Out of hospital cardiac arrest management has become increasingly complex and consequently so has the role of the online medical control physician. This session will briefly review the latest science on out of hospital cardiac arrest. I will use actual online medical control calls to help the audience learn the science and best practices for managing an out of hospital cardiac arrest from the EMS radio. The main points covered include 1) When to transport? Work patient on scene versus expedited transport. 2) When to terminate? Termination of resuscitation science including how to incorporate ETCO2 into the TOR rules. Recorded on Monday, April 24, 2023.

Clinically, the patient has all the signs of an acute MI - except for one thing: a diagnostic ECG. What am I not seeing? Is there something else I should be looking for?During the last 10 years, we have discovered that many "non-STEMIs" were actually complete coronary artery occlusions. But the patient was incorrectly categorized and failed to receive optimal management. Three different presentations of acute coronary occlusions will be presented and the skills to recognize these difficult presentations will be defined and addressed in detail. This will include discussion of the newly recognized Aslanger pattern, the “South African Flag Sign” (isolated occlusion of the first diagonal branch) and an early STEMI presenting as ST depression. Recorded on Monday, April 24, 2023.

As more patients are living longer with more severe heart failure, the phenomenon of electrical storm will likely become a more common presentation to the ED. We will discuss the recognition, etiologies and management options of electrical storm in the Emergency Department. Recorded on Monday, April 24, 2023.

Your patient has acute pulmonary edema but no history of heart failure, has a normal ejection fraction on your echo, and is not responding to your usual interventions. Should we let the intensivist and cardiologist figure it out the next day? No! Critical aortic stenosis has a high mortality rate and is often missed in the Emergency Department. Learn how to diagnose this valvulopathy on your bedside echo and how to manage these critically ill patients. Identify and stabilize these patients early, then call your cardiothoracic surgeon. Recorded on Monday, April 24, 2023.

It's easy to get buried in the avalanche of new emergency cardiology literature that gets published every week in cardiology. Which of the articles are relevant to emergency physicians rather than cardiologists? Which articles should change your practice? The speaker has sorted through the literature for you and will discuss the handful of articles from the past year that are critical to your emergency medicine practice, the articles that "you've got to know!” Recorded on Saturday, April 22, 2023.

This session will focus on a review of the LVAD, its two basic sub-types, evaluation and assessment of the LVAD patient, and the management of the range of clinical presentations typical of these patients in the ED. We will review and understand the "normal" presentation of the LVAD patient. We will then review the range of presentations typical of the LVAD ED patient, including [1] stable hemodynamics with potential LVAD malfunction, [2] unstable hemodynamics with potential LVAD malfunction. [3] unstable patient with normal LVAD function, and [4] cardiac arrest. Management approaches for each of these scenarios will be presented. Recorded on Sunday, April 23, 2023.

Let's get you home! ADPs and single troponins in the ED. Recorded onTuesday, April 25, 2023.

I will present approximately 15 articles that are potentially practice changing and/or highly clinically relevant from the prehospital literature focusing on those that affect both prehospital and In-ED care. Recorded on Sunday, April 23, 2023.

Each year, new medications are created that are useful in the management of patients with diseases. Additionally, there are new indications for old medications discovered that lead to better outcomes. The speaker will discuss some of these new drugs and new indications that have implications for patients with cardiovascular disease and how useful they can be in the hands of emergency physicians. Recorded on Saturday, April 22, 2023.

During you last cardiac arrest patient, did you fumble around with the ultrasound machine unsure how to implement it into your ACLS guidelines? Learn a stepwise approach to incorporate basic and advanced ultrasound skills during your next code. We will cover topics including using ultrasound to assess hand-placement in CPR, diagnose reversible causes, and differentiate Pseudo-PEA from PEA from Fine Ventricular Fibrillation. In this lecture, you will learn how to effectively incorporate ultrasound into your ACLS algorithm. Recorded on Sunday, April 23, 2023.

