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CRACKCast & Physicians as Humans on CanadiEM

CRACKCast (Core Rosen's and Clinical Knowledge) helps residents to "Turn on their learn on" through podcasts that assist with exam prep by covering essential core content. Physicians as Humans explores the struggles that physicians face and how they have overcome them. From addictions, mental health issues, and all manner of personal crises will be discussed to help let those who are currently struggling know that they are not alone. CanadiEM aims to improve emergency care in Canada by building an online community of practice for healthcare practitioners and providing them with high quality, freely available educational resources.
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Now displaying: Page 3
Apr 24, 2017

This episode covers Chapter 72 of Rosen’s Emergency Medicine. All those pearls you need for ears, masses, nose bleeds and weird stones in weird places.

  1. Define Otitis Media
    1. Acute
    2. Chronic
    3. Recurrent
  2. Describe the diagnosis treatment of Otitis Media
  3. What are the complications of OM?
  4. Describe the diagnosis and tx of Otitis Externa
  5. Differentiate from malignant otitis externa
  6. What is Ramsay Hunt Syndrome? How is it Tx?
  7. Describe your approach to sudden hearing loss
    1. How is it treated?
  8. Name 10 causes of epistaxis
  9. Describe your approach to tx epistaxis
    1. Anterior bleeds
    2. Posterior bleeds
  10. What is the differential diagnosis of neck masses?
  11. What is SIALOLITHIASIS? How is it tx? 
Apr 20, 2017

This episode covers Chapter 71 of Rosen’s Emergency Medicine. For such a small organ, the eye has A LOT of things to cover. Here we finish up in everything you need to know about that juicy ball of potential badness.

  1. List 10 causes of ↓ vision post blunt eye trauma
  2. What historical features are concerning for intra-ocular foreign body?
  3. List 4 options for treatment of corneal abrasions
  4. Describe the management of traumatic hyphema
  5. What causes the finding of a ‘second pupil’ post-trauma?
  6. Describe the physical findings of globe rupture and describe management
  7. List 5 indications for ophtho consultation for eyelid lacerations
  8. Describe diagnosis and treatment for orbital floor fractures:
  9. List 2 findings on X-ray of orbital floor fracture
  10. List indications for surgical repair of orbital floor fracture
  11. Describe the clinical findings of retrobulbar hemorrhage and the steps in performing lateral canthotomy
  12. List 3 complications of ocular trauma
Apr 10, 2017

This episode covers Chapter 70 of Rosen’s Emergency Medicine.

 

  1. How are teeth traditionally numbered?
  2. Describe the classification and management of tooth fractures
  3. Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation?
  4. Explain Ludwig’s Angina and its management
  5. List 3 complications of maxillary (eg canine) tooth infection?
  6. Describe management of Dental Caries vs Periapical abscess
  7. Describe your approach to Acute Necrotising Ulcerative Gingivitis
    1. what is Vincent’s Angina?
    2. what is cancrum oris?
  8. Rapid Fire treatment for the following:
    1. Post root canal pain
    2. Cracked Tooth or Split root syndromes
    3. Maxillary Sinusitis
    4. Atypical Odontalgia
    5. Post extraction pain
    6. Neuropathic pain
    7. Temporomandibular Myofascial Pain Dysfunction Syndrome
    8. Pericoronitis
    9. Apthous Stomatitis


WiseCracks

  1. Spot diagnosis
Apr 3, 2017

This episode covers Chapter 69 of Rosen’s Emergency Medicine.

 

Sign Post:


1. List six types of elder abuse?
2. List ten risk factors for elder abuse?
3. List ten questions to screen for elder abuse?
4. What are some indicators on the medical history and physical exam that may suggest ongoing elder abuse?
5. Discuss ethical and legal implications of elder abuse. Who needs to be reported?

Mar 20, 2017

 

This episode covers Chapter 67 of Rosen’s Emergency Medicine. Its a heavy topic, but important to get right.

  • What precautions should be taken prior to engaging in potential sexual abuse cases?
  • What information can be useful in determining the location and likelihood of injury in sexual assault?
  • What is the prevalence of mental illness in sexual assault patients?  Which populations are found to have a higher proportion of mental illness?  What effect does mental illness have on the severity of the attack?
  • What factors make genital injury more likely to be observed?  Less likely?
  • What are the risks of STI's after sexual assault?
  • What are appropriate treatments for STI prophylaxis in cases of suspected sexual abuse/assault?
  • What resources exist to help medical providers and any victims of sexual abuse?
  • What differences should be considered with male victims of sexual assault?

