A week ago, I posted an airway review paper by Scott Weingart and Richard Levitan that I think is a must read.  Today I decided to do a podcast reviewing the paper in order to really get it out there and talk about the major points.  The best part of the paper is the description of the NO DESAT technique which virtually eliminates hypoxia during RSI and will make your next intubation a lot easier.  While this podcast is a lot more advanced than the usual “basic” topics that I usually talk about, its important to know about these techniques.  My 0.02- they will become the new standard of care in the near future but you can hear about them now.

First- read the paper in Annals of Emergency Medicine– free full text access

Then listen to the podcast here

If you haven’t already watched it- go the the EMCrit site and watch Dr. Levitan’s airway lecture

Please give me your feedback on this episode so I know whether to do more of these in the future.  Don’t worry- this episode isn’t a replacement for a regular episode.  I’m already hard at work on an episode talking about the basics of trauma resuscitation.  I love trauma so its gonna be good!

-Steve

A few months back I asked for your help in filling out a survey on EM Basic that I was going to use for a poster presentation at the CORD-EM 2012 Academic Assembly.  I got back from Atlanta yesterday and it was an amazing conference.  I learned a ton about how to better teach in the ED, caught up with some attendings and residency directors from my medical school days, and made some new connections in the EM world.

Here’s the abstract on EM Basic that was submitted to CORD

EM Basic CORD-EM abstract

Here’s the poster that was presented at CORD (powerpoint slide)

EM Basic CORD-EM poster

And a photo of the finished product

Thanks again to everyone who filled out a survey- I really appreciate it.

-Steve

Hey everybody,

Just an extra post to add some great extra info onto the airway podcast and the most recent one on How to give a good ED patient presentation.

First- the airway podcast.  During that episode, I mentioned a lot of techniques advocated by Dr. Richard Levitan.  I’ve been to several of his lectures and they taught me so much about how to approach an airway.  I was disappointed that I couldn’t share one of his lectures when I was doing the airway podcast but no more.  Scott Weingart from the EMCrit podcast posted a 75 minute video of a lecture that he gave on airway during grand rounds at Mount Saini and it is fantastic.  If you want to learn about all of the techniques that I was advocating from the master himself- drop what you are doing and watch this lecture.  It will change how you approach an airway.

EMCrit episode #70- Airway Management with Rich Levitan

EM Basic podcast on Airway (we’re not worthy!)

Second- also for the airway podcast.  Dr. Levitan references a paper that he recently wrote with Scott Weingart on how to effectively pre-oxygenate patients before and even during intubation.  If you are following me on Twitter you’ve probably already seen this but if you haven’t read it- stop what you are doing and read it.  I predict these techniques will soon become standard of care and will make your intubations much safer by avoiding hypoxia.  I’m even contemplating doing a mini-podcast on the techniques that the paper advocates because I think they are so important.  The paper is a quick read but its a game changer and its available for free on the Annals of Emergency Medicine website.

Preoxygenation and Prevention of Desaturation During Emergency Airway Management

Finally- a few reader comments and a twitter posting on the How to give a good ED patient presentation podcast.  A listener name Javier left a comment with links to two papers that have other great tips on how to give a good ED patient presentation

1. Reuben Strayer, MD: How to think like an emergency medicine physician.
http://emupdates.com/2010/09/15/screencast-how-to-think-like-an-emergency-physician/

2. The 3-minute emergency medicine medical student presentation: a variation on a theme.

http://www.ncbi.nlm.nih.gov/pubmed/18691216

And on twitter- David Marcus who goes by the handle @EMIMDoc had one caveat to add to my differential diagnosis list of “3 life threats followed by what you think it is.”  His take- DDx – 3 deadly, 2 zebras, 2 most likely.  I like it- its more complete and shows that you have the zebras in mind.

That’s it for this update but I’ve got one more for today- the results of the EM Basic survey and the poster presentation from CORD-EM Academic Assembly

-Steve

Being able to give a good ED patient presentation will not only help you get a good grade on your EM rotation, it will also make sure that nothing is missed in the patient’s care.  In this episode, I’ll discuss the nuts and bolts of forming and delivering a solid ED patient presentation that is complete and concise at the same time.  I’ll also give a few example presentations so you can put it all together.  The show notes here are condensed down so you can carry them around with you on shift so you don’t forget anything.  There is even a card sized version in the show notes for even further portability.  Feel free to take the Word format show notes and re-format them to fit your needs.

How to give a good ED patient presentation podcast

Show Notes (Word Format)

Show Notes (PDF Format)

Shortness of breath is a chief complaint that we encounter each day in the ED.  This chief complaint encompasses a huge differential and this is a long podcast.  As always, I’ll break this chief complaint down into the diagnoses that we can’t miss and how to treat the underlying causes of shortness of breath for both kids and adults.

Shortness of breath podcast

Shortness of Breath show notes (Word format)

Shortness of Breath show notes (PDF format)

Two more podcast recommendations

PEM ED- Pediatric emergency podcast by Andy Sloas- a PEM fellow at Texas Children’s Hospital who provides great information on pediatric emergency medicine topics including febrile infants, clearing the pediatric c-spine, pediatric airway, and more

PEM ED podcast

Dirt Medicine- A podcast by Pete Anderson, MD made for military medics but with great information for any prehospital or ED provider.  He covers relevant topics on RSI, burn resuscitation, and how to use ketamine, to name a few.

The Dirt Medicine podcast