CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries

This episode of CRACKCast covers Rosen's Chapter 187, The Immunocompromised Patient. This chapter covers the unique population of immunocompromised patients, including management of febrile neutropenia, as well as common infections seen in these patients and how to treat them.

Core Questions List 4 factors altering pharmacokinetics in the elderly (ADME) List 6 factors contributing to adverse events from medications in the elderly Beers List Which 8 meds are most responsible for adverse events in the elderly? List 5 harmful drug interactions in the elderly What are top 10 STOPP criteria?

This episode of CRACKCast covers Rosen's chapter 183, approach to the geriatric patient. Our geriatric patients can often mask serious diagnoses with vague presentations and multiple co-morbidities.

This episode of CRACKCast covers Rosen's Chapter 181, Labor and Delivery. This chapter covers the high risk realm of ED deliveries, including potential complications such as PROM, malpresentation and umbilical cord emergencies.

This episode of CRACKCast covers Rosen's Chapter 179, Drug Therapy in Pregnancy. There is a lot of fear and anxiety often present within pharmacologic therapy in pregnancy, but having informed, shared decision making with patients can lead to safer outcomes and adherence when treating.

This episode of CRACKCast covers Rosen's Chapter 178, Co-Morbid Medical Emergencies during Pregnancy. This chapter covers many complicated issues that arise during the care of pregnant patients already suffering from concomitant medical illness, and how to manage these conditions balancing risks to both mother and fetus.

This episode of CRACKCast covers Rosen's Chapter 177, Acute Complications of Pregnancy. This chapter covers many acute issues that arise during the unique physiologic state that is pregnancy, from first trimester bleeding to diagnostic challenges and management of other conditions during pregnancy.

Core questions What are the indications for orthopedic surgery for clavicle fracture? List 5 Xray features of supracondylar fracture Describe the Gartland Classification for Extension-type supracondylar fractures List specific complications of a supracondylar fracture. Describe the sequence of ossification around the elbow. What is Baumann's Angle? (shownotes) Monteggia fracture-dislocation Toddler's fracture Nursemaid's elbow. Describe the radiographic findings and management of: Describe the Ortolani and Barlow maneuvers. (shownotes) List 3 physical exam findings consistent with DDH. List 10 causes of hip pain in children Provide a differential diagnosis of limp in the toddler, school-aged child and adolescent. How would you differentiate between transient synovitis and septic arthritis in a child with hip pain? What is the most common location for septic arthritis in a child? What is the prognosis for transient synovitis? What is the most common cause of septic arthritis? Age 2 months – 5 yrs 5 yrs – 12 yrs > 12 yrs Prosthetic joint Sickle cell disease Immunocompromised What are the important pathogens of septic arthritis in the following groups: Describe three mechanisms for the development of septic arthritis in children. Regarding synovial fluid analysis, which tests should be ordered. How are the results interpreted? Describe the management of a child with septic arthritis? What the indications for operative debridement? What are the potential complications of septic arthritis? Describe the pathophysiology of Legg-Perthes disease; how does slipped capital femoral epiphysis (SCFE) occur? Describe the common clinical presentation of SCFE + LCPD Describe 2 radiographic findings consistent with SCFE + LCPD How is SCFE classified? How is this classification used to determine management? (shownotes) What is the risk of bilateral SCFE? (shownotes) What are the potential complications of SCFE? (shownotes) What is a juvenile Tilleaux fracture? How does it occur? What is a triplanar fracture? List seven red flags for pediatric back pain. What is spondylolysis? What is spondylolisthesis? How is it managed? List 4 common apophyseal injuries in children. Wisecracks: List 6 specific xray findings / fractures consistent with non-accidental injury (shownotes) What is a corner / bucket handle fracture? What are the investigations in a complete skeletal survey (shownotes) List 4 conditions with similar presentation to child abuse (shownotes) List causes of pathologic fractures in children. What is the utility of blood culture, ESR and CRP in a child with suspected septic arthritis of the hip? What the mechanism of a lateral elbow condyle fracture and how are they managed? (shownotes) What is the mechanism of a medial elbow condyle fracture and how are they managed? (shownotes) What is the most common pediatric fracture?

