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Emergency Medical Minute
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Добавлен 25 май 2016
The Emergency Medical Minute (EMM) is a Colorado 501(c)(3) non-profit organization promoting free medical education to nurses, medics, doctors & other clinicians. In addition to being medicine’s most prolific podcast, we also host events in and around Denver.
Episode 937: Pneumomediastinum
Contributor: Megan Hurley MD
Educational Pearls:
What is the mediastinum?
The thoracic cavity is separated into different compartments by membranes
The lungs exist in their own pleural cavities, and the mediastinum is everything in between
The mediastinum extends from the sternum to the thoracic vertebrae and includes the heart, the aorta, the trachea, the esophagus, the thymus, as well as many lymph nodes and nerves.
What is a pneumomediastinum?
Air in the mediastinum
How can pneumomediastinum be categorized?
Traumatic
Ex. Stab wound to the trachea
Ex. Boerhaave’s Syndrome of the esophagus, possibly from an endoscopic procedure. This mechanism in particular is a higher risk of infection ...
Educational Pearls:
What is the mediastinum?
The thoracic cavity is separated into different compartments by membranes
The lungs exist in their own pleural cavities, and the mediastinum is everything in between
The mediastinum extends from the sternum to the thoracic vertebrae and includes the heart, the aorta, the trachea, the esophagus, the thymus, as well as many lymph nodes and nerves.
What is a pneumomediastinum?
Air in the mediastinum
How can pneumomediastinum be categorized?
Traumatic
Ex. Stab wound to the trachea
Ex. Boerhaave’s Syndrome of the esophagus, possibly from an endoscopic procedure. This mechanism in particular is a higher risk of infection ...
Просмотров: 36
Видео
Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation
Просмотров 66День назад
Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adverse effect through inhibition of mitochondrial 11-β-hydroxylase activity A recent meta-analysis analyzing etomidate as an induction agent showed the following: 11 randomized-controlled trials with 2704 pa...
Episode 935: Pregnancy Extremis - TOLDD
Просмотров 4714 дней назад
Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriate management of critically ill pregnant patients is TOLDD T: Tilt the patient to the left lateral decubitus position This position relieves pressure exerted from the uterus onto the inferior vena cava,...
Episode 934: Subendocardial Ischemia
Просмотров 3321 день назад
Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of ventricular repolarization (T-wave). It should appear isoelectric (flat) in a normal ECG. What if the ST segment is elevated? This is evidence that there is an injury that goes all the way through the...
Episode 933: Benign Convulsions with Gastroenteritis
Просмотров 26Месяц назад
Contributor: Alec Coston MD Educational Pearls: Causes of seizures in a fairly well-appearing child with diarrhea: Electrolyte abnormalities: hypocalcemia, hyponatremia Also hyperkalemia which causes arrhythmias and syncope - can appear like seizures Hypoglycemia If the child has diarrhea and appears very sick, differential diagnosis may include: Hemolytic uremic syndrome (HUS): simultaneous oc...
Episode 931: Naloxone in Cardiac Arrest
Просмотров 60Месяц назад
Contributor: Aaron Lessen MD Educational Pearls: Can opioids cause cardiac arrest? Opioids can cause respiratory suppression and the subsequent low oxygen levels can lead to arrhythmias and eventually cardiac arrest. In 2023, 17% of out-of-hospital cardiac arrests (OHCA) were attributable to opioids. Given that this is a rising cause of cardiac arrest, should we just treat all cardiac arrest wi...
Episode 929: Traumatic Aortic Injury
Просмотров 652 месяца назад
Contributor: Aaron Lessen MD Educational Pearls: Aortic injury occurs in 1.5-2% of patients who sustain blunt thoracic trauma Majority are caused by automobile collisions or motorcycle accidents Due to sudden deceleration mechanism accidents Clinical manifestations Signs of hypovolemic shock including tachycardia and hypotension, though not always present Patients may have altered mental status...
Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley
Просмотров 222 месяца назад
Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley Contributors: Meghan Hurley MD, Travis Barlock MD, Jeffrey Olson MS3 Show Pearls Map of South Africa Referenced South Africa Geography Lesson There is a big disparity between Cape Town and its neighbor Khayelitsha. Cape Town is the legislative capital and economic hub of South Africa, known for its inf...
Episode 928: Neutropenic Fever
Просмотров 522 месяца назад
Contributor: Taylor Lynch, MD Educational Pearls: What is neutropenic fever? Specific type of fever that is seen in cancer patients and other patients with impaired immune systems These patients are highly susceptible to infection Typically occurs 7-10 days after the last chemotherapy dose, this is when the immune system is the weakest It is useful to know the specific type of malignancy. For e...
