CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries

Danger Zone E01 - Surgical Airway

In this episode of Danger Zone, our hosts examine a relatively rare procedure performed in the ED – the Surgical Airway! They discuss indications, procedural considerations, and important clinical pearls.

CRACKCast E216 - Jaundice

Core Questions Explain broad causes of elevated bilirubin (obstructive, hepatocellular, and hemolysis) and the significance of direct vs. indirect hyperbilirubinemia (Fig 25.1) Explain your approach to the history and physical exam in patients with jaundice (Fig 25.2)  List 10 causes of jaundice (Table 25.2)  Explain your approach to ancillary testing in patients with jaundice.  Wisecracks What are the stages of hepatic encephalopathy?   What is the triad of acute hepatic failure?...

First year Diaries E05

In this episode, Kevin Dong interviews Dr. Mohamed Hagahmed on his transition to practice and how to prepare for your board/licensing exams after you graduate from residency. Dr. Mohamed Hagahmed is an Assistant Clinical Professor in the Department of Emergency Medicine at UT Health San Antonio.

CRACKCast E215 - Abdominal Pain

Core Questions What are risk factors for serious underlying causes of abdominal pain? (Box 24.1)  Explain key symptoms and signs to look for in the evaluation of the patient with abdominal pain.  What diagnoses are associated with different patterns of abdominal pain? (Fig 24.1)  List 5 critical and 5 emergent causes of abdominal pain (Table 24.1, 24.2)  Explain an approach to ancillary testing in abdominal pain.  Outline a diagnostic algorithm for patients with abdominal pain (Fi...

First Year Diaries E04

In this episode of First Year Diaries, I am joined by Dr. Daniel Ting and Dr. Jared Baylis. Dr. Daniel Ting is a first-year staff at UBC, who is currently working from the Vancouver General Hospital and BC Children’s Hospital. Dr. Jared Baylis is also a first-year staff, working at the Kelowna General Hospital. I asked them what it is like to transition from residency to working as staff physicians. Later, we discussed the challenges they face as staff physicians and how residency prepared t...

CRACKCast E214 – Chest Pain

Core Questions Describe an approach to key history and physical exam for chest pain patients presenting to the ED. (Table 23.2 and 23.3)  List 5 critical diagnoses, 5 emergent, and 5 nonemergent diagnoses to consider in the patient presenting with chest pain. (Table 23.1) Describe an approach to the critically ill patient with undifferentiated chest pain. (Figure 23.1) Describe an approach to ancillary testing in chest pain. (Table 23.4 and 23.5) List the risk factors associated wit...

ClerkCast Ep04 - Adult Fever

Today we are sitting down with Dr Alim Pardhan. Dr Pardhan is the FRCP EM program director at McMaster University, Hamilton General Hospital ED side lead, and a passionate medical educator. Your key takeaways from this episode are: Understanding the mechanisms behind fever and hyperthermia The causes of hyperthermia - think drugs, CNS infections, thyroid storm, and environmental exposure Five big, bad, and deadly causes of fever in our patients in the ED - necrotizing fasciitis! Endoc...

CRACKCast E213 - Dyspnea

Core Questions Define the following terms: Dyspnea Tachypnea Hyperpnea Hyperventilation Dyspnea on exertion Orthopnea Paroxysmal Nocturnal Dyspnea What anatomical structures are responsible for controlling respiratory effort? Outline an approach to the history for the dyspneic patient. Detail the physical examination for the dyspneic patient and highlight pivotal exam findings that point to specific pathologies. Outline the differential diagnosis for the patient presen...

CRACKCast E212 - Hemoptysis

Core Questions:    Define “massive hemoptysis”. Which vessels, when injured, are typically associated with small and massive hemoptysis, and how do the vessel characteristics influence the degree of bleeding? Outline an approach to the history and physical examination for a patient presenting with hemoptysis. Outline the differential diagnosis for hemoptysis and highlight five critical and five emergent diagnoses that cause hemoptysis. (Box 21.1 and 21.2) What ancillary tests are ...

