Emergency Medicine

Learning objectives: How do immune checkpoint inhibitors work? What are the most common treatment-related side effects of immune checkpoint inhibitors on the GI tract? What are the methods to diagnosed immune checkpoint inhibitor associated colitis? To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=cancer

Learning objectives: How do immune checkpoint inhibitors work? What are the most common treatment-related side effects of immune checkpoint inhibitors on the heart? What are the methods to diagnosed immune checkpoint inhibitor associated cardiotoxicity? To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=cancer

Neutropenic fever is an oncologic emergency that carries high morbidity and mortality and is a common condition seen in the Emergency Department. This lecture provides a concise and condensed overview of the definitions, etiology, workup, and up to date treatment strategies to manage neutropenic fever. Ultimately, the aim of this lecture is to make practitioners feel more comfortable managing neutropenic fever in their current practice environments. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/neutropenic-fever/?collection=emergency+medicine&chapter=cancer

Basic emergency medicine critical actions are applicable and appropriate in the cancer population. Breast, Lung, and Melanoma are the most common tumors to metastasize to the brain while Breast, Lung, and Prostate are the most common to go to the spine. Dexamethasone is a common initial treatment of choice in cases of suspected spinal cord compression or elevated ICP from a brain metastasis. The imaging modality of choice is an MRI with and without contrast of brain and/or entire spine (or both, depending on the circumstances). Treatment of these patients requires a multidisciplinary team that includes their primary oncologist, neurology, neurosurgery, and radiation oncology. We must strive to treat cancer patients' pain adequately and ease suffering as much as possible in these challenging cases. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=cancer

A short introduction to the Cancer Chapter from Kumar Alagappan, Professor of EM at MDAnderson Cancer Centre. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/oncologic-emergency-medicine-in-a-cancer-center/

This talk goes over a general overview of spinal cord injuries and emergencies. We go over some basic anatomy of the spinal cord, followed by clinical presentations, grading scale, and imaging modalities to help assess these injuries. Lastly, we go over management options and treatments of potential complications that arise from spinal cord injuries. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain To listen to more podcasts and interviews with healthcare professionals, please visit https://stmungos-ed.com/podcast

Status epilepticus is a life-threatening emergency. However, there are different forms of status epilepticus: focal to bilateral tonic-clonic status epilepticus and focal status epilepticus. Focal status epilepticus may have prominent motor symptoms, often with impaired awareness, or may be nonconvulsive. The implications of this are important: the treatment of focal to bilateral tonic-clonic seizures requires immediate action. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This talk highlights how a quick scroll through a non contrasted head CT can provide important information about the severity of illness. We review normal anatomy and easily recognized distorsions of neuroanatomy that suggest severe brain injury and impending herniation. The talk focuses on how these brain injured patients can be managed to prevent further injury and how simple bedside exams findings coupled with neuroradiologic findings can guide bedside management. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This talk highlights how a quick scroll through a non contrasted head CT can provide important information about the severity of illness. We review normal anatomy and easily recognized distorsions of neuroanatomy that suggest severe brain injury and impending herniation. The talk focuses on how these brain injured patients can be managed to prevent further injury and how simple bedside exams findings coupled with neuroradiologic findings can guide bedside management. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This talk explores the acute management of traumatic brain injury (TBI) with a focus on severe traumatic brain injured patients. We review the global burden of TBI and societal impact. We discuss characterizing TBI severity. We review the imaging to obtain based on various factors related to the injury. We discuss the critical role of the provider in preventing secondary injury in brain injured patients and how to manage a brain injured patient in the acute setting. Throughout the presentation, we review evidence-based guidance. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This talk goes over a brief overview of the two types of stokes, the importance of time when dealing with acute treatments, and the mechanism of action with alteplase. We go over the selecting the appropriate candidates for thrombolytic use and the recent trend to transition from alteplase to Tenecteplase. Lastly, we go over some of the potential complications from thrombolytic use and review the reversal agents needed for intracerebral hemorrhages. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This is a summary of the key considerations when managing ICH patients - epidemiology, pathophysiology, anatomy, diagnosis, assessment, treatment and more. And what is current evidence-bases 'best practice'? To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This talk reviews the important aspects of diagnosing subarachnoid hemorrhage in a patient who presents with sudden onset severe headache. I will review the importance of the history, nuances and limitations of diagnostic strategies including CT, lumbar puncture, CTA and MRI. I will present various published guidelines and recommendations for management of the patient with diagnosis of subarachnoid hemorrhage. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

