Emergency Medical Minute

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Karen Prestia, MBA, Director, Marketing & Communications, Mental Health Center of Denver

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributors: Allison Miller, LCSW, LAC, Program Manager of Child and Family Outpatient Services, Mental Health Center of Denver, and Jon Roberts, LCSW, CAC II, Licensed Mental Health Therapist, Mental Health Center of Denver

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributors: Tracy Vozar, Ph. D., Director of the Infant and Early Childhood Mental Health Specialty,  and Jennifer M. Tippett, Psy. D., Director of the Substance Use Disorder Specialty, both at the University of Denver's Graduate School for Professional Psychology

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributors: Marion Rorke, MPH, Substance Use Resource Coordinator, City and County of Denver, and Maggie Kauffman, MPH, Health Equity Data Analyst, City and County of Denver, and Jean Finn, RN, Substance Misuse Manager, City and County of Denver

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributors: Lesley Brooks, MD, Chief Medical Officer, Sunrise Community Health Center; Medical Director – Quality, North Colorado Health Alliance, and Heather Ihrig, RN, CO-SLAW Program Director, North Colorado Health Alliance, and Meredith Silverstein, PhD, Sr. Research Associate, Butler Institute for Families, Graduate School...

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Khara Croswaite Brindle, MA, LPC, ACS, Croswaite Counseling, PLLC

From DU's 1st annual Colorado Behavioral Health and Wellness Summit: Contributor: Steven Wright, MD, Colorado Consortium for Prescription Drug Abuse Prevention

Contributor: John Winkler Educational Pearls: There is increasing resistance to antimalarial drugs, especially in P. falciparum . This trend started with chloroquine, but is now spreading to the other first-line drugs.  Resistant strains have been identified in Cambodia and Thailand 220 million people were infected last year The best treatment of malaria is prevention from bites - DEET and permeth...

Contributor: Jared Scott, MD Educational Pearls In a 4 yr period at 2 hospital systems, unprofessional behavior of surgeons was monitored via a complaint system. Number of complaints was compared with surgical complications.  In 13000 patients over this period, the number of surgical complications was found to vary with the number of complaints. Surgeons with  with zero complaints had a 10% compli...

Contributor: Dylan Luyten, MD Educational Pearls: Bag-valve masks (BVM) typically  have a port to connect O2 to. Unfortunately room air becomes entrained in the mask, reducing the FiO2 delivered to the patient. This can be overcome by using a PEEP (positive end-expiratory pressure) valve on the BMV  PEEP valves function by keeping alveoli open in the lungs at the end of expiration. This increases...

Lisa Raville and Dr. Josh Blum, two pioneers of harm reduction in Denver, discuss the addiction crisis, the current state of harm reduction and how it will evolve in the future.   Intro Music: Backbay Lounge Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/

Contributor: Erik Verzemnieks, MD Educational Pearls: Important to realize complications can occur in the post-opioid overdose patient regardless of cause Narcan administration has been associated with non-cardiogenic pulmonary edema, although the mechanism of this is not quite known Symptoms include progressive shortness of breath and hypoxia.  Treatment is with positive-pressure ventilation and...

Contributor: Jared Scott, MD Educational Pearls: Non-accidental trauma (NAT) to children is commonly missed by medical providers Try to remember TEN-4-FACES as a useful aide for concerning patterns that may reflect NAT: T orso, e ars, n eck and any bruising in child 4 months or longer F renulum, a ngle of the mandible, c heek, e yes, s clera References Pierce MC, Magana JN, Kaczor K, Lorenz DJ, Me...

Author: Don Stader, MD Educational Pearls: Suboxone, methadone, and naltrexone are commonly used as treatments for opiate use disorder.  Naltrexone is a full mu-opiate receptor antagonist, making acute pain control difficult in patients taking it.  Options for pain control in patients on naltrexone include nerve blocks, NSAIDS, ketamine, and high doses of opiates.  Of the opiates, Dilaudid (hydrom...

Author: John Winkler, MD Educational Pearls: The plague (black death) is caused by the Yersinia Pestis bacteria. This bacteria is spread by fleas and carried by rats. It is very contagious and only needs ~ 100 bacteria to cause an infection.  The pulmonary form presents with cough, fever, night sweats, hemoptysis and has a near 100% fatality rate if not treated in the first day of symptoms The bub...

Author: Don Stader, MD Educational Pearls: Abstinence from substances such as tobacco or alcohol are effective strategies to achieve long term sobriety However, abstinence is not an effective strategy for achieving sobriety with opiate use disorder (OUD) Up to 90% of those who use an abstinence-only strategy for OUD will relapse within a month.  Attending a rehabilitation facility increases mortal...

Author: Rachel Beham, PharmD Educational Pearls: There are currently many Ebola vaccines that are being studied, and one (recombinant VZV-Ebola vaccine) is currently being used in Africa. This vaccine has so far shown good efficacy in reducing Ebola infections and mortality from Ebola in those who do become infected.  There are antibody-based treatments that are currently under investigation for t...

Author: John Winkler, MD Educational Pearls: There is a new outbreak of Ebola in The Congo. This is likely due to civil war and rebel attacks on healthcare workers in the area.  Ebola is now spreading from the Congo into neighboring Uganda, but vaccination efforts are staving off the spread across the border  Early symptoms of Ebola are similar to the flu Spread occurs through close contact with b...

Contributor: Jared Scott, MD Educational Pearls: Sleep deprivation and disturbed sleep cycles increases the risk of many acute and chronic medical issues such as motor vehicle accidents, diabetes, cardiovascular disease, psychiatric disease,  and shift work sleep disorder (difficulty sleeping, fatigue, interference with daily activities) Stages of sleep  Stage 1: 5-10 minutes (light sleep, may not...

Contributor: Chris Holmes, MD Educational Pearls: In ancient Egypt, pregnant women would urinate over barley and wheat seeds to help determine the sex of thier fetus, as well as if they were pregnant. Amazingly, this has 70% accuracy (!!) for determining pregnancy (not sex). Piss Prophets in the middle ages would examine urine for changes in color to determine if a woman was pregnant or not.  In t...

Contributor: Nick Tsipis, MD Educational Pearls: Communication proves time and time again to be most helpful in preventing surprises after patient admission Frequent re-evaluations and repeat vital signs can be important to evaluating a patient's risk for deterioration once admitted as well as selecting the proper level of care at admission Broad categories of patients who most commonly have a cha...

On the first installment of this new series, Dr. Michael Hunt shares stories, lessons and advice as he reflects on his 35 year