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

CRACKCast E085 - Aortic Dissection

CRACKCast E084 - Hypertension

This episode covers chapter 84 of Rosen's Emergency Medicine. All the little nuggets of medical goodness you wanted to know about hypertension related emergencies. Define the three classes of hypertension relevant to emergency medicine practice List 10 possible etiologies for hypertension. What is the pathophysiology of target-organ damage? How does hypertensive encephalopathy occur? List 6 hypertensive emergencies; their management goals; the optimal agents for BP control and any r...

CRACKCast E083 - Endocarditis & Valvular Heart Disease

This episode covers Chapter 83 of Rosen's Emergency Medicine.   List 6 RFs for bacterial endocarditis List 5 common bacteria responsible for infective endocarditis Give three examples of immunologic sequelae of IE. Give three examples of vascular sequelae of IE. What are the diagnostic criteria for endocarditis, and how are they used? List 5 lab or investigative findings in bacterial endocarditis Describe the treatment of infective endocarditis List four complications of IE....

CRACKCast E082 - Pericardial & Myocardial Disease

This episode covers chapter 82 of Rosen's Emergency Medicine. Take a listen for all those juicy pericardial-pump-pearls!   List eight causes of pericarditis. Describe typical pain of pericarditis, expected lab work abnormalities, What is the typical sequence of ECG changes in pts with pericarditis? (the stages) Describe the treatment of pericarditis associated with: Uremia, Neoplasm, and SLE Outline the management of Dressler's syndrome. What is the pathophysiology of cardiac ta...

CRACKCast E081 - Heart Failure

This episode covers Chapter 81 of Rosen’s Emergency Medicine. This one is mint! Heart failure is one of those must-know-about presentations, you WILL see this in the ED.   Define Cardiac index Preload Afterload Describe: How compliance changes the relationship between end diastolic pressures and volume the Frank-Starling relationship Pousseils Law and LaPlaces Law List 3 CV and 4 Neurohormonal physiologic compensatory mechanisms in CHF List the 5 most common disease proc...

CRACKCast EP080 - Implantable Cardiac Devices

This episode covers chapter 80 of Rosen's Emergency Medicine. All those juicy pearls about those funny little [black] boxes in your patients chest.   Chapter 80 – Implantable Cardiac Devices   List 5 Indications for permanent pacing What are common Pacemaker types? Pacemaker nomenclature - what do the 5 letters mean List the causes of pacemaker malfunction (main categories with 2 examples each) List the complications of a pacemaker insertion What is pacemaker pseudo-malfunct...

CRACKCast E079 - Dysryhthmia

This episode covers Chapter 79 of Rosen’s Emergency Medicine. All those funny squigly marks on the ECG confusing you? Us too. Here is some knowledge to help you out. What is the blood supply of the following parts of the conduction system: SA node, AV node What are the three pathophysiologic mechanisms for dysrhythmias? What causes & how does AV nodal reentry tachycardia occur? List the classes of antidysrhythmics. Describe their mechanism of action and usual uses, as well as an exa...

CRACKCast E078 - ACS Part B

Here is the follow-up to the mammoth ACS chapter. This one has some key factoids to put into your mind map / memory pallace / organic computer.   List Sgarbossa criteria for AMI in pre-existing LBBB What is Takotsubo cardiomyopathy and how does it present? Describe the kinetics of cardiac biomarkers (Troponins and CK) List DDx for ↑ Troponin What is the utility of CTA in the diagnosis of MI? What is the role of ED-based chest pain centers? List 3 phases of delay in the managem...

CRACKCast E078 - ACS

This episode covers Chapter 78 of Rosen's Emergency Medicine. Acute Coronary Syndromes... its a gooder. Acute Coronary Syndromes Part A (Monday) Define Stable Angina, UA, AMI Describe the pathophysiology of AMI What are the components of prehospital management of AMI List population RFs for CAD. Do they matter in the evaluation of a specific patient? List RFs for atypical presentation of ACS. What are the risks of atypical presentations? List 8 early complications of AMI and b...

