University Maryland Medical Center in Baltimore, the founder of the EM Nerd blog and the co-host of the Annals of EM podcast. The new format sees Justin Morgenstern, Teresa Chan, Rory Spiegel and Anton Helman doing deep dives into the world's literature on specific practical questions while highlighting some important evidence-based medicine concepts. The question we ask in this Journal Jam podcast: Is there a role for D-dimer testing in the workup of aortic dissection in the ED? The post Journal Jam 9 – D-dimer to Rule Out Aortic Dissection appeared first on Emergency Medicine Cases.

The PESIT study in the New England Journal of Medicine stirred up controversy in the FOAM world earlier in October 2016.  In this episode we cover the following posts on this article on pulmonary embolism in syncope: Dr. Rory Spiegel of EMnerd  Dr. Ryan Radecki of EM Literature of Note St. Emlyn's Rebel EM  Then, We delve into core content on syncope usingRosen's Emergency Medicine (8th edition) and Tintinalli's Emergency Medicine (8th edition) Chapter 52   Thanks for listening! -Jeremy Faust and Lauren Westafer

This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM:

This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM: Thrombolytics for Acute Stroke

This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM: Thrombolytics for Acute Stroke

This week we review a number of controversial topics in SSTI management with a focus on the role of antibiotics in abscess management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_45_0_Final_Cut.m4a Download Leave a Comment Tags: Abscess, Cellulitis, Controversy, I+D, Irrigation, TMP-SMX Show Notes Core EM: Predictors of failed outpatient cellulitis treatment EM Nerd: The Case of the Pragmatic Wound REBEL EM: Trimethoprim-sulfamethoxazole for uncomplicated skin abscesses EM Lyceum: Abscess, “Answers” References Peterson D et al. Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients with Uncomplicated Cellulitis. Acad Emerg Med 2014; 21: 526-31. PMID: 24842503...

This week we review a number of controversial topics in SSTI management with a focus on the role of antibiotics in abscess management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_45_0_Final_Cut.m4a Download Leave a Comment Tags: Abscess, Cellulitis, Controversy, I+D, Irrigation, TMP-SMX Show Notes Core EM: Predictors of failed outpatient cellulitis treatment EM Nerd: The Case of the Pragmatic Wound REBEL EM: Trimethoprim-sulfamethoxazole for uncomplicated skin abscesses EM Lyceum: Abscess, “Answers” References Peterson D et al. Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients with Uncomplicated Cellulitis. Acad Emerg Med 2014; 21: 526-31. PMID: 24842503

This week we review a number of controversial topics in SSTI management with a focus on the role of antibiotics in abscess management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_45_0_Final_Cut.m4a Download Leave a Comment Tags: Abscess, Cellulitis, Controversy, I+D, Irrigation, TMP-SMX Show Notes Core EM: Predictors of failed outpatient cellulitis treatment EM Nerd: The Case of the Pragmatic Wound REBEL EM: Trimethoprim-sulfamethoxazole for uncomplicated skin abscesses EM Lyceum: Abscess, “Answers” References Peterson D et al. Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients with Uncomplicated Cellulitis. Acad Emerg Med 2014; 21: 526-31. PMID: 24842503

Today we are visited by Dr. Rory Spiegel. The man behind EM Nerd and the most recent winner of the EMRA Educator and FOAMer of the year! Dr. Spiegel is most recently completing his Resuscitation Fellowship at Stony Brook University Medical Center where every day activities focus on two things: the creation of an ED-ICU model AND reviewing/critiquing scientific papers. Today he will be doing his best to concentrate his brilliance into a 45 minute presentation. I have heard a ton of lectures on EBM, but never before has one made so much sense in such a short period of time!

This week we discuss the work up for dementia and delirium as well as a bit on ischemic CVA management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_29_0_Final_Cut.m4a Download Leave a Comment Tags: CVA, Delirium, Dementia, Stroke, tPA Show Notes SAEM Geriatric Guidelines (includes screening tools for delirium): GEMCast: Diagnosing and Managing Delirium in Older Adults Gioia, LC et al. Blood pressure management in acute intracerebral hemorrhage: current evidence and ongoing controversies. Curr Opin Crit Care. 2015; 21(2):99-106. PMID: 25689125 Miller J et al. Management of hypertension in stroke. Ann Emerg Med. 2014; 64(3): 248-55. PMID: 24731431 EM Nerd: A Truncated Summation of the Adventure of the Cardboard Box Ed in the ED WDYS: Talking about tPA – Expert and Community Commentary   Read More

This week we discuss the work up for dementia and delirium as well as a bit on ischemic CVA management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_29_0_Final_Cut.m4a Download Leave a Comment Tags: CVA, Delirium, Dementia, Stroke, tPA Show Notes SAEM Geriatric Guidelines (includes screening tools for delirium): GEMCast: Diagnosing and Managing Delirium in Older Adults Gioia, LC et al. Blood pressure management in acute intracerebral hemorrhage: current evidence and ongoing controversies. Curr Opin Crit Care. 2015; 21(2):99-106. PMID: 25689125 Miller J et al. Management of hypertension in stroke. Ann Emerg Med. 2014; 64(3): 248-55. PMID: 24731431 EM Nerd: A Truncated Summation of the Adventure of the Cardboard Box Ed in the ED WDYS: Talking about tPA – Expert and Community Commentary   Read More

This week we discuss the work up for dementia and delirium as well as a bit on ischemic CVA management. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_29_0_Final_Cut.m4a Download Leave a Comment Tags: CVA, Delirium, Dementia, Stroke, tPA Show Notes SAEM Geriatric Guidelines (includes screening tools for delirium): GEMCast: Diagnosing and Managing Delirium in Older Adults Gioia, LC et al. Blood pressure management in acute intracerebral hemorrhage: current evidence and ongoing controversies. Curr Opin Crit Care. 2015; 21(2):99-106. PMID: 25689125 Miller J et al. Management of hypertension in stroke. Ann Emerg Med. 2014; 64(3): 248-55. PMID: 24731431 EM Nerd: A Truncated Summation of the Adventure of the Cardboard Box Ed in the ED WDYS: Talking about tPA – Expert and Community Commentary   Read More

Are you ready for endovascular therapy in ischemic CVA? We discuss some of the ins and outs focusing on the MR CLEAN trial. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_27_0_Final_Cut.m4a Download Leave a Comment Tags: CVA, Ischemic Stroke, MR CLEAN Show Notes Montori VM et al. Randomized trials stopped early for benefit: a systematic review. JAMA 2005; 294(17): 2203-9. PMID: 16264162 EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EM Nerd: A Truncated Summation of the Adventure of the Cardboard Box (Reviews the major endovascular treatment studies) Read More

Are you ready for endovascular therapy in ischemic CVA? We discuss some of the ins and outs focusing on the MR CLEAN trial. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_27_0_Final_Cut.m4a Download Leave a Comment Tags: CVA, Ischemic Stroke, MR CLEAN Show Notes Montori VM et al. Randomized trials stopped early for benefit: a systematic review. JAMA 2005; 294(17): 2203-9. PMID: 16264162 EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EM Nerd: A Truncated Summation of the Adventure of the Cardboard Box (Reviews the major endovascular treatment studies) Read More

Are you ready for endovascular therapy in ischemic CVA? We discuss some of the ins and outs focusing on the MR CLEAN trial. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_27_0_Final_Cut.m4a Download Leave a Comment Tags: CVA, Ischemic Stroke, MR CLEAN Show Notes Montori VM et al. Randomized trials stopped early for benefit: a systematic review. JAMA 2005; 294(17): 2203-9. PMID: 16264162 EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EM Nerd: A Truncated Summation of the Adventure of the Cardboard Box (Reviews the major endovascular treatment studies) Read More

