Episodes

  • Episode 13: Diplopia
    Jul 24 2024

    A patient walks into the Emergency Department with a complaint of Diplopia. "I'm seeing Double".
    How do you approach this situation?
    What are the causes?
    How do we tell the difference between Monocular and Binocular?
    Here are 5 things I do.

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    9 mins
  • Episode 12: Guillain Barre Syndrome
    Feb 23 2024

    This is a low frequency High stakes Disease we cannot miss.

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    12 mins
  • Episode 11: Do steroids decrease mortality in severe community acquired pneumonia
    Feb 15 2024

    Here is a controversial paper with mortality findings very different to what has been published before.
    The Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial, was a double-blind, randomised, controlled, superiority trial, conducted in 31 French ICUs.
    Intravenous hydrocortisone, 200mg, was given within 24 hours of onset of severity criteria (median time < 15 hours). The results were very different to the previous study conducted in 42 ICU centres.

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    8 mins
  • Episode 10: Does using a small volume BVM affect ROSC?
    Feb 15 2024

    Airway in Cardiac Arrest is still a bit of a mystery. We don't really know if we should intubate early. Contrary to prior studies showing no benefit of intubation over BVM or SGA, new evidence may be pointing in a different direction. We don't know the correct rate of breaths or volume of breaths or FiO2. Small animal studies and 'expert' opinion restrict our delivery of breaths to a maximum of 10 per minute and the volume of each breath to about 500 mL. 

    This has resulted in some centres now using paediatric BVMs for adult resuscitation. Do these work? Previous studies may have shown no inferiority, but here is a new study, that suggests that traditional BVMs may be better.

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    9 mins
  • Episode 9: The EM Show Podcast: What it's all about.
    Jan 5 2024

    The Clinical Cases Podcast, also called The EM Show. Coming to EM Mastery Soon

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    1 min
  • Episode 8: Atrial Flutter with a High degree Block
    Dec 6 2023

    A patient presents feeling dizzy when standing. His ECG shows he is in Atrial Flutter with a variable block. The block is significant. In some places it is 8:1. His blood pressure is 130 mmHg systolic. He is normally on Diltiazem. What should we do?

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    10 mins
  • Episode 7: Cases in Shock: Choosing Inotropes and vasopressors.
    Nov 29 2023

    How do you approach the patient in shock? Septic shock, Cardiogenic Shock, shock due to a massive pulmonary embolism?
    There is no perfect drug, however Noradrenaline may be as perfect as it gets.

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    15 mins
  • Episode 6: Hypertensive Emergencies
    Nov 21 2023

    Is there such an entity as a Hypertensive Urgency? Probably not. Hypertensive Emergencies are a Clinical Diagnosis as they involve end-organ damage.
    Apart from Aortic Dissection and preeclampsia, we shouldn't decrease systolic Blood pressure by more than 20-25% in the first hour. What STEMI, or ICH, or stroke?What is the best medication to use? We look at that in this episode, taken from a lecture I gave in 2023.

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    18 mins