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

This episode covers chapter 84 of Rosen's Emergency Medicine. All the little nuggets of medical goodness you wanted to know about hypertension related emergencies. Define the three classes of hypertension relevant to emergency medicine practice List 10 possible etiologies for hypertension. What is the pathophysiology of target-organ damage? How does hypertensive encephalopathy occur? List 6 hypertensive emergencies; their management goals; the optimal agents for BP control and any relevant caveats List five intravenous antihypertensive medications and their mechanism of action. Describe the ER management of poorly controlled HTN Wisecracks: What are the management targets / indications for treatment in the following pts: 57 yo male with ICH and no signs of ↑ ICP. 39 yo female with SAH in the ED. 22 yo female with eclampsia. 66 yo female with ACS. 57 yo male with aortic dissection. 62 yo female with ICH, ↓ GCS, shift on CT scan.

This episode covers Chapter 83 of Rosen's Emergency Medicine. List 6 RFs for bacterial endocarditis List 5 common bacteria responsible for infective endocarditis Give three examples of immunologic sequelae of IE. Give three examples of vascular sequelae of IE. What are the diagnostic criteria for endocarditis, and how are they used? List 5 lab or investigative findings in bacterial endocarditis Describe the treatment of infective endocarditis List four complications of IE. List the indications for infectious endocarditis prophylaxis. What are the empiric antibiotics used for pts with suspected infectious endocarditis? Describe the Jones Criteria for Acute Rheumatic Fever What is the treatment of rheumatic fever Name three causes of acute mitral regurgitation. How is acute MR managed? What is the pathophysiology of mitral valve prolapse? How does it present? List four causes of mitral stenosis. List four causes of aortic valve insufficiency. List 3 physical exam findings associated with AS What is critical aortic stenosis?Outline the ED management for a pt with critical aortic stenosis with CHF and hypotension. List 5 complications of prosthetic valves. WiseCracks: Describe Janeway lesions Osler nodes Splinter hemorrhages Roth Spots What are the HACEK organisms, and what is their significance in pts with IE? Brief run down of all valvular disease - in one or two lines.

This episode covers chapter 82 of Rosen's Emergency Medicine. Take a listen for all those juicy pericardial-pump-pearls! List eight causes of pericarditis. Describe typical pain of pericarditis, expected lab work abnormalities, What is the typical sequence of ECG changes in pts with pericarditis? (the stages) Describe the treatment of pericarditis associated with: Uremia, Neoplasm, and SLE Outline the management of Dressler's syndrome. What is the pathophysiology of cardiac tamponade? Describe the mechanism of hypotension in pericardial tamponade and list 4 expected findings on physical examination. Describe the procedural steps in pericardiocentesis List 4 causes of pneumopericardium and one specific PEX finding List five causes of constrictive pericarditis. What is the pathophysiology of purulent pericarditis? List 5 organisms responsible for infectious pericarditis? How is it managed? Describe the pathophysiology of hypertrophic cardiomyopathy Describe the clinical exam and ECG findings associated with HCM List 5 RFs for sudden death in HCM A pt with known hypertrophic cardiomyopathy presents to the ED with acute cardiogenic pulmonary edema causing mild hypoxia. What is the general approach to management in the ED? Explain your choices. List four causes of dilated cardiomyopathy. Describe ECG findings of dilated cardiomyopathy List 5 RFs for developing a dilated cardiomyopathy In what time frame would one expect peripartum DCM? List 5 causes of restrictive cardiomyopathy List 8 common pathogens responsible for myocarditis, and 3 non-infectious causes of myocarditis Describe the stages of viral myocarditis and the management at each stage Wisecracks: What are some functions of the pericardium? What are Chagas Disease and Trichinosis, list bizz-buzz features for each? What are the expected cardiac findings in Lyme disease and how is it treated? How does sarcoid affect the heart? Amyloidosis?

This episode covers Chapter 81 of Rosen's Emergency Medicine. This one is mint! Heart failure is one of those must-know-about presentations, you WILL see this in the ED. Define Cardiac index Preload Afterload Describe: How compliance changes the relationship between end diastolic pressures and volume the Frank-Starling relationship Pousseils Law and LaPlaces Law List 3 CV and 4 Neurohormonal physiologic compensatory mechanisms in CHF List the 5 most common disease processes resulting in HF and briefly describe the contribution of each Describe the different classifications of heart failure: Acute vs. Chronic HF Systolic vs. Diastolic dysfunction Right vs. Left sided HF High-output vs. Low-output HF Describe the NYHA function HF Classes and the Killip Classification List 10 common precipitants of acute HF List 6 historical predictors of acute HF and 6 clinical features of acute HF List 5 CXR and 5 ECG findings of HF What is the role of BNP in HF? Describe the primary management goals in acute HF Describe the mechanism of action of NIPPV in HF. Who needs to be intubated? When is it contraindicated? Describe the pharmacologic treatment strategy for: Acute pulmonary edema + adequate perfusion Acute pulmonary edema + hypotension How do nitrates work in acute pulmonary edema? What is the dose? List 10 treatment options for chronic HF