ClerkCast E03 - Abdominal Pain

We are finally back with episode 3 of ClerkCast! Today we will be talking about ABDOMINAL PAIN with McMaster FRCP EM resident Dr Rakesh Gupta Key takeaways from this episode include: 1. Thinking outside the GI tract for patients with abdominal pain 2. The importance of a good physical exam 3. What type of imaging is best for your patient? Hint: it depends! 4. How to consult your inpatient colleagues! P-I-Q-U-E-D Thanks for the listen!

CRACKCast E211 – Sore Throat

Core Questions:    What are the three anatomically-distinct zones of the pharynx, and what structures outline their borders? Ultrasound of the Neck Lateral neck radiograph Nasopharyngoscopy CT Soft Tissues Neck Describe the utility of the following imaging modalities in the patient with sore throat. Outline five viral, five bacterial, and five other potential aetiologies of sore throat in the ED patient? (Table 20.1) Outline the components of the Modified Centor Score and de...

CRACKCast E210 - Red and Painful Eye

Core Questions:    Detail the pertinent points to review when taking the history of a patient presenting with a red and painful eye - Box 19.2 Outline an approach to the ocular physical examination - Box 19.3 Outline the components of the slit lamp examination - Box 19.4  What signs and symptoms, if present, likely indicate the presence of serious ocular pathologies - Box 19.1 What is a relative afferent pupillary defect and what conditions cause it? List ten causes of increase ...

CRACKCast E209 – Diplopia

Core Questions:    What is diplopia and how is it classified? What four questions help clinicians delineate the potential cause of a patient’s diplopia? What are the cardinal directions of gaze and how are they tested? Outline the physical exam for the patient with monocular and binocular diplopia. Outline the DDx for monocular diplopia? Outline the DDx for binocular diplopia? [Table 18.1] Detail the different oculomotor palsies. [Figure 18.3] Detail the various lacunar stro...

ClerkCast Ep06 - Dealing with Call

Ruminations from two residents about handling and thriving in call shifts for medical students.

ClerkCast E02 - Chest Pain

Welcome to ClerkCast! A podcast for medical students by medical students, focusing on cognitive approaches to common EM presentations. This episode covers how to approach patients with chest pain in the Emergency Department as a medical student with our guest co-host Dr. Shawn Mondoux, staff EM doc at St Joseph's Hospital in Hamilton, and a Quality Improvement guru We cover: 1. The SIX CAN'T MISS chest pain diagnoses 2. Acute coronary syndrome and the Terrible Triad 3. Aortic disse...

CRACKCast E208 – Headache

Core Questions:    List three primary headache disorders Describe the pathophysiology of migraines and name three Emergency Department treatments for same List five critical and five emergent causes of headache (Table 17.1) Outline your approach to the history for the patient presenting with headache ( Box 17.1) Outline your approach to the physical exam for the patient presenting with headache (Table 17.3) Describe your diagnostic approach to the patient with a suspected SAH ...

ClerkCast - Ep00 - What Is ClerkCast!

An intro to the latest CanadiEM podcast, ClerkCast!   Hosted by two McMaster medical students, Lauren Beals and Ben Forestell, ClerkCast is your one stop shop for approaches to common EM presentations... enjoy!

ClerkCast E01 - Emergency Medicine 101

Welcome to ClerkCast! A podcast for medical students by medical students, focusing on cognitive approaches to common EM presentations. This episode covers how to succeed in the Emergency Department as a medical student with our guest co-host Dr. Teresa Chan, staff EM doc at Hamilton Health Sciences, CanadiEM co-founder, and medical educator extraordinaire We cover: 1. How to structure your differential diagnosis in the ED 2. Eye-balling a patient - edits have been made clarifying the...

First Year Diaries E03

On this episode of First Year Diaries, I am joined by Dr. Mike Kirlew, a rural family and emergency medicine physician from Sioux Lookout in Northern Ontario. I asked him about how he ended up working in a rural area, and what it is like working with scarce medical resources. Later, we discussed how a resident physician can prepare themselves for working in a rural community, and how best to transition to living in a rural area.

