Introducing EM Basic Essential Evidence- your boot camp guide to emergency medicine literature. Each episode will review an important emergency medicine article from the ground up. We’ll review the study’s design, basic statistics, results, and wrap it up with some analysis to help you understand the study and how to put it into your everyday practice. The goal here is to provide a guide through the emergency medicine literature so you can read and understand the “must know” studies out there.

This is also the re-launch of EM Basic to a weekly podcast format.  Every monday morning, a new episode will be uploaded to start the week. Each week will alternate between a regular review episode and an essential evidence episode. For the essential evidence episodes, I will try to split up the episodes each month- one episode on a landmark article and one episode on a newer article that is making the rounds. I have a list of articles that I will be talking about but if there are any studies out there that you think I should cover, email me at steve@embasic.org.

For this first episode, we’ll talk about the famous Rivers sepsis study that started the push to early goal directed therapy for sepsis in the ED. Although I talked about this study a lot on the sepsis podcast a while back, we’ll talk more in depth about the study so you can really understand it.

Rivers NEJM Sepsis Study- website link (free full text)

Rivers NEJM Sepsis Study- PDF (direct download)

EM Basic Essential Evidence podcast- Rivers Sepsis NEJM

Hyponatremia (low serum sodium) is one of the most common electrolyte disorders encountered in the ED. Most of the time this electrolyte disorder requires us to do less- not more. However, if the patient is critically ill from their hyponatremia then we need to know how to quickly intervene and even be a little creative if we don’t have the medications that we want. We’ll review how to do the right thing for these patients, track down the cause of hyponatremia, and make the right decisions so we don’t cause any harm.

Hyponatremia podcast

Hyponatremia Show Notes (Word Format)

Hyponatremia Show Notes (PDF)

Websites that I talked about:

EMchatter.com– A blog made by John Schonert, an EM PGY-3 from West Virginia.  His blog is a collection of the best in EM education.  Subscribe to the weekly updates to get short summaries of the best EM on the web for free.  Better yet- if you find something you like, submit your own link for consideration.

The short coat blog– Made by Lauren Westafer, an MS-4 interested in emergency medicine who is publishing some great stuff.  Medical students and residents will find useful reviews of the literature on common emergency medicine topics as she wades through them herself.  Don’t be fooled- she is writing well above her training level and the reviews from the ground up are really insightful- especially if you are new to emergency medicine.

In this episode, we will discuss the diagnosis and treatment of stroke and transient ischemic attack (TIA).  The ED is the front line in stroke care so we need to know how to work up this chief complaint.  We’ll go over how to recognize the signs and symptoms of a stroke, how to get a rapid and complete history, how to screen patients for contraindications to thrombolytics, and how to catch a few stroke mimics.

Also- today is the 1 year anniversary of the first episode of EM Basic.  Thank you to all the listeners out there who have made this project a success.

NIH stroke scale(website)

NIH stroke scale (direct download PDF)

SMART:EM podcast on evidence for thrombolytics in actue ischemic stroke

Stroke and Transient Ischemic Attack (TIA) Podcast

Stroke and Transient Ischemic Attack (TIA) Show Notes (Word Format)

Stroke and Transient Ischemic Attack (TIA) Show Notes (PDF)

This episode is part 2 of the procedural sedation podcast.  This episode focuses on the medications that we commonly use for procedural sedation.  First, we’ll review the use of oxygen during procedural sedation and then talk about basic airway maneuvers before we talk about individual medications.  For each drug, the drug class, dosing, duration of action, and adverse effects will be discussed with the overall theme of patient safety.

Here is a link to emupdates.com- a website by Dr. Reuben Strayer.  In this post is a short video on how to effectively ventilate using a BVM with two people- and only one of them needs medical training!

11 minute screen cast- emergency ventilation

Procedural Sedation Part 2- Medications

Procedural Sedation Part 2- Medications Show Notes (Word Format)

Procedural Sedation Part 2- Medications Show Notes (PDF)

This is the first of two episodes on procedural sedation. In the ED we need to provide safe and effective procedural sedation and analgesia whenever we do painful procedures. It is our job to relieve anxiety and pain in our patients and we need to know how to do this right. This episode will focus on how to prepare for a procedural sedation. We will talk about how to make the decision as to who is an appropriate candidate for procedural sedation in the ED, the depth of sedation, and how to prepare all of our equipment so that we leave nothing to chance. This will be in preparation for the second episode where we will talk about the medications that we use in procedural sedation.

ACEP clinical guideline on Procedural Sedation

Procedural Sedation Part 1 Podcast- Preparation

Procedural Sedation Part 1 Show Notes (Word Format)

Procedural Sedation Part 1 Show Notes (PDF)