This episode covers chapter 80 of Rosen's Emergency Medicine. All those juicy pearls about those funny little [black] boxes in your patients chest. Chapter 80 – Implantable Cardiac Devices List 5 Indications for permanent pacing What are common Pacemaker types? Pacemaker nomenclature - what do the 5 letters mean List the causes of pacemaker malfunction (main categories with 2 examples each) List the complications of a pacemaker insertion What is pacemaker pseudo-malfunction? What is pacemaker syndrome, which type of pacer is most commonly involved, and what is the tx? What does magnet application do to a pacemaker? to an ICD? Indications for ICD Causes of shock delivery in patient with ICD Causes of syncope/presyncope in patient with ICD Fxns of an ICD Wise Cracks What do you see on ECG when pacer battery dies (2)? What is twiddler's syndrome? Describe your Approach to LVAD complications Approach to Pacemakers

This episode covers Chapter 79 of Rosen's Emergency Medicine. All those funny squigly marks on the ECG confusing you? Us too. Here is some knowledge to help you out. What is the blood supply of the following parts of the conduction system: SA node, AV node What are the three pathophysiologic mechanisms for dysrhythmias? What causes & how does AV nodal reentry tachycardia occur? List the classes of antidysrhythmics. Describe their mechanism of action and usual uses, as well as an example of each. How does digoxin work as an antidysrhythmic? When is it used? List underlying etiologies of sick sinus syndrome. What are three ECG presentations of sick sinus syndrome? Define 1° heart block. List three causes. Differentiate between the two types of 2° heart block with respect to etiology, ECG appearance and management. What is 'high grade' heart block? How is it managed? Describe the difference between AV dissociation & 3° AV block. Compare PAC's to PVC's. Give a differential diagnosis of irregularly irregular tachycardia. Define pre-excitation and list the 3 ECG features of classic WPW Explain the concept of antidromic and orthodromic conduction with respect to WPW. Which pts with WPW should not receive AV node blockers? Why? List 10 causes of PVC and VT How do you differentiate b/n SVT with aberrant conduction & ventricular tachycardia? List 10 causes of atrial fibrillation. Describe the management of AFIB, including a discussion about the CHADS2 score and long term stroke risk. What is Brugada syndrome? What is the management? WiseCracks: List 8 side effects of Amiodarone. Describe features that favor VT over SVT. Describe the Brugada approach to the Dx of VT List Causes of acquired pause-dependent QT prolongation causing Torsades & List causes of adrenergic dependent TdP Describe the treatment of pause dependent TdP Define PSVT and describe management What's Ashman's phenomenon?

Here is the follow-up to the mammoth ACS chapter. This one has some key factoids to put into your mind map / memory pallace / organic computer. List Sgarbossa criteria for AMI in pre-existing LBBB What is Takotsubo cardiomyopathy and how does it present? Describe the kinetics of cardiac biomarkers (Troponins and CK) List DDx for ↑ Troponin What is the utility of CTA in the diagnosis of MI? What is the role of ED-based chest pain centers? List 3 phases of delay in the management of AMI; and describe the time-points in ED management of AMI. What are door-to-needle and door-to-balloon timelines by AHA recommendations? Describe the mechanism of action and indications/contraindications for Nitroglycerin Morphine BBlockers ACE-I Antiplatelet Therapies Anti-thrombins Describe eligibility criteria for Fibrinolytics List contraindications to Fibrinolytic therapy in MI What is the utility of Rescue PCI and Facilitated PCI? List 5 indications for Rescue PCI Describe factors assisting with decision to utilize PCI or thrombolytics In NSTEMI, who will benefit from an early invasive strategy of management? Wise Cracks: What is the HEART Score? What is the management of ACS in the setting of recent cocaine use? How is STEMI diagnosed in the setting of LBBB? How is STEMI diagnosed in the setting of a ventricular pacemaker? When should you be getting a 15 lead ECG?