CRACKCast E207 – Dizziness and Vertigo

Core Questions:    What is dizziness and what pathologies can cause it? Define vertigo and acute vestibular syndrome What three systems are involved in the maintenance of equilibrium and how many of these systems must be affected to cause vertigo? Trace the neuronal impulse from the vestibular apparatus to the muscle endplate Define nystagmus List five peripheral causes of vertigo (see Table 16.2) List five central causes of vertigo (see Table 16.2) Differentiate between cen...

CRACKCast E206 – Seizures

Core Questions:    Define seizure and provide an explanation of the classification systems for seizure Define recruitment as it relates to seizure development and progression Differentiate between seizure and syncope Differentiate between neurogenic and psychogenic seizures List 5 diagnoses that can mimic seizures (see Box 15.2) Define status epilepticus and differentiate between convulsive and non-convulsive status epilepticus List 10 causes of status epilepticus in adults (s...

ThromboPhonia E02

The same 65-year-old man who was seen earlier with an ICH has now recovered. His past medical history is remarkable for hypertension, dyslipidemia, a mechanical aortic valve replacement, diabetes, and sleep apnea. His list of medications include ramipril, atorvastatin, aspirin, metformin, and warfarin. Should his anti-coagulation be resumed? If so, how long should the clinician wait prior to re-starting his medications? Objective 1: Summarize the most recent guidelines regarding when to ...

CRACKCast E205 – Confusion

Core Questions:    Define confusion. What is your differential diagnosis for the confused patient? Differentiate between organic and functional causes of confusion. What is the Quick Confusion Scale (QCS) and how is it calculated? What is the Brief Confusion Assessment Method (bCAM) and how is it used? What is the Mini-Mental State Examination (MMSE) and how is it scored? What ancillary tests are used when working up the confused patient? What is the role of thiamine in the ...

First Year Diaries E02 - My Philosophy By David Carr

Today on First Year Diaries I am joined by Dr. David Carr, a University Health Network emergency physician, renowned medical education speaker, and Toronto Blue Jays physician. In this episode, I asked him to impart his wisdom to new staff physicians like myself and share his approaches to a successful career in medicine. Later in the interview, we also discuss workflow strategies for the ED, common mistakes made by new physicians, and tips on how to maintain wellness/avoid burnout.   Qu...

CRACKCast E204 – Depressed Consciousness and Coma

Core Questions: 1. Define coma and differentiate coma from lethargy and stupor. 2. Name five neuroanatomic structures involved in maintaining arousal. 3. List five critical and five emergent causes of depressed consciousness. (see Table 13.1) 4. Describe your approach to the history and physical examination for the patient with depressed consciousness. 5. Outline your exam to accurately assess the Glasgow Coma Scale (GCS). (see Table 13.2) 6. What is the FOUR score, and how is it...

CRACKCast E203 – Syncope

Core Questions:    List 10 life-threatening causes of syncope  List 10 medications that can precipitate syncope  What are the red flags on history and physical exam in syncope?  What are markers of increased short-term risk in syncope patients? (box)  What are 5 ECG findings to look for in the syncopal patient?   List five indications for admission and inpatient evaluation for the patient with syncope?   Wisecracks:    What is the significance of a patient presenting with ...

CRACKCast E202 – Cyanosis

Core Questions:   Define cyanosis and explain what causes it? What is central cyanosis and what typically causes it? What is peripheral cyanosis and what typically causes it? At what concentration of deoxyhemoglobin does cyanosis present? List 10 differential diagnoses for cyanosis - Box 11.2? Describe your initial workup for the patient with cyanosis.- Figure 11.3/11.4 What is the oxyhemoglobin dissociation curve and what information can be taken from it? - Figure 11.1 Name...

CAEPCast: The SIM Olympiad with Dr. Tamara McColl

From CAEP 2019 I always love the activities and experiences at CAEP, but year after year I’m drawn to the Simulation Olympiad. Every time I think it’s just incredible. This year, I decided to talk with some of the people who make the SIMOlympiad such a great experience for audiences and participants alike. In my first interview, I heard about what the average SIM team looks like, how the competition runs, and what the scope of the material covers. We also got the details on what the charac...