This episode of CRACKCast covers Chapter 174 in Rosen's 9th Edition. Today, we will go over common topics in paediatric neurology and emergency medicine that will help you on your next shift! Knowledge of neurologic disorders is essential for any practitioner of emergency medicine, so strap in for a high-yield post. Core Questions List ten causes of provoked (acutely symptomatic) seizures. List four episodic disorders that may mimic seizures in neonates and four in non-neonates. How does it differ if you are unable to obtain IV or IO access? Give an approach to acute seizure control in a 9-month-old and in a 5-year-old. What is the definition of status epilepticus? List 6 medical treatments for status epilepticus. What is the definition of a simple febrile seizure? Describe the management of febrile seizure. Which patients should have outpatient imaging and neurology follow-up? Which children with seizure should be admitted to hospital? List 5 reasons for CT Head after seizure and describe management after the 1st peds seizure. List 10 differential diagnoses for headache in peds. List 8 indications for radiologic imaging in patients with headache. With regards to presentation and management, how are migraines different in children? Describe the criteria which define migraine headache (review). List 10 causes of pediatric ataxia. Describe an approach to the pediatric patient with ataxia. List 5 central and 5 peripheral causes of vertigo. Which is the more common cause of vertigo in children? List 8 risk factors for pediatric stroke. Wisecracks Describe each of the following: Infantile Spasms Absence Epilepsy Benign Rolandic Epilepsy of Childhood Lennox-Gastaut Syndrome What is the most common cause of status epilepticus in children? In adults? List five side effects of therapeutic dilantin use. When is LP indicated in children with febrile seizures? Give causes of acute, acute recurrent, chronic progressive and chronic non-progressive headaches. Describe the presentation of infantile botulism.

This episode of CRACKCast covers Rosen's Chapter 173, Genitourinary and Renal Tract Disorders. Torsion, phimosis, UTIs, stones, and priapism are some of the high-yield topics covered here. Core questions: 1. List a DDx for priapism and describe treatment. 2. Describe the management of a paraphimosis. 3. Describe the management of a phimosis. 4. What is the pathophysiology of balanoposthitis? What is the most common bug in balanoposthitis? 5. How is balanoposthitis managed? 6. Describe the diagnosis and management of pediatric epididymitis and orchitis. 7. Describe the diagnosis and management of testicular torsion. 8. List common bacteria in peds UTI and describe treatment in patients 9. List 6 ddx renal mass – how should these be imaged first? 10. Give a differential diagnosis of proteinuria in children. 11. What is the most common cause of proteinuria in children? 12. Provide a differential diagnosis of acute renal failure in children. What is the most common causes? 13. Describe the clinical presentation of glomerulonephritis in a child. 14. Define hypertension in a child. 15. List causes of hypertension in a child. 16. List 2 medical treatments for acute HTN crisis in children. 17. What are the two types of HUS? What are the typical presenting features? 18. Describe the management of HUS and HSP in kids. Wisecracks: 1. List three complications of circumcision. 2. Describe approaches to penile entrapment and tourniquet states. 3. Which side is a varicocele concerning and why? 4. Other than cystitis and pyelonephritis, list 6 other causes of pediatric dysuria 5. List 10 ddx for hematuria in peds. 6. List 5 false indicators of hematuria. 7. List 6 causes of nephrotic syndrome in peds. 8. List 5 complications of acute renal failure in children. 9. How does E. coli cause HUS? Which strain of E. coli is the concerning one?

Core Questions: 1) What are three pathophysiologic types of diarrhea? Give an example of a cause for each. 2) List 6 common causes of childhood infectious diarrhea in developed countries. 3) List 5 important differential diagnoses of diarrhea in children. 4) List 5 important differential diagnoses of vomiting in children. 5) When should you initiate a medical evaluation of children with acute diarrhea? 6) Describe the typical presentation of: Rotavirus Norovirus Salmonella Shigella Yersinia E. Coli C. Difficile 7) List routine and high risk treatment recommendations for common bacteria causing acute infectious diarrhea in children: Salmonella non-typhi Salmonella typhi Shigella Campylobacter jejuni Yersinia enterocolitica C. Difficile Vibrio cholerae Vibrio parahaemolyticus E. Coli 8) List the presenting features and treatments for three common protozoa causing infectious diarrhea in children. 9) Define and describe your diagnosis and management approach to dehydration that is: Mild Moderate Severe Associated with Hypo/Hypernatremia Wisecracks: 1) Name 5 causes of bloody diarrhea. 2) Other than vomiting and diarrhea from infectious gastroenteritis, list 6 causes of volume depletion. 3) Name the components of the Gorelick scale. 4) What's the 4-2-1 rule?