CRACKCast E077 - Pleural Disease

This episode covers Chapter 77 of Rosen’s Emergency Medicine. The Pleural Space is not to be trifled with! List 5 RFs for 1° spontaneous PTX.   What is the most common pathophysiologic cause of PTX? List 8 causes of 2° spontaneous PTX List 5 clinical findings suggestive of tension PTX Describe how to estimate the size of a PTX Describe the management of 1° and 2° spontaneous PTX Describe the procedure needle aspiration of a PTX. List 3 benefits of this over TT Describe the pro...

CRACKCast E076 - Pneumonia

This episode covers Chapter 76 of Rosen’s Emergency Medicine. Have you ever seen pneumonia? Yeah.... we thought so. Now here are all the nitty-gritty details. What are the typical associative pathogens? Describe the typical clinical presentation/RFs/Management for each of the following -S. pneumonia -H. influenzae -Staph aureus -Klebsiella -Mycoplasma pneumoniae & Chlamydia pneumoniae -Legionella -Anaerobes -Pseudomonas -PJP & Other Fungal Pneumsonia -Tuberculosis -Tularemia -...

CRACKCast E075 - URTI

This episode covers Chapter 75 of Rosen’s Emergency Medicine.   1. List potential causes of pharyngitis. (List 5 viral and 5 bacterial etiology of pharyngitis) 2. What are the indications for steroids in a patient with pharyngitis? 3. List causes of epiglottitis. 4. What are the deep spaces of the neck? List 4 deep space infections of the neck 5. What are the typical bacterial causes of deep space infections? What are the different syndromes called? 6. What are the potential co...

CRACKcast E074 - COPD

This episode covers Chapter 74 of Rosen’s Emergency Medicine. As Vanilla is to chocolate, COPD is to Asthma. Look for all things wheez-e-y here. Define acute exacerbation Describe GOLD classification for COPD List factors of decompensation or triggers of an AECOPD Name 4 mimics for AECOPD What are the clinical features used to diagnose AECOPD? Describe the ED management of AECOPD. What does the end tidal tracing look like in COPD? List indications and contraindications to NIPP...

CRACKCast E073 - Asthma

This episode covers Chapter 73 of Rosen’s Emergency Medicine. The ancient Greeks knew about Asthma... so should you! We give you all the major points for diagnosis and treatment in the ED.   Sign post   10 different causes of a wheeze. List 8 risk factors for death from asthma List 6 objective findings of severe asthma 10 therapies for an acute severe asthma exacerbation Discuss a ventilation strategy for the critically-ill asthmatic patient Discuss disposition and discharge...

CRACKCast E072 - Otolaryngology

This episode covers Chapter 72 of Rosen’s Emergency Medicine. All those pearls you need for ears, masses, nose bleeds and weird stones in weird places. Define Otitis Media Acute Chronic Recurrent Describe the diagnosis treatment of Otitis Media What are the complications of OM? Describe the diagnosis and tx of Otitis Externa Differentiate from malignant otitis externa What is Ramsay Hunt Syndrome? How is it Tx? Describe your approach to sudden hearing loss How is it tre...

CRACKCast E071 - Ophthalmology Part B

This episode covers Chapter 71 of Rosen’s Emergency Medicine. For such a small organ, the eye has A LOT of things to cover. Here we finish up in everything you need to know about that juicy ball of potential badness. List 10 causes of ↓ vision post blunt eye trauma What historical features are concerning for intra-ocular foreign body? List 4 options for treatment of corneal abrasions Describe the management of traumatic hyphema What causes the finding of a ‘second pupil’ post-trauma...

CRACKCast E071 - Ophthalmology

CRACKCast E070 - Oral Medicine

This episode covers Chapter 70 of Rosen’s Emergency Medicine.   How are teeth traditionally numbered? Describe the classification and management of tooth fractures Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation? Explain Ludwig’s Angina and its management List 3 complications of maxillary (eg canine) tooth infection? Describe management of Dental Caries vs Periapical abscess Describe your approach to Acute Necrotising Ulcerati...

E069 - Elder Abuse & Neglect

This episode covers Chapter 69 of Rosen’s Emergency Medicine.   Sign Post: 1. List six types of elder abuse? 2. List ten risk factors for elder abuse? 3. List ten questions to screen for elder abuse? 4. What are some indicators on the medical history and physical exam that may suggest ongoing elder abuse? 5. Discuss ethical and legal implications of elder abuse. Who needs to be reported?

