Chronic Pain

Part one of a two part series on caring for patients with chronic pain Pearls: With few exceptions, opiate therapy should be reserved for the short-term treatment of acute somatic pain due to tissue injury. Patients with acute pain should be informed early on that once tissue healing starts, opiates will be discontinued and the …

Pediatric C-spine Clearance

When we want to clinically clear the adult cervical spine, what do we do? We whip out a handy dandy decision instrument. Canadian C-spine? Yes! NEXUS? Boom, you betcha! But when it comes to kids, there’s just nothing out there that even resembles a prospectively validated clearance tool. We’re left with are gestalt, experience, and …

Scott Weingart on the State of Things

Scott Weingart is a thought leader in critical care and emergency medicine medicine. His EMCrit podcast has changed the game in medical education and improved care of crucially ill patients across the planet. ERCast sat down with Scott to get his opinion on beer, medical education, FOAMed, critical care, podcasting, and life in general. http://traffic.libsyn.com/ercast/Weingart_on_the_state_of_things.output.mp3 …

The Subarachnoid Enigma

Six hours means so much when it comes to subarachnoid hemorrhage. That is the inflection point when blood may no longer look like fresh blood on a CT. Several studies have shown that a negative ct done within 6 hours of headache onset effectively excludes clinically significant bleeding (extrapolated to mean aneurysmal subarachnoid hemorrhage). Of course …

No CPR in Trauma Arrest?

In October 2013, Scotty Weingart was on the show and suggested that closed chest CPR has no role in traumatic cardiac arrest. It made sense because, after all, the things that cause a traumatic arrest won’t be helped by closed chest compressions. Tension pneumothorax, pericardial tamponade, hypovolemia from exsanguination – pushing on the chest isn’t going …

Revenge of the Nerd: Coronary CT? Ehhh, no

A follow up to our interview with Judd Hollander on the use of Coronary CT Angiography in the emergency department. Bonus section: A measles primer http://traffic.libsyn.com/ercast/Revenge_of_the_nerd.output.mp3 Direct Download Guest post by Rory Spiegel, A.K.A Captain Basil, A.K.A EM NERD In today’s age of Modern Medicine, we consistently favor the objective findings provided by medical technology over the …

A requiem for oral contrast

Interested in trying your hand at medical podcasting for Primary Care RAP? Listen to the show and then send me a note rob@hippoeducation.com http://traffic.libsyn.com/ercast/Oral_contrast_laid_to_rest_ercast.output.mp3 DIRECT DOWNLOAD   Enteral contrast for CT diagnosis of appendicitis Commentators: Sanjay Arora MD and Michael Menchine MD Written summary courtesty of EMRAP. Author: Marlowe Majoewski Drake FT et al. Enteral Contrast …