EMRAP and AIR Respiratory (March 2020)
AIR: https://www.aliemu.com/courses/respiratory-2019/
EM:RAP for Asynchronous Learning! For credit, first, listen to the entire podcast. Your participation in the discussion board here is your attestation that you have listened and engaged with the content in a meaningful way.
EM:RAP: https://www.emrap.org/episode/emrap2020march/poolside
When you have finished listening to the podcast, answer the following questions:
1. Please list three things you learned from this podcast that you were not aware of before.
2. Are there any areas of your practice that you would change after listening to this podcast? If so, what would you do differently?
3. What topics mentioned in this podcast is considered too “bleeding edge” (ex. too new, lacks enough evidence, not ready for prime time). Are there any practices mentioned in this podcast that you would consider to not be applicable to our practice setting here at BMC?
2 comments
Please list three things you learned from this podcast that you were not aware of before.
When performing CPR in the field for drowning patients, 1) Focus on crowd control 2) Emphasize oxygenation first since most of these arrests are due to hypoxia. 3) Expect a large amount of liquid/foam/emesis to come out of the patient’s mouth as you do compressions.
Are there any areas of your practice that you would change after listening to this podcast? If so, what would you do differently?
From now when I contact consultants I will make sure to not only document who I spoke with, what time we spoke but also outline the key points of the discussion.
What topics mentioned in this podcast is considered too “bleeding edge” (ex. too new, lacks enough evidence, not ready for prime time).
Are there any practices mentioned in this podcast that you would consider to not be applicable to our practice setting here at BMC?
I enjoyed learning about acute mountain sickness, High Altitude Cerebral Edema and High Altitude Pulmonary Edema but I don’t anticipate we will have patients presenting with these diagnoses at BMC.
1. The acute mountain sickness segments were really interesting. I didn’t know that diagnosis required headache + at least one other symptom. I was also completely unaware that there was a severity score for grading (don’t recall seeing that in a textbook or seeing mention of it on Rosh doing practice questions). I also learned that by calling a consultant, even for “informal” advice, that may be establishing a patient-physician relationship between them and the patient if they are the on-call doctor. Additionally, the segment on calcium channel blocker overdose was really interesting. Hearing about high dose insulin reminds me of cases I’ve seen at other hospitals where nursing refuses to give doses “that high”, but now it seems to be more widely understood as the correct practice when indicated. I hadn’t thought about pressors for patients refractory to high-dose insulin, but I’m glad that they recommend starting with norepi because that keeps things as simple as possible across pathologies. A fourth thing I learned (bonus points?!) was about the different types of apophysitis. I have heard that term many times in the past (usually relating to Osgood-Schlatter or Sever’s disease), but never really stopped to think what that term meant or anything particular to the pathophysiology or management. Great segment!
2. As I prepare to enter into independent practice, I will definitely be more mindful about engaging consultants and how to document those conversations.
3. Like many of the previous months, the topic this month (cardioversion of a-fib in the ED) that I think is not ready for primetime is due to the fact that it involves care from multiple disciplines and these types of things have to be coordinated between departments in advance.