E068 - Intimate Partner Violence

CRACKCast E067 - Sexual Assault

  This episode covers Chapter 67 of Rosen’s Emergency Medicine. Its a heavy topic, but important to get right. What precautions should be taken prior to engaging in potential sexual abuse cases? What information can be useful in determining the location and likelihood of injury in sexual assault? What is the prevalence of mental illness in sexual assault patients?  Which populations are found to have a higher proportion of mental illness?  What effect does mental illness have on the sev...

E066 - Child Maltreatment

CRACKCast E065 - Forensic Medicine

This episode covers Chapter 65 of Rosen’s Emergency Medicine. Its a big intro into the next few chapters covering forensic medicine in the emergency department. Tighten up those boot straps, this stuff is heavy!   What are some pearls and pitfalls for ER physicians when dealing with Forensic Emergency Medicine?   What are proper terms used to describe wound injury patterns? What’s the anatomy of a cartridge (bullet)? What are the types and important aspects of wound ballistics? What...

CRACKCast E064 - Chemical Injury

This episode covers Chapter 64 of Rosen’s Emergency Medicine. Worried about what to do with those patient's coming in with their skin melting off from a chemical exposure? We've got you covered.   1) Describe the difference between Alkali and Acid injuries 2) Describe a HAZMAT response on scene 3) Describe the decontamination of an individual 4) List PPE for first responders or caregivers Wisecracks -Name two acids that cause damage through liquefactive necrosis -List Chemical...

CRACKCast E063 - Thermal Burns

This episode of CRACKCast covers Rosen’s Chapter 63, Thermal Burns. These patients are often the sickest in the department and many are on their way to the ICU. There are life-saving interventions that are begun in the emergency department with significant impacts on morbidity and mortality, and many are discussed in this episode. Signposts: List zones of burns List 6 indications for intubation in the burn patient List and describe 2 formulas for fluid resuscitation Describe depth c...

CRACKCast E062 - Venomous Animal Injuries

This episode covers Chapter 62 of Rosen’s Emergency Medicine. Does leaving the comfort of your warm, safe bed scare you? After this chapter, it might... Sign Post: List the 4 families of venomous snakes. Describe phenotypic characteristics of Pit-Vipers Describe phenotypic characteristics of coral snakes? List the grades of pit viper envenomation and indicate therapy? Describe a black-widow spider and expected management goals? Describe a brown recluse spider and expected manage...

CRACKCast E061 - Mammalian Bites

This episode covers Chapter 61 of Rosen’s Emergency Medicine. Know anything about mammalian bites...? Yeah, neither did we until we read this chapter. Lots of juicy clinical pearls.    List 5 pathogens responsible for infection from Dog bite List 4 risk factors for overwhelming sepsis from dog bite What first line antibiotic is a good choice for cat and dog bites? What species are known to cause infection with Pasteurella multocida? What are the risk factors for infection with ani...

CRACKCast E060 - Foreign Bodies

This episode of CRACKCast covers Rosen’s Chapter 60, Foreign Bodies. This episode covers an approach to foreign bodies, including location specific tips, complications and safe removal in the ED. Describe your approach to Ocular FB What is Seidel Sign? List indirect signs of FB on Xray List complications of ear FB Describe the process of anesthesia of the ear and preparation for FB removal Describe 5 techniques for removal of FB from ear Describe the management of TM perforation...

Physicians as Humans Podcast E03: Making Space for Depression

In the third episode of the Physicians as Humans project, I corresponded with a Canadian emergency physician who sent me her personal account of depression.  The result is this beautiful, thoughtful story that she has graciously allowed me to read for the podcast. This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact [email protected]. Music for Episode 02 (All songs have been modified for the project)...

CRACKCast E059 - Wound Management Principles

This episode of CRACKCast covers Rosen’s Chapter 59, Wound Management Principles. This episode covers the nitty-gritty details of wound management and what you need to know to get that perfect wound closure!   Questions: 1) List risk factors for wound infection 2) List the 5 stages of wound healing 3) List toxic doses of local anesthetics 4) 3 types of wound closure? 5) List advantages of and contraindications of tissue adhesives 6) List indications for tetanus immune prophylaxis 7) Li...