This talk presents a case and discuss the diagnostic workup of the patient with acute dizziness. Evie will address pitfalls of diagnosis, and a strategy for the workup of the patient with dizziness using timing and triggers, as well as the HiNTS exam and its usefulness in this population. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

Confusion is one of the commonest presentations in the emergency department. It is a symptom that presents an underlying problem in any organ system that most of the time can be life threatening if not identified and proper intervention initiated timely. Can occur before or during the patient stay in hospital. Confusion can be due to an interplay among so many factors or causes. Therefore, an emergency care provide should have a wide set of knowledge to tease out all the possible causes in their patient to reduce on the morbidity and mortality.. Using the ABCDE approach within first five minutes of patient interaction in very integral to patient care and outcome. Further appropriate investigations and their interpretation is very important as it will aid in proper interventions. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

Pancreatitis is a common presentation in the emergency department globally, yet quite often missed. Patients present at various stages of the disease trajectory. Those that are earlier missed will present with life threatening conditions hence increasing morbidity and mortality. A few of the cases will not have the classical presentation. Emergency medicine clinicians should therefore equip themselves with the knowledge about pancreatitis to enable them to take a good history and do proper clinical patient examination. With the advances in medicine and accessibility, proper investigations should be done to aid in diagnosis and to also role out other causes or comorbidities. Timely and appropriate interventions should then be applied to improve outcome and quality of life in these patients. In resource limited settings, the higher index of suspicion and aggressive intervention helps prevent constraining the few resources since patients wont progress to severe cases which demand more resources and expertise. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

Headache is a common reason that people come to emergency departments but sorting out who has a serious secondary headache and who has a benign cause is not always easy. Informed by recent international studies of headache in emergency departments, this talk will discuss the causes of headache, high risk features that can inform decision-making about investigation and variation in treatment of benign headache. The focus will then switch to migraine focussing on the ED specific evidence-based for abortive treatments. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=brain

Skin infections are a common presenting complaint to the emergency department. This talk provides an overview of animal bites, other infected skin infections, abccesses and necrotising facsciitis. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=bowel

Acute appendicitis is the most common reason for emergency abdominal surgery. Untreated appendicitis, when associated with rupture, can lead to abscess, peritonitis, sepsis, and death. Uncomplicated appendicitis (i.e., localized appendicitis), which has traditionally been treated with urgent appendectomy, accounts for approximately 80% of cases. In the past three decades, numerous trials of nonoperative treatment in patients with acute uncomplicated appendicitis have been conducted, and the use of antibiotic agents as a first strategy has become acknowledged as a safe option, including with emergency department care and then discharge with outpatient management. In this lecture, I review the expected outcomes associated with initial operative and nonoperative treatment of acute uncomplicated appendicitis and offer guidance on counseling patients to help them chose between the two approaches. To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=bowel

Learning objectives of this talk: Understand the mechanism of action of tranexamic acid Be aware of the effects of tranexamic acid in bleeding patients Know who should be treated, when and where To watch the lecture, and learn more about the speaker, please visit https://www.continulus.com/library/?collection=emergency+medicine&chapter=blood

This talk reviews both the prevention of VTE and its treatment. Thrombotic risk assessment of patients are reviewed then appropriate methods of thrombosis prevention are recommended. Options and dosing of anticoagulation is discussed with a focus on the direct oral anticoagulants. Various treatment choices are next reviewed ranging from bed-rest to thrombolytic therapy. Finally there is a discussion of how to decide duration of therapy. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

