TOTAL EM - Tools Of the Trade and Academic Learning in Emergency Medicine
245 episodes - English - Latest episode: over 1 year ago - ★★★★★ - 71 ratingsWe are a FOAMED project devoted to providing TOTAL care everywhere. This is done by sharing the Tools Of the Trade and Academic Learning in Emergency Medicine (TOTAL EM). We believe in education for emergency medicine professionals and the public.
Homepage Apple Podcasts Google Podcasts Overcast Castro Pocket Casts RSS feed
Episodes
Podcast #45 - Tips for Tricky Wound Closures with Brian Lin
May 30, 2017 17:00 - 9 minutes - 8.25 MBBrian Lin is an impressive physician with expert knowledge in wound management and care. It was well worth the visit to talk to him in person about some of the more intricate parts of wound management. At SEMPA 360 this year he gave so many pearls that there is no doubt he was a treasure to the conference. If you could not make it this year or want a reminder of some of the key points, check out the notes and listen to the podcast.
Podcast #44 - Incorporating Change in a Slow Changing Environment
May 23, 2017 17:00 - 20 minutes - 18.4 MBMedicine is slow to change, and using #FOAMed can be a challenge at times if you feel stuck and unable to speed up the process. Today, we talk about some tips that could help you better move things along in your department and among colleagues.
Podcast #43 - A Primer to Sepsis
May 16, 2017 17:00 - 29 minutes - 26.6 MBWe have two previous guests today that are returning to talk about a familiar topic: sepsis. There has been a lot of coverage recently but we want to cover it from a different angle by getting back to basics while including some of the key updates from recent literature and guidelines. This recording was originally made for the Emergency Quality Network (E-QUAL) which is part of the American College of Emergency Physicians (ACEP). It was our pleasure to work with ACEP to provide this con...
Podcast #42 - Is Shenfu Injection a Cure for Sepsis?
May 09, 2017 17:00 - 16 minutes - 15.4 MBToday we are covering a study on a medication not commonly used in the United States or most of the world: Shenfu. It is not discussed much but does have implications as a potential cure for sepsis and has been used in China for the last two decades. Given the recent discussions about cures for sepsis based on other studies, it seemed appropriate to talk about something with a growing body of evidence that most of the world may be ignoring without a good reason.
Podcast #41 - How to Avoid the Dial Tone on Your Consults and Recent Updates
May 02, 2017 17:00 - 11 minutes - 10.3 MBWe have all been there before. The consult that just does not go to plan. Most of us first experience it as students and it can drive us mad. Recently, while at the Podcasting Course in Lexington, Kentucky a fun and brief podcast was made covering the subject. This was a group project and hopefully this will remind us to cover more content on "soft skills" such as consults and daily interactions. Mainly, the things not covered in any sort of medical texts at least on a regular basis.
Podcast #40 - Interview with the SEMPA's first EMPA of the Year, Jon Monti
April 25, 2017 17:00 - 20 minutes - 18.7 MBMajor Jonathan Monti, PA-C is our first SEMPA 360 posting from the recent 2017 conference. We were able to talk to a variety of people at the conference thanks to the staff there and we truly appreciate their help. For the first time ever, SEMPA had what they call the "EMPA of the Year" award and this went to the very deserving Major Monti. We had the exclusive chance to interview him immediately after the award and his thoughts are included here.
Podcast #39 - Grab Bag of Tips and Ideas with Rob Orman
April 18, 2017 17:00 - 38 minutes - 26.8 MBRob Orman is back again for another fun week where we continue his "grab bag" interview. I need to make a quick warning that there is some language in this podcast so if you are easily offended please be warned now. However, language is very brief and minimal at best. This interview was done in a lot of fun and we hope you find it entertaining, too.
Podcast #38 - How to Manage the Upset Patient with Rob Orman
April 11, 2017 17:00 - 20 minutes - 19 MBWe just came back from SEMPA 360 and it was a blast! But today, we have a two part interview with Rob Orman. The first half, today's discussion, is all about patient satisfaction. Next week, we will further our "grab bag" discussion with some other interesting questions that others wanted to hear from Rob about, but all I can say is you do not want to miss the pearls from the interview so make sure to listen to both!
Podcast #37 - Acute Decompensated CHF with Michelle Perkins
April 04, 2017 17:00 - 27 minutes - 25.4 MBAcutely decompensated CHF can be a highly dangerous condition and one that needs immediate management. Previous Resuscitation Leadership Academy (RLA) student Michelle Perkins comes on for her debut to discuss management of this condition.
Podcast #36 - Primer on Clinically Important Hypertension in the Emergency Department
March 28, 2017 17:00 - 20 minutes - 18.9 MBThis week's podcast is all about hypertension. Like a previous podcast, #13 on abscess management, this podcast is in response to a recent Skeptic's Guide to Emergency Medicine (SGEM) post that TOTAL EM was featured on. We want to add to that discussion by expanding on clinically important hypertension in the emergency department. This primer will most likely only be the start to future discussions on deeper reviews about hypertension that we need to be concerned about in emergencies.
Podcast #35 - POCUS and Undifferentiated Dyspnea with Patrick and Frank
March 21, 2017 17:00 - 47 minutes - 43.1 MBWe are back for our first ever trio podcast! We have two previous PA guests, Patrick Bafuma and Frank Norman, to discuss a new paper regarding dyspnea and POCUS. At this time, the paper has not received much publicity but we agreed it was important to cover. Like our last podcast, this one is a bit longer but it is well worth your time so please look over the blog and listen to the podcast. A quick apology though as to the audio quality, especially in the second half. Due to a technical...
Podcast #34 - Complications of Chemotherapy with Kris Maday
March 14, 2017 17:00 - 49 minutes - 45.2 MBKris Maday is back for another podcast which is also available at the PAINE Podcast this time to discuss complications of chemotherapy. We review some of the most common conditions that also possess a risk to be life threatening for those fighting cancer. Since chemotherapy is designed to kill rogue cancer cells (some by sniper, some by nuke), there is bound to be collateral damage. The detailed show notes provided are in large part from Kris Maday's review of the literature.
Podcast #33 - Rural/Remote MCIs Part One with Greg Schmor
March 07, 2017 18:00 - 35 minutes - 32.7 MBReading the title you may be concerned that this interview is broken up into multiple parts but fear not for this is a new series we are starting! Greg Schmor, a critical care paramedic in Canada is our first guest in a series of podcasts that we plan to have on Rural Mass Casualty Incidents (MCIs). In any system, MCIs are a challenge but there are unique difficulties that are seen in the rural/remote environment or at least are exacerbated by such an environment. This series can be of be...
Podcast #32 - Is Prophylactic Hydration with IV Contrast in CT a "Busted" Pseudo-Axiom?
February 28, 2017 18:00 - 19 minutes - 17.8 MBIt may feel like we have been talking about a lot on imaging recently, but in emergency medicine, we do a lot of imaging! More specifically, CTs are a cornerstone in the emergency department and contrast is frequently used. However, there have been concerns about the use of contrast in higher risk populations which we have also discussed before. In patients at higher risk, is prophylactic hydration beneficial? We discuss that on today's podcast with a new randomized control trial.
Podcast #31 - Integrating an Ultrasound Program with Frank Norman
February 21, 2017 18:00 - 19 minutes - 17.5 MBWe have Frank Norman back on the podcast to talk a little more about the Society of Physician Assistants in Clinical Ultrasound (SPACUS) but also to discuss integrating an ultrasound program into an already busy PA school curriculum or getting it into the work place. Especially in rural or remote settings, this can be a significant challenge, but we cover it in today's podcast.
Podcast #30 - SPACUS and POCUS Competency with Frank Norman
February 14, 2017 18:00 - 22 minutes - 20.3 MBFrank Norman joins the podcast today to discuss the Society of Physician Assistants in Clinical Ultrasound (SPACUS) and point of care ultrasound (POCUS) competency. The conversation also includes teasing out competency versus certification. Listening to this podcast is great not only for those who are new to ultrasound but also for those with experience and looking to help out others interested in POCUS.
Podcast #29 - PAs Managing ED Peds Patients: How Good Are We? with Patrick Bafuma
February 07, 2017 18:00 - 29 minutes - 26.9 MBWith Physician Assistants (PAs) starting to celebrate 50 years of the profession, there is still debate as to the quality of care provided by PAs. There have been studies on the topic, but very little in the field of emergency medicine and the paper we discuss today helps address this issue. Today with our guest Patrick Bafuma we tackle that very question along with a discussion of PAs in emergency medicine in general.
Podcast #28 - Deep Dive on Safety of IV Contrast in CTs with Paul Schunk
January 31, 2017 18:00 - 44 minutes - 40.6 MBContrast has been hotly debated in the radiology and emergency medicine world. Many of these contrast medications have demonstrated safety and efficacy. However, a deep dive has been sorely needed on this subject and with recent relevant papers over the last year this felt like the right time. Joined by Dr. Paul Schunk, we explore the mysteries and evidence that exists for contrast safety in CTs for acute kidney injury and contrast induced nephropathy.
Podcast #27 - Out with the Hard Collar and in with the Soft Collar with Minh Le Cong
January 24, 2017 18:00 - 32 minutes - 29.8 MBSoft collars are being supported more with a growing body of literature. There is growing support for the change from semi-rigid (hard) collars to soft collars by a number of organizations, especially prehospital, in nations such as Australia. After our initial primer podcast on this subject, we review some of the finer points to this debate on this podcast. Details on the pros and cons are mentioned more extensively in the podcast itself so take a listen.
Podcast #26 - HeartCode ACLS: Worth It?
January 17, 2017 18:00 - 21 minutes - 19.7 MBHow have you taken ACLS? Most of us will have taken a course in person but what if you are not able to do the course in person before your license expires? Do you take an online course and if so which one? In this podcast we review one option, HeartCode ACLS, and discuss the pros/cons of the course. As always, there is nothing to disclose as any of the courses and organizations mentioned do not have any financial ties with this author.
Podcast #25 - A Primer to the C-Collar Debate with Minh Le Cong
January 10, 2017 18:00 - 15 minutes - 14.6 MBTo some, the rightful place for a rigid cervical collar is in a trash bin, but is it really that easy? Parts of Australia seem to think so and have made a hard push in that direction. To prepare us for the debate, this podcast is devoted to an introduction of the issue. A primer if you will. Minh Le Cong helps explain more in the podcast.
Podcast #24 - Single Dose Dexamethasone in Adult Asthma
January 03, 2017 18:00 - 13 minutes - 12 MBDexamethasone is commonly used in the treatment of asthma exacerbations both in adults and children. It is growing popularity with new research that supports its role over traditional alternatives such as prednisone. One key difference is its longer lasting effect. However, this new paper demonstrates some potential limitations as discussed in this review.
Podcast #23 - A Review for 2016
December 27, 2016 18:00 - 10 minutes - 9.53 MBAlthough a lot good and bad has happened around the world in 2016, this year marked the first year for TOTAL EM. This project has been beneficial for many and continues to get very positive feedback. The message continues though and this podcast talks about the past year along with the future of this podcast.
Podcast #22 - Rural Rants on Night Shift and Early Adopters
December 20, 2016 18:00 - 21 minutes - 19.7 MBFritz Fuller, PA-C is back for another great podcast this time for our inaugural Rural Rants which features a discussion on night shift as well as early adopters. With Rural Rants we talk about the unconventional or at least approach it in a way that many do not want to talk about in your traditional academic setting. Not only do we rant though, but we come up with ways to improve and develop solutions.
Podcast #21 - Tales from the Holler Podcast on Tips for Initial Rural Critical Care
December 13, 2016 18:00 - 23 minutes - 21.9 MBWe have had many recent firsts on the podcast, and this is the first of two new concepts coming up with a new regular guest, Fritz Fuller. Fritz is a PA practicing in emergency medicine. He plans on coming on regularly for such discussions as these "Tales from the Holler" as well as "Rural Rants" which will be our next type of new podcast. Until next week, enjoy this first episode of "Tales from the Holler."
Podcast #20 - Patient and Provider Podcast on Pearls and Pitfalls of Rule Out Criteria
December 06, 2016 18:00 - 19 minutes - 18.2 MBRule out criteria can be our biggest friends or our worst enemies depending on how we use them. They are not perfect, but can save us from a lot of over-testing. In this blog and podcast, we talk about the good and the bad along with how to use rule out criteria appropriately.