This episode covers Chapter 78 of Rosen's Emergency Medicine. Acute Coronary Syndromes... its a gooder. Acute Coronary Syndromes Part A (Monday) Define Stable Angina, UA, AMI Describe the pathophysiology of AMI What are the components of prehospital management of AMI List population RFs for CAD. Do they matter in the evaluation of a specific patient? List RFs for atypical presentation of ACS. What are the risks of atypical presentations? List 8 early complications of AMI and briefly describe the management of each one. Describe the progression of ECG changes in STEMI List expected ECG changes (ST↑ and reciprocal ST↓) and culprit vessel for the following: Anterior wall MI Lateral wall MI Inferior wall MI RV wall MI Posterior wall MI Describe the ECG characteristics of Left Main Occlusion What is Wellens' sign and what is it's significance List 10 DDx for ST-elevation Describe the ECG features of Benign early repolarization Pericarditis LBBB RBBB Ventricular-paced rhythm LVH / Strain-pattern LV aneurysm Wise Cracks: What are the STEMI equivalents? Know these patterns!!!

This episode covers Chapter 77 of Rosen's Emergency Medicine. The Pleural Space is not to be trifled with! List 5 RFs for 1° spontaneous PTX. What is the most common pathophysiologic cause of PTX? List 8 causes of 2° spontaneous PTX List 5 clinical findings suggestive of tension PTX Describe how to estimate the size of a PTX Describe the management of 1° and 2° spontaneous PTX Describe the procedure needle aspiration of a PTX. List 3 benefits of this over TT Describe the procedure of TT. List 6 complications of TT placement and contraindications. List 10 causes of pleural effusion. What is the most common transudative and exudative? What is starling's law and how does it apply to the development of pleural effusions List 5 CXR findings of pleural effusion Describe Light's Criteria for pleural effusion and list 5 other tests to perform on pleural fluid. What does a low pH indicate? Describe the procedure of thoracentesis. List 2 contraindications and 9 complications Wise Cracks What is Catamenial pneumothorax? How is it tx? How do you properly Secure a chest tube? Describe the seldinger technique for chest tube insertion What are the false positives for PTX on lung U/S?

This episode covers Chapter 76 of Rosen's Emergency Medicine. Have you ever seen pneumonia? Yeah.... we thought so. Now here are all the nitty-gritty details. What are the typical associative pathogens? Describe the typical clinical presentation/RFs/Management for each of the following -S. pneumonia -H. influenzae -Staph aureus -Klebsiella -Mycoplasma pneumoniae & Chlamydia pneumoniae -Legionella -Anaerobes -Pseudomonas -PJP & Other Fungal Pneumsonia -Tuberculosis -Tularemia -Hantavirus List the typical etiologies of viral pneumonia. Which patient groups should receive pneumovax? Which pneumonias can present with cavitating lesions (abscesses) on x-ray What is the differential for possible pneumonia visible on CXR? Describe the analysis of pleural fluid. -Which effusions should be sampled? -What are Light's criteria? What is the CURB65 score?

This episode covers Chapter 75 of Rosen's Emergency Medicine. 1. List potential causes of pharyngitis. (List 5 viral and 5 bacterial etiology of pharyngitis) 2. What are the indications for steroids in a patient with pharyngitis? 3. List causes of epiglottitis. 4. What are the deep spaces of the neck? List 4 deep space infections of the neck 5. What are the typical bacterial causes of deep space infections? What are the different syndromes called? 6. What are the potential complications of deep space neck/face infections? List 5. 7. When do the sinuses typically develop? 8. What the pathophysiology of sinusitis? What are the typical pathogens? 9. Describe the management of acute rhinosinusitis and list 6 predisposing factors Wisecracks: List 5 suppurative and 5 non-suppurative complications of GABHS List 4 findings on lateral neck xray of epiglottitis Describe an approach to airway management in deep space neck infections What are lateral neck xray findings suspicious for RPA?

This episode covers Chapter 74 of Rosen's Emergency Medicine. As Vanilla is to chocolate, COPD is to Asthma. Look for all things wheez-e-y here. Define acute exacerbation Describe GOLD classification for COPD List factors of decompensation or triggers of an AECOPD Name 4 mimics for AECOPD What are the clinical features used to diagnose AECOPD? Describe the ED management of AECOPD. What does the end tidal tracing look like in COPD? List indications and contraindications to NIPPV in COPD Which patients with AECOPD should be treated with antibiotics? Which patients with AECOPD require admission? List indications for intubation for AECOPD Wise Cracks List 4 CXR and 3 ECG findings in COPD

This episode covers Chapter 73 of Rosen's Emergency Medicine. The ancient Greeks knew about Asthma... so should you! We give you all the major points for diagnosis and treatment in the ED. Sign post 10 different causes of a wheeze. List 8 risk factors for death from asthma List 6 objective findings of severe asthma 10 therapies for an acute severe asthma exacerbation Discuss a ventilation strategy for the critically-ill asthmatic patient Discuss disposition and discharge planning for an acute asthma exacerbation presenting to the ER Wise Cracks What is delayed sequence intubation? Can it be used for severe Asthma exacerbation? What about pregnancy and Asthma is so important?

