The show notes for PE Part 1 are posted and available here

PE Part 1 (Word Format)

PE Part 1 (PDF)

This episode has been a long time in the making- presenting Pulmonary Embolism, part 1.  PE is a deadly diagnose that we frequently have to consider in the ED.  The presentations can be very varied but we need to know how to work up this disease while avoid unnecessary testing and harm to our patients.  In part 1, we will discuss risk factors for PE, symptoms that should make you suspicious for PE, and how to order the correct labs and imaging to diagnose this serious condition.

PE Part 1 Podcast

PE Part 1 Show Notes (Word Format)

PE Part 1 Show Notes (PDF)

EM Trends– a new FOAM blog on “what’s trending in EM”- great reviews of current literature

Links mentioned in the podcast:

Symptoms associated with PE– large prospective multi-center study (2.9% hemoptysis, 47% chest pain, 79% Shortness of breath)

PE diagnostic accuracy with increasing clinical experience (Accuracy for EM-1- 71%, EM 2-3 75%, EM 4 and attendings- 78%)

PERC rule- original paper

PERC rule- EM Basic Essential Evidence Episode

Other PE decision rules (revised Geneva and Wells)- not as commonly used as PERC

ercast podcast on imaging for PE in pregnancy with Jeff Kline

Hi everyone,

I just fixed the issue with the latest episode- a followup to the COPD podcast discussing the use of oxygen in COPD patients.  You will likely need to delete the previous podcast from your iTunes/RSS feed and download the podcast again.

Here’s the link for the podcast

Here’s the link to the original post

Sorry for the mixup- you stay classy, podcast listeners

Steve

The last podcast on COPD led to some great discussion online about the use of oxygen in patients with COPD.  To address this, Drs. Tim Peck and Colby Redfield are back with a quick summary to clarify how to best use oxygen in patients with COPD.  There’s also another cameo by the one and only Dr. Peter Rosen on how to succeed in emergency medicine.

Here’s the big points:

-Don’t hesitate to give high flow oxygen to hypoxic patients with shortness of breath- especially in the first 30-60 minutes of the resuscitation.

-After the patient has stabilized- give enough oxygen via nasal cannula (or lower flow face mask) to titrate their pulse ox between 88 and 92%.  DO NOT leave patients with COPD on high flow oxygen for long periods of time.

Oxygen in COPD- followup

Here are some relevant references for further reading.

1. New, A.  Oxygen: kill or cure? Prehospital hyperoxia in the COPD patient.  Emerg Med J. 2006 February; 23(2): 144–146.

2. Austin MA et al. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: Randomised controlled trial. BMJ 2010 Oct 18; 341:c5462. 

3. Kilgannon JH, et al. Association Between Arterial Hyperoxia Following Resuscitation From Cardiac Arrest and In-Hospital Mortality. JAMA Vol 303, No 21, June 2, 2010;2165-2171. 

4. Cornet AD, Kooter AJ, Peters MJ, Smulders YM. The potential harm of oxygen therapy in medical emergencies. Crit Care. 2013;17(2):313.

EM Basic is back with another episode of the EM Basic Project.  In today’s episode Drs. Tim Peck and Colby Redfield review the chief complaint of shortness of breath with a focus on COPD.  Even though we did an episode on shortness of breath a while back, it’s always great to get a new perspective on this chief complaint.  Today’s episode also features a very special guest cameo by the name of Dr. Peter Rosen.  He pretty much started EM as a speciality and you may have seen his name on a textbook or two.

The authors are also launching a new website today called iClickEM in beta version.  This site may very well change the way you gather and collate your online education in Emergency Medicine.  They will be starting in a closed-beta version with 1,000 access codes available starting today.  So if you are interested in getting in on the ground floor and helping them build this website, check it out at iClickEM.com

Please send me submissions for the EM Basic Project so we can keep moving with the podcast.  If you didn’t see the previous post, I recently started an online Master’s in Medical Education which has taken a lot of time away from the podcast.  Things will get better with the new year as my course load drops but I still need your help to produce new content!  If you are interested, check out the submission page, pick a topic, and let’s get started.

COPD/SOB Podcast

COPD/SOB Shownotes (Word Format)

COPD/SOB Shownotes (PDF)