Podcast #19 - Patient and Provider Podcast on Anaphylaxis
November 29, 2016 18:00 - 18 minutes - 17.3 MBAnaphylaxis is a life-threatening condition. It needs to be identified quickly and treated appropriately to save a patient's life. Today marks our first ever "Patient and Provider" podcast. This means that although the podcast itself is still meant to provide more of the basics, the blog will also be helping educate patients in the relevant condition. Check both the blog and the podcast for all the details.
Podcast #18 - Basic Approach to Airway Management with Kris Maday
November 22, 2016 18:00 - 47 minutes - 43.6 MBSometimes we have to go back to the basics. Airway management has its many advanced methods but with all the great FOAMed out there, very little of it covers the basic approach. We wish to remedy this with guest Kris Maday, PA-C. He is another PA with a podcast. His is called the PAINE Podcast and can be easily found.
Podcast #17 - Making ED to EMS Hand-offs Better with Geoff Horning
November 15, 2016 18:00 - 18 minutes - 16.8 MBWhen a patient needs to be given to EMS for transfer to another facility, it is important to have a solid hand-off. The last podcast was about the EMS to ED hand-off process and it was the most popular podcast to date. With paramedic Geoff Horning the discussion continues with his thoughts about how EMS and ED can work together to make an even better transfer of care.
Podcast #16 - How to Make the EMS to ED Hand-off Better with Geoff Horning
November 08, 2016 18:00 - 20 minutes - 19.9 MBWhen EMS brings a patient to the ED, there are many factors that can make that hand-off either good or bad. It seems like no matter how hard each side tries, the message does not always carry over. A lot of it comes down to not addressing the basics of EMS hand-offs to the emergency department. Today, we will be covering how to make that hand-off better with our paramedic friend, Geoff Horning.
Podcast #15 - Implementing the Vortex Approach
November 01, 2016 17:00 - 19 minutes - 18.1 MBThere was a lot of coverage for the original Vortex Approach and the revised version has also caught some attention. Others like Minh Le Cong have covered it and the British Journal of Anesthesia has the paper available for free (at this time). It is definitely worth going to the Vortex Approach website as well for details, especially regarding training.
Podcast #14 - Intro to Vortex Approach and a Little Star Trek
October 25, 2016 13:00 - 27 minutes - 25.1 MBThe Vortex Approach is another game changer in airway management. This podcast features Dr. Nicholas Chrimes reviewing this technique to manage the airway. He also ties in some Star Trek in there (listen to the podcast to know who his favorite character is).
Podcast #13 - Cold Hard Steel and the Abscess
October 18, 2016 13:00 - 26 minutes - 24.5 MBIf you have worked in emergency medicine for any length of time, you have seen an abscess. No, it's not a spider bite, it's almost always an abscess. With abscess management, there are a number of approaches. We are going to review a relatively evidence based approach to treating these pus filled pockets of joy. Grab your eye protection and masks as this can get messy.
Podcast #12 - PA Week 2016 and Recent Updates
October 11, 2016 13:00 - 20 minutes - 19.1 MBThis is not your usual podcast. To be fair, what has been the usual podcast with us? We have gone over certain papers and a few interviews, but this is a young podcast. It was important to give everyone an update on what is currently going on, and that is exactly what this podcast is all about.
Podcast #11 - Why the King Vision Beats DL with Jeff Jarvis
October 04, 2016 13:00 - 28 minutes - 25.7 MBWe are back for the second half of our conversation with Jeff Jarvis. If you missed the first half, go back and listen to Podcast #10 as it will make more sense. We discussed his EMS system that only uses video laryngoscopy (VL) with intubation. This is huge and unique with this group. However, it was a process to find what was best for him and where he acts as a medical director. In this part of the conversation, we talk about the benefits of VL and how he chose the King Vision. He ...