This episode covers Chapter 72 of Rosen's Emergency Medicine. All those pearls you need for ears, masses, nose bleeds and weird stones in weird places. Define Otitis Media Acute Chronic Recurrent Describe the diagnosis treatment of Otitis Media What are the complications of OM? Describe the diagnosis and tx of Otitis Externa Differentiate from malignant otitis externa What is Ramsay Hunt Syndrome? How is it Tx? Describe your approach to sudden hearing loss How is it treated? Name 10 causes of epistaxis Describe your approach to tx epistaxis Anterior bleeds Posterior bleeds What is the differential diagnosis of neck masses? What is SIALOLITHIASIS? How is it tx?

This episode covers Chapter 71 of Rosen's Emergency Medicine. For such a small organ, the eye has A LOT of things to cover. Here we finish up in everything you need to know about that juicy ball of potential badness. List 10 causes of ↓ vision post blunt eye trauma What historical features are concerning for intra-ocular foreign body? List 4 options for treatment of corneal abrasions Describe the management of traumatic hyphema What causes the finding of a 'second pupil' post-trauma? Describe the physical findings of globe rupture and describe management List 5 indications for ophtho consultation for eyelid lacerations Describe diagnosis and treatment for orbital floor fractures: List 2 findings on X-ray of orbital floor fracture List indications for surgical repair of orbital floor fracture Describe the clinical findings of retrobulbar hemorrhage and the steps in performing lateral canthotomy List 3 complications of ocular trauma

This episode covers Chapter 70 of Rosen's Emergency Medicine. How are teeth traditionally numbered? Describe the classification and management of tooth fractures Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation? Explain Ludwig's Angina and its management List 3 complications of maxillary (eg canine) tooth infection? Describe management of Dental Caries vs Periapical abscess Describe your approach to Acute Necrotising Ulcerative Gingivitis what is Vincent's Angina? what is cancrum oris? Rapid Fire treatment for the following: Post root canal pain Cracked Tooth or Split root syndromes Maxillary Sinusitis Atypical Odontalgia Post extraction pain Neuropathic pain Temporomandibular Myofascial Pain Dysfunction Syndrome Pericoronitis Apthous Stomatitis WiseCracks Spot diagnosis

This episode covers Chapter 69 of Rosen's Emergency Medicine. Sign Post: 1. List six types of elder abuse? 2. List ten risk factors for elder abuse? 3. List ten questions to screen for elder abuse? 4. What are some indicators on the medical history and physical exam that may suggest ongoing elder abuse? 5. Discuss ethical and legal implications of elder abuse. Who needs to be reported?

This episode covers Chapter 67 of Rosen's Emergency Medicine. Its a heavy topic, but important to get right. What precautions should be taken prior to engaging in potential sexual abuse cases? What information can be useful in determining the location and likelihood of injury in sexual assault? What is the prevalence of mental illness in sexual assault patients? Which populations are found to have a higher proportion of mental illness? What effect does mental illness have on the severity of the attack? What factors make genital injury more likely to be observed? Less likely? What are the risks of STI's after sexual assault? What are appropriate treatments for STI prophylaxis in cases of suspected sexual abuse/assault? What resources exist to help medical providers and any victims of sexual abuse? What differences should be considered with male victims of sexual assault? ------------------------------ Thank-you to Dr. Sampsel for her assistance with this episode!

This episode covers Chapter 65 of Rosen's Emergency Medicine. Its a big intro into the next few chapters covering forensic medicine in the emergency department. Tighten up those boot straps, this stuff is heavy! What are some pearls and pitfalls for ER physicians when dealing with Forensic Emergency Medicine? What are proper terms used to describe wound injury patterns? What's the anatomy of a cartridge (bullet)? What are the types and important aspects of wound ballistics? What signs would you see for the various ranges of fire of a bullet? What are common red flags to alert you to the possibility of domestic violence? What risk factors make domestic violence more common? Describe the different types of blunt force pattern injuries and the pathophysiology of how they occur. Do the same for sharp force and thermal wounds. What does the Health Insurance Portability and Accountability Act permit a physician to disclose to the investigating law enforcement officer?