CanadiEM Call for Digital Scholars Fellowship 2019-2020

CRACKCast E201 – Weakness

Core Questions: 1. What structures are affected by UMJ, LMJ, and NMJ lesions, and what are causes of weakness associated with each? 2. What are common signs of UMN, LMN, and NMJ dysfunction? 3. What are (7) pathophysiologic causes of non-neurologic weakness (Box 10.1)? 4. What is the DDx of neuromuscular weakness? (Table 10.1) 5. Describe an approach to general weakness in the ED. Wisecracks: 1. Differentiate between “plegia” and “paresis”. 2. List (5) DDx‘s for non-neurologi...

First Year Diaries E01 - Transition to EM Practice

Today’s episode is to aid new physicians to traverse through the first few months of their independent practice safely and effectively. As a new physician myself, I had the luxury of having many mentors and colleagues who were gracious enough to help me find my way in providing safe patient care. Additionally, they assisted me on integral aspects that we don’t necessary learn or get exposed to as a resident, such as billing, department flow, and the politics of the ED. However, as a new staf...

CRACKCast E200 – Fever in the Adult Patient

Core Questions: What structure controls body temperature and how does it go about controlling it? What are pyrogens and how are they classified? What is the difference between fever and hyperthermia? What is the role of PGE2 in fever and what medications can you give to combat its effects? List four factors that blunt the febrile response. What are the benefits and pitfalls of the febrile response? List five infectious and five non-infectious causes of fever. (see Box/Table 9.1)...

CRACKCast E199 – Adult Resuscitation

Core Questions:   Describe your history and physical exam in the patient being actively resuscitated. Discuss the process of deterioration to cardiac arrest with respiratory failure and cardiac obstruction. List 6 aspects of optimal CPR. What medications have been shown to improve outcomes in cardiac arrest? List 8 differential diagnoses for PEA arrest (See Table 8.4) What is electromechanical dissociation (EMD) and how does it differ from pseudo electromechanical dissociation (...

CRACKCast E198 – Brain Resuscitation

Core Questions: What is cerebral autoregulation? Describe your parameters for post-arrest care of a brain injured patient. List 7 interventions for management of a patient with elevated ICP. What are the equations for cerebral blood flow and cerebral perfusion pressure? Describe a protocol for induced hypothermia after cardiac arrest. In the patient with a traumatic brain injury, what is the optimal drug for and duration of seizure prophylaxis?   Wisecracks: What are Lundberg ...

CRACKCast E197 – Shock

This episode covers Chapter 6 in Rosen's 9th edition, shock. 

Steps to Success in Enhanced Training in Emergency Medicine

Are you a Family Medicine resident about to graduate and embark on an extra year of training in Emergency Medicine (EM)? Are you worried you don’t know what it is really like to be an Emergency Medicine resident and you want to find a guide to help maximize your learning in a short and extremely fast year? As a recent CCFP-EM graduate, I can strongly relate to your fears. The one year of extra training is an important one, and you will learn a plethora of information that will be pertine...

CRACKCast E196 - Monitoring the Emergency Patient

This updated episode of CRACKCast covers Rosen’s Chapter 005, Monitoring the Emergency Patient (9th Ed.). Core Questions: List modalities for measurement of BP and note which modalities are likely to over and underestimate blood pressure. What is pulse pressure and how does it relate to stroke volume? List 4 indications for an arterial line. What is the Beer-Lambert Law and how does it allow us to measure pulse oximetry? How do dyshemoglobinemias affect your measured SpO2? What ...

CRACKCast E195 – Procedural Sedation and Analgesia

This updated episode of CRACKCast cover’s Rosen’s Chapter 004, Procedural Sedation and Analgesia (9th Ed.).

CRACKCast E194 - Pain Management

This episode of CRACKCast covers Chapter 3 in Rosen’s Emergency Medicine (9th Ed.) – Pain Management. This podcast will give you a solid approach to the basics pain management to use on your next shift! Core Questions: 1. Define the following terms (Box 3.1): Allodynia Amnesia/amnestic Local anesthesia Analgesia Hypnotic Narcotic Nociceptor Noxious stimulus Opiate Opioid Pain Procedural Sedation Sedative 2. Describe a practical approach to stepwise management of...