Deciding who - and how - to work up for pulmonary embolism in the ED can be confusing. This discussion reviews the recent literature regarding the use of the PERC rule, the YEARS algorithm, and the age-adjusted d-dimer and how these strategies can be used to safely evaluate our patients while decreasing the need for CT imaging in the ED. We will also talk about strategies for anticoagulation - what drug do you pick for the patient who's going home, and what do you pick for the patient you're admitting? Recorded on Monday, April 24, 2023.

Congratulations! You have ROSC! Well, had it… Learn how to prevent the cyclic ROSC-arrest-ROSC-arrest dilemma with a step-by-step approach to management immediately after achieving ROSC from EM intensivists who bring to you the continuum of post-arrest care. Learn to think ahead to that next possible arrest and adjust when the pressures swing and the mental status sways. Go from ROSC to hemodynamically stable like a pro and get your patient ready for transport or transfer. What medications should you start? What lines should you have? What predicts safe transfer to another facility? Come find out! Recorded on Sunday, April 23, 2023.

As Gloria Estefan would say, “The rhythm is gonna get ya!” Children presenting in an abnormal rhythm can cause palpitations for everyone involved. In a crisis, you can always fall back on PALS/ACLS since algorithms are for doing and not thinking. This session will help you recognize and stabilize rhythm pediatric rhythm disturbances. It will also provide clinical pearls for the “oh no’s” and contingency plans for when all else fails. Recorded on Sunday, April 23, 2023.

Norepinephrine: what isn’t it good for? But what happens when it doesn’t work? When it's not enough? How about the starting order: norepinephrine, then vasopressin, then epinephrine? Dobutamine? Calcium? Bicarbonate? Heard of methylene blue or angiotensin II? Learn when and why certain medications do and don't work in certain circumstances. It's all the situations you hope you don't see on shift, all in one heart-pounding session. This session will cover practical advice from EM intensivists about pulling out of the blood pressure nose dive in refractory shock. BYOB (bring your own bicarb). Recorded on Sunday, April 23, 2023.

It's V Fib!Seeing ventricular fibrillation on the monitor during a pulse check in a cardiac arrest is reason to celebrate and shock, hoping that ROSC is within reach.But what happens when your POCUS views of the heart show fibrillation and your monitor does not?This session will efficiently break down the data that exists and help you make sense of who is fibbing and what to do. Recorded on Monday, April 24, 2023.

An EKG slides across your desk. You take a glimpse and sign it. Then another. Then another. But, wait! This one is a pediatric EKG. Still just taking a glimpse? This session will start with an easy and memorable approach to interpreting a pediatric EKG, then highlight EKG patterns that need to be rapidly recognized by the EM physician. Recorded on Tuesday, April 30, 2024.

The talk will focus on the acute Aortic dissection pathway from the point of diagnosis through clinical decision making and treatment. It will provide an insight into the current challenges, highlight best practices and outline the the key principles and actions to improve care for Emergency Acute Aortic dissection patients The talk will commence with two real life cases of missed Acute aortic dissection in young patients and will walk through in detail the key management principles to identify and treat these patients in a timely manner. Recorded on Tuesday, April 30, 2024.

This is what every emergency physician trains for: saving a cardiac arrest patient from the jaws of death. But what should your priorities be when your arrest gets pulses back? With the ever evolving post-ROSC literature, should you spend your time cooling the patient, arguing with the cath attending to get them to the lab, or pushing the radiologist to get them through the donut of truth? What's the right pressor to improve their outcome? How can you start the neuroprognostication process in the department? Dr. Duncan will take you on a tour of the latest evidence based practices and plethora of literature around the Post ROSC patient. Recorded on Sunday, April 28, 2024.

It is easy to get buried in the avalanche of new emergency cardiology literature that gets published every week in cardiology. Which of the articles are relevant to emergency physicians rather than cardiologists? Which articles should change your practice? The speaker has sorted through the literature for you and will discuss the handful of articles from the past year that are critical to your emergency medicine practice, the articles that "you've got to know!” Recorded on Sunday, April 28, 2024.