This talk reviews several bleeding emergencies. Three causes of thrombocytopenia – immune thrombocytopenia (ITP), thrombotic thrombocytopenia purpura (TTP) and disseminated intravascular coagulation (DIC) – are reviewed. ITP presents with severe thrombocytopenia and is treated with steroids/IVIG. The presentation of TTP varies from mild thrombocytopenia to severe mental status changes and is treated with plasmaexchange. DIC is always due to an underlying illness and treatment is focused on factor replacement plus treatment of the primary cause. Finally treatment of bleeding due to antithrombotic therapy is reviewed. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

This talk goes over the most common causes of inhirted bleeding disorders. There are two major types of hemophilia – deficiency in factor VIII and IX – which predominant occur in men. Hemophilia A is deficiency of factor VIII and is the most common form of hemophilia treated with factor concentrate. Hemophilia B is less common but treatment principles are the same. There are multiple types of von Willebrand Disease as this is a complex molecular that both carries factor VIII and forms large multimers essential for platelet function. Mild forms of vWD can be treated by desmopressin but von Willebrand factor is needed for more severe types. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

This talk covers the most common causes of anemia. Iron deficiency – probably the most common acquired anemia – is discussed with details about testing and treatment. Serum ferritin is the most efficient test for iron status Oral iron only needs to be given once a day and for patients who can't replete or tolerate oral iron, intravenous iron is a safe option. Thalassemia – defects in the protein part of hemoglobin – is the most common cause of inherited anemia. Most patients are carriers present with microcytosis and varying degrees of anemia but severely affect patients are transfusion dependent. Increasingly B12 deficiency is being found. Diagnosis is better made by use of metabolic testing with assay of methylmalonic acid. Oral therapy suffices for most patients. Finally recommendations are made for evaluating anemic patients. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

Basic and advanced airway management in emergency circumstances are frequently complicated by the occurrence of contamination with regurgitated material or frank bleeding in cases of gastrointestinal bleeding or head and facial trauma. Airway contamination prevents effective and safe oxygenation and ventilation, and furthermore, severely complicates advanced airway management when endotracheal intubation is attempted. The Suction-Assisted Laryngoscopy Airway Decontamination (SALAD) Technique is intended to simplify the care of patients with contaminated airway in both basic and advanced airway management scenarios. SALAD utilizes a large bore rigid suction catheter to simultaneously evacuate the oropharyngeal airway contaminants as well as the hypopharyngeal airway contaminants proactively, to improve the effectiveness of the various airway management procedures. Furthermore, SALAD teaches the caregiver to utilize the rigid suction catheter as a tool to simplify the insertion of basic (oropharyngeal airway) and advanced (laryngoscope and supraglottic airway) airway tools, improving the effectiveness of these techniques in emergency situations. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

This is a talk on how to manage tracheostomy in the Emergency Department. During the talk, we shall go through the definitions, indications and contraindications of the procedure, the types of tubes, the various techniques of tracheostomy available, the procedure itself and how to manage some of the complications in the ED.This talk has open access video links available at the end from the New England Journal of Medicine. These video links will describe the different techniques that are out there and their use can be guided by the resource settings and local management protocols in place. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

Obesity is becoming a worldwide health problem and a challenge for clinicians. Managing the airway requires an understanding of the physiology and anatomic features of obesity. The daily practice of elective bariatric surgery has provided experience and expertise but emergency situations are still the cause of morbidity. The advent of video-laryngoscopy has provided a welcome solution to many problems and supraglottic airways are also useful in providing needed ventilation. In addition, postoperative respiratory management is also essential. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

The invention of the laryngeal mask by Dr. Archie Brain in 1988 began an era of airway management and anesthetic innovation that continues today. The supraglottic airway is an alternative to mask ventilation and endotracheal intubation yet provides another solution to management of the difficult airway. The device has undergone an evolution in design and function and today exists as an invaluable tool in managing our challenging patient population and surgical demands. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

In this talk, Jon does a deep dive into airway management in critical care. Using a patient story, he examines the airway team: their experience, training and readiness, and argues that critical care practitioners may be under-prepared, under-confident or out-of-practice, with poor access to immediate senior help. He emphasises the importance of structured in-theatre airway training and refresher training for senior practitioners. He makes the case for streamlining and standardising equipment, and for the routine use of video-laryngoscopy, capnography, checklists and cognitive aids. He ends with a message of hope - that it is possible to move away from the high adverse event rates seen in NAP4 and the INTUBE studies, and improve patient safety during airway management in critically ill patients. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