This episode covers Chapter 64 of Rosen's Emergency Medicine. Worried about what to do with those patient's coming in with their skin melting off from a chemical exposure? We've got you covered. 1) Describe the difference between Alkali and Acid injuries 2) Describe a HAZMAT response on scene 3) Describe the decontamination of an individual 4) List PPE for first responders or caregivers Wisecracks -Name two acids that cause damage through liquefactive necrosis -List Chemical Agents used in Warfare / Terrorism -What chemicals should you NOT irrigate with water?

This episode of CRACKCast covers Rosen's Chapter 63, Thermal Burns. These patients are often the sickest in the department and many are on their way to the ICU. There are life-saving interventions that are begun in the emergency department with significant impacts on morbidity and mortality, and many are discussed in this episode. Signposts: List zones of burns List 6 indications for intubation in the burn patient List and describe 2 formulas for fluid resuscitation Describe depth classification for burn injuries List indicators of upper airway and lower airway burns What is the Rule of 9's and how is it modified in pediatrics List criteria for transfer to burn unit Describe basic burn dressing management List 5 burn prevention strategies Wisecracks: What are the indications for an escharotomy What are the primary considerations in mechanical ventilation of burn patients

This episode covers Chapter 62 of Rosen's Emergency Medicine. Does leaving the comfort of your warm, safe bed scare you? After this chapter, it might... Sign Post: List the 4 families of venomous snakes. Describe phenotypic characteristics of Pit-Vipers Describe phenotypic characteristics of coral snakes? List the grades of pit viper envenomation and indicate therapy? Describe a black-widow spider and expected management goals? Describe a brown recluse spider and expected management goals List 3 classes of venomous marine injuries, and describe key principles of management for each? WiseCrack: What does expert opinion suggest to avoid anaphylaxis in non-recombinant antivenin administration? What is the most toxic, per weight, venom? What are the general phenotypic features of poisonous snakes in North America?

This episode covers Chapter 61 of Rosen's Emergency Medicine. Know anything about mammalian bites...? Yeah, neither did we until we read this chapter. Lots of juicy clinical pearls. List 5 pathogens responsible for infection from Dog bite List 4 risk factors for overwhelming sepsis from dog bite What first line antibiotic is a good choice for cat and dog bites? What species are known to cause infection with Pasteurella multocida? What are the risk factors for infection with animal bites? Describe the treatment of Monkey Bites? When is anti-viral prophylaxis NOT indicated for a monkey bite What is the duration of therapy of antiviral prophylaxis? Describe the recommendations for wound closure and antibiotics in bite cases Wisecracks: What about seal bites? What about rabies in BC? Waterhouse-Friderichsen syndrome & capnocytophagia-related Gangrene sepsis - what are they?

This episode of CRACKCast covers Rosen's Chapter 60, Foreign Bodies. This episode covers an approach to foreign bodies, including location specific tips, complications and safe removal in the ED. Describe your approach to Ocular FB What is Seidel Sign? List indirect signs of FB on Xray List complications of ear FB Describe the process of anesthesia of the ear and preparation for FB removal Describe 5 techniques for removal of FB from ear Describe the management of TM perforation secondary to FB Describe 5 techniques for removal of FB from nose Describe a step-wise approach to pediatric FB airway obstruction List 7 symptoms of Esophageal FB List 8 complications of esophageal FB List 4 complications specific to button battery ingestions List indications for removal of esophageal FBs List 4 removal techniques of esophageal FB List 5 techniques for management of food bolus and their mechanism of action List the criteria for continued expectant management for intestinal FB Describe the stepwise management of a Rectal FB Wisecracks: What is the safe dose of topical anesthetics? How do you test the radiolucency of an object? What is a Cafe Coronary? What is Penetration Syndrome? Differentiate Body stuffing from Body Packing

In the third episode of the Physicians as Humans project, I corresponded with a Canadian emergency physician who sent me her personal account of depression. The result is this beautiful, thoughtful story that she has graciously allowed me to read for the podcast. This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact [email protected]. Music for Episode 02 (All songs have been modified for the project) ambient by strange day. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. Cease by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. I Dunno by Grapes. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. Lost Within by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. Moon by LEMMiNO. Music provided by Music for Creators under a Creative Commons Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 license. Tomorrow by Bensound Laws of Movement by The Passion HiFi. www.thepassionhifi.com

This episode of CRACKCast covers Rosen's Chapter 59, Wound Management Principles. This episode covers the nitty-gritty details of wound management and what you need to know to get that perfect wound closure! Questions: 1) List risk factors for wound infection2) List the 5 stages of wound healing3) List toxic doses of local anesthetics4) 3 types of wound closure?5) List advantages of and contraindications of tissue adhesives6) List indications for tetanus immune prophylaxis7) List 5 specific wound care instructions8) List 7 situations where antibiotic prophylaxis is indicated in wound management WiseCracks: Evidence guided tips for scar healing? How to decrease pain of anaesthetic injection? Where can I find a concise guide to Suture material use?