CRACKCast E058 - Ankle & Foot

This episode covers Chapter 58 of Rosen’s Emergency Medicine: Orthopaedic Ankle and Foot injuries. Its a gooder for sure.   Describe the bones of the foot and important joints/ligaments List Ankle stress tests Describe an approach to ankle x rays (including the Ottawa ankle rules) Describe the Weber classification List indications for ortho referral in the ER Describe the management of Achilles and Tibialis posterior tendon ruptures Describe the Hawkin’s classification of tala...

CRACKCast E057 - Knee & Lower Leg

This episode covers Chapter 57 of Rosen’s Emergency Medicine.   1) List contents of popliteal fossa 2) Describe Ottawa knee Rule 3) Describe Schatzker classification for tibial plateaus fractures 4) Describe the Insall-Salvati ratio 5) Describe the management of a knee dislocation 6) Describe the management and classification of patellar fracture and dislocation 7) List 6 overuse syndromes 8) Describe the sensory and motor function of nerves of the lower extremity 9) Desc...

CRACKCast E056 - Hip and Femur

This episode covers Chapter 56 of Rosen’s Emergency Medicine. 1) List 3 compartments of leg and contents 2) List 8 causes of AVN (traumatic and atraumatic) 3) List 5 most common primary cancers metastatic to bone 4) List 15 causes of hip pain without an obvious hip fracture 5) List 3 techniques for reduction of the hip 6) Describe 4 types of hip dislocation. Wisecracks Pediatric hip/femur pathology? Hip dislocations Classification of femur fractures 6 causes of a child w...

CRACKcast E055 - Pelvic Trauma

This episode covers Chapter 55 of Rosen’s Emergency Medicine.   1) Describe common pelvic fractures and their classification      A)Young-Burgess classification      B)Tile classification      C)Denis classification 2) List 3 categories of complications of pelvic fractures 3) Describe the approach and management of hemodynamically unstable pelvic fracture. 4) List 5 radiographic cues to posterior arch fractures 5) What is the management of penetrating pelvic trauma   Wi...

CRACKCast E054 - MSK Back Pain

This episode covers Chapter 54 of Rosen’s Emergency Medicine.  1) Describe the myotomes and dermatomes L3-S1 2) List 4 Red Flag Diagnoses with associated RFs, Hx, PEX findings 3) Describe SLR, crossed-SLR, flip-test, reverse SLR and their implications 4) List 5 indications for Xray in low back pain 5) Discuss the discrimination of functional from organic back pain 6) Describe the management of: a. Fracture b. Cauda Equina Syndrome c. Spinal Infection d. Vertebral Malignan...

CRACKCast E053 - Shoulder

CRACKCast E052 - Elbow And Humerus

This episode covers Chapter 52 of Rosen's Emergency Medicine.  Describe an approach to the pediatric elbow Classify supracondylar fractures in children List 3 complications of supracondylar fractures Describe the management of supracondylar fractures Describe the management of humeral shaft fractures – displaced and non-displaced Describe 3 injuries common in Little-leaguer's elbow Describe the management and classification of radial head fractures Describe the expected neurov...

CRACKCast E051 - Wrist And Forearm

This episode covers Chapter 51 of Rosen’s Emergency Medicine.  1) Describe normal radiographic relationships: Radial length measurement Radial inclination Volar Tilt Scapholunate angle Capitolunate angle Wrist arcs 2) Describe xray findings and management of Scaphoid fracture Lunate fracture Triquetral fracture 3) Describe Mayfield’s stages of carpal instability 4) Describe DISI and VISI 5) Describe xray findings and management of Colles’ Smith’s Barton’s Hutch...