Thrombophonia E01: Mechanical Valves and Intracranial Hemorrhage

The first episode of the Thrombophonia podcast addresses three objectives: 1. Summarize an approach to the acute management of patients with intracerebral hemorrhage while on anticoagulation for a mechanical heart valve 2. Describe the benefits and risks of anticoagulant reversal, including the risk of thromboembolism 3. Describe the principles of effective communication and collaboration of bleeding & clotting cases with consultants

CRACKCast E193 - Mechanical Ventilation and Noninvasive Ventilatory Support

This episode of CRACKCast covers Chapter 2 in Rosen’s Emergency Medicine (9th Ed.) – Mechanical Ventilation and Noninvasive Ventilatory Support. 

CRACKCast E192 – Airway

This Episode of CRACKCast covers Rosen's Chapter 1 - Airway. We are updating the first several episodes with 9th edition content. Enjoy! There's a reason that the first chapter of Rosen's is devoted to airway. These are some of the most critical skills we need to know as emergency clinicians. This episode provides an overview of core airway knowledge and skills.

CRACKCast E191 – Weapons of Mass Destruction

This episode of CRACKCast covers Chapter 193 in Rosen's Emergency Medicine (9th Ed.) – Weapons of Mass Destruction. Although attacks involving WMD's are relatively uncommon, being thoroughly prepared for these events will prove invaluable for the community affected. Sit tight and listen in to make sure you are ready if the unthinkable should happen. Core Questions: 1) List 6 potential agents that may be used as weapons of mass destruction. 2) List 6 features of weapons of mass destruct...

CRACKCast E190 – Disaster Preparedness

Core questions     Define a disaster Describe PICE nomenclature List 6  potentially paralytic PICE List 6 critical substrates for hospital operations Describe START triage and SAVE List the 5 functional elements of an incident command system Describe the 4 stages comprehensive emergency management Describe the 5 elements of a hospital disaster response plan List the 8 basic components of a hospital comprehensive disaster response planning process     Wisecracks:   Descri...

CRACKCast E189 – Air Medical Transport

Core Questions     List 6 criteria for air medical transport.  When should/could helicopter EMS transport be beneficial?     List advantages and disadvantages of rotor-wing aircraft and fixed-wing aircraft,  relating to each other and land-transfer.     What are 6 principles of landing zone safety?     Wisecracks:   What are the most common in-flight emergencies on commercial flights? What are some practical implications of providing in-flight emergency care?    

CRACKCast E188 – Emergency Medical Service: Overview and Ground Transport

This episode of CRACKCast covers Chapter 190 of Rosen's Emergency Medicine(9th Ed.). After listening to this podcast, you will have a more comprehensive understanding of the intricacies of pre-hospital care and be better able to address issues in your community's out-of-hospital healthcare network.

CRACKCast E187 – The Combative and Difficult Patient

This episode of CRACKCast covers Chapter 189 in Rosen's Emergency Medicine (9th Ed.) – The Combative and Difficult Patient. Next time a severely agitated patient rolls into the department, you won't even break a sweat!

CRACKCast E186 - Substance Abuse

This episode of CRACKCast covers Rosen’s Chapter 140 (9th Edition), Substance Abuse. This chapter gives a brief overview regarding the burden of substance abuse from adolescent to elderly patients. An important consideration in the emergency department is self-awareness and advocacy for these patients that often are challenging to interact with and can provoke countertransference.

CRACKCast E185 - Alcohol Related Disease

This episode of CRACKCast covers Rosen’s Chapter 142 (9th Edition), Alcohol Related Disease. This chapter covers the spectrum of alcohol use, including effects of mild, moderate, and severe use disorders, including prevention, screening, diagnosis and management. We also examine the wide variety of complications associated with acute and chronic alcohol use.

CRACKCast E184 - The Solid Organ Transplant Patient

This episode of CRACKCast covers Rosen's chapter 188, The Solid Organ Transplant Donor. Although short in duration, this chapter has straightforward and useful information for emergency physicians in regards to complications possible with transplant donors.