EMGuidewire's Podcast
108 episodes - English - Latest episode: about 2 months ago - ★★★★★ - 63 ratingsJoin the faculty and residents of Carolinas Emergency Medicine Residency Program, one of the oldest programs in the country, as they explore some of the Core Concepts of Emergency Medicine as well as many of the niche environments of this important arena of specialty care.
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Episodes
Intern Nuggets '24: A-fib and A-flutter
March 05, 2024 21:40 - 13 minutes - 13.1 MBJoin the team from EMGuidewire from CMC Emergency Medicine Residency for another Intern Nuggets! In this episode, Drs. Crow and Lim discuss some tips on how they have approached the first half of their intern years as well as review management of Atrial Fibrillation and Atrial Flutter.
Intern Nuggets '23 #1 - Agitation Management Tips
November 04, 2023 17:28 - 11 minutes - 16.8 MBJoin the crew from Carolinas Medical Center Emergency Medicine (@CMCEM) and EMGuidewire (@EMGuidewire) as they introduce a new group of interns as they discuss some of the first lessons they have learned about Agitation Management in the ED.
Intern Nuggets #4 2023: Myositis
March 31, 2023 12:50 - 7 minutes - 11.6 MBJoin the EMGuidewire team from Carolinas Medical Center's Emergency Medicine Residency Program as Drs. Calienes Cerpa and Bissell gather together to discuss another great case filled with learning points. In this episode, they review myositis in a pediatric patient.
Intern Nuggets #3 2023: Heart Blocks
March 16, 2023 20:00 - 13 minutes - 12.7 MBJoin the EMGuideWire team from Carolinas Medical Center, Emergency Medicine Residency, as Drs. Calienes and Bissell discuss Heart Blocks.
Quick Cases with Drs. Diurba and Folk - Septic Pulmonary Emboli
February 08, 2023 00:06 - 10 minutes - 10.2 MBJoin the crew from Carolinas Medical Center's Emergency Medicine Residency and EMGuidewire as they discuss some interesting cases with Drs. Sofiya Diurba and Destiny Folk. This episode deals with a complex, critically ill adult who has septic pulmonary emboli.
Quick Cases with Drs. Diurba and Folk - Critical Pediatric Case
February 07, 2023 23:46 - 11 minutes - 11.7 MBJoin the crew of EMGuidewire and the Residents and Faculty at Carolinas Medical Center Emergency Medicine Residency as they learn along with Drs. Sofiya Diurba and Destiny Folk. In this episode, Drs. Folk and Diurba will discuss an educational Pediatric Case that involves some critical decisions!
Intern Nuggets 2022 #2 Self Care and Migraine Cocktails
November 05, 2022 17:52 - 12 minutes - 17.3 MBJoin the EMGuidewire team from Carolinas Medical Center's Emergency Medicine Residency Program as Drs. Bissell and Calienes Cerpa discuss some more important topics in their Intern Nuggets series. In this episode, they address some important Self Care issues that all interns (and likely everyone) need to consider. They also discuss the possible components in those very popular "migraine cocktails."
Resident Wellness Proactive Counseling
September 02, 2022 21:05 - 14 minutes - 14.1 MBJoin Drs. Diurba and Folk and the EMGuidewire team from @CMCEM as they begin an important conversation regarding Resident and Physician Wellness. If we exercise our bodies to remain physically healthy, shouldn't we exercise our emotional selves as well? Perhaps some proactive counseling sessions can be good for us all.
Intern Nuggets 2022 #1 Palpitations
August 30, 2022 14:41 - 11 minutes - 11.1 MBJoin the EMGuideWire's team as they celebrate the beginning of the new academic year by introducing us to two new interns who will be taking over the Intern Nuggets! Drs. Calienes and Dr. Bissell take over the task of discussing interesting cases that they have encountered during the start of their careers. This episode finds them wrestling with a challenging case of palpitations and anxious feelings.
Pediatric Pain Management - EMSC Improvement Project
June 29, 2022 22:26 - 20 minutes - 28.8 MBJoin the EMGuidewire team and Drs. Allen and Fox from Carolinas Medical Center as they discuss tips for Mitigating Anxiety and Pain in the Pediatric patient. This episode is published in concert with EMSC Innovation and Improvement Center. The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M...
Intern Nuggets #7: SAEM Learning Points
June 27, 2022 19:31 - 11 minutes - 11.7 MBJoin the EMGuidewire team from Carolinas Emergency Medicine Residency as Drs. Diurba and Folk discuss their favorite learning points from this year's SAEM scientific assembly conference.
Intern Nuggets #6: Reversal of Anticoagulants
June 24, 2022 20:07 - 11 minutes - 11.7 MBJoin Drs. Diurba and Folk, stellar Carolinas Medical Center Emergency Medicine Interns, and the EMGuidewire team as they discuss various reversal options for the numerous anticoagulants that exist today.
Intern Nuggets #5
May 10, 2022 20:24 - 9 minutes - 9.04 MBJoin Drs. Folk and Diurba, Emergency Medicine Interns enjoying their training at Carolinas Medical Center, as they discuss a case of Altered Mental Status with the EMGuidewire Team!
Intern Nuggets #5: Altered Mental Status
May 10, 2022 20:24 - 9 minutes - 9.04 MBJoin Drs. Folk and Diurba, Emergency Medicine Interns enjoying their training at Carolinas Medical Center, as they discuss a case of Altered Mental Status with the EMGuidewire Team!
Intern Nuggets #4
February 15, 2022 20:17 - 9 minutes - 13.8 MBJoin Drs. Folk and Diurba, Emergency Medicine Interns enjoying their training at Carolinas Medical Center, as they discuss Beer Potomania and Hyponatremia with the EMGuidewire Team!
Intern Nuggets #4: Beer Potomania and Hyponatremia
February 15, 2022 20:17 - 9 minutes - 13.8 MBJoin Drs. Folk and Diurba, Emergency Medicine Interns enjoying their training at Carolinas Medical Center, as they discuss Beer Potomania and Hyponatremia with the EMGuidewire Team!
Intern Nuggets 3
November 15, 2021 22:35 - 17 minutes - 24.3 MBJoin the EMGuidewire team as Drs. Folk and Diurba explore another episode of INTERN NUGGETS! In this episode, they discuss an approach to the medically complex patient as well as giving and receiving feedback. They also explore the extremely important topic of burnout and ways to avoid it.
Intern Nuggets #3: Approach to Complex Patients and Feedback and Avoiding Burnout
November 15, 2021 22:35 - 17 minutes - 24.3 MBJoin the EMGuidewire team as Drs. Folk and Diurba explore another episode of INTERN NUGGETS! In this episode, they discuss an approach to the medically complex patient as well as giving and receiving feedback. They also explore the extremely important topic of burnout and ways to avoid it.
Occlusive Myocardial Infarction Intro
November 04, 2021 18:50 - 29 minutes - 27.6 MBJoin the team from EMGuideWire from Carolinas Medical Center as Dr. Clare Gunn gets to chat with Dr. Pendell Meyers about the challenges of relying on the STEMI paradigm and what other factors to consider when evaluating patients for Occlusive Myocardial Infarctions (OMI).
Tension Pneumoperitoneum: More Than Bad Belly Pain
October 01, 2021 15:01 - 9 minutes - 9.4 MBJoin the @EMGuideWire team from @CMCEM as they learn from former Chief Resident, Dr. Rushnell, how to manage the complex condition of Tension Pneumoperitoneum.
Pediatric DVT and PE
September 24, 2021 18:04 - 8 minutes - 8.26 MBJoin the EMGuideWire team from the CMC EM Residency Program as we welcome back Dr. Rushnell, prior CMC EM Chief Resident, to discuss the challenging topic of Pediatric DVT and PE.
Guillain–Barré Syndrome
September 03, 2021 16:17 - 14 minutes - 20.2 MBJoin the EMGuideWire Team from Carolinas Medical Center (@CMCEM) and Dr. Mark Kastner and Dr. Matthew Cravens in the Chief's Corner as they discuss the presentation and diagnosis of the challenging diagnosis of Guillain–Barré Syndrome.
Intern Nuggets #2: Sign-out Tips and Pediatric Dehydration and BRUE
August 18, 2021 20:36 - 16 minutes - 15.9 MBJoin the crew from EMGuidewire as they are joined, once again, by Drs. Diurba and Folk for their unique perspectives from an intern's point of view. This month's Intern Nugget will cover sign-out and transition of care tips as well as some learning point on pediatric dehydration management and BRUE.