Core questions: List 8 causes of neonatal jaundice and indicate whether they are conjugated or unconjugated List indications for work-up of a jaundiced infant What are RFs for hyperbilirubinemia? (8) What is the differential diagnosis for vomiting in a child? Describe the typical presentation of each of the following: Hypertrophic pyloric stenosis Malrotation with midgut volvulus NEC GERD Intussusception Hirschsprung's Disease Meckel's Diverticulum HSP List Xray findings for each of the following: Malrotation with midgut volvulus (2) NEC (4) Intussusception (5) Hirschsprung's Disease (2) Describe the conservative management of a patient with GERD. What is the preferred diagnostic test for diagnosis for intussusception? List causes of lead points in pts with intussusception. Describe each of the following signs on physical exam: Sandifer's syndrome Red-currant Jelly Stools Dance's Sign Rovsing's sign Psoas Sign Obturator Sign Describe the "Rule of 2" for Meckel's Diverticulum What are 3 common locations of lodging in the esophagus List 3 indications for FB removal from stomach. Describe the management of button battery FBs What is HSP? How does it typically present? List three complications of HSP. Why is appendicitis different in very young children? List 10 causes of pancreatitis in children List 10 causes of biliary tract disease in children List conditions associated with the development of gallstones in children. Wisecracks. What are the risk factors for necrotizing enterocolitis? Describe the proposed pathophysiology of necrotizing enterocolitis? List five pathologic causes of constipation in a child. What is the most concerning complication of hirschsprung's disease? How does it occur? What is gallbladder hydrops? What conditions is it associated with?

This episode of CRACKCast reviews Rosen's Chapter 170, Pediatric Cardiac Disorders. This podcast covers the common infectious complications leading to pediatric cardiac issues. Additionally, we will review Kawasaki's Disease, Acute Rheumatic Fever, HOCM, and much more. Episode Overview: 1. Describe procedures and conditions for which prophylaxis for bacterial endocarditis is recommended. 2. Describe 2 potential prophylaxis regimens. 3. What is the differential diagnosis of myocarditis? What is the most common cause of myocarditis in children? 4. What is the differential diagnosis of pericarditis in children? Describe any differences b/n adults and children. 5. What are the clinical diagnostic criteria for Kawasaki's disease? 6. If the clinical criteria are not met, but you are still suspicious, how else might Kawasaki's disease be diagnosed? 7. What are some unusual clinical presentations of Kawasaki's disease? 8. How is Kawasaki's disease managed? What is treatment directed towards preventing? 9. List the Jones Criteria for the diagnosis of Acute Rheumatic Fever. 10. Describe the management of Acute Rheumatic Fever. 11. List 10 causes of sudden death in young athletes. 12. What is a normal pediatric QT interval. 13. What are ECG findings of HCM? Wisecracks: 1. What is the hyperoxia test? How is it clinically useful? 2. Describe common Xray findings in CHD: "boot-shaped heart", "egg-on-a-string", "snowman". 3. What is Eisenmenger's Syndrome? 4. Until what age is the thymus visible on CXR? 5. List 8 ductal dependent cardiac lesions in the neonate. 6. List features of pathologic heart murmur . 7. When does the ductus arteriosus close functionally? Physically?

This episode of CRACKCast covers Rosen's Chapter 170, Pediatric Cardiac Disorders. This podcast covers cyanotic and acyanotic cardiac defects, the presentation and management of congestive heart failure in pediatric populations, and the management of common arrhythmias in children. A second podcast will release next week detailing other issues in pediatric cardiology. Episode Overview: 1. What is the most common form of congenital heart disease? 2. List 6 Acyanotic and 8 Cyanotic types of CHD. 3. What are the ductal dependent heart lesions? 4. Describe the emergent management of the hypoxic infant with a suspected ductal dependent cardiac lesion. 5. List types of CHD which are most likely to present outside of the neonatal period. 6. What are the anatomic anomalies seen in Tetralogy of Fallot? What is the pathophysiology of a Tet spell and how is it managed? What is a ductal-dependent ToF? 7. Describe the management of CHF in the infant. 8. List 12 conditions associated with a high risk of developing dysrhythmias. 9. Compare SVT and ST. 10. Describe the management of SVT in the infant/child.