 

------------------------------

Thank-you to Dr. Sampsel for her assistance with this episode!

Mar 6, 2017

This episode covers Chapter 65 of Rosen’s Emergency Medicine. Its a big intro into the next few chapters covering forensic medicine in the emergency department. Tighten up those boot straps, this stuff is heavy!

 

  1. What are some pearls and pitfalls for ER physicians when dealing with Forensic Emergency Medicine?  
  2. What are proper terms used to describe wound injury patterns?
  3. What’s the anatomy of a cartridge (bullet)? What are the types and important aspects of wound ballistics?
  4. What signs would you see for the various ranges of fire of a bullet?
  5. What are common red flags to alert you to the possibility of domestic violence? What risk factors make domestic violence more common?
  6. Describe the different types of blunt force pattern injuries and the pathophysiology of how they occur. Do the same for sharp force and thermal wounds.
  7. What does the Health Insurance Portability and Accountability Act permit a physician to disclose to the investigating law enforcement officer?
Feb 27, 2017

This episode covers Chapter 64 of Rosen’s Emergency Medicine. Worried about what to do with those patient's coming in with their skin melting off from a chemical exposure? We've got you covered.

 

1) Describe the difference between Alkali and Acid injuries

2) Describe a HAZMAT response on scene

3) Describe the decontamination of an individual

4) List PPE for first responders or caregivers


Wisecracks

-Name two acids that cause damage through liquefactive necrosis
-List Chemical Agents used in Warfare / Terrorism
-What chemicals should you NOT irrigate with water?

Feb 20, 2017

This episode of CRACKCast covers Rosen’s Chapter 63, Thermal Burns. These patients are often the sickest in the department and many are on their way to the ICU. There are life-saving interventions that are begun in the emergency department with significant impacts on morbidity and mortality, and many are discussed in this episode.

Signposts:

  1. List zones of burns
  2. List 6 indications for intubation in the burn patient
  3. List and describe 2 formulas for fluid resuscitation
  4. Describe depth classification for burn injuries
  5. List indicators of upper airway and lower airway burns
  6. What is the Rule of 9’s and how is it modified in pediatrics
  7. List criteria for transfer to burn unit
  8. Describe basic burn dressing management
  9. List 5 burn prevention strategies

Wisecracks:

  1. What are the indications for an escharotomy
  2. What are the primary considerations in mechanical ventilation of burn patients
Feb 13, 2017

This episode covers Chapter 62 of Rosen’s Emergency Medicine. Does leaving the comfort of your warm, safe bed scare you? After this chapter, it might...

Sign Post:

  1. List the 4 families of venomous snakes.
  2. Describe phenotypic characteristics of Pit-Vipers
  3. Describe phenotypic characteristics of coral snakes?
  4. List the grades of pit viper envenomation and indicate therapy?
  5. Describe a black-widow spider and expected management goals?
  6. Describe a brown recluse spider and expected management goals
  7. List 3 classes of venomous marine injuries, and describe key principles of management for each?

 

WiseCrack:

  • What does expert opinion suggest to avoid anaphylaxis in non-recombinant antivenin administration?
  • What is the most toxic, per weight, venom?
  • What are the general phenotypic features of poisonous snakes in North America?
Feb 6, 2017

This episode covers Chapter 61 of Rosen’s Emergency Medicine. Know anything about mammalian bites...? Yeah, neither did we until we read this chapter. Lots of juicy clinical pearls. 

 

  1. List 5 pathogens responsible for infection from Dog bite
  2. List 4 risk factors for overwhelming sepsis from dog bite
  3. What first line antibiotic is a good choice for cat and dog bites?
  4. What species are known to cause infection with Pasteurella multocida?
  5. What are the risk factors for infection with animal bites?
  6. Describe the treatment of Monkey Bites?
  7. When is anti-viral prophylaxis NOT indicated for a monkey bite
    1. What is the duration of therapy of antiviral prophylaxis?
  8. Describe the recommendations for wound closure and antibiotics in bite cases

 

Wisecracks:

  1. What about seal bites?
  2. What about rabies in BC?
  3. Waterhouse-Friderichsen syndrome & capnocytophagia-related Gangrene sepsis - what are they?
Jan 30, 2017

This episode of CRACKCast covers Rosen’s Chapter 60, Foreign Bodies. This episode covers an approach to foreign bodies, including location specific tips, complications and safe removal in the ED.

