Hey everybody,
Today I discovered an issue with the iTunes feed that may have resulted in iTunes subscribers missing out on episodes since late July and/or only downloading the PDFs of the show notes instead of the audio files.  I think I have it fixed- it may only affect you if you use the desktop version of iTunes because I didn’t have any issues with it on my iPhone.  So if you subscribe through iTunes- you may want to refresh your feed and you may have to unsubscribe then re-subscribe to get the episodes you missed.

Here are the affected episodes:

Essential Evidence- Therapeutic Hypothermia

Essential Evidence- BMJ Subarachnoid Hemorrhage

Essential Evidence- The NEXUS Study

Hyperkalemia

Essential Evidence- NEJM Rivers Sepsis

Hyponatremia

Stroke and Transient Ischemic Attach (TIA)

Sorry for the mix-up- I hope the episodes download correctly from now on.  Let me know if you find any other issues

Steve

This episode of EM Basic Essential Evidence will review the two articles that led to the adoption of therapeutic hypothermia as a treatment for survivors of cardiac arrest. This is a simple yet highly effective therapy that improves survival and neurological outcome in survivors of cardiac arrest so it is important that we know and understand these two articles.

EM Basic Essential Evidence- Therapeutic hypothermia

NEJM Therapeutic Hypothermia (Free full text website link to NEJM issue)

NEJM Therapeutic Hypothermia articles (Free full text direct download)

This is an article published in the last year in the British Medical Journal that looked at the sensitivity of modern CT scanners in detecting subarachnoid hemorrhage. This article made a lot of waves because it suggested that a head CT within 6 hours of headache onset is 100% sensitive for subarachnoid hemorrhage.  Some have called it a practice changer that allows us to avoid doing a lumbar puncture so its important to read it for yourself and decide if it should change your practice.

BMJ Subarachnoid Hemorrhage Study (free full text website link)

BMJ Subarachnoid Hemorrhage Study (free full text PDF direct download)

BMJ Subarachnoid Hemorrhage podcast

Non-invasive ventilation is a great technique that we can use for just about any patient who is short of breath.  We can use it to avoid intubation in our patients who are close to respiratory failure.  In this episode, we’ll talk about how non-invasive ventilation works, which patients we can use it on, and how to actually make it happen.  For that last part, I’ll borrow from a post by Seth Treuger at his blog mdaware.org on how to start non-invasive ventilation quickly while keeping it comfortable for the patient.

mdaware.org blog post– “Selling Ice Cream in the Desert” aka how to make NIV work on any patient

Non-invasive Ventilation Podcast

Non-invasive Ventilation Show Notes (Word Format)

Non-invasive Ventilation Show Notes (PDF)

This episode will discuss the NEXUS study.  NEXUS studied thousands of patients to validate a set of rules so that we can “clinically clear” patients with possible c-spine injury without getting an x-ray. This study has helped us avoid radiation in certain low-risk patients, saved the cost of x-rays and CT scans, and speed these patients through the ED. We’ll talk a lot about the statistical side of this study and how you can apply it in your everyday practice.

The NEXUS study (free full text website link)

The NEXUS study (free full text PDF direct download)

The NEXUS study podcast