This episode covers Chapter 58 of Rosen's Emergency Medicine: Orthopaedic Ankle and Foot injuries. Its a gooder for sure. Describe the bones of the foot and important joints/ligaments List Ankle stress tests Describe an approach to ankle x rays (including the Ottawa ankle rules) Describe the Weber classification List indications for ortho referral in the ER Describe the management of Achilles and Tibialis posterior tendon ruptures Describe the Hawkin's classification of talar neck fractures Describe the diagnosis and management of calcaneal fractures and list 3 injuries associated with calcaneal fractures Describe the anatomy and classification of lisfranc injuries Describe the management of metatarsal shaft fractures. List 6 predisposing conditions for stress fractures List 4 causes each of hindfoot pain and forefoot pain Differentiate between Jones and Dancer's fracture Describe 4 plain-film radiographic abnormalities for stress fracture Describe the Tillaux fracture and pathophysiology Wisecracks: Discuss soft tissue injuries of the ankle Name 6 other mimics of the " it's just an ankle sprain"

This episode covers Chapter 57 of Rosen's Emergency Medicine. 1) List contents of popliteal fossa 2) Describe Ottawa knee Rule 3) Describe Schatzker classification for tibial plateaus fractures 4) Describe the Insall-Salvati ratio 5) Describe the management of a knee dislocation 6) Describe the management and classification of patellar fracture and dislocation 7) List 6 overuse syndromes 8) Describe the sensory and motor function of nerves of the lower extremity 9) Describe the 4 compartments of the lower leg and their contents 10) Describe the management of Tibial tubercle fractures and Osgood-Schlatter Disease 11) List 4 complications of tibial shaft fractures 12) Describe the management of proximal fibula fractures Wisecracks What is a Baker's cyst and how is it managed? What are extensor mechanism injuries in the knee? DDx of acute onset calf pain?

This episode covers Chapter 56 of Rosen's Emergency Medicine. 1) List 3 compartments of leg and contents 2) List 8 causes of AVN (traumatic and atraumatic) 3) List 5 most common primary cancers metastatic to bone 4) List 15 causes of hip pain without an obvious hip fracture 5) List 3 techniques for reduction of the hip 6) Describe 4 types of hip dislocation. Wisecracks Pediatric hip/femur pathology? Hip dislocations Classification of femur fractures 6 causes of a child with a limp

This episode covers Chapter 55 of Rosen's Emergency Medicine. 1) Describe common pelvic fractures and their classification A)Young-Burgess classification B)Tile classification C)Denis classification 2) List 3 categories of complications of pelvic fractures 3) Describe the approach and management of hemodynamically unstable pelvic fracture. 4) List 5 radiographic cues to posterior arch fractures 5) What is the management of penetrating pelvic trauma Wisecracks: 1) How are open pelvic fractures diagnosed and managed? 2) What is the classification of acetabular fractures? 3) How are coccygeal fractures managed?

This episode covers Chapter 54 of Rosen's Emergency Medicine. 1) Describe the myotomes and dermatomes L3-S1 2) List 4 Red Flag Diagnoses with associated RFs, Hx, PEX findings 3) Describe SLR, crossed-SLR, flip-test, reverse SLR and their implications 4) List 5 indications for Xray in low back pain 5) Discuss the discrimination of functional from organic back pain 6) Describe the management of: a. Fracture b. Cauda Equina Syndrome c. Spinal Infection d. Vertebral Malignancy e. Simple Radiculopathy 7) List 8 DDx for Thoracic back pain Wisecracks: Backpain treatment cocktails? When to order the CT scan? How to estimate the amount of post-void residual volume with ultrasound?

This episode covers Chapter 52 of Rosen's Emergency Medicine. Describe an approach to the pediatric elbow Classify supracondylar fractures in children List 3 complications of supracondylar fractures Describe the management of supracondylar fractures Describe the management of humeral shaft fractures – displaced and non-displaced Describe 3 injuries common in Little-leaguer's elbow Describe the management and classification of radial head fractures Describe the expected neurovascular injuries and management of posterior elbow dislocations List the indications for x-ray in radial head subluxation Describe the management of olecranon bursitis