Podcast #10 - The Death of DL with Jeff Jarvis
September 27, 2016 13:00 - 20 minutes - 18.9 MBYou read that right! Dr. Jeff Jarvis is a medical director who only uses video laryngoscopy (VL) for the EMS agencies he acts as a medical director. Not only that, but in his own practice in emergency medicine, he uses a VL system. What is so great with VL that they ditched traditional direct laryngoscopy? Well for that, you will need to listen to the show. However, there are some key points discussed that we wanted to include in our show notes for our readers.
Podcast #9 - Your Questions with Jim DuCanto
September 20, 2016 13:00 - 25 minutes - 23.8 MBHave you heard of Jim DuCanto? If not, then you missed our last podcast. You can listen to either of them in any order, but since you are here, go ahead and listen to this one first. However, we highly recommend that you go to Podcast #8 after that to see what our guest has been up to recently. If you manage airways take a listen as it has some interesting findings. In this podcast, Jim DuCanto tells us more about himself and answers questions from Twitter. Go to totalem.org to rea...
Podcast #8 - Jim DuCanto and his Recent Supraglottic Airway Study
September 13, 2016 13:00 - 25 minutes - 22.9 MBYou may not have heard of Jim DuCanto specifically, but you have probably heard about his SALAD (Suction Assisted Laryngoscopy Airway Decontamination technique. Click on the links that we have here if you have not heard of him or his technique including this one from Life in the Fast Lane. Don't worry, we will wait right here... Are you back now? Does it make sense? We will talk about it more soon. However, we had a very unique conversation about something you most likely have not hear...
Podcast #7 - Ketofol and the POKER Trial
September 06, 2016 13:00 - 20 minutes - 18.4 MBAfter our talk with Minh Le Cong from the PHARM podcast, we decided it was appropriate to discuss the POKER Trial. No, it is not about cards, but rather about if propofol mixed with ketamine is better than propofol alone. In addition to this podcast, there have been a few other blogs such as St. Emlyn's and REBEL EM that reviewed this study. At this time, we believe that this is the only podcast to create an audio discussion in detail on the subject (we may have missed someone and we apo...
Podcast #6 - Part Two of Minh on Ketamine
August 30, 2016 13:00 - 32 minutes - 29.9 MBThe image above is the chemical structure of ketamine, and that is exactly what we are talking about today. This is the second half of our conversation with Minh Le Cong who is best known for his involvement on Twitter with the FOAMED world and his PHARM podcast. If you did not listen to the first half, please go back to Podcast #5 to listen to that portion. Otherwise, get ready for the second half of this excellent conversation.
Podcast #5 - Ketamine with @Ketaminh
August 23, 2016 13:00 - 34 minutes - 31.5 MBMinh Le Cong is known worldwide especially on Twitter and his PHARM website. On August 16, 2016 he agreed to get on Skype and discuss ketamine in detail with me. Although we lost some of the original audio due to a mistake on my end, we still recorded approximately one hour's worth of audio. Due to the length, we are breaking up the discussion into two separate podcasts. The second one will come out next week. So sit back, relax, and enjoy the conversation.
Podcast #4 - Acute Back Pain
August 16, 2016 13:00 - 19 minutes - 18.3 MBYes, that oh so common complaint that brings patients into the ER. With acute back pain, everyone seems to have their own cocktail for treatment, but what has been shown to work? In this reviewed of a trial in JAMA published October 20, 2015 we review a randomized control trial that looked into just this issue.
Podcast #3 - The REACT-2 Trial
July 25, 2016 15:00 - 22 minutes - 20.4 MBYou have waited long enough! It is time for some real information and that has come in the form of a paper I find very important. The REACT-2 study was published online with The Lancet on June 28, 2016. I started looking at it right away but did not get the chance to actually post about the topic until now. Listen to the podcast, read the blog, but do not forget to read the original paper, too!
Podcast #2 - About Me
July 25, 2016 14:00 - 3 minutes - 3.26 MBI realized in my last podcast that I really did not mention much about myself. This second podcast includes details about myself and my background. There is still much to tell but hopefully this will give you enough information for us to get started.
Podcast #1 - An Introduction
July 25, 2016 13:00 - 3 minutes - 3.21 MBIt has finally happened! We have our very first podcast up and running. It is short and to the point with only some quick information as to the TOTAL EM project in podcast form. Click below to learn more about what is mentioned in the podcast and to listen to the podcast itself.