Episode 927: Functional Gallbladder Syndrome
Просмотров 542 месяца назад
Contributor: Jorge Chalit-Hernandez, OMS3 Typically presents with biliary colic Right upper quadrant abdominal pain lasting more than 30 minutes and subsiding over several hours Often associated with fatty meals but not always Must rule out other causes of pain Peptic ulcer disease - typically presents with epigastric pain Pancreatitis - pain that radiates to the back or family history of pancr...
Episode 926: Supraventricular Tachycardia
Просмотров 722 месяца назад
Contributor: Taylor Lynch MD Supraventricular tachycardias (SVTs) arise above the bundle of His The term SVT includes AV nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), atrial tachycardia, atrial fibrillation, atrial flutter, and multifocal atrial tachycardia AVNRT is the most common form of SVT Paroxysmal Spontaneous or provoked by exertion, coffee, alcohol,...
Episode 925: Table Sugar for Tongue Entrapment
Просмотров 362 месяца назад
Contributor: Aaron Lessen, MD Educational Pearls: Pediatric case study where the child’s tongue was stuck in the opening of a hard plastic drink lid Entrapment restricts circulation which causes fluid to build and the tongue becomes more edematous with time There is a risk of ischemia with prolonged entrapment Initially tried 2% viscous lidocaine for analgesia and lubricant The ER recognized th...
Episode 924: Pregnancy Cold Remedies
Просмотров 342 месяца назад
Contributor: Megan Hurley, MD Educational Pearls: Fevers Tylenol Up until 20 weeks NSAIDs are ok but after 20 weeks they are contraindicated Can limit the amount of amniotic fluid produced Can lead to growth restriction Can cause premature closure of the ductus arteriosus Cough Cough drops Humidifier Guafenesine and dextromethorphan (Mucinex) is not well studied but is probably ok with caution ...
Episode 923: Blunt Cerebrovascular Injury
Просмотров 433 месяца назад
Episode 923: Blunt Cerebrovascular Injury
Laboring Under Pressure Episode 3: Hypertensive Disorders of Pregnancy with Dr. Kiersten Williams
Просмотров 413 месяца назад
Laboring Under Pressure Episode 3: Hypertensive Disorders of Pregnancy with Dr. Kiersten Williams
Episode 920: Pediatric Growth Estimates
Просмотров 303 месяца назад
Episode 920: Pediatric Growth Estimates
Episode 919: EKG Criteria for Adenosine
Просмотров 734 месяца назад
Episode 919: EKG Criteria for Adenosine
Episode 918: Automated Blood Pressure Cuffs
Просмотров 654 месяца назад
Episode 918: Automated Blood Pressure Cuffs
Podcast 914: Neuroleptic Malignant Syndrome (NMS)
Просмотров 995 месяцев назад
Podcast 914: Neuroleptic Malignant Syndrome (NMS)
Episode 913: Vasopressors after ROSC
Просмотров 685 месяцев назад
Episode 913: Vasopressors after ROSC
Episode 911: Anticholinergic Toxicity
Просмотров 1485 месяцев назад
Episode 911: Anticholinergic Toxicity
Episode 910: Cellulitis Recovery Timeline
Просмотров 756 месяцев назад
Episode 910: Cellulitis Recovery Timeline
Episode 909: Prehospital Blood Pressure Management in Suspected Stroke
Просмотров 536 месяцев назад
Episode 909: Prehospital Blood Pressure Management in Suspected Stroke
It's criminal that you suggest not using an antiviral drug like Hydroxychloriquine and a macrolide antibiotic like Azithromycin, you should lose your license in medicine. Shame on you for pushing government propaganda.
BS
Wow. I went though med school, adult psych residency, child fellowship and LEND fellowship for neurodevelopmental disorders. How am I just learning Prl can be used to help differentiate szs and PNES?! Or maybe I did and forgot? Anyway, thank you, E-medmin!
I have that along with ataxia mo balance
Gadolinium is referred to as contrast dye. You said it's not so much a contrast, as it is an element. What is the differentiator between these two things? Hospitals and facilities refer to it as contrast. Gadolinium is super toxic, and we have patient stories that you should take a listen to if you're interested in hearing from those who were disabled by gadolinium deposition disease.
give me diarrhea any day
Son (11 yr 10 mos) just had non displaced distal radius buckle fracture. Put in splint for 3 weeks and was told he can refund to volleyball when removed in 3 weeks. Also told okay to practice serving & bumping prior to that. Is that safe?
My drug court is so money hungry they don’t gaf about helping you
I took about 30 150mg xr and i had a seizure (1) in the hospital for 2 days with 2mg every 6 hours. I take 450mg a day currently with no seizure also taking 1000mg keppra.
You should have did a fibrinogen and degradation products. In 10 minutes you would have had a blood clot diagnosis of the brain.
Seemed impossible, but it’s been over 2 years and I don’t crave a drop of alcohol, the key difference was that I didn’t suffer withdrawal, not even within the first 30 days, just happened after go’ogling Steffon Barkload's latest and genuinely quitting because I was a mess.