CRACKCast E050 - Hand

CRACKCast E049 - General Orthopedic Principles

CRACKCast E048 - Peripheral Vascular Trauma

CRACKCast E047 - Genitourinary Trauma

This episode covers Chapter 47 of Rosen’s Emergency Medicine. 1. List 6 general indicators of genitourinary trauma? Lower urinary tract and external genitalia   What are the four parts of the male urethra? What is the mechanism of an anterior urethral injury (at least 5 causes)? What is the mechanism of a posterior urethral injury? List 4 indications for retrograde urethrogram before foley placement? Describe the technique for a retrograde urethrogram? Classify bladder injuries an...

CRACKCast E046 - Abdominal Trauma

This episode covers chapter 46 of Rosen's Emergency Medicine text book.   Episode Overview: 1) What are three mechanisms of injury in blunt trauma? 2) List expected seat-belt injuries 3) What are the most common intra-abdominal injuries in children? 4) Differentiate between the use of CT scan, diagnostic peritoneal lavage (DPL) and ultrasound – advantages & disadvantages. 5) List intra-abdominal injuries that may be missed on CT. 6) Describe the process of local wound explora...

CRACKCast E045 - Thoracic Trauma

This episode covers Chapter Chapter 45 of Rosen’s Emergency Medicine text book and is full of pearls for Thoracic Trauma. Sign Post: Differentiate Chest wall injury, rib fracture, and flail chest Describe the clinical presentation and management of a sternal fracture Describe Injuries to lung parenchyma What is Traumatic asphyxia? List 6 indication for tube thoracostomy  Indications for OR Thoracotomy  What is the management of Diaphragmatic injury? Differentiate between myocardial...

CRACKCast E044 - Neck Trauma

This episode of CRACKCast covers Rosen’s Chapter 044, Neck Trauma. Continuing in our trauma series, this episode tackles the challenging issue of neck trauma and injuries, and explores the anatomy and relevant considerations in the diagnosis and management of both blunt and penetrating neck injuries. Episode Overview: 1) Describe the landmarks and structures using the Zones of the neck & the Triangles of neck 2) List 6 hard and 6 soft signs of penetrating neck trauma. What are the indi...

CRACKCast E043 - Spinal Injuries

This episode covers Chapter 043 of Rosen’s Emergency Medicine, Spinal Injuries. Episode Overview Describe the anatomical contents of the anterior and posterior spinal columns List cervical spinal injuries for the following mechanisms, and indicated whether they are stable or unstable Flexion x 6 Shear / AP forces x 1 Flexion-Rotation x 2 Extension x 3 Vertical Compression x 2 List 8 unstable C-spine injuries Describe an approach to C-Spine X-rays, and define normal: Pre...

CRACKCast E042 - Facial Trauma

This episode covers Chapter 42 of Rosen’s Emergency Medicine, Facial Trauma. 1) Describe the anatomy of the bones, glands, and ducts of the face. At what ages do the sinuses appear? 2) List 5 types of facial fractures. 3) Describe the clinical presentation and associated radiographic findings of an orbital blowout fracture. 4) Describe an orbital tripod fracture and its management. 5) List the indications for antibiotics in a patient with facial trauma? 6) What is the importance ...

Physicians as Humans Podcast E02: An Illness Close to Home

In the second episode of the Physicians as Humans project, I speak with Dr. Rob Rogers (@EM_Educator), a leading educator in emergency medicine and director of The Teaching Course. He shares his experiences of dealing with a devastating illness in his own family and the effect it had on his career as an emergency physician. This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact [email protected].   If you...

CRACKCast E041 - Traumatic Brain Injury

This episode covers Chapter 41 of Rosen’s Emergency Medicine. 1) list 7 causes of altered LOC in the trauma patient 2)  List four herniation syndromes. Describe the pathophysiology of uncal herniation and the typical presentation. Describe the presentation of central herniation. 3)  Describe how cerebral blood flow in relationship to the following parameters: PO2 , PCO2 , MAP and ICP. What are the indications for ICP monitoring?   4) What is the Canadian CT head rule? What are ...

CRACKCast E040 - Injury Prevention and Control

This episode of CRACKCast covers Rosen’s Chapter 040, Injury Prevention and Control. 1) What are the three key aspects to Injury Control? 2) What makes up the Injury Triangle? 3) List 6 of 10 potential strategies for preventing transfer of energy Wisecracks: 1) What can you actually do, as a health practitioner, to help injury prevention?