Emergency Medicine Journal Club Cast

Vitals & Useful Links: Learn about one important etiology of epigastric pain (see spoilers below if you want to know which one - hint: We've covered a type of it before!) PulmCrit has a great post about it here (spoilers) In this episode, Jordan (PGY1.5) takes Kyle (PGY0) and Arman (PGY0) through a case of epigastric abdominal pain. We quickly get to the diagnosis, but the etiology and management are fascinating! As per usual, Nurse Barb and Jordan lay down some wisdom on the way the real world of medicine works. How would you approach this case? As always, we learn a couple of very important points about the epigastric abdominal pain. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about important management strategies for burn patients (see spoilers below if you want to know more) Podcast - EMCrit Episode on Burns (spoilers) emDOCs - Burns (spoilers) Brynne is back! According to one of our two iTunes reviews, she has been voted the best host of the podcast yet, so let's hope she lives up to her high standard. On this episode, Brynne (MS4), leads Arman (MS4), and Kyle (MS4) through a case of a burn patient who sounds eerily similar to our old eye pain patient from a few weeks ago....hmmmm suspicious. As always, we learn some important management strategies for burn patients from our favorite future surgical intern. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Here's Brynne's article on Smoke Inhalation Injuries Toon, M. H., Maybauer, M. O., Greenwood, J. E., Maybauer, D. M., & Fraser, J. F. (2010). Management of acute smoke inhalation injury. Critical care and resuscitation, 12(1), 53. And here's her article on advances in burn care Ipaktchi, K., & Arbabi, S. (2006). Advances in burn critical care. Critical Care Medicine, 34(9), S239-S244. DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about one important etiology of fever & abdominal pain (see spoilers below if you want to know which one) EM Clerkship Podcast - Pediatric Abdominal Pain In this episode, Arman (MS4) takes Kyle (MS4) and Neil (MS3) through a case of worsening fever and abdominal pain that had already been previously been evaluated. Nothing is ever too simple in the world of pediatric emergency medicine! As always, Nurse Barb is moonlighting in the pediatric emergency room to guide our hosts to the appropriate management. How would you approach this case? As always, we learn a couple of very important points about the GU side of abdominal pain. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Here is the article from Ultrasound Quarterly presented today: Cavorsi, K., Prabhakar, P., & Kirby, C. (2010). Acute pyelonephritis. Ultrasound Quarterly, 26(2), 103–105. https://doi.org/10.1097/RUQ.0b013e3181dc7d0b An article on pyelonephritis from the great site emDocs: http://www.emdocs.net/pyelonephritis-its-not-always-so-straightforward/ And of course - a great UpToDate article on complicated UTIs: https://www.uptodate.com/contents/acute-complicated-urinary-tract-infection-including-pyelonephritis-in-adults DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about one important etiology of eye pain (see spoilers below if you want to know which one) EM Clerkship Podcast - Evaluating Eye Complaints EM Cases - Nontraumatic Eye Emergencies Welcome back from our extended break! Sometimes life just gets in the way and your one week break turns into a one month break, but the EMJC crew is back with a new guest and a very special case. This week, Kyle (MS4) leads Adam (MS3) and new guest Nikita (MS3) through a case of a young male with an eye complaint, all with the help of Arman (MS4) aka Nurse Barb. How would you approach this case? As always, we learn a couple of very important points about eye complaints. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Here are the UpToDate articles we presented today: Uveitis etiology and Uveitis treatment  Here is an article on A Systematic Approach to Emergencies in Uveitis Al-Dhibi, H. A., Al-Mahmood, A. M., & Arevalo, J. F. (2014). A systematic approach to emergencies in uveitis. Middle East African journal of ophthalmology, 21(3), 251–258. https://doi.org/10.4103/0974-9233.134687 Here is an article on diagnosis and management of anterior uveitis Agrawal, R. V., Murthy, S., Sangwan, V., & Biswas, J. (2010). Current approach in diagnosis and management of anterior uveitis. Indian journal of ophthalmology, 58(1), 11–19. https://doi.org/10.4103/0301-4738.58468 DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about management  and etiologies of a case of weakness and fatigue in an middle aged female EMCrit - Internet Book of Critical Care chapter on management of this patient's bradycardia Jordan is back! EMJCCast's favorite PGY1 (almost 2!) is here to lay down some knowledge with Kyle (MS4) and Arman (MS4) in this case of weakness and fatigue in a middle aged female. How would you approach this case? As always, we learn some important management strategies for a specific etiology of weakness & fatigue. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Here is the ACLS Algorithm for management of bradycardia Liu, L. A., RN. (2019, December 19). ACLS bradycardia Algorithm. Retrieved March 15, 2021, from https://www.acls.net/acls-bradycardia-algorithm.htm Here is the AHA's article on management of symptomatic bradycardia American Heart Association. (2005). Part 7.3: Management of symptomatic bradycardia and tachycardia. Circulation, 112(24 suppl). EMCrit has a great brief chapter about bradycardia on the Internet Book of Critical Care here; Josh Farkas also covers why we should use epinephrine over atropine for initial management here Here's an article on non-occlusive MI & vasospastic angina Beijk, M. A., Vlastra, W. V., Delewi, R., van de Hoef, T. P., Boekholdt, S. M., Sjauw, K. D., & Piek, J. J. (2019). Myocardial infarction with non-obstructive coronary arteries: a focus on vasospastic angina. Netherlands Heart Journal, 27(5), 237-245. And a great approach to bradycardia in the ED from our favorite EM Clerkship DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about management  and etiologies of a headache in pregnancy (see spoilers below if you want to find out which one) EM Clerkship Podcast - Headache EMJC is live in 3D! This week, before an intern boot camp class, Kyle (MS4) leads Charlie (MS4) and Arman (MS4) live and in-person* through a case of a woman presenting with a headache. Did we mention she was pregnant? How would you approach this case? As always, we learn some important management strategies for a specific etiology of headache. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *All participants have been vaccinated and were distanced during the show *****EPISODE SPOILERS BELOW***** Here's Kyle's Review Article on Migraines in Pregnancy Negro, A., Delaruelle, Z., Ivanova, T. A., Khan, S., Ornello, R., Raffaelli, B., ... & Mitsikostas, D. D. (2017). Headache and pregnancy: a systematic review. The journal of headache and pain, 18(1), 1-20. And a great approach to headache in the ED from EM Clerkship DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about management of a first time seizure (see spoilers below if you want to find out how) EM Clerkship Podcast - Seizure (spoilers) EM Clerkship Podcast - Status Epilepticus ACEP Clinical Policies - Seizure EMJC is back to our regularly scheduled episodes! This week Arman (MS4) leads Kyle (MS4) and Frankie (MS4) through a case of a woman presenting after a first time seizure. How would you approach this case? As always, we learn some important management strategies for seizures. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Here's Arman's Article on Management of Status Epilepticus Glauser, T., Shinnar, S., Gloss, D., Alldredge, B., Arya, R., Bainbridge, J., Bare, M., Bleck, T., Dodson, W. E., Garrity, L., Jagoda, A., Lowenstein, D., Pellock, J., Riviello, J., Sloan, E., & Treiman, D. M. (2016). Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy currents, 16(1), 48–61. https://doi.org/10.5698/1535-7597-16.1.48 Arman's Article on the ESETT Trial Cock, H. R., & ESETT Group. (2011). Established status epilepticus treatment trial (ESETT). Epilepsia, 52, 50-52. EM Cases - Management of Status Epilepticus DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Grab some roses and a heart shaped box of chocolates - it's the Valentine's Day Special! As is tradition we have a 3-part Valentine's Day Special episode featuring many of our previous guests! In this one Danny, Nate, and Taylor talk about glass, roses, and balconies. Join us to learn about some interesting and non-romantic Valentine's Day-themed Emergency Medicine topics. This week Arman, Kyle, Adam, Pranav, Taylor, Danny, Abby, Nate, and Chris come together to talk all things love/romance/oral microbiome/foreign body related for this weekend. We want to avoid spoilers as much as possible, but we discuss topics ranging from hickies to broken hearts. We also talk chocolate facts! We hope you enjoy this one, and stay tuned for future holiday episodes! If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Danny's Article: Ploner M, Gardetto A, Ploner F, Scharl M, Shoap S, Bäcker HC. Foreign rectal body - Systematic review and meta-analysis. Acta Gastroenterol Belg. 2020;83(1):61-65. Nathan's Articles: Mangat, P., & Jawad, A. S. (2007). A case of rose thorn tenosynovitis. Grand Rounds, 7, 16-17 Taylor's Articles: Davis D, Seaman TJ, Newton EJ. Calcaneus Fractures. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430861/ and this Radiopaedia article on calcaneal fractures DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Grab some roses and a heart shaped box of chocolates - it's the Valentine's Day Special! As is tradition we have a 3-part Valentine's Day Special episode featuring many of our previous guests! In this one Adam, Abby, and Chris talk about kisses, octopi/octopuses?, and cyanopia. Join us to learn about some interesting and non-romantic Valentine's Day-themed Emergency Medicine topics. This week Arman, Kyle, Adam, Pranav, Taylor, Danny, Abby, Nate, and Chris come together to talk all things love/romance/oral microbiome/foreign body related for this weekend. We want to avoid spoilers as much as possible, but we discuss topics ranging from hickies to broken hearts. We also talk chocolate facts! We hope you enjoy this one, and stay tuned for future holiday episodes! If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Adam's Article: Kort R, Caspers M, van de Graaf A, van Egmond W, Keijser B, Roeselers G. Shaping the oral microbiota through intimate kissing. Microbiome. 2014;2:41. Published 2014 Nov 17. doi:10.1186/2049-2618-2-41 Abby's Article: Bybee KA, Kara T, Prasad A, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med. 2004;141(11):858-865. doi:10.7326/0003-4819-141-11-200412070-00010 Chris's Article: Yafi FA, Sharlip ID, Becher EF. Update on the Safety of Phosphodiesterase Type 5 Inhibitors for the Treatment of Erectile Dysfunction. Sex Med Rev. 2018;6(2):242-252. doi:10.1016/j.sxmr.2017.08.001 DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Grab some roses and a heart shaped box of chocolates - it's the Valentine's Day Special! As is tradition we have a 3-part Valentine's Day Special episode featuring many of our previous guests! In this one - Arman and Pranav talk about Cupid and high school! Join us to learn about some interesting and non-romantic Valentine's Day-themed Emergency Medicine topics. This week Arman, Kyle, Adam, Pranav, Taylor, Danny, Abby, Nate, and Chris come together to talk all things love/romance/oral microbiome/foreign body related for this weekend. We want to avoid spoilers as much as possible, but we discuss topics ranging from hickies to broken hearts. We also talk chocolate facts! We hope you enjoy this one, and stay tuned for future holiday episodes! If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Arman's Article: Benedetto U, Caputo M, Kosti A, et al. Cupid's arrow retained in the heart. J Thorac Dis. 2019;11(1):E1-E3. doi:10.21037/jtd.2018.12.12 Pranav's Article: Wu TY, Hsiao J, Wong EH. Love bites--an unusual cause of blunt internal carotid artery injury. N Z Med J. 2010;123(1326):112-115. Published 2010 Nov 26. DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about one important etiology of abdominal pain (see spoilers below if you want to know which one) Podcasts: Abdominal Pain Basics (EM Clerkship), This Episode's Topic (EM Clerkship) *SPOILERS* EM Basic Show Notes: Female Abdominal Pain Recommendations for Management of This Episode's Topic *SPOILERS* In a big twist this week, we welcome our friend and future surgeon Brynne (MS4) to lead Arman (MS4) and Kyle (MS4) through a surgical emergency case. As always, we learn a couple very important points about one etiology of abdominal pain including some non-surgical interventions we can perform in the Emergency Room. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Here's Brynne's article on Adhesive Disease in Abdominal Surgery Ten Broek, R. P., Issa, Y., van Santbrink, E. J., Bouvy, N. D., Kruitwagen, R. F., Jeekel, J., ... & van Goor, H. (2013). Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis. Bmj, 347. Her Article on Small Bowel Obstruction Mullan, C. P., Siewert, B., & Eisenberg, R. L. (2012). Small bowel obstruction. American Journal of Roentgenology, 198(2), W105-W117. Another Article on Adhesive Disease Menzies, D., & Ellis, H. (1990). Intestinal obstruction from adhesions--how big is the problem?. Annals of the Royal College of Surgeons of England, 72(1), 60. Grading of Adhesive Disease Long-Term Prognosis After Operation for Adhesive Disease Risk of Adhesion Recurrence DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about how to manage pediatric head and neck trauma (see spoilers below if you want to know how) Pediatric Emergency Playbook Podcast - Blunt Head Trauma PEM ED Podcast - Clearing the Pediatric C-Spine EMJC's in-house gymnast graces us with his presence as Kyle (MS4) leads Arman (MS4) and Nathan (MS4) through a case of a child brought to the ED after a trampoline accident. How would you approach this case? As always, we learn a couple of very important points about pediatric trauma and injuries. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *****EPISODE SPOILERS BELOW***** Here's the article on PECARN Head Injury Algorithm Kuppermann, N., Holmes, J. F., Dayan, P. S., Hoyle, J. D., Atabaki, S. M., Holubkov, R., … & Pediatric Emergency Care Applied Research Network. (2009). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. The Lancet, 374(9696), 1160-1170. Here's the PECARN C-Spine Paper Leonard, J. C., Kuppermann, N., Olsen, C., Babcock-Cimpello, L., Brown, K., Mahajan, P., … & Pediatric Emergency Care Applied Research Network. (2011). Factors associated with cervical spine injury in children after blunt trauma. Annals of emergency medicine, 58(2), 145-155. PECARN Algorithm - MD Calc Comparison of PECARN, CATCH, and CHALICE Ped EM Morsels Links: PECARN, Trampoline Injuries, and C-Spine Injuries Nexus Criteria - MD Calc DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about one important etiology of anxiety and flu-like symptoms (see spoilers below if you want to know which one) emDOCs article on the etiology of this case (spoiler) Great inphographic on this case (spoiler) EMCRIT Internet Book of Critical Care Chapter on this case (spoiler) Clinical decision making tool (spoiler) Adam finally leads the guys through a case! The original EMJC crew is back together as Adam (MS3) leads Arman (MS4) and Kyle (MS4) through a case of a young male with anxiety, diarrhea, and "feeling warm". How would you approach this case? As always, we learn a couple of very important points about this constellation of symptoms and the treatment for this case. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *****EPISODE SPOILERS BELOW***** Here's Adam's review article on Serotonin Syndrome Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013;13(4):533-540. Case Report of Paroxetine Induced Serotonin Syndrome Hudd TR, Blake CS, Rimola-Dejesus Y, Nguyen T-T, Zaiken K. A Case Report of Serotonin Syndrome in a Patient on Selective Serotonin Reuptake Inhibitor (SSRI) Monotherapy. Journal of Pharmacy Practice. 2020;33(2):206-212. doi:10.1177/0897190019841742 Article on Demystifying Serotonin Toxicity Demystifying serotonin syndrome (or serotonin toxicity) Ai-Leng Foong, Kelly A. Grindrod, Tejal Patel, Jamie Kellar Canadian Family Physician Oct 2018, 64 (10) 720-727; DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Vitals & Useful Links: Learn about one important etiology of chest pain and important workup details (see spoilers below if you want to know which one) Podcast: Approach to Chest Pain - EM Clerkship Podcast We're back! The EMJC crew is back together for Season 2 in 2021, bringing you more cases with better audio quality AND our recently launched website: emjccast.com. In our first episode back, Arman (MS4) leads Kyle (MS4), Pranav (MS4), and Pranav's clicky pen through a case of a female presenting with chest pain. How would you approach this case? As always, we learn a couple very important points about chest pain and some relevant diagnostics. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com.. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *****EPISODE SPOILERS BELOW***** Here's Arman's article on AKI after CT Aycock, R. D., Westafer, L. M., Boxen, J. L., Majlesi, N., Schoenfeld, E. M., & Bannuru, R. R. (2018). Acute kidney injury after computed tomography: a meta-analysis. Annals of emergency medicine, 71(1), 44-53. NS, LR, and sodium bicarb for preventing contrast-induced nephropathy Sodium Bicarb and Acetylcysteine to prevent AKI American College of Radiology and National Kidney Foundation consensus statement on IV contrast media use in CKD Prophylactic hydration to prevent contrast-induced nephropathy Vitamin D insufficiency in radiologists DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com. Intro Music: “Walk Through the Park” by Track Tribe

Happy Hazardous Holidays! This is our *belated* holiday special - filled with surprise new hosts, toxic ingestions, slips and falls (off the roof), and Christmas-tree-light filled ex laps. We hope you enjoy. 