#COOUDCHW love myth one, never thought about pain killers as a way to absolutely kill pain
#COOUDCHW I didn't know that black tar h was basically only usable by injection or how many times people need to inject substances to stay "well"
Thanks buddy so helpful
Yeah this is true I know it bc I’ve been thru it. Usually you have to wait it out still.. benzos are honestly the best I think to help but as most are addicts, it’s understandable to not want to use them.
fracture en motte de beurre
Bartoletti Lodge
Mine looks like that but not that red, best natural fastest way to heal? Been there for months
Fisher Creek
100% agree, I just realized that Mario updated his favorite way to tackle ED and it's crazy! Although what he previously talked about was pretty decent, it was difficult to follow, I just go'ogled the latest by Mario Volpstein, it's so much simpler and potent now!
Effertz Place
Oh I got knocked out from fentanyl and buprenorphine. I was knocked out and don’t remember the ambulance ride. Woke up in ICU.
Im using Colchicine and thats my doctor prescribe and all is good,..side effect is LBM ( Loss bowel movement ) similar to diarrhea, but its not a problem..its cleansing my digestive system..all toxic from my intestines are been remove ang my gout is treated and its like Im dieting because my weight is reduce...its a big help especially by Hypertension...
❤
Jokes, f ing idiots
White James Jackson George Gonzalez Kenneth
2D
Thank you for sharing this. I’m in the hospital for the second time with my child for a possible BRUE. She is 6 weeks now (was 3 weeks at first BRUE) and was a preemie, her episode lasted 15 minutes. I was terrified.
Necesito que sea en español
I'm so tired of this idea that treating acute or perioperative pain in a suboxone patient with actual pain medicine is going to somehow increase relapse rates. It needs to stop. It isn't true. You want to know what does increase relapse rates? Not treating pain effectively. Which, is literally how 90% of addicts got to where they are. By trying to self treat/medicate chronic pain. I've had two surgeries now while taking suboxone. One thing they'll tell you is to divide your dose up to 3x a day. Doesn't work. I had septoplasty and a turbinectomy while taking 16mg. They told me taking 10mg of oxy every 4 hours should work. It did NOTHING. So, I call the doctor back, that didn't do anything and I'm in severe pain. Try taking two more. OK. So then, I was on 30mg of oxycodone in a 4 hour period. Didn't do anything. Called him back, he says he doesn't know what to tell me. I cried, threw the pain meds away, and suffered through it. Was one of the worst weeks of my life. The other was a jaw arthroscopic surgery and arthrocentesis. I was told the surgeon didn't feel comfortable prescribing ANY pain medication. My options were to have the surgery without pain meds. Or, don't have it. I needed it because my jaw kept locking and going into these terribly painful spasms. She said any pain meds would need to be prescribed by my suboxone doctor. When I asked her, she said I don't prescribe that stuff in this clinic. If I did, my boss would look at me like I've got a third eye on my forehead. So again, I sat in extreme pain for a week, and eventually got through it. Not sure what this doctor is taking about though. I wish they'd just ask us what works and what doesn't. Not, tell us what should work based off of what some book says. The ONLY thing that will get through the suboxone is fentanyl. It has a similar binding efficacy, and is a similar enough lipid to knock some of the bupe off and share the receptors. But, good luck on getting a fent patch or lollipop, or really anything to actually help you with pain and be treated like a human being. The last two procedures I've had were like being tortured. I've got my third procedure planned for the 29th and it's rather funny watching the doctors tell me what's going to work. Then I say, well we did that last time and it didn't. So...why will it this time? Uhhhhm.... Ahhhh.... Do you want the procedure or not? Yes, I just want a pain plan in place I know will actually work this time. Not be treated like a farm animal that will eventually get over it. For acute pain and being on suboxone, it's fent, dillauded, or nothing. That's the only two things I've seen to ever work. I have a degree in biology, have worked in the medical field, and was labeled an addict because I had a hard time coming off of 150mg of morphine a day, with 90mg of oxy per day, to zero, because the VA got told by the DEA they were prescribing more than the civilian hospitals. Really? The place that treat people who've been in an almost two decade long war, need more pain medication or benzos to stay sane after witnessing the absolute worst humanity has to offer. Don't let these doctors and surgeons push you into a surgery unless they have a pain plan in place you agree with. If it you know it isn't going to work, speak up.
You won't necessarily have withdrawals but you can get rebound pain in your back.
No for spinal epidural abscess u should get a decompressive laminectomy with debridement
This is what I have
Here are some of the things that zyprexa did to me. Sexual dysfunction, loss of interest in my hobbies (and everything else), constipation, insomnia, fear of open spaces, depression, etc. etc.etc. and this was only a year or so of using. I threw it away.
