In this episode Dr. John Foote (University of Toronto’s CCFP(EM) residency program director) and Dr. Joel Yaphe (the director of the University of Toronto’s Annual Update in Emergency Medicine conference in Whistler), review 5 important presentations in the patient with cancer: fever, shortness of breath, altered mental status, back pain and acute renal failure; with specific attention to key cancer-related emergencies such as febrile neutropenia, hypercalcemia, superior vena cava syndrome, hyperviscosity syndrome and tumor lysis syndrome. Dr. Yaphe also presents his ‘Best Case Ever’, an iatrogenic disaster that you will never forget.

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This past February I helped organize, and spoke at, the Univeristy of Toronto’s 26th Annual Update in EM Conference in Whistler, British Columbia, and there were so may great talks with amazing clinical pearls that we decided to wade through the 18 hours of audio recordings and packaged some of the key highlights for you here……

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In this episode, Dr. Jordan Chenkin & Dr. Jamie Blicker discuss positioning, landmarking, and best technique for lumbar puncture, how to minimize post-LP headache and traumatic taps, as well as when CT head is not required prior to LP.  They discuss the indications, contraindications, trouble-shooting and pros and cons of needle aspiration, small bore pleural catheter with Heimlich valve and large bore chest tube for the treatment of spontaneous pneumothorax.  Dr. Chenkin presents an intriguing argument for why he uses ultrasound-guided fracture reduction routinely in the ED, and we end with a few tips and tricks using skin adhesive for some unorthodox indications. Listen to or download this episode »

In this episode dedicated to emergency procedures pearls and pitfalls, tips and tricks, Dr. Jordan Chenkin & Dr. Jamie Blicker take us step by step through how best to perform surgical airways and pericardiocentesis, as well as place central lines and intraosseous lines. They explain the various methods for surgical airways including the bougie-assisted surgical airway. They review the indications, contraindications, and complications for all of these life saving procedures, and give us some amazing tips and tricks on what to do when things aren’t going as expected.

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Dr. Andrew Arcand & Dr. Laura Tate discuss the key clinical pearls and pitfalls in the recognition and management of many apparently benign conditions that have serious morbidity, including high pressure injection injuries, flexor tenosynovitis, gamekeeper’s thumb, fight bites, hook of the hammate fractures and many more important hand emergencies.

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Dr. Anil Chopra & Dr. David Carr discuss the breadth of presentations and key diagnostic clues of Aortic Dissection. They review the value of ECG, CXR and biomarkers as well as compare and contrast the use of Transesophageal Echo and CTA in this sometime elusive diagnosis. Being the authors of the Tintanalli chapter on Occlusive Arterial Disease, they give as lots of clinical pearls and pitfalls when it comes to acute limb ischemia. We end with a discussion on the trials and tribulations of Compartment Syndrome.

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