Vitals & Useful Links: Learn about an important etiology of syncope. See spoilers below if you want to know which one Podcast: Approach to  Syncope - EM Clerkship Podcast Warning: this is not an educational episode (but it should be fun SURPRISE!) As 2020 comes to a close, we bring you our final episode of the year, officially ending our first season of EMJC Cast. Kyle (MS4) leads his college friends Ari, Conor, and Curtis, none of whom are medical students, through a case of a male presenting after a syncopal episode. Arman (MS4) helps out as Nurse Barb. We wanted to have some fun at the end of the year and see how some non-medical people can handle a medical simulation case, so this episode will be a lot less educational than others, but hopefully a bit more fun. A big thanks to Ari, Conor, and Curtis for joining us this week, and a bigger thanks to Nurse Barb (Arman) for putting up with them. How would you approach this case? As always, we learn a couple very important points about evaluating and treating syncope. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com *****EPISODE SPOILERS BELOW***** Kyle's Article on Early IV iron transfusions in the ED  Beverina, I., Razionale, G., Ranzini, M., Aloni, A., Finazzi, S., & Brando, B. (2020). Early intravenous iron administration in the Emergency Department reduces red blood cell unit transfusion, hospitalisation, re-transfusion, length of stay and costs. Blood transfusion = Trasfusione del sangue, 18(2), 106–116. Article on Type and Screen vs Type and Cross DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com. Intro Music: "Walk Through the Park" by Track Tribe

Vitals & Useful Links: Learn about an important etiology of seizures. See spoilers below if you want to know which one. Podcast: Approach to Seizures - EM Clerkship Podcast Clinical Reference: ACEP Clinical Guidelines on Seizures As 2020 comes to a close, we bring you our final episode of the year, officially ending our first season of EMJC Cast. We want to say a HUGE thank you to every single listener who has tuned in, especially our fan in Papua New Guinea, as well as to all of our cohosts who have joined us so far. In this episode full of twists and turns, Kyle (MS4) leads Arman (MS4), Abby (MS4), and Nathan (MS4) through a case of a male presenting with a chief complaint of "seizure". How would you approach this case? As always, we learn a couple very important points about evaluating and treating seizures. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *EPISODE SPOILERS BELOW* CIWA Assessment for Alcohol Withdrawal MD Calc is a great tool to use for the CIWA-Ar for Alcohol Withdrawal. Kyle's Article on Phenobarbital vs CIWA-Ar Protocol for Treatment of Alcohol Withdrawal Tidwell, W. P., Thomas, T. L., Pouliot, J. D., Canonico, A. E., & Webber, A. J. (2018). Treatment of alcohol withdrawal syndrome: phenobarbital vs CIWA-Ar protocol. American Journal of Critical Care, 27(6), 454-460. Kyle's Article on Single Dose Phenobarbital in the ED Rosenson, J., Clements, C., Simon, B., Vieaux, J., Graffman, S., Vahidnia, F., ... & Alter, H. (2013). Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study. The Journal of emergency medicine, 44(3), 592-598. EM Cases Podcast on Alcohol Withdrawal A great discussion of the diagnosis and management of alcohol withdrawal, including some talk about tongue tremors/fasciculations. Toronto Star Article on Tremor Evaluation App DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com. Intro Music: "Walk Through the Park" by Track Tribe

Vitals & Useful Links: Learn about an important etiology of Altered Mental Status. See spoilers below if you want to know which one. Podcast: Approach to Altered Mental Status - EM Clerkship Podcast  Clinical Reference: CDEM M4 Curriculum - Altered Mental Status This week Jordan is still with us to teach us some critical care medicine. Jordan is an EM intern who joins us to lead Kyle (MS4) and Arman (MS4) through a case of a woman who is brought to the hospital for altered mental status. How would you approach this case? As always, we learn a couple very important points about evaluating and treating AMS. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *EPISODE SPOILERS BELOW* Jordan's Article on Rapid BP Lowering in Acute ICH Anderson CS, Heeley E, Huang Y, Wang J, Stapf C, Delcourt C, Lindley R, Robinson T, Lavados P, Neal B, Hata J, Arima H, Parsons M, Li Y, Wang J, Heritier S, Li Q, Woodward M, Simes RJ, Davis SM, Chalmers J; INTERACT2 Investigators. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. N Engl J Med. 2013 Jun 20;368(25):2355-65. doi: 10.1056/NEJMoa1214609. Epub 2013 May 29. PMID: 23713578. Intensive BP Lowering in Acute Cerebral Hemorrhage Qureshi AI, Palesch YY, Barsan WG, Hanley DF, Hsu CY, Martin RL, Moy CS, Silbergleit R, Steiner T, Suarez JI, Toyoda K, Wang Y, Yamamoto H, Yoon BW; ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med. 2016 Sep 15;375(11):1033-43. doi: 10.1056/NEJMoa1603460. Epub 2016 Jun 8. PMID: 27276234; PMCID: PMC5345109. Frequency of Inverted T-Waves in Acute Strokes (Cerebral T-Waves) Stone, J., Mor-Avi, V., Ardelt, A., & Lang, R. M. (2018). Frequency of inverted electrocardiographic T waves (cerebral T waves) in patients with acute strokes and their relation to left ventricular wall motion abnormalities. The American Journal of Cardiology, 121(1), 120-124. EMDocs: ICH ECG Pointers Check out this site for a great case that walks through some of the pathophysiology of ICH as well as a discussion on Cerebral T-Waves DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com. Intro Music: "Walk Through the Park" by Track Tribe

Vitals & Useful Links: Learn about an important etiology of abdominal pain. See spoilers below if you want to know which one. Podcast: Approach to Abdominal Pain - EM Clerkship Podcast  and Nausea and Vomiting - EM Clerkship Podcast Clinical Reference: ACEP Clinical Guidelines on This Episode's Topic (*SPOILER ALERT*) This week we welcome a new host, Jordan, who has the honor of being EMJC's first MD on the podcast and brings us back to some EM basics. Jordan is an EM intern who joins us to lead Kyle (MS4) and Arman (MS4) through a case of a young woman with nausea, vomiting, and abdominal pain. How would you approach this case? As always, we learn a couple very important points about evaluating and treating abdominal pain, nausea, and vomiting. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *EPISODE SPOILERS BELOW* Jordan's Article on Antibiotic Therapy for Acute Appendicitis Salminen, P., Tuominen, R., Paajanen, H., Rautio, T., Nordström, P., Aarnio, M., ... & Virtanen, J. (2018). Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial. Jama, 320(12), 1259-1265. Surviving Sepsis Campaign Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., ... & Rochwerg, B. (2017). Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive care medicine, 43(3), 304-377. DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com. Intro Music: "Walk Through the Park" by Track Tribe

Vitals & Useful Links: Learn about one etiology of lower GI bleeding. See spoilers below if you want to know which one. Podcast: Approach to GI Bleed - EM Clerkship Podcast  Clinical Reference: Approach to Acute Lower GI Bleed This week the gang is back together to pay homage to Episode 1. Kyle (MS4) leads Arman (MS4) and Adam (MS3) through a case of an elderly male with bright red blood per rectum (bloody poops part 2). How would you approach this case? As always, we learn a couple very important points about evaluating GI bleeds. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com. *EPISODE SPOILERS BELOW* UpToDate Page on Radiation Proctitis Friedman, L., & Hong, T. (2019). Clinical manifestations, diagnosis, and treatment of radiation proctitis. In C. G. Willett (Ed.), UpToDate. Retrieved November 16, 2020. Here's the article on prophylactic sucralfate Hovdenak, N., Sørbye, H., & Dahl, O. (2005). Sucralfate does not ameliorate acute radiation proctitis: randomised study and meta-analysis. Clinical Oncology, 17(6), 485-491. And here's the article on sucralfate paste enemas McElvanna, K., Wilson, A., & Irwin, T. (2014). Sucralfate paste enema: a new method of topical treatment for haemorrhagic radiation proctitis. Colorectal Disease, 16(4), 281-284. Lastly, here's the article on hyperbaric oxygen therapy Clarke, R. E., Tenorio, L. C., Hussey, J. R., Toklu, A. S., Cone, D. L., Hinojosa, J. G., ... & Walker, M. B. (2008). Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up. International Journal of Radiation Oncology* Biology* Physics, 72(1), 134-143. DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com. Intro Music: "Walk Through the Park" by Track Tribe