Core questions: Name 8 non-infectious causes that may present as pneumonia Describe the workup for a child with suspected pneumonia? What are the typical causes of bacterial pneumonia and viral pneumonia in the following age groups: 1 month – 3 months 3 months – 5 years ≥ 5 years What is the empiric treatment of bacterial pneumonia in these age groups for outpatients? For inpatients? List 8 complications of pneumonia List 6 criteria for admission with pneumonia What are three clinical complications of cystic fibrosis? What is the pathophysiology of CF? How is suspected pneumonia in a patient with CF treated? Wisecracks: What is the cause of whooping cough? What are the stages of whooping cough? How is whooping cough managed? How is the flu shot used in the pediatric population? Describe common pneumonia syndromes: Chlamydia trachomatis Mycoplasma pneumonia What is the most common bacterial infection in CF?

Core questions: Excluding asthma, list 8 causes of wheeze Outline the pathophysiology of asthma. What are the features of mild, moderate and severe asthma? Describe the PRAM score List 8 medications for asthma treatment with doses What is the typical ED management for a pts with an asthma exacerbation? Describe adjunctive therapies that might be used in a patient with refractory symptoms. How are PO corticosteroids used in the management of asthma? When should children be started on inhaled corticosteroids? Outline a plan for disposition of a pt presenting to the ED with an acute asthma exacerbation. What are risk factors for sudden death in a patient with asthma? List risk factors for bronchiolitis. What are the typical pathogens of bronchiolitis? What is the pathophysiology of bronchiolitis? How is bronchiolitis managed? Which children with bronchiolitis should be admitted to hospital? List potential complications of RSV. Wisecracks: What's the natural history of infants/toddlers who wheeze? What is a peak flow? What is the FEV1? What are the advantages to measuring peak flow? What are the disadvantages? Risk factors for death in bronchiolitis

Core questions: What is the pathophysiology of inspiratory and expiratory stridor? Provide a differential diagnosis for stridor in children (based on location: supraglottic, glottic, subglottic) list at least three in each category. What is the typical presentation of a retropharyngeal abscess? Describe the management of a RPA. What are the typical pathogens? What the typical pathogens in epiglottis? How are these patients managed? Differentiate between croup and other conditions mimicking croup. Contrast mild, moderate, and severe croup. What is the management of croup? Which children with croup require admission to hospital? Management of upper airway FB: Describe the management of an airway obstruction (progresses from partial obstruction to full obstruction to unconscious) in a 6 month old. In a 6 year old? Wisecracks: Ddx of stridor (8) (review) List 5 Xray findings of epiglottitis Which infections are associated with croup? How do you handle the CICV scenario?

Core questions: List 10 non-infectious causes of fever in children List 3 bacterial pathogens responsible for infections in the following age groups 0-28 days 1-3 months 3-36 months > 3 yr List 5 tests to perform on CSF Describe the empiric management of fever in the neonate (0-28 days) Why is ceftriaxone not recommended for the neonate? Describe one of The Rochester criteria The Philadelphia criteria Define simple and complex febrile seizure. What are indications for LP? What is the likelihood of Recurrent febrile seizure after 1 st presentation Risk of epilepsy after first febrile seizure? List 6 causes of Fever and Petechiae Describe the criteria for the diagnosis of Toxic Shock Syndrome What sickle cell patients require prophylaxis and why? What Abx? List the Duke criteria for infective endocarditis. Wisecracks: Provide a differential diagnosis for fever (review question) Which patients are excluded from the Rochester Criteria? What are the low-risk Rochester Criteria, and how are these children managed? Which age groups should always have a urinalysis when presenting with fever without source? Which children should have a CXR to r/o pneumonia in the setting of fever without source?