The bougie (tracheal tube introducer) is valuable for patients with difficult airways or after failed intubation attempts. Recent clinical reports demonstrate improved first attempt success when the bougie is used for all patients, regardless of difficulty level. This is especially true if the intubator has incorporated bougie use into their routine clinical practice. The bougie is a simple, intuitive device, but knowledge of a few key techniques is required. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

A review of Rapid Sequence Intubation from the original description via the latest evidence to the latest modifications. What remains the same and what has changed? Learning objectives for this talk: Describe the original/classic RSI Understand when it is indicated and how that has changed recently Appreciate the key modifications to the classic RSI based on recent evidence To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

A review of Rapid Sequence Intubation from the original description via the latest evidence to the latest modifications. What remains the same and what has changed? Learning objectives for this talk: Describe the original/classic RSI Understand when it is indicated and how that has changed recently Appreciate the key modifications to the classic RSI based on recent evidence To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

A review of Rapid Sequence Intubation from the original description via the latest evidence to the latest modifications. What remains the same and what has changed? Learning objectives for this talk: Describe the original/classic RSI Understand when it is indicated and how that has changed recently Appreciate the key modifications to the classic RSI based on recent evidence To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

A review of Rapid Sequence Intubation from the original description via the latest evidence to the latest modifications. What remains the same and what has changed? Learning objectives for this talk: Describe the original/classic RSI Understand when it is indicated and how that has changed recently Appreciate the key modifications to the classic RSI based on recent evidence To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

A review of Rapid Sequence Intubation from the original description via the latest evidence to the latest modifications. What remains the same and what has changed? Learning objectives for this talk: Describe the original/classic RSI Understand when it is indicated and how that has changed recently Appreciate the key modifications to the classic RSI based on recent evidence To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

A review of Rapid Sequence Intubation from the original description via the latest evidence to the latest modifications. What remains the same and what has changed? Learning objectives for this talk: Describe the original/classic RSI Understand when it is indicated and how that has changed recently Appreciate the key modifications to the classic RSI based on recent evidence To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

Learning objectives for this talk: Understand the importance of objective measurement of fraction of expired oxygen in determining proper pre-oxygenation during rapid sequence intubation and how denitrogenation of the FRC and maximal oxygenation of the blood will lead to longer duration of apnea without desaturation times Understand the impact denitrogenation and patient positioning have on potential pulmonary shunting which may place the patient at risk of rapid desaturation Understand the importance human factors play in challenging procedural situations such as rapid sequence intubation and how situational awareness can be lost during times of high stress To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

Learning objectives for this talk: Understand the importance of objective measurement of fraction of expired oxygen in determining proper pre-oxygenation during rapid sequence intubation and how denitrogenation of the FRC and maximal oxygenation of the blood will lead to longer duration of apnea without desaturation times Understand the impact denitrogenation and patient positioning have on potential pulmonary shunting which may place the patient at risk of rapid desaturation Understand the importance human factors play in challenging procedural situations such as rapid sequence intubation and how situational awareness can be lost during times of high stress To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

Airway management in the ED and other acute care settings has followed the 'ABC' priority paradigm. Open the airway, apply oxygen then support oxygenation and ventilation with a 'definitive' airway A.K.A a tracheal tube. The challenge and focus of airway management in emergencies has been on the technical imperative of laryngoscopy and intubation and therefor success is usually referenced by correct placement of the tube. First pass success (FPS) has been the primary outcome in a majority of publications examining airway management. This reverse rationalization is supported by numerous publications in every setting demonstrating an association between increasing number of attempts and patient morbidity and mortality. The focus of airway management is to support oxygenation and ventilation while maintaining physiologic homeostasis. The tube provides neither benefit nor harm airway management and success should therefor, be defined by a broader contextual surrogate for patient outcomes. Clinicians should strive for FPS rates >90%, without critical hypoxemia or hypotension performed in a timely manner. To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway