Episode Archives - The Emergency Medical Minute

Episode Archives

Podcast 792: Rectal Prolapse

Contributor: Jarod Scott, MD Educational Pearls: Rectal prolapse is an evagination of the rectal tissue through the anal opening Factors that weaken the pelvic floor muscles increase the risk of rectal prolapse These include age > 40, female, multiple pregnancies, constipation, diarrhea, cystic fibrosis, prior pelvic floor surgeries, or other pelvic floor abnormalities Noninvasive treatment…

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Podcast 791: Hyperglycemic Hyperosmolar State

Contributor: Aaron Lessen, MD Educational Pearls: Hyperglycemic Hyperosmolar State (HHS) is less common than Diabetic Ketoacidosis (DKA) but is associated with a mortality rate up to 10 times greater than that seen in DKA Typically seen in elderly patients with severely elevated blood glucose levels (>1000 mg/dL) and an increased plasma osmolality Unlike in DKA,…

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Podcast 790: Opioids vs OTC Pain Meds

Contributor: Aaron Lessen, MD Educational Pearls: NSAIDs are a potential alternative to opioids for pain management and are associated with decreased rates of adverse effects A recent study evaluated the effectiveness of ibuprofen and oxycodone for pain management in pediatric patients with isolated, acute-limb fractures Participants were discharged home with either ibuprofen or oxycodone and…

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Podcast 789: DOAC

Contributor: Aaron Lessen, MD  Educational Pearls: Direct Oral Anticoagulants (DOACs) have surpassed Warfarin and Lovenox® for anticoagulation as they do not require injection and allow for easier discharge. In the ED, they are commonly prescribed after PE or DVT diagnosis.  Common DOACs are Apixaban (Eliquis®) and Rivaroxaban (Xarelto®). There has not been a direct head…

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MHM: Substance-Induced Psychosis (Part I)

Substance-Induced Psychosis (Part I) In this first episode of a two-part mini-series, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, as they discuss the different substances that cause psychosis and their unique presentations in the ED and in the psychiatric world. First, Dr. Haddad establishes a medical…

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Podcast 788: Tracheostomy Bleeding

Contributor: Aaron Lessen, MD Educational Pearls: Tracheostomy bleeding is a rare but potentially life-threatening complication that usually occurs within the first month of tracheostomy tube placement No matter how severe the bleeding, every patient should be evaluated to rule out a tracheo-innominate fistula between the tracheostomy and the innominate artery If the patient is currently…

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Podcast 787: TAVR and Stroke

 Contributor: Nick Hatch, MD Educational Pearls: Transcatheter aortic valve replacement (TAVR) is an increasingly common endovascular procedure to treat aortic stenosis TAVR is an alternative to the open approach surgical aortic valve replacement (SAVR) for patients who are inoperable or are high risk surgical candidates Following TAVR, there is increased risk of stroke, particularly…

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The Not So Simple Status Epilepticus From A Tumor That’s Not A Tumor

The Not So Simple Status Epilepticus From A Tumor That’s Not A Tumor Chief Complaint: Seizure HPI: 16-year-old male brought in by EMS for seizure-like activity for 15 minutes while at his uncle’s house. On arrival to scene, EMS noted tonic clonic activity was noted in all extremities by EMS and 5mg IM Versed given…

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Podcast 786: Smiling Death

Contributor: Nick Hatch, MD Educational Pearls: “Smiling Death” describes the prehospital phenomenon of a person who is happy to be extricated from an extended period of crush injury, but dies suddenly soon after the rescue.   Smiling Death is caused by Crush Syndrome. Crush Syndrome begins when large areas of tissue are damaged by compression and…

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