  1. Describe your approach to Ocular FB
  2. What is Seidel Sign?
  3. List indirect signs of FB on Xray
  4. List complications of ear FB
  5. Describe the process of anesthesia of the ear and preparation for FB removal
  6. Describe 5 techniques for removal of FB from ear
  7. Describe the management of TM perforation secondary to FB
  8. Describe 5 techniques for removal of FB from nose
  9. Describe a step-wise approach to pediatric FB airway obstruction
  10. List 7 symptoms of Esophageal FB
  11. List 8 complications of esophageal FB
  12. List 4 complications specific to button battery ingestions
  13. List indications for removal of esophageal FBs
  14. List 4 removal techniques of esophageal FB
  15. List 5 techniques for management of food bolus and their mechanism of action
  16. List the criteria for continued expectant management for intestinal FB
  17. Describe the stepwise management of a Rectal FB

 

Wisecracks:

  1. What is the safe dose of topical anesthetics?
  2. How do you test the radiolucency of an object?
  3. What is a Cafe Coronary? What is Penetration Syndrome?
  4. Differentiate Body stuffing from Body Packing
Jan 27, 2017

In the third episode of the Physicians as Humans project, I corresponded with a Canadian emergency physician who sent me her personal account of depression.  The result is this beautiful, thoughtful story that she has graciously allowed me to read for the podcast.

This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact velmurug@ualberta.ca.

Music for Episode 02 (All songs have been modified for the project)

  1. ambient by strange day. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
  2. Cease by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
  3. I Dunno by Grapes. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
  4. Lost Within by A Himitsu. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license.
  5. Moon by LEMMiNO. Music provided by Music for Creators under a Creative Commons Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 license.
  6. Tomorrow by Bensound
  7. Laws of Movement by The Passion HiFi. www.thepassionhifi.com
Jan 23, 2017

This episode of CRACKCast covers Rosen’s Chapter 59, Wound Management Principles. This episode covers the nitty-gritty details of wound management and what you need to know to get that perfect wound closure!

 

Questions:

1) List risk factors for wound infection
2) List the 5 stages of wound healing
3) List toxic doses of local anesthetics
4) 3 types of wound closure?
5) List advantages of and contraindications of tissue adhesives
6) List indications for tetanus immune prophylaxis
7) List 5 specific wound care instructions
8) List 7 situations where antibiotic prophylaxis is indicated in wound management

 

WiseCracks:

Evidence guided tips for scar healing?

How to decrease pain of anaesthetic injection?

Where can I find a concise guide to Suture material use?

Jan 16, 2017

This episode covers Chapter 58 of Rosen’s Emergency Medicine: Orthopaedic Ankle and Foot injuries. Its a gooder for sure.

 

  1. Describe the bones of the foot and important joints/ligaments
  2. List Ankle stress tests
  3. Describe an approach to ankle x rays (including the Ottawa ankle rules)
  4. Describe the Weber classification
  5. List indications for ortho referral in the ER
  6. Describe the management of Achilles and Tibialis posterior tendon ruptures
  7. Describe the Hawkin’s classification of talar neck fractures
  8. Describe the diagnosis and management of calcaneal fractures and list 3 injuries associated with calcaneal fractures
  9. Describe the anatomy and classification of lisfranc injuries
  10. Describe the management of metatarsal shaft fractures.
  11. List 6 predisposing conditions for stress fractures
  12. List 4 causes each of hindfoot pain and forefoot pain
  13. Differentiate between Jones and Dancer’s fracture
  14. Describe 4 plain-film radiographic abnormalities for stress fracture
  15. Describe the Tillaux fracture and pathophysiology


Wisecracks:

  1. Discuss soft tissue injuries of the ankle
  2. Name 6 other mimics of the “ it's just an ankle sprain” 
Jan 9, 2017

This episode covers Chapter 57 of Rosen’s Emergency Medicine.

