The prehospital episode

By popular demand, this episode will be dedicated to talking about prehospital issues. I’ve had several people write me and ask for my 0.02 on how EMS can better be our “eyes and ears” in the field so here’s my take on this question. I’ll also talk about how the ED staff can better interact with our EMS colleagues so we can both work together to deliver optimal care to our patients. Hopefully this will serve as a starting point for conversations between EMS providers and ED staff and I encourage anyone to post comments on these issues to the blog.

Prehospital Episode

Sepsis

This is a topic podcast on sepsis. This is a hot topic in emergency medicine and we are usually the front line in the fight against sepsis. Ever since the Rivers sepsis article emergency department physicians, nurses, techs, and even prehospital providers have played a much larger role in instituting early aggressive therapy for patients with sepsis. This podcast will go over the basics of sepsis (you may be surprised to know that a patient with strep pharyngitis and  fever technically meets criteria for sepsis) and reviews the basics of how to aggressively treat severe sepsis and septic shock.

UPDATE MARCH 2017: If you are reading this post, there is a new episode on the updated Sepsis Guidelines- you can see it here.  I’ll keep this up but there won’t be a link to the previous sepsis podcast because it is out of date

Link to the Sepsis update (goes live on March 6th, 2017): Sepsis 3.0 update

Before you go any further, if you haven’t read this article already, take a few minutes and read the original Rivers sepsis article form the New England Journal of Medicine that changed the game in regards to Emergency Department management of sepsis.  Here is the full text link (free access):

Rivers NEJM sepsis study

Check out the latest guidelines and literature on sepsis at the Surviving Sepsis campaign website

Survivingsepsis.org

Also mentioned in the podcast is a new trauma blog that I’ve started following.  It’s called the Trauma Professionals blog and it is written by Dr. Michael McGonigal, a trauma surgeon in Minnesota.  Each post goes through a trauma topic with supporting primary literature.  If you are looking to expand your knowledge on advanced trauma topics, this is the blog to go to.

The Trauma Professional’s Blog

Sepsis show notes (Word format)

Sepsis show notes (PDF format)

(These are obviously out of date but I figured I would keep them if anyone was interested)

-Steve

Generic drug names reference

A few international listeners have requested that I use generic names since the brand names can vary from country to country.  From here on out, I will mention the generic name of each drug that I talk about at least once whenever I first mention that drug on the podcast.

In addition- I just created a reference of all the drugs I have talked about up to the current episode on syncope.  What I quickly realized is that I use brand names on some drugs but there are others that I mention only by generic names.

For example, I have always ordered Zofran but never ondansetron.  On the flip side- I have always ordered etomidate but never Amidate.  For clarity sake, for each episode I start with the drugs that I mentioned by trade name then followed by the drugs that I mentioned only by generic name (followed by the common US brand name just as an FYI).  It sounds confusing but it will make sense once you look at the reference.

Finally- I updated all of the show notes to reflect these changes.  The first time a brand name is mentioned, the generic name should follow it in parentheses.  From there on out, if I can fit the generic name in without breaking up the flow, I did but mostly the generic name is only mentioned the first time.  If I have missed any drugs or have misspelled any of them, please drop me an email at steve@embasic.org so I can correct it.

I hope this helps the international listeners and current medical students who solely learn the generic names of drugs.

-Steve

EM Basic Generic Drug Reference (Word Format)

EM Basic Generic Drug Reference (PDF Format)

EM Basic Show Notes Master File- updated with generic names (Word Format)

EM Basic Show Notes Master File- updated with generic names (PDF Format)

Syncope

Syncope (or “passing out”) is a chief complaint that we deal with a lot in the emergency department.  While most causes of syncope are benign and need nothing more than reassurance, we need to be on the lookout for the serious causes of syncope.  This episode will focus on the definition of syncope, how to get a complete history, catch the red flags, perform a targeted workup that doesn’t keep the patient in the ED forever, and how to scrutinize an EKG for the deadly arrhythmias that we can’t miss.

In addition, per a request from a podcast listener, there is a bonus section on how to effectively rehydrate patients in the ED.  You may be surprised that there are other options besides putting an IV in everyone

Syncope podcast

Syncope show notes (Word format)

Syncope show notes (PDF format)

Diabetic Ketoacidosis (DKA)

This is a topic episode on Diabetic Ketoacidosis (DKA). We’ll discuss the diagnosis and treatment of this complex disease process and how to avoid pitfalls that can harm the patient. There will also be tons of clinical pearls including treatment of DKA’s cousin Hyperglycemic Hyperosmolar State (HHS) and pediatric DKA considerations.

Also, you can now follow EM Basic on Twitter- @embasic for news on the latest episodes and anything else interesting that I find related to emergency medicine.

This episode is also the debut of a new microphone setup that gives a much higher audio quality for the podcast.

Diabetic Ketoacidosis (DKA)

DKA show notes (Word format)

DKA show notes (PDF Format)