The Point of Care Podcast

Navigating hepatic encephalopathy can be complex, and the role of ammonia levels is often misunderstood. In this concise episode, we clarify why hepatic encephalopathy is fundamentally a clinical diagnosis, not one based solely on lab values, and reveal the crucial limitations of ammonia testing. Learn when ammonia levels are genuinely helpful - specifically in acute liver failure - and why relying on them for routine diagnosis or trending can lead clinicians astray, diverting focus from essential clinical assessment. Subscribe to our Substack: https://substack.com/@rokeefemd

A comprehensive guide on how to complete a thorough history and physical (H+P) for patients presenting to the hospital with opioid withdrawal.00:15 Admission Checklist for Opioid Withdrawal00:40 Triage and Chart Check02:01 Critical Considerations and Admission Orders03:10 Initial Treatment Options for Opioid Withdrawal05:32 Detailed HPI Intake Questions07:33 Physical Exam Notes08:35 Key Takeaways and ConclusionSubscribe to our Substack to receive updates and IM/Hospital Medicine recaps directly to your inbox.POCM Opioid Withdrawal Inpatient AdmissionPOCM Opioid Use Disorder and Withdrawal Clinical Review13 Essential Facts for Managing Opioid Withdrawal in 2025

Many patients with hypertension have primary aldosteronism, but most at-risk patients are never tested. Learn who needs screening, how to order an ARR without unnecessary washouts, and why timely diagnosis prevents heart, vessel, and kidney damage. Based on “Things We Do For No Reason – Failing to Consider Primary Aldosteronism in Hypertension” (Journal of Hospital Medicine). Source: https://pubmed.ncbi.nlm.nih.gov/40113595/Subscribe to our Substack: https://rokeefemd.substack.com/

Today's quick admit episode is a rapid review on the evaluation of vertigo and dizziness in a hospital setting.Visit https://www.pointofcaremedicine.com/inpatient-admission/dizziness-and-vertigo to see the online admission template and follow along.Timestamps00:00 - Intro and Summary02:13 - Admission Checklist02:51 - HPI Intake06:54 - Focused Physical Exam09:06 - Differential Diagnosis09:49 - Initial Workup10:22 - TreatmentRelated ContentDizziness and Vertigo Clinical Review https://www.pointofcaremedicine.com/review-article/dizziness-and-vertigo12 Key Principles for Diagnosing and Managing Dizziness and Vertigo https://www.pointofcaremedicine.com/blog-post/12-key-principles-for-diagnosing-and-managing-vertigo-and-dizziness

Atrial Fibrillation: Clinical ReviewThis full-length clinical review episode on atrial fibrillations is designed to help take your fund of knowledge to the next level!Visit https://www.pointofcaremedicine.com/review-article/atrial-fibrillation to see the online Clinical Review Article.Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.Timestamps00:00 Introduction to Atrial Fibrillation00:12 Key Takeaways01:13 Definitions02:17 Etiologies04:22 Pathophysiology07:28: Physical Exam08:18 Diagnostic Workup10:25 Treatment - Stroke Prevention14:17 Treatment - Rate Control16:13 Treatment - Rhythm Control19:05 Treatment - Risk Modification20:10 Clinical Pearls29:54 Review of Clinical Trials34:11 Additional Resources and ConclusionShow NotesReview ArticlesAtrial Fibrillation A Review Direct Oral Anticoagulants in Patients with ESRD Catheter ablation for atrial fibrillation: indications and future perspective Related ContentAfib with RVR Admission Template20 Atrial Fibrillation Facts Every Physician Needs to Know in 202510 Key Facts About Ablation for Atrial FibrillationCKD and Atrial Fibrillation: Navigating the Anticoagulation MazeDisclaimer: The content of this video and any associated media is meant for educational and information purposes only. RMO Medical Education does not provide medical advice, diagnosis, or treatment.

This full-length episode on the inpatient management of acute pancreatitis includes not only the admission framework, but also key clinical pearls on the background, pathophysiology, etiologies, presentation, diagnosis, treatment, and complications associated with the disease to help take your understanding to the next level! Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode. Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia. Timestamps 00:00:00 - Background and Epidemiology 00:01:13 - A Note on Chronic Pancreatitis 00:01:31 - Admission Checklist 00:03:49 - HPI Intake 00:04:33 - Physical Exam 00:05:20 - Etiology and Differential 00:06:20 - Plan - Work Up 00:07:30 - Plan - Treatment 00:09:31 - If You Remember Nothing Else 00:10:04 - Pearls - Pathophysiology 00:11:15 - Pearls - Etiology and Risk Factors 00:12:56 - Pearls - Presentation and Diagnosis 00:15:56 - Pearls - Treatment 00:18:08 - Pearls – Complications Show Notes Reviews Acute Pancreatitis: A Review ⁠(JAMA, 2021)⁠ Acute Pancreatitis ⁠(NEJM, 2016) Trials WATERFALL Trial - Aggressive (20 ml/kg bolus + 3 ml/kg/hr) vs Non-Aggressive (10 ml/kg bolus + 1.5 ml/kg/hr) fluid resuscitation in acute pancreatitis - fluid overload resulted in 20.5% vs 6.3% of patients but no difference in the development of moderately severe or severe pancreatitis ⁠(NEJM, 2022) Other Literature Enteral versus parenteral nutrition for acute pancreatitis ⁠(Cochrane, 2010)⁠ A Critical Evaluation of Laboratory Tests in Acute Pancreatitis ⁠(Am J Gastroenterol, 2002) Blogs and Summaries Clinical Problem Solvers - Acute Pancreatitis Illness Script Internet Book of Critical Care - Pancreatitis Radiopaedia - Imaging Findings in Acute Pancreatitis Pathway Guidelines Summary - Acute Pancreatitis

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode. Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care without getting bogged down by unnecessary details or trivia. Timestamps 00:00:08 – Background 00:01:12 – Pathophysiology 00:01:55 – Admission Checklist 00:03:29 – HPI Intake 00:04:19 – To Note on Exam 00:04:58 – Plan: Workup 00:05:40 – Plan: Treatment 00:07:28 – If You Remember Nothing Else 00:08:28 – Pearls 00:10:43 – Literature Literature IWGDF/IDSA Guidelines on Diagnosis and Treatment of Diabetes-Related Foot Infections (Diabetes Metab Res Rev, 2023) Diabetic Foot Ulcers and Their Recurrence (NEJM, 2017) Diabetic Foot Ulcers: A Review (JAMA, 2023)