Core questions: 1) List age specific vital signs (RR, HR): "1 odd yr - 60 count down aid" 2) What is the lower fifth percentile of systolic BP for the neonate, infant, and 1-10 yr old child? 2) Describe the 3 components of the Pediatric Assessment Triangle. 3) Describe the Canadian Pediatric Triage and Acuity Scale 4) List 5 historical indicators of child abuse 5) List 5 features suggestive of child abuse on physical examination and/or radiology? Wisecracks: What are developmental milestones (gross motor and otherwise) for 1-24 months? What are other considerations in the management of pediatric patients: consent, pediatric-readiness, pediatric-friendly ERs?

This episode of CRACKCast covers Rosen's 9th Edition, Ch. 159. In the podcast, we will look at the sedative hypnotic toxidrome and the various agents that bring patients to your ED. Core questions: Describe the components of the GABA receptor complex and their physiologic effect Describe the sedative-hypnotic toxidrome, and list 8 drugs in the DDx How do barbiturates work? What are the clinical symptoms of barbiturate overdose? How are they managed? How do benzodiazepines work? List risk factors for benzodiazepine withdrawal and its management What are the indications for flumazenil? What are the contraindications? How does chloral hydrate toxicity present? What is the clinical presentation of GHB toxicity? How is GHB withdrawal managed? Wisecracks: List 2 drugs used for 'date-rape' and describe their toxicity What Benzos WILL NOT be detected on urine drug screen?

This episode of CRACKCast covers Chapter 158 in Rosen's Emergency Medicine, 9th Edition. Core Questions: For each of the following, describe the expected toxicity: Jequirity pea, rosary Umbrella tree, Dieffenbachia, Dumb cane Capsicum annum Water Hemlock Jimson Weed, Deadly Nightshade Eucalyptus oil Poinsettia Oleander, Foxglove Tobacco Pokeweed Rhododendron Yew Castor Beans List 5 mushrooms with early onset toxicity and 3 with late onset – and describe the toxicity expected. List 4 mechanism of toxicity resulting from the use of herbal medicine. List 4 plants containing cardiac glycosides. What is Buckthorn?

This episode of CRACKCast covers Rosen's 9th Edition Chapter 155, Antipsychotics. Continuing along the spectrum of toxicologic exposures, these agents account for a large number of presentations to emergency departments every year. Being equipped with the knowledge of how to deal with the side effects of these medications and their associated toxidromes is imperative and may help you save lives in the future.

This episode of CRACKCast covers Rosen's Chapter 154, Lithium. You will have a solid approach to lithium overdose after listening to this episode!

Core questions: Describe the cholinergic toxidrome from organophosphates Describe the clinical presentation of organophosphate toxicity. How is organophosphate toxicity managed? What are the complications of organophosphate toxicity? What is the difference between organophosphates and carbamates? What are the unique features of chlorinated hydrocarbon toxicity? What is an example of a chlorinated hydrocarbon? How are they managed? How do Substituted Phenols (Dinitrophenol) cause toxicity? How are they managed? How is toxicity from chlorophenoxy Compounds (Agent Orange) managed? What is expected in paraquat toxicity? and how is this managed? What are the toxic effects of pyrethrins and pyrethroids? Wisecracks: What is aging - in relation to organophosphate toxicity? What is the maximum formulation of DEET in pediatrics? When should you not use DEET?

This episode of CRACKCast covers Rosen's 9th Ed Chapter 151, Iron and Heavy Metals. While often not recognized in the acute care setting, chronic toxicity from heavy metals is common and has high morbidity, especially in pediatric populations and requires careful attention to risk factors and symptomatology.

Core questions: List 6 commonly abused opioids (Table 156:1) Describe the opioid toxidrome (list opioid effects on Neuro, Resp, Ophtho, CV, GI, Derm) List opioid preparations associated with the following presentations: Long QTc → Prolonged QRS → Seizures → Hallucinations →) Sensorineural hearing loss → Serotonin syndrome → i) What is the dose of narcan? ii) What is the duration of action? iii) How do you administer a narcan infusion? What opioid overdoses/ingestions need longer than 6 hours of observation? What is the clinical presentation of opioid withdrawal? What are risk factors for opioid withdrawal? List 3 medications effective for opioid withdrawal. What is the number one killer of people under 50? What is Suboxone? How do you do a Suboxone induction? WiseCracks: List 5 ddx for opioid intoxication (CNS + resp depression, + miosis). What opioids don't cause miosis? Risk factors for opioid overdose? What is NAPE? Narcan induced pulmonary edema. Difference between a "body packer" and "body stuffer"?

