Emergency Medicine Cases

Hip complaints are bread-and-butter emergency medicine—but every so often they are anything but straightforward. The obvious shortened, externally rotated leg after a fall is one thing; the patient with acute hip pain, a normal x-ray, unremarkable blood work, and no clear diagnosis is another. Hip fractures are also far from benign, carrying a 30-day mortality of 6–7% and a 1-year mortality of about 20%, often triggering a cascade of pain, immobility, delirium, deconditioning, and death. But hip fractures are only the tip of the iceberg. In this EM Cases episode, Dr. Arun Sayal and Dr. Matt DiStefano go beyond “get an x-ray and call ortho” to tackle hip fractures, occult injuries, atraumatic hip pain, and hip dislocations. We answer questions like: Why do so many patients never return to baseline after a hip fracture? What can we do in the ED to avoid delaying surgery? What are the best pain management and delirium prevention strategies? Which physical exam findings help diagnose an occult hip fracture? How do we distinguish hip from pelvic fractures clinically? When is a normal x-ray not enough, and when should we proceed to CT or MRI? What is POCUS useful for in the painful hip? How should hip fractures be classified to change ED management? How should we approach atraumatic hip pain? How do native and prosthetic hip dislocations differ? What clinical position suggests posterior versus anterior dislocation? Which reduction technique should we choose? What is the Whistler technique? What are the nuances of post-reduction management? And much more. Please consider a donation to EM Cases to support ongoing high-quality Free Open Access Medical Education: https://emergencymedicinecases.com/donation/

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 daily activities if deficits persist. Yet, non-disabling does not mean benign. Non-disabling strokes occupy the same ischemic continuum as TIAs and carry a substantial risk of early recurrence with disabling stroke. In this EM Cases podcast we answer questions such as: Which patients with non-disabling stroke can safely go home with prompt follow-up and which require urgent investigation or admission? Which stroke mimics do we need to be on the look out for and how do we identify them at the bedside? How dangerous is thrombolysis in a patient with presumed stroke who turns out to be a stroke mimic? What are the key distinguishing features between a stroke and functional neurologic disorder? What are the most common causes of stroke in young people that we commonly miss? How does stroke etiology dictate the management pathway? What are the indications for carotid endarterectomy in patients with non-disabling stroke and what is the ideal timing of the endarderectomy? When is dual antiplatelet therapy vs single antiplatelet thereapy vs anticoagulant therapy indicated? What is the best medication strategy for the patient on a DOAC for atrial fibrillation who presents to the ED with a non-disabling stroke? For patients not on a DOAC for atrial fibrillation who come in with a stroke, when is it safe to start anticoagulation? and many more... Make A Donation: https://emergencymedicinecases.com/donation/.com

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 pediatric distal radius buckle fractures & the FORCE trial. Dr. Justin Morgenstern on Delayed Sequence Intubation (DSI): RCT Takeaways. Dr. Brit Long on ESRD & Dialysis in the ED: altered mental status. Dr. Lisa Thurgur & Victoria Myers on leadership and medical education. Please consider a donation to EM Cases to ensure ongoing high quality free open access medical education here: https://emergencymedicinecases.com/donation/

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 Communication with Dr. Shawn Segeren, ESRD with Dr. Brit Long, Leaders in EM Dr. Catherine Varner... Please consider donating to EM Cases here: https://emergencymedicinecases.com/donation/

On this EM Quick Hits podcast: Pediatric Torticollis with Dr. Deb Shconfeld, Approach to Stable Wide Complex Tachydysrhythmias with Dr. Anand Swaminathan, Post-intubation Neurocritical Care 5 best practices with Dr. Andrew Petrosoniak, Hyponatremia Correction Rates with Dr. Justin Morgenstern, Paronychia Management with Dr. Andrew Tagg, and Women in EM Leader Series with Judith Tintinalli and Dr. Victoria Myers...Donate to EM Cases to help ensure continued Free Open Access Medical Education in the future here: https://emergencymedicinecases.com/donation/

On this month's EM Quick Hits podcast: Dr. Mathew MacArther on Occipital Nerve Block, Dr. Ian Chernoff on PoCUS in Pulmonary Embolism, Dr. Hans Rosenberg on Myelopathy, Dr. Shawn Segeren on Team Resuscitation, Dr. Brit Long on Incidental Neutropenia and Dr. Kylie Booth on Peer Programs. Please help ensure continued Free Open Access of the entire EM Cases Learning System by donating here: https://emergencymedicinecases.com/donation/

In this month's EM Quick Hits podcast: Zafar Qasim & Andrew Petrosoniak on whole blood transfusion in trauma, Justin Morgenstern on calcium pre-treatment to prevent diltiazem-induced hypotension, Kiran Rikhraj on dynamic LV outflow tract obstruction, Anand Swaminathan on resuscitative thoracotomy, Andrew Tagg on uterine casts, and Jesse McLaren on scale & proportionality in occlusion MI ECG interpretation. **Please support EM Cases to continue to be free open access by making a donation: https://emergencymedicinecases.com/donation/