Join the team from EMGuideWire from Carolinas Medical Center as Dr. Clare Gunn gets to chat with Dr. Pendell Meyers about the challenges of relying on the STEMI paradigm and what other factors to consider when evaluating patients for Occlusive Myocardial Infarctions (OMI).
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Intern Nuggets 3
17:08Join the EMGuidewire team as Drs. Folk and Diurba explore another episode of INTERN NUGGETS! In this episode, they discuss an approach to the medically complex patient as well as giving and receiving feedback. They also explore the extremely important topic of burnout and ways to avoid it.
Occlusive Myocardial Infarction Intro
29:14Join the team from EMGuideWire from Carolinas Medical Center as Dr. Clare Gunn gets to chat with Dr. Pendell Meyers about the challenges of relying on the STEMI paradigm and what other factors to consider when evaluating patients for Occlusive Myocardial Infarctions (OMI).
Tension Pneumoperitoneum: More Than Bad Belly Pain
9:23Join the @EMGuideWire team from @CMCEM as they learn from former Chief Resident, Dr. Rushnell, how to manage the complex condition of Tension Pneumoperitoneum.
Pediatric DVT and PE
8:09Join the EMGuideWire team from the CMC EM Residency Program as we welcome back Dr. Rushnell, prior CMC EM Chief Resident, to discuss the challenging topic of Pediatric DVT and PE.
14:10Join the EMGuideWire Team from Carolinas Medical Center (@CMCEM) and Dr. Mark Kastner and Dr. Matthew Cravens in the Chief's Corner as they discuss the presentation and diagnosis of the challenging diagnosis of Guillain–Barré Syndrome.
Intern Nuggets #2: Sign-out Tips and Pediatric Dehydration and BRUE
16:26Join the crew from EMGuidewire as they are joined, once again, by Drs. Diurba and Folk for their unique perspectives from an intern's point of view. This month's Intern Nugget will cover sign-out and transition of care tips as well as some learning point on pediatric dehydration management and BRUE.
4 Factor PCC in Trauma
11:47Join the EMGuideWire Team as they welcome back Dr. Chelsea Rushnell, prior Chief Resident at CMC Emergency Residency, to discuss the management of the anticoagulated trauma patient. Perhaps just flooding individuals with FFP is not the best strategy. Dr. Rushnell will review the evidence for the use of 4 Factor PCC.
Intern Nugget #1: Imposter Syndrome, Complex Regional Pain Syndrome, and Analgesia Options
12:18Join the EMGuideWire team from CMC EM residency as they hear a fresh perspective... from newly minted residency Interns, Drs. Destiny Folk and Sofiya Diurba. For this Intern Nugget, they address: 1) Imposter Syndrome and how to overcome it. 2) Complex Regional Pain Syndrome and how to manage it. 3) Analgesia options in the ED
Penetrating Cardiac Trauma
20:28Join the EMGuidewire team at Carolinas Medical Center Emergency Medicine program as they discuss important topics. This week, Drs. Cravens and Kastner discuss Penetrating Cardiac Injury (PCI): -The diagnosis of PCI is made in the trauma bay with repeat cardiac ultrasound exams and chest x-ray. If suspicion remains high despite inconclusive imaging, operative subxiphoid pericardial window is the definitive diagnostic modality. -Large pericardial injury, especially from ballistic injuries, can result in PCI without positive pericardial fluid on FAST, if the blood is draining into the hemithorax. This would result in hemothorax, but not always with high enough drainage to mandate operative intervention if PCI is not kept with high index of suspicion. -ED management of PCI is stabilization until the patient can be managed in the OR with sternotomy and external cardiac repair. In the pulseless patient with recent arrest, ED thoracotomy is indicated, provided operating room intervention is available immediately following. Unstable patients with a pulse need immediate operative intervention; if FAST is positive for pericardial fluid, ED pericardiocentesis should be considered as a temporizing measure in these patients, especially if transfer is needed for OR intervention.
Diabetic Ketoacidosis Emergent Management
34:22Join the EMGuideWire Team from CMC EM group as they explore the initial thoughts and management of a patient who presents with severe Diabetic Ketoacidosis (DKA). For this episode, Drs. Claire Milam and Travis Barlock explore the initial considerations and practical management tips. Definitions of severity of DKA: Mild pH: 7.25-7.3 CO2: 15-18 mEq/L Anion Gap: > 10 mEq/L Mental Status: Alert Blood Glucose: >250 mg/dl Urine and Serum Ketones: Positive Moderate pH: 7.0-7.24 CO2: 10-15 mEq/L Anion Gap: >12 mEq/L Mental Status: Alert to Drowsy Blood Glucose: >250 mg/dl Urine and Serum Ketones: Positive Severe pH: CO2: Anion Gap: > 12 mEq/L Mental Status: Stuporous to Comatose Blood Glucose: >250 mg/dl Urine and Serum Ketones: Positive