EM Quick Hits 20 Imaging Renal Colic, Human Trafficking, Atrial Fibrillation During COVID, Transvenous Pacemaker Placement, COVID Lung POCUS, COVID Derm, Virtual Simulation

Emergency Medicine Cases - En podcast af Dr. Anton Helman - Tirsdage

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Topics in this EM Quick Hits podcast Justin Morgenstern on imaging in renal colic patients (0:31) Hanni Stoklosa on recognition and management of human trafficking (7:27) Rohit Mohindra on management of atrial fibrillation in the COVID era (20:21) Anand Swaminathan on transvenous pacemaker placement (24:48) Rob Simard on COVID-19 lung POCUS (32:07) Brit Long & Michael Gottlieb on COVID-19 dermatology (37:32) Sarah Foohey & Paul Koblic on virtual simulation (44:29) Podcast production and sound design by Anton Helman, voice editing by Sheza Qayyum Podcast content, written summary & blog post by Graham Mazereeuw, edited by Anton Helman Cite this podcast as: Helman, A. Swaminathan, A. Long, B. Gottlieb, M. Foohey, S. Koblic, P. Mohindra, R. Stoklosa, H. Simard, R. Morgenstern J. EM Quick Hits 20 - Imaging in Renal Colic, Human Trafficking, Atrial Fibrillation in COVID-19, Transvenous Pacemaker Placement, COVID-19 Lung POCUS, COVID-19 Dermatology, Virtual Simulation. Emergency Medicine Cases. June, 2020. https://emergencymedicinecases.com/em-quick-hits-20-june-2020/. Accessed [date]. Imaging in renal colic * Most cases do not require imaging * Clear-cut indications for imaging: * Worried about alternative diagnosis * Febrile or septic * Uncontrolled pain or urgent surgical intervention anticipated * CT renal colic is the gold standard. However, less than 5% detect a clinically important alternative diagnosis and most CT scans do not change management * POCUS is helpful: sensitivity is only 70%, specificity is 75% for all stones but POCUS is unlikely to miss large stones requiring surgical management Expand to view reference list * Moore CL, Carpenter CR, Heilbrun ME, et al. Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus. Ann Emerg Med. 2019;74(3):391-399. * Smith-Bindman R, Aubin C, Bailitz J, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med. 2014;371(12):1100-10. Human Trafficking * The ED is the front line for human trafficking: most trafficked persons access healthcare while being trafficked and they most commonly present to the ED * Definition: a crime involving the recruitment, transportation, harbouring and/ or exercising control, direction or influence over the movements of a person in order to exploit that person, typically through sexual exploitation or forced labour * Means of control can be force, fraud and/or coercion (psychological, financial, threats to person or family) * Trafficked persons present with a variety of chief complaints: suicidal ideation, substance use, and illnesses of poor living conditions are common * You have the skills to suspect that a person may be trafficked * Vulnerable groups * Under-regulated, underpaid industries * Migrant workers * Substance use/addiction (particularly opioids) * Individuals experiencing homelessness * Individuals supported through child welfare syste...