EM:RAP and AIR (Renal / GU) (August 2020)
AIR: https://aliemu.com/courses/renalgu2020/
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.
https://www.emrap.org/episode/emrap2019august/august
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 topic 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?
One comment
Three things I learned:
1. Pulmonary blebs can become so large that radiologists may be unable to differentiate them from pneumothoracies and that putting a chest tube in these patients can obviously be very bad. In the future, when there is any question I will be sure to use US to look for lung sliding before putting in a chest tube.
2. I knew about honey being a common cause of infant botulism, but was unaware of the ways in which construction, and earthquakes have been associated with botulism. I also did not know that the major presenting symptom in infant botulism is constipation.
3. When considering post surgical Chole patients representing I was unaware that dropped stones can often be radiopaque and not picked up on CT scan or US and may actually need an MRI for detection.
Practice Change:
I found it interesting that at the University of Maryland they use lupus, rheumatoid arthritis, HIV, chronic kidney disease, chronic cocaine use, alcoholism and hepatitis C as risk factors that count for the HEART score. I will be sure to take that in to consideration when risk stratifying my patients.
Bleeding Edge:
I think that these new case reports, and small studies associating Marijuana use with increased risk of MI and stroke, heart arrhythmia, especially atrial fibrillation are very interesting. I think that the data is not quite there especially when it comes to controlling for possibly impure Marijuana consumption as well as possibly higher levels of other substance use in these patients. I will definitely consider it when taking care of patients with cardiac presentations, but do not think the data is there yet to formally incorporate it into risk stratification.