This episode covers Chapter 51 of Rosen's Emergency Medicine. 1) Describe normal radiographic relationships: Radial length measurement Radial inclination Volar Tilt Scapholunate angle Capitolunate angle Wrist arcs 2) Describe xray findings and management of Scaphoid fracture Lunate fracture Triquetral fracture 3) Describe Mayfield's stages of carpal instability 4) Describe DISI and VISI 5) Describe xray findings and management of Colles' Smith's Barton's Hutchinson's / Chauffer's DRUJ Disruption 6) Describe management of pediatric Forearm fractures Torus fractures Greenstick fractures 7) List 8 RFs for Carpal Tunnel Syndrome + Describe 2 tests for CTS 8) Describe the Monteggia and Galeazzi's fracture patterns

This episode covers Chapter 47 of Rosen's Emergency Medicine. 1. List 6 general indicators of genitourinary trauma? Lower urinary tract and external genitalia What are the four parts of the male urethra? What is the mechanism of an anterior urethral injury (at least 5 causes)? What is the mechanism of a posterior urethral injury? List 4 indications for retrograde urethrogram before foley placement? Describe the technique for a retrograde urethrogram? Classify bladder injuries and describe the mechanism of injury. Differentiate between extraperitoneal and Intraperitoneal bladder rupture Describe the indications and technique for retrograde cystogram? Outline the management of the different types of bladder injuries. List 3 clinical findings of a penile fracture Describe the management of penile Constricting devices Superficial hematoma Superficial lacerations Degloving injury Penile Fracture Penile amputation Blunt scrotal trauma Bites Upper urinary tract What is the presentation of a ureteric injury? What are the indications for renal imaging in an adult trauma patient? In a pediatric trauma ? Describe the management of renal injuries: Blunt Penetrating Wisecracks: What is the most common site of urethral injuries?

This episode covers chapter 46 of Rosen's Emergency Medicine text book. Episode Overview: 1) What are three mechanisms of injury in blunt trauma? 2) List expected seat-belt injuries 3) What are the most common intra-abdominal injuries in children? 4) Differentiate between the use of CT scan, diagnostic peritoneal lavage (DPL) and ultrasound – advantages & disadvantages. 5) List intra-abdominal injuries that may be missed on CT. 6) Describe the process of local wound exploration. List 5 ways to determine if peritoneum has been violated 7) List clinical indications for laparotomy in blunt and penetrating abdominal trauma 8) Describe the management of unstable blunt abdominal trauma Pelvic fracture Head injury (closed head injury) Wide mediastinum (aortic injury) 9) Provide an approach to anterior abdominal trauma with: Evidence of peritoneal violation (penetrating injuries) Evidence of intra-abdominal injury with blunt abdominal trauma 10) Provide an approach to flank injuries 11) Provide an approach to back injuries Wisecracks: 1) Describe indications and technique of diagnostic peritoneal lavage (DPL). What is a positive DPL? 2) List 1 absolute contraindication and 4 relative contraindications to DPL 3) What is Waddel's triad? 4) What are Gray-Turner and Cullen's signs? 5) How much blood is detectable by bedside US?

This episode covers Chapter Chapter 45 of Rosen's Emergency Medicine text book and is full of pearls for Thoracic Trauma. Sign Post: Differentiate Chest wall injury, rib fracture, and flail chest Describe the clinical presentation and management of a sternal fracture Describe Injuries to lung parenchyma What is Traumatic asphyxia? List 6 indication for tube thoracostomy Indications for OR Thoracotomy What is the management of Diaphragmatic injury? Differentiate between myocardial concussion, contusion and rupture Review indications for ED Thoracotomy Describe your approach to identification and management of pericardial tamponade CXR findings for blunt aortic injury. List the 6 most common causes of esophageal perforation What is the Nexus CT Chest Rule? WiseCracks: Clinical conditions that mimic esophageal perforation Describe the basic approach to ED thoracotomy What is Electrical Alternans?

This episode of CRACKCast covers Rosen's Chapter 044, Neck Trauma. Continuing in our trauma series, this episode tackles the challenging issue of neck trauma and injuries, and explores the anatomy and relevant considerations in the diagnosis and management of both blunt and penetrating neck injuries. Episode Overview: 1) Describe the landmarks and structures using the Zones of the neck & the Triangles of neck 2) List 6 hard and 6 soft signs of penetrating neck trauma. What are the indications for immediate OR vs CTA in managing penetrating neck trauma 3) Describe an approach to managing acute neck trauma in the ER 4) Describe the management of venous air embolism 5) Describe techniques for airway management in penetrating neck trauma 6) Describe the management of suspected pharyngoesophageal trauma. What are signs of esophageal injury? 7) List 3 hard signs of laryngotracheal trauma and describe airway management dilemmas Wisecracks: 1) Differentiate between choking, hanging and strangulation 2) Define judicial and non-judicial hanging and describe expected injury patterns