Caution on MRI with contrast gadolinium. I am a MRI w /Contrast's victim in 2020 : Next day of an abdomen MRI with contrast Gadolinium injection : muscle, joints, nerves pain, feet and hands and fingers tingling electric, fogging memory. The cost of an MRI is about $4,000- $6,000, They order me to a CT scan, then an MRI and an MRI with contrast together. Then more problem to your health, they send you to others specialists to get more treatment , then no cure available.The pain last for ever to today almost 5 years. I have notified FDA, but no help. They did not warn me before the injection, but oblige me to sign on the brochure when I came to pickup the DVD of MRI result. Please FDA help protect our human citizen. The Physician have to warn, explain to patient before ordering MRI with contrast. In Europe they forbid the MRI contrast gadolinium. Date 8/4/2003' ( see Gadolinium Toxicity, Gadolinium Deposition Disease).
I was poisoned by gadolinium too (Gadovist) and have normal kidney function. Horrifically debilitating neurotoxin that destroyed my life. Shame on these radiologists for using this so routinely. So many lies being told about these drugs.The risk is much higher than advertised because they don't consider any effects outside of acute reactions and NSF to exist. Patients are having their lives destroyed without proper consent.
Jesus' loves you ❤
My 3 month old had this!! I'm in the UK and my GP fobbed me off for a week when my baby's skin started coming off. I took him to accident and emergency and was scolded for not bringing him sooner, but my GP was gaslighting me, saying i was an overwrought first time mother. But i took him everu day for a week abd it got to the point wjere i couldnt even put nappies (diapers) on him. He was prescribed oral antibiotics and told he wasnt in pain, but the ABs caused diarrhoea which then burnt his raw skin in the groin - even his little oenis was affected. THEN once he was admitted to the Paediatric ward, the nurses and doctors there completely dismissed it all and sent us home TWICE in 5 weeks, even though a third of his tiny body was covered in raw open weeping wounds. It was honestly the worst time of my life. We had to fight every inch of the way to be taken seriously and my baby to be treated appropriately. In the end we had to be referred to Great Ormond Street Hospital to get treated appropriately. Awful.
To bad they can not keep it in stock😈
Mine started with pain in my neck, the most unbelievable pain, left it alone, and 2 months and 2 strokes later! Here I am
Most bougie failures occur because of the failure of the resident to positively and correctly diiferentriate the patients airway from their own rectum.
I think i have this type of sydrome
Yes...I am 100% sure. Colchicine is a miracle drug for me. If I take it early enough into a flare up, it clears it up for me within just a few days. I get flare ups a few times a year and have had 2 full blow flare ups in the past 5'ish years and it's the worse pain I've ever experienced in my life. It feels like a bone has broken in half in my foot with a bunch of shards of jagged glass. I tell people I can't freaking walk, and I think they think I'm being overly dramatic...but no, I'm serious. I can't freaking walk! Yes. I am 100% sure I want Colchicine for Gout.
The diagnosis is irrelevant. Convulsions are treated with anticonvulsants, simple.
I’m just learning more about the different in between Palliative Care and Hospice . I’m. CNA ….. is quite interesting how people in general avoid conversations about death .I see how cold some Drs can be ; I don’t think they do it on purpose , is just luck of answers because is not in answer. Drs are human , and we forget. I read about do to the fact that some family’s think I have in answer No. I don’t in that way that they expect……. However , I help them to talk with the Drs or RN’s .so far so good . Went a patient ask me if the going to pass . My amsterdamés is yes , we all going to pass went? I don’t know , nobody knows . However that is a conversation that you have to have with God . But the more we ask and learn about dead is better . It. Should be a normal conversation . Not a tabu . The body knows how to die and born it come with are mechanisms. What are we afraid is the unknown., very normal . Thank you for this video
I took cocaine and had chest pain and took 20mg propranolol and my heart is beating even faster after 45 mins...or more aggressively and the chest pain worsened. I don't recommend.
I had typhlitis due to the medication ocrevus.
How did u treated
This medicine is absolutely garbage!!!! It was taken of the market before because it was trash … I’m currently in a living hell from this medicine. I was given via IV yesterday in the ER for dizzy spells ect. Ever since 28 hours later I can’t sleep I can’t eat, I can’t sit still I’m having mild hallucinations when I try to sleep. Heart rate up and down. I was sent home only told to take Benadryl. NEVER TAKE THIS DRUG!! Do your own research
This medication totally messes me up in the brain, hallucination all day for 3 months, dizziness, insomnia, intense agitation, depression, anxiety, memory loss. Extreme head pressure. Sensitive to light on my vision. Felt lost and confused. This is a crazy drug
This guy is the biggest clueless bozo giving out dangerous advice....failed high school mentality wanting views.
Hey what about cefpodxime for gonohreea in throat