Episode 62 Diagnostic Decision Making in Emergency Medicine

Episode 62 Diagnostic Decision Making in Emergency Medicine

This is Part 1 of EM Cases' series on Diagnostic Decision Making with Walter Himmel, Chris Hicks and David Dushenski discussing the intersection of evidence-based medicine, cognitive bias and systems issues to effect our diagnostic decision making in Emergency Medicine. In this episode we first discuss 5 strategies to help you master evidence-based diagnostic decision making to minimize diagnostic error, avoid over-testing and improve patient care including: 1. The incorporation of patients' values and clinical expertise into evidence-based decisions 2. Critically appraising diagnostic studies 3. Understanding that diagnostic tests are not perfect 4. Using the concept of test threshold to guide work-ups 5. Understanding that the predictive value of a test depends on the prevalence of disease We then go on to review some of the factors that play into the clinician’s and patient’s risk tolerance in a given clinical encounter, how this plays into shared decision making and the need to adjust our risk tolerance in critical situations. Finally, we present some strategies to prevent over-testing while improving patient care, patient flow and ethical practice.

Episoder(394)

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 Des 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 Des 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 Nov 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 Okt 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 Okt 20251h 25min

Ep 207 Sleep Strategies for Shift Work

Ep 207 Sleep Strategies for Shift Work

Discover evidence-based sleep strategies for shift workers. Optimize performance, recovery, and health with tips from sleep expert Dr. Michael Mak... If you find this beneficial please consider a dona...

16 Sep 20251h 21min

EM Quick Hits 67 Tick Borne Illness Update, Pediatric ECG Interpretation, Nailbed Repair, Closed Loop Communication, ESRD, Leaders in EM Dr. Catherine Varner

EM Quick Hits 67 Tick Borne Illness Update, Pediatric ECG Interpretation, Nailbed Repair, Closed Loop Communication, ESRD, Leaders in EM Dr. Catherine Varner

On this EM Quick Hits podcast: Tick Borne Illness Update with Dr. Issac Bogoch, Pediatric ECG Interpretation with Dr. Kathleen Stephanos, Nailbed Repair with Dr. Matthew McArther, Closed Loop Communic...

26 Aug 20251h

Ep 206 Massive Hemorrhage Protocols 2.0 – Update on the 7 Ts

Ep 206 Massive Hemorrhage Protocols 2.0 – Update on the 7 Ts

In this update to the 7 T’s of Massive Hemorrhage Protocols with Dr. Jeannie Callum and Dr. Andrew Petrosoniak, we explore the most current, evidence-informed strategies for bleeding patients, from po...

4 Aug 20251h 27min

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