This episode covers Chapter 043 of Rosen's Emergency Medicine, Spinal Injuries. Episode Overview Describe the anatomical contents of the anterior and posterior spinal columns List cervical spinal injuries for the following mechanisms, and indicated whether they are stable or unstable Flexion x 6 Shear / AP forces x 1 Flexion-Rotation x 2 Extension x 3 Vertical Compression x 2 List 8 unstable C-spine injuries Describe an approach to C-Spine X-rays, and define normal: Predental space Soft-tissue spaces Line of Swischuck Describe Canadian C-Spine Rule + Nexus Rule Describe incomplete cord lesions Describe: Wallenburgs Syndrome Dejeune Onion Skin Pattern of Analgesia Horners Syndrome Cauda Equina How does the bulbocavernosus reflex reflect the presence of spinal shock List features of sacral sparing List Dermatomes/ Myotomes / Spinal reflexes List 6 causes of Horner's For what C-spine injuries is a CT-a indicated to R/O vascular injury Are Steroids indicated for C-spine injuries For whom is surgical intervention indicated immediately with a spinal cord injury Define neurogenic shock and describe its management Define spinal shock What is the risk of cervical injury in Down's Syndrome? Rheumatoid Arthritis? What are the Denver criteria?

This episode covers Chapter 42 of Rosen's Emergency Medicine, Facial Trauma. 1) Describe the anatomy of the bones, glands, and ducts of the face. At what ages do the sinuses appear? 2) List 5 types of facial fractures. 3) Describe the clinical presentation and associated radiographic findings of an orbital blowout fracture. 4) Describe an orbital tripod fracture and its management. 5) List the indications for antibiotics in a patient with facial trauma? 6) What is the importance of perioral electrical burns? 7) What are the indications for specialist repair of an eyelid laceration? 8) Describe the classification and management of dental fractures. What is the management of an avulsed tooth? What is a luxed tooth? How is it managed? What is an alveolar ridge fracture? 9) Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation?

In the second episode of the Physicians as Humans project, I speak with Dr. Rob Rogers (@EM_Educator), a leading educator in emergency medicine and director of The Teaching Course. He shares his experiences of dealing with a devastating illness in his own family and the effect it had on his career as an emergency physician. This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact [email protected]. If you are unfamiliar with the project, please read this post for more information on the origin of this podcast series. The CanadiEM podcast can be added to your podcast application from the iTunes store or by entering the podcast RSS feed. If you would prefer to download it, click here. It can also be streamed above. Thanks for listening and please refer your colleagues! Music for Episode 02 (All songs have been modified for the project) ambient by strange day. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. Moon by LEMMiNO. Music provided by Music for Creators under a Creative Commons Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 license. Icy Vindur by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. Flourish, Wither, Bye by A Himitsu Music provided by Music for Creators under a Creative Commons — Attribution 3.0 Unported— CC BY 3.0 license. Where Silence is Nonexistent by A Himitsu Music provided by Music for Creators under a Creative Commons — Attribution 3.0 Unported— CC BY 3.0 license. Tomorrow by Bensound Pressure by Riot

This episode covers Chapter 41 of Rosen's Emergency Medicine. 1) list 7 causes of altered LOC in the trauma patient 2) List four herniation syndromes. Describe the pathophysiology of uncal herniation and the typical presentation. Describe the presentation of central herniation. 3) Describe how cerebral blood flow in relationship to the following parameters: PO2 , PCO2 , MAP and ICP. What are the indications for ICP monitoring? 4) What is the Canadian CT head rule? What are the inclusion criteria. What is the New Orleans CT head rule? What are the inclusion criteria? Which test is more sensitive? More specific? 5) What is a concussion? How is a concussion managed? What are potential complications? Define second impact syndrome & return to play 6) Outline the ED management goals of TBI. differentiated between direct and indirect TBI What are the indications for seizure prophylaxis following TBI? What are the indications for antibiotics in TBI? Complications of TBI? 7) 7 clinical features of basal skull # Wisecracks CT tips: 3 signs of cerebral edema on CT, 5 differences on CT between SDH And EDH, List 3 CT findings in DAI What are: the Monroe-Kellie doctrine, the Cushing's reflex, What is kernihan's notch, and how does this syndrome present?

This episode of CRACKCast covers Rosen's Chapter 040, Injury Prevention and Control. 1) What are the three key aspects to Injury Control? 2) What makes up the Injury Triangle? 3) List 6 of 10 potential strategies for preventing transfer of energy Wisecracks: 1) What can you actually do, as a health practitioner, to help injury prevention?