In this episode Dr. David Dushenski & Dr. Ross Claybo discuss the very common presentation of vaginal bleeding in the first half of pregancy. They run through the key clinical pearls of the history, the physical, interpretation of the BhCG and the value of serum progesterone in working up these patients. The newest on bedside emergency department ultrasound is discussed and the key pitfalls of interpreting transvaginal ultrasound. The various types of spontaneous abortion including septic abortion are reviewed as well as the management of the unstable patient with massive vaginal hemorrhage. Ectopic pregnancy, in all it’s various presentations is reviewed with particular attention to the most common pitfalls and how to avoid them. We wrap it up with a mind-blowing case of Dr. Dushenski’s.

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In anticipation of Episode 23 on ‘Vaginal Bleeding in the First Half of Pregnancy’ with Dr. Ross Claybo and Dr. David Dushenski, we have Dr. Claybo’s Best Case Ever. In the upcoming episode we will…….

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In this bonus episode, our second instalment of the highlights from the 25th Annual Update in Emergency Medicine from Whistler B.C., we have Dr. David Carr updating us on infectious diseases, Dr. Dennis Scolnick giving us the low down on pediatric urological emergencies, Dr. Anil Chopra reviewing the pearls and pitfalls of managing shock states, and much more. Read the full details of this episode »

This past February I helped organize, and lectured at, the Univeristy of Toronto’s 25th 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 the key highlights for you here – for free!

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In this episode we have the triumphant return of Dr. Anil Chopra the author of past Tintinalli chapters on thromboembolic and arterial disease, and with him Dr. John Foote the CCFP(EM) residency program director at the University of Toronto. We kick it off with Dr. Foote’s key pearls in his approach to undifferentiated dyspnea and go on to discuss how best to develop a clinical pre-test probability for the diagnosis of pulmonary embolism using risk factors, the value of the PERC rule, Well’s criteria and how clinical gestalt plays into pre-test probability. Dr. Chopra tells about the appropriate use of D-dimer to improve our diagnostic accuracy without leading to over-investigation and unwarranted anticoagulation. We then discuss the value of V/Q scan in the workup of PE, and the pitfalls of CT angiography. A discussion of anticoagulation choices follows and the controvesies around thrombolysis for submassive PE are reviewed.

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In anticipation of Episode 21 on Respiratory Emergencies, Dr. John Foote the CCFP(EM) residency program director at the University of Toronto presents his Best Case Ever related to the dyspeic patient.

In the upcoming episde, Dr. Foote and Dr. Anil Chopra, the author of past Tintinalli chapters on thromboembolic and arterial disease discuss how to approach the patient with dyspnea and the pearls and controversies of pulmonary embolism. They discuss how best to develop a clinical pre-test probability for the diagnosis of pulmonary embolism using risk factors, some new evidence about the PERC rule, Well’s criteria and how clinical gestalt plays into pre-test probability. Dr. Chopra tells about the appropriate use of D-dimer to improve our diagnostic accuracy without leading to over-investigation and unwarranted anticoagulation, and how it can be used in pregnancy and in the elderly. We then discuss the value of V/Q scan in the workup of PE, and the pitfalls of CT angiography. A discussion of anticoagulation choices follows and the controvesies around thrombolysis for submassive PE are reviewed.

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