4 Factor PCC in Trauma
August 06, 2021 16:17 - 11 minutes - 11.6 MBJoin the EMGuideWire Team as they welcome back Dr. Chelsea Rushnell, prior Chief Resident at CMC Emergency Residency, to discuss the management of the anticoagulated trauma patient. Perhaps just flooding individuals with FFP is not the best strategy. Dr. Rushnell will review the evidence for the use of 4 Factor PCC.
Intern Nugget #1: Imposter Syndrome, Complex Regional Pain Syndrome, and Analgesia Options
August 03, 2021 16:57 - 12 minutes - 12.1 MBJoin the EMGuideWire team from CMC EM residency as they hear a fresh perspective... from newly minted residency Interns, Drs. Destiny Folk and Sofiya Diurba. For this Intern Nugget, they address: 1) Imposter Syndrome and how to overcome it. 2) Complex Regional Pain Syndrome and how to manage it. 3) Analgesia options in the ED
Emergency Medicine Residency Intern Nugget #1
August 03, 2021 16:57 - 12 minutes - 12.1 MBJoin the EMGuideWire team from CMC EM residency as they hear a fresh perspective... from newly minted residency Interns, Drs. Destiny Folk and Sofiya Diurba. For this Intern Nugget, they address: 1) Imposter Syndrome and how to overcome it. 2) Complex Regional Pain Syndrome and how to manage it. 3) Analgesia options in the ED
Penetrating Cardiac Trauma
July 27, 2021 19:38 - 20 minutes - 19.5 MBJoin the EMGuidewire team at Carolinas Medical Center Emergency Medicine program as they discuss important topics. This week, Drs. Cravens and Kastner discuss Penetrating Cardiac Injury (PCI): -The diagnosis of PCI is made in the trauma bay with repeat cardiac ultrasound exams and chest x-ray. If suspicion remains high despite inconclusive imaging, operative subxiphoid pericardial window is the definitive diagnostic modality. -Large pericardial injury, especially from ballistic injuries,...
Diabetic Ketoacidosis Emergent Management
November 25, 2020 21:37 - 34 minutes - 32.3 MBJoin the EMGuideWire Team from CMC EM group as they explore the initial thoughts and management of a patient who presents with severe Diabetic Ketoacidosis (DKA). For this episode, Drs. Claire Milam and Travis Barlock explore the initial considerations and practical management tips. Definitions of severity of DKA: Mild pH: 7.25-7.3 CO2: 15-18 mEq/L Anion Gap: > 10 mEq/L Mental Status: Alert Blood Glucose: >250 mg/dl Urine and Serum Ketones: Positive Moderate pH: 7.0-7.24...
Posterior Eye Pathology Core Concepts
November 17, 2020 00:22 - 21 minutes - 20.6 MBJoin the Drs. Ray and Barlock from the EMGuideWire team as the discuss the initial assessment and evaluation of some ocular complaints with specific attention to pathology of the Posterior Eye. SHOWNOTES: Key Points Always get visual acuity for any eye complaint Swinging flashlight test can help with your diagnosis Dilate the eyes for optimal fundoscopic exam Optic neuritis -> give IV steroids Use U/S to look for papilledema along with optic nerve sheath diameter Find the optic nerv...
Severe Asthma Management in the ED
November 02, 2020 20:05 - 33 minutes - 31.6 MBJoin the EMGuidewire team as Drs. Serven and Blackwell discuss the management of the patient presenting with Severe Status Asthmaticus in the Emergency Department. Don't forget to review the basic concepts that were published earlier... this time the focus is on the critically ill patient.
Trauma Assessment
September 21, 2020 15:53 - 26 minutes - 25.4 MBJoin the EMGuidewire Team as they address how to prepare for the arrival of a trauma patient in your Emergency Department. Drs. Serven and Blackwell from Carolinas Medical Center Emergency Medicine Residency Program will give us some insight and pearls on how to manage the potential chaos.
Approach to Bradycardia in the Emergency Department
September 09, 2020 21:05 - 21 minutes - 20.5 MBJoin Drs. Serven and Blackwell from the EMGuidewire team (from the Carolinas Medical Center Emergency Medicine Residency) as they discuss some of the Basic strategies to the initial evaluation and management of a patient with significant Bradycardia. See website (www.emguidewire.com) for complete show notes... but here is a sneak peak: Quick Differential: DIMES D – drugs (digoxin, CCB, beta blockers, cholinergic drugs, TCAs, Clonidine) I – ischemia (heart and brain)/ infection (sepsis,...
Airway Management Preparation
September 03, 2020 18:17 - 37 minutes - 34.8 MBJoin the EMGuideWire team as Drs. Serven and Shreve are joined by Dr. Trigonis to discuss simple strategies to make sure your room is set up and you are prepared for performing an emergent intubation on your patients in the Emergency Department. Shownotes - Once through start to finish: Set up suction Set up pre-oxygenation (nasal cannula, NRB, BVM as backup) Choose a tube + back up tube Lube the tube, check the tube Choose a stylet Set up video and DL Ask nurse for meds ...
Pulmonary Edema and Hypertension
August 23, 2020 18:16 - 19 minutes - 18.7 MBJoin Drs. Alyssa Thomas and Victoria Serven from Carolinas Medical Center Emergency Medicine Residency Program and the EMGuideWire Team as they discuss how they initially evaluate and manage the patient who present with acute pulmonary edema and hypertension.
Point of Care Ultrasound for COVID-19 Patients
April 21, 2020 20:42 - 27 minutes - 26.2 MBJoin the EMGuideWire team as they explore the use of Point-of-Care Ultrasound for the evaluation of patients with possible COVID-19 infection. Dr. Patrick Lam, from the Carolinas Medical Center Department of Emergency Medicine Department Division of Ultrasound, will guide us on the techniques and pro-tips for this application.
Healthcare Disparities and COVID Pandemic
April 14, 2020 18:39 - 42 minutes - 40 MBJoin EMGuideWire team as they listen in to EM Residency Conference at Carolinas Medical Center (in Charlotte, NC) and learn from Emily MacNeill, MD as she discusses "What Happens When a Disease Management System Crashes into a Public Health Crisis."
Neurologic Manifestations and Complications of COVID-19
April 10, 2020 19:36 - 46 minutes - 43.8 MBJoin the EMGuideWire team as they learn from one of the world's foremost experts in neurologic emergencies, Dr. Andrew Asimos. This episode will address the Neurologic Manifestations and Complications of the COVID-19 Infection.
Hydroxychloroquine Toxicity
April 03, 2020 20:48 - 24 minutes - 23.4 MBJoin the EMGuideWire team as they listen to Dr. Geib discuss how to recognize and manage Hydroxychloroquine toxicity, which may become more prevalent during the current COVID-19 pandemic.
ARDS Management during COVID 19
April 03, 2020 20:07 - 52 minutes - 49 MBJoin the EMGuideWire team as they learn from Critical Care fellow, Dr. Russell Trigonis while he addresses the important aspects of managing ARDS in patients with COVID-19 infections.
Trauma and Pregnancy
February 25, 2020 18:29 - 15 minutes - 15.1 MBOB Trauma Core Concepts Physiologic changes of pregnancy: physiologic anemia, decreased SVR, increased HR, increased RR, and pelvic vessel engorgement Traumatic complications: placental abruption, preterm labor (PTL), uterine rupture, and pelvic fx Abruption triad = abd pain, large for dates uterus, vaginal bleeding Perform cervical check to eval for PTL Obtain Type and Screen and KB test Give Rhogam if mom is Rh neg. 50 mcg if <12 wks, 300mcg if > 12 wks Check fetal HR after E...
Ludwig's Angina
January 30, 2020 22:04 - 12 minutes - 14.4 MBJoin the EMGuideWire Crew from CMC EM Residency Program as they discuss Ludwig's Angina and the management Priorities!!! BACKGROUND Angina = “Strangling” Bilateral infection of submental, submandibular, and sublingual spaces 70-85% of cases arise from odontogenic source Periapical abscesses of mandibular molars Piercings (frenulum) URI more common cause in children Source of infection often polymicrobial Most commonly viridans; also Staphylococcus and Bacteroides species P...
SVC Syndrome
January 15, 2020 17:16 - 9 minutes - 9.91 MBJoin the EMGuideWire team as they discuss Superior Vena Cava Syndrome! Shownotes: Definition: Any condition leading to obstruction of blood flow through the SVC Pathophysiology: Pathology in adjacent anatomy (lung, lymph node, thymus, mediastinum) or within the SVC itself obstructs venous return to the right atrium. As the SVC is compressed, venous collaterals form alternative pathways returning blood to the right atrium which can dilate over several weeks. As a result, upper body ven...
NonFatal Strangulation and Domestic Violence
November 08, 2019 19:50 - 16 minutes - 15.6 MBOctober was Domestic Violence month and in an effort to help highlight this very important topic, join Drs. Salzman, Dragoo, and Richardson from Carolinas Emergency Medicine Residency while they discuss the very important presentation of Strangulation. This is not a mere gesture of power, it may be our last opportunity to save this patient's life! Pearls Strangulation victims are 750% more likely to become a homicide victim. Strangulation is not choking. Call it what it is. External ...
Running a Code
October 25, 2019 12:45 - 13 minutes - 13.6 MBJoin the EMGuideWire crew as they discuss some tips and pearls on how to skillfully run a medical resuscitation. Pearls Preparation is everything. Get your staff, and get your stuff! Call out names, be redundant, and say what you are thinking out loud. Don’t go for the tube! Supraglottic airways are quicker and safer! High quality compressions are life saving. V-tach and V-fib are usually ischemic. PEA is usually non-cardiac. PEA? Is it Wide or Narrow? Narrow - think proced...
Sepsis Management in the ICU
October 10, 2019 20:58 - 18 minutes - 17.5 MBThe EMGuideWire Team is visited by a prior crew member, Russell Trigonis, MD! Join them as they discuss how the patient diagnosed with Sepsis in your ED has their care continued in the ICU! Pearls Start pressors with IVF (30-40cc/kg). NE at 7mcg/min peripherally can always be stopped, but better earlier than later. Increase NE until at 20mcg/min, if still hypotensive, then add a 2nd pressor like Vasopressin at 0.03units/min and 100mg Hydrocortisone Q8h. Start antibiotics early and ide...
Pediatric Sepsis
September 30, 2019 14:26 - 12 minutes - 12 MBIt it the end of Sepsis Awareness Month, but there is a BONUS Monday (Sept. 30th), so why not a BONUS episode! Join the EMGuideWire Team as they explore the challenges the children bring to this clinical condition. Let's review Pediatric Sepsis! Pearls: Screening should be age adjusted. Identify severe sepsis. Treat w/early antibiotics, balanced fluid administration, and EPI if needed. SIRS in children must be age-adjusted. HR & RR > 2 standard deviations of nml; WBC age adjusted. ...
Guided Resuscitation for Sepsis
September 23, 2019 18:10 - 15 minutes - 15.2 MBJoin the EMGuideWire Crew as they continue to explore the High Yield management points for Sepsis! This week's Episode's Pearls: Early fluids save lives. Give 40cc/kg bolus in first 3 hours. But don’t fluid overload the patient! U/S the heart and lungs: A plethoric IVC, immobile mitral valve, and B lines on the lungs should urge you to be more cautious with fluids. Goal in all patients is to establish an adequate MAP ASAP! Fluids + Vasopressors! Vasopressor titration algorithm: First ...
Antibiotics for Sepsis
September 16, 2019 11:00 - 12 minutes - 12.1 MBJoin the EMGuideWire crew once again for this month's series on Sepsis in honor of Sepsis Awareness month. Episode 3 will cover antibiotic use and selection. Antibiotics for Sepsis Take a history and perform a chart biopsy first! Consider past infections, bug susceptibilities, healthcare acquired vs. community acquired infection, foreign travel, and comorbidities. Always check local antibiogram and prior culture results. Septic shock - Start broad spectrum antibiotics within 1 hour. ...
Fluids in Sepsis
September 09, 2019 14:12 - 13 minutes - 13.1 MBSepsis Awareness Month continues! Join the EMGuideWire Team as they dive into the issues of Fluid selection for resuscitation. 1) Fluids are not all created equal. Use balanced fluids for large volume resuscitation. 2) Lactated Ringers is likely the best choice available in the ED. Plasmalyte is also a good option, if you have it. 3) You can start low dose vasopressors peripherally if you need to, rather than continuing to flood patients with fluids for hypotension.
Sepsis Definitions
September 02, 2019 19:27 - 14 minutes - 13.8 MBJoin the EMGuideWire Team,from Carolinas Emergency Medicine Residency Program in Charlotte, NC, as they explore the critical core concepts on the important topic of Sepsis. In this first episode, the team will discuss the definitions of Sepsis. Pearls: Sepsis is a dysregulated systemic inflammatory response to infection causing intravascular inflammation, tissue ischemia, cytopathic injury, and dysregulated apoptosis. SIRS terminology is now outdated. Current terminology is “Sepsis” (SI...