This lecture will examine the current evidence regarding the use of vasopressors versus high dose insulin euglycemic therapy for the treatment of beta blocker and calcium channel blocker toxicity, a topic which is often quite contentious in toxicology and emergency medicine circles. Recorded on Sunday, April 28, 2024.

Chest pain! ECG! No brainer! The ED Physician most notably orders and interprets the ECG in the evaluation of patients with suspected life-threatening cardiac pathology, namely STEMI. There are several scenarios in which the ECG may be used as a primary diagnostic tool for non-myocardial infarction medical conditions, including but not limited to, metabolic disorders, drug toxicity, syncope, and complications of valvular disease. This presentation will evaluate clinical scenarios in which the diagnosis was actually “buried in the ECG”. Recorded on Sunday, April 28, 2024.

This lecture is comprised of two parts: the first part provides clear guidelines to categorize a pulmonary embolism ranging from low risk to massive. The second part uses this categorization to discuss appropriate and cutting-edge management options. Recorded on Tuesday, April 30, 2024.

Is there a difference between acute heart failure and cardiogenic shock? How do I assess for either condition? Anything new in how I manage either patient? Isn't it just furosemide with dobutamine or epinephrine anyways? This session will help you differentiate between acute heart failure and cardiogenic shock. We will also discuss new treatment options and recent management guidelines. After this session, you will be equipped with an approach to choosing the right treatment for a patient with the delicate heart. Recorded on Tuesday, April 30, 2024.

Wide complex tachycardias (WCT) are often a conundrum for emergency physicians. The diagnosis is very difficult to differentiate between benign diagnoses and more serious ones. This leads to management conundrums as well. During this lecture, the speaker will discuss some things to look for to help differentiate the more serious from the more benign. The speaker will also discuss management options for patients with WCT to help avoid a bad outcome. Recorded on Wednesday, May 1, 2024.

The number of critically ill patients that present to EDs across the world continues to increase. In addition to seeing more critically ill patients, emergency physicians are frequently tasked with providing critical care long beyond the initial resuscitation. Prolonged boarding of critically ill patients is associated with numerous adverse events and increased morbidity and mortality. Given the continued increase in quantity of critically ill patients along with the persistence of boarding critically ill patients, it is imperative for the EP to be knowledgeable about recent literature in resuscitation and critical care medicine, so that critically ill patients continue to receive current evidence-based care. The speakers will highlight important articles from the 2023-2024 literature that pertain to the resuscitation and management of select critically ill patients. Recorded on Sunday, April 28, 2024.

This session will be part two of the three part series where the same patient that initially presented to the community hospital with a failing RV in the backdrop of chronic pulmonary hypertension has now been safely transferred to the academic medical center. EM-CCM physicians will now roleplay and troubleshoot pragmatic, bedside challenges for the care of these patients in an academic setting where there is a relative abundance of resources and specialists. Challenges around airway management, procedures and even cardiac arrest will be discussed and an evidence based care algorithm that can be readily deployed for the care of these patients in the ED will be presented. Recorded on Monday, April 29, 2024.

EMS gives you a notification that a critically ill LVAD patient is arriving. What are you going to do if they have no pulse? Can I do chest compressions? How do I figure out the blinking yellow and red signs on the LVAD controller? Do the LVAD warning, alarms help me troubleshoot my patient's problems in any way? Come walk through a case of a stable and unstable LVAD patient and develop a systematic approach to stabilize, assess, manage and treat two LVAD patients. Afterwards, you might feel like a pro and say I can handle the next LVAD patient. Recorded on Tuesday, April 30, 2024.

Come along on this three-part galactic ultrasound adventure where the first part of the saga, "A New Fraction" will help simply ejection fraction into four broad categories. In the second episode, "The Fluid Strikes Back", we'll cover multiple non-invasive methods to accurately assess a patient's volume status to better assist the emergency physician on deciding when to administer IV fluids. In the final episode, "Return of the Function", we'll review quickly and accurately obtaining an apical four chamber to better left and right heart strain so the emergency physician can make important treatment decisions even faster. Recorded on Wednesday, May 1, 2024.