 

1) List contents of popliteal fossa

2) Describe Ottawa knee Rule

3) Describe Schatzker classification for tibial plateaus fractures

4) Describe the Insall-Salvati ratio

5) Describe the management of a knee dislocation

6) Describe the management and classification of patellar fracture and dislocation

7) List 6 overuse syndromes

8) Describe the sensory and motor function of nerves of the lower extremity

9) Describe the 4 compartments of the lower leg and their contents

10) Describe the management of Tibial tubercle fractures and Osgood-Schlatter Disease

11) List 4 complications of tibial shaft fractures

12) Describe the management of proximal fibula fractures

 

Wisecracks

 

  • What is a Baker’s cyst and how is it managed?
  • What are extensor mechanism injuries in the knee?
  • DDx of acute onset calf pain?

 

 

Jan 2, 2017

This episode covers Chapter 56 of Rosen’s Emergency Medicine.

1) List 3 compartments of leg and contents

2) List 8 causes of AVN (traumatic and atraumatic)

3) List 5 most common primary cancers metastatic to bone

4) List 15 causes of hip pain without an obvious hip fracture

5) List 3 techniques for reduction of the hip

6) Describe 4 types of hip dislocation.

Wisecracks

  1. Pediatric hip/femur pathology?
  2. Hip dislocations
  3. Classification of femur fractures
  4. 6 causes of a child with a limp
Dec 26, 2016

This episode covers Chapter 55 of Rosen’s Emergency Medicine.

 

1) Describe common pelvic fractures and their classification

     A)Young-Burgess classification

     B)Tile classification

     C)Denis classification

2) List 3 categories of complications of pelvic fractures

3) Describe the approach and management of hemodynamically unstable pelvic fracture.

4) List 5 radiographic cues to posterior arch fractures

5) What is the management of penetrating pelvic trauma

 

Wisecracks:

1) How are open pelvic fractures diagnosed and managed?

2) What is the classification of acetabular fractures?

3) How are coccygeal fractures managed?

Dec 19, 2016

This episode covers Chapter 54 of Rosen’s Emergency Medicine. 

1) Describe the myotomes and dermatomes L3-S1

2) List 4 Red Flag Diagnoses with associated RFs, Hx, PEX findings

3) Describe SLR, crossed-SLR, flip-test, reverse SLR and their implications

4) List 5 indications for Xray in low back pain

5) Discuss the discrimination of functional from organic back pain

6) Describe the management of:

a. Fracture

b. Cauda Equina Syndrome

c. Spinal Infection

d. Vertebral Malignancy

e. Simple Radiculopathy

7) List 8 DDx for Thoracic back pain


Wisecracks:
Backpain treatment cocktails?
When to order the CT scan?
How to estimate the amount of post-void residual volume with ultrasound?

 

Dec 5, 2016

This episode covers Chapter 52 of Rosen's Emergency Medicine. 

  1. Describe an approach to the pediatric elbow
  2. Classify supracondylar fractures in children
  3. List 3 complications of supracondylar fractures
  4. Describe the management of supracondylar fractures
  5. Describe the management of humeral shaft fractures – displaced and non-displaced
  6. Describe 3 injuries common in Little-leaguer's elbow
  7. Describe the management and classification of radial head fractures
  8. Describe the expected neurovascular injuries and management of posterior elbow dislocations
  9. List the indications for x-ray in radial head subluxation
  10. Describe the management of olecranon bursitis

 

Nov 28, 2016

This episode covers Chapter 51 of Rosen’s Emergency Medicine. 

1) Describe normal radiographic relationships:

  1. Radial length measurement
  2. Radial inclination
  3. Volar Tilt
  4. Scapholunate angle
  5. Capitolunate angle
  6. Wrist arcs

2) Describe xray findings and management of

  1. Scaphoid fracture
  2. Lunate fracture
  3. Triquetral fracture
3) Describe Mayfield’s stages of carpal instability

4) Describe DISI and VISI

5) Describe xray findings and management of

  1. Colles’
  2. Smith’s
  3. Barton’s
  4. Hutchinson’s / Chauffer’s
  5. DRUJ Disruption
6) Describe management of pediatric
  1. Forearm fractures
  2. Torus fractures
  3. Greenstick fractures

7) List 8 RFs for Carpal Tunnel Syndrome + Describe 2 tests for CTS

8) Describe the Monteggia and Galeazzi’s fracture patterns

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