We cover Dr. Rory Spiegel's blog EMNERD, covering an article in Chest 2015 by Pivetta et al, discussing the ways lung ultrasound (US) may be far more helpful than the brain natriuretic peptide (BNP) in determining heart failure in the dyspneic patient.  Then we delve into likelihood ratios and show notes can be found at FOAMCAST.org Bottom Line, LR of 1 is useless. It doesn't change the likelihood of using the disease. + LR >5 is good, + LR of 10 means that a test is useful and, if positive, patient most likely had the disease - LR 0.2 is ok but a - LR of 0.1 is much more helpful. Using a Fagan nomogran, one can understand how various likelihood ratios (and tests with their known LRs) may affect the post-test probability (i.e. the likelihood the patient has the disease). The utility of tests also depends on the pretest probability.  

This week we cover Dr. Rory Spiegel's post on initial non-operative management of acute appendicitis in his blog post on EMnerd reviewing a paper by Salminen et al. Then we review appendicitis and some other right lower quadrant abdominal pearls using Rosen's Emergency Medicine and Tintinalli as a guide. We have Rosh Review questions and more available on our website, FOAMcast.org. Thanks y'all! -Jeremy Faust and Lauren Westafer  

In this Journal Jam we have Dr. Michelle Lin from Academic Life in EM interviewing two authors, Dr. Rebecca Smith‑Bindman, a radiologist, and Dr. Ralph Wang an EM physician both from USCF on their article “Ultrasonography versus Computed Tomography for suspected Nephrolithiasis” published in the New England Journal of Medicine in 2014. There is currently a wide practice variation in the imaging work-up of the patient who presents to the ED with a high suspicion for renal colic. On the one extreme, some EM physicians use CT to screen all patients who present with renal colic, while on the other extreme, other EM physicians do not use any imaging on any patient who has had previous imaging. The role of POCUS and radiology department ultrasound as an alternative to CT in the work up of renal colic has not been clearly defined in the ED setting. This study was a pragmatic multi-centre randomized control trial of patients in whom the primary diagnostic concern was renal colic, that tried to answer the question: is there a significant difference in the serious missed diagnosis rate, serious adverse events rate, pain, return visits, admissions to hospital, radiation dose and diagnostic accuracy if the EM provider chose POCUS, radiology department ultrasound or CT for their initial imaging modality of choice. This Journal Jam is peer review by EMNerd's Rory Spiegel. [wpfilebase tag=file id=618 tpl=emc-play /] [wpfilebase tag=file id=619 tpl=emc-mp3 /] The post Journal Jam 3 – Ultrasound vs CT for Renal Colic appeared first on Emergency Medicine Cases.

In this Journal Jam we have Dr. Michelle Lin from Academic Life in EM interviewing two authors, Dr. Rebecca Smith‑Bindman, a radiologist, and Dr. Ralph Wang an EM physician both from USCF on their article “Ultrasonography versus Computed Tomography for suspected Nephrolithiasis” published in the New England Journal of Medicine in 2014. There is currently a wide practice variation in the imaging work-up of the patient who presents to the ED with a high suspicion for renal colic. On the one extreme, some EM physicians use CT to screen all patients who present with renal colic, while on the other extreme, other EM physicians do not use any imaging on any patient who has had previous imaging. The role of POCUS and radiology department ultrasound as an alternative to CT in the work up of renal colic has not been clearly defined in the ED setting. This study was a pragmatic multi-centre randomized control trial of patients in whom the primary diagnostic concern was renal colic, that tried to answer the question: is there a significant difference in the serious missed diagnosis rate, serious adverse events rate, pain, return visits, admissions to hospital, radiation dose and diagnostic accuracy if the EM provider chose POCUS, radiology department ultrasound or CT for their initial imaging modality of choice. This Journal Jam is peer review by EMNerd's Rory Spiegel. [wpfilebase tag=file id=618 tpl=emc-play /] [wpfilebase tag=file id=619 tpl=emc-mp3 /] The post Journal Jam 3 – Ultrasound vs CT for Renal Colic appeared first on Emergency Medicine Cases.