This episode of CRACKCast covers Rosen's Chapter 141, Toxic Alcohols. This chapter covers exposure to your stereotypical toxic alcohols (i.e., ethylene glycol and methanol) as well as the consequences of ingesting ethanol and isopropyl alcohol.

This episode of CRACKCast covers Rosen's Chapter 153, Inhaled Toxins. This chapter covers exposure to various inhalation toxins including CO, hydrogen sulfide, etc. and includes their treatment and management for acute exposures.

This episode of CRACKCast covers Rosen's 9th Ed Chapter 147, Cardiovascular Drugs. With increasingly common use of these medications for heart disease and an ever aging population, it is imperative to understand the prompt recognition and therapy for toxic exposures. Recognition of the more lethal agents and how to disposition these patients in the ED are the cornerstones of this chapter.

This episode of CRACKCast covers Rosen's 9th Edition Chapter 154, Cocaine and Other Sympathomimetics. Continuing along the spectrum of toxicologic exposures, these agents account for a large number of presentations to emergency departments every year. Having an in-dept understanding of their mechanism of action and a solid approach to the assessment and treatment of these patients is critical.

This episode of CRACKCast covers Rosen's 9th Ed Chapter 152, Hydrocarbons. Continuing the spectrum of toxicologic exposures, these agents account for relatively few presentations. Recognition of the more lethal agents and how to disposition these patients in the ED are the cornerstones of this chapter.

This episode of CRACKCast covers Rosen's 9th Ed Chapter 150, Hallucinogens. This chapter covers exposure to several families of hallucinogenic toxins, their presentations, complications, and treatment.

This episode of CRACKCast covers Rosen's Chapter 153, Caustics. This chapter covers oral exposure to caustic agents, including the ED management, complications and potential treatment.

This episode of CRACKCast covers Rosen's 9th Edition Chapter 146, Antidepressants. Continuing the section on toxicology, antidepressants make up one of the most commonly prescribed medications in the general population. The use and misuse of antidepressants can have serious consequences and having a high suspicion of overdose in suicidal patients can lead to timely antidote therapy.

This episode of CRACKCast Covers Rosen's Chapter 145, Anticholinergics. You will learn everything you need to know for the next hot and bothered patient that rolls in to the ED!

This episode of CRACKCast covers Rosen's Chapter 149, Aspirin and Nonsteroidal agents. You will become well-versed in the presentation of Salicylism and how to manage it. The episode also touches on NSAID overdose, with rare severe complications.

This 148th episode of CRACKCast covers Rosen's 9th edition, Chapter 143, acetaminophen. Also known as paracetamol and Tylenol, you need to know this overdose cold!

This episode of CRACKCast covers Rosen's Chapter 147, A General Approach to the Poisoned Patient. This is probably one of the most cornerstone podcasts we have done, and you'll enjoy the pearls dropped by staff ED-Toxicologist, Dr Jesse Godwin.

In this 146th episode of CRACKCast, we cover Radiation injury. A very rare, but important topic to know cold. From alpha particles to triage systems, we've got you covered.

This episode of CRACKCast covers Rosen's Chapter 144, High Altitude Medicine. The problems encountered can be mostly be prevented through slow ascent and generally treated with oxygen and descent. This summary of respiratory physiology will explain why people can find themselves quickly quite unwell at high altitudes.

This episode of CRACKCast covers Rosen's Chapter 145, Drowning. Not only an important topic to know about in the resuscitation bay, but also out in the world!

This episode of CRACKCast covers Rosen's Chapter 143, Diving Injuries and Dysbarism. While infrequently encountered except for those centers frequented by SCUBA enthusiasts, we must know the hard facts on the potentially life-threatening diving related injuries that may occur suddenly and need urgent attention.

This episode of CRACKCast covers Chapter 134 of Rosen's Emergency Medicine (9th Ed.): Electrical and Lightning Injuries. Core questions: What is the relationship between current, voltage and resistance? How does this relate to potential for injury from electrical and lightning injuries? What are the types of electrical injury? (based on type of current) Differentiate between AC and DC current injuries. List 4 types of electrical burns and 5 mechanisms of lightning injury List 5 expected injury patterns for high-voltage and lightning injuries List clinical findings (early and late) associated with electrical injuries. List clinical findings associated with lightning exposure. Describe the skin injuries associated with lightning and electricity. Describe the modifications in field triage of multiple victims following a lightning strike. Describe the prehospital management of electrical injuries List 6 admission criteria for electrical/lightning injuries List 6 complications of high-voltage injuries Tips to avoid getting hit by lightning Wisecracks: List six mechanisms of lightning injury. ECG features of lightning strike. What is keraunoparalysis? Describe the management of a pregnant patient (1st trimester and 2nd /3rd trimester) in the setting of electrical injury. How are perioral electrical burns managed? List three early and three late complications.

This 141st episode of CRACKCast covers Rosen's 9th edition, Chapter 133, heat illness. Want to mentally escape from the throes of our gripping winter? Let's go straight into heat illnesses.

Core Questions List 5 mechanisms of heat loss and 5 physiological responses to cold Describe 3 CV manifestations of hypothermia What are the risk factors for hypothermia? List 6. Define mild, moderate and severe hypothermia. Describe the CNS, CVS, hematologic and GU presentations associated with hypothermia for each stage (mild, moderate, severe) What are the changes made to BLS and ACLS in the setting of hypothermia? What are the indications for CPR, defibrillation, and antidysrhythmics in the hypothermic patient? Differentiate between active and passive rewarming. What are the two types of active rewarming? What are five indications for active rewarming? Describe 6 techniques for active rewarming. Active External Rewarming Active Core Rewarming What are examples of: In what situations would you not initiate resuscitation of a hypothermic patient? Wisecracks What is core-temperature afterdrop? List 5 DDx for an Osborne J-wave List 5 laboratory abnormalities expected in hypothermia What three mechanisms cause worsening bleeding in trauma in hypothermia? Describe 5 management considerations other than rewarming in hypothermia What are the prehospital management priorities for the hypothermic patient in each of these categories: mild, moderate and severe?

This episode of CRACKCast covers Rosen's Chapter 131, Frostbite. You will be a pro at managing the spectrum of cold injury that can present to the ED!

This episode of CRACKCast covers Rosen's Chapter 138, Sepsis Syndromes. Sepsis is a topic that has undergone a lot of change in the last 15 years since the Rivers paper was published. This episode covers the original definitions of SIRS and sepsis, while also covering more recent evidence & the newest evidence-based treatment protocols.

This episode of CRACKCast covers Rosen's Chapter 129, Skin Infections. These are common and rarely life threatening, but careful consideration should be given for those who may benefit from admission over outpatient treatment. This is a big episode covering the bugs, presentations, and useful tips when treating these infections in the ED.

Episode Overview: List 6 risk factors for bone and joint infections Describe the classification of osteomyelitis (based on pathophysiology) List the 3 most common bacteria causing osteomyelitis/septic arthritis for each age group: neonate, child, adult; and the following circumstances: Sexually active adolescent Infected prosthesis Sickle cell disease IVDU Human bite Plantar puncture wound Diabetic foot Describe a diagnostic approach to osteomyelitis. What is the utility of bloodwork? List 4 early findings of osteomyelitis on Xray List 5 complications of osteomyelitis List 6 differential diagnoses for osteomyelitis Describe the empiric management of suspected osteomyelitis What is the clinical triad of septic arthritis? Describe typical findings in joint aspiration + radiography. List 5 complications of septic arthritis What is the triad of disseminated Gonococcal disease? List X-ray findings of septic arthritis in a joint with a prosthesis. List 10 differential diagnoses for septic arthritis Describe the empiric management of suspected septic arthritis Wisecracks: What is Kocher's Criteria? What is a Biofilm? What is its clinical significance?

Episode 135 of CRACKCast covers Rosen's 9th edition, Chapter 127, tuberculosis. TB, or not TB, that is the question. This episode will elucidate the early recognition, risk factors, therapy and precautions regarding this worldwide killer.