Journal Jam 1: Age Adjusted D-dimer with Jeff Kline and Jonathan Kirschner

Journal Jam 1: Age Adjusted D-dimer with Jeff Kline and Jonathan Kirschner

In this first ever episode of the Journal Jam podcast, a collaboration between EM Cases, Academic Life in EM and The Annals of Emergency Medicine's Global Emergency Medicine Journal Club, Teresa Chan and I, along with Jeff Kline, Jonathan Kirschner, Anand Swaminathan, Salim Rezaie and Sam Shaikh from ALiEM, discuss the potential for Age Adjusted D-dimer to rule out pulmonary embolism in low risk patients over the age of 50. We discuss 4 key questions about the ADJUST-PE Study from JAMA in March 2014 including: Would you order a CTPA on a 60 year old woman with an age adjusted D-dimer of 590 ng/L? The problem until now has been that the older the patient, the more likely the D-dimer is to be positive whether they have a PE or not, so many of us have thrown the D-dimer out the window in older patients and go straight to CTPA, even in low risk patients. If you are a risk averse doc, this strategy will lead to over-utilization of resources, huge costs, length of stay, radiation effects etc; and if you’re not so risk averse, then you might decide not to work up the low risk older patient at all and miss clinically important PEs. expert peer reviewFor all the questions discussed on this podcast, the original Google Hangout interview from which this podcast was based, and the crowd sourced opinions from around world, visit the ALiEM website. Many thanks to all the talented people who made this podcast possible. Together, we're smarter!

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Ep 212 PECARN Febrile Young Infant Prediction Tool: When To Safely Forgo LP and Empiric Antibiotics

Ep 212 PECARN Febrile Young Infant Prediction Tool: When To Safely Forgo LP and Empiric Antibiotics

If you’ve been practicing EM for more than a decade, your approach to the febrile young infant has (appropriately) evolved. For years, the default was LP + empiric antibiotics + admission for almost e...

27 Tammi 47min

EM Quick Hits 70 MedMal Cases Upper Back Pain, Traumatic Pneumothorax/Hemothorax Decision Making, Risk Stratification of ICH for Consultation, Post-Circumcision Bleeds, IV Contrast Allergy, Emotional Contagion

EM Quick Hits 70 MedMal Cases Upper Back Pain, Traumatic Pneumothorax/Hemothorax Decision Making, Risk Stratification of ICH for Consultation, Post-Circumcision Bleeds, IV Contrast Allergy, Emotional Contagion

In this month's EM Quick Hits podcast: Mike Weinstock discusses with Anton a case of upper back pain in this month's Medmal Cases, Andrew Petrosoniak on traumatic pneumothorax and hemothorax decision ...

13 Tammi 1h 6min

Ep 211 Thyrotoxicosis and Thyroid Storm: Recognition and Management

Ep 211 Thyrotoxicosis and Thyroid Storm: Recognition and Management

In this Part 2 of our 2-part podcast series on thyroid emergencies Anton, Dr. George Willis and Dr. Alyssa Louis answer questions such as: When a patient presents with “sepsis without a source,” what ...

30 Joulu 20251h 13min

Ep 210 Decompensated Hypothyroidism Recognition and Management

Ep 210 Decompensated Hypothyroidism Recognition and Management

In the ED, we regularly care for sick patients presenting acutely with abnormal vital signs, altered mental status, and end organ dysfunction. Oftentimes, the culprit ends up being sepsis, or overdose...

16 Joulu 20251h 12min

EM Quick Hits 69 Pediatric Urinary Retention & Acute Transverse Myelitis, Post-Dural Puncture Headache, Med Mal Cases: Clenched Fist Injury, IV Thrombolysis for Minor Stroke, EM Leadership Spotlight #4

EM Quick Hits 69 Pediatric Urinary Retention & Acute Transverse Myelitis, Post-Dural Puncture Headache, Med Mal Cases: Clenched Fist Injury, IV Thrombolysis for Minor Stroke, EM Leadership Spotlight #4

On this month's EM Quick Hits podcast: Deborah Schonfeld on the differential diagnosis and work up of pediatric urinary retention & acute transverse myelitis, Jesse McLaren on his Tryptic Approach to ...

2 Joulu 20251h 32min

Ep 209 Nondisabling Stroke Recognition and Management

Ep 209 Nondisabling Stroke Recognition and Management

In this Part 2 or our 2-part podcast update on ED stroke management with Dr. Katie Lin and Dr. Walter Himmel we explore non-disabling strokes, where symptoms are mild enough that patients can continue...

11 Marras 20251h 19min

Ep 208 Paradigm Shift in Ischemic Stroke Management Part 1: Disabling Strokes

Ep 208 Paradigm Shift in Ischemic Stroke Management Part 1: Disabling Strokes

We are amidst a paradigm shift in the emergency management of acute ischemic stroke. The traditional way of categorizing ischemic strokes as 'minor' vs 'major' is no longer relevant to what we do in t...

28 Loka 20251h 36min

EM Quick Hits 68 Osteomyelitis, Tourniquet Technique, Pediatric Distal Radius Buckle Fractures, DSI RCT, AMS in ESRD & Dialysis, EM Leadership Spotlight #3

EM Quick Hits 68 Osteomyelitis, Tourniquet Technique, Pediatric Distal Radius Buckle Fractures, DSI RCT, AMS in ESRD & Dialysis, EM Leadership Spotlight #3

On this month's EM Quick Hits podcast: Dr. Isaac Bogoch on recognition and management of osteomyelitis in the ED, Dr. Anand Swaminathan on tourniquet tips and tricks. Dr. Andrew Tagg on managing pedia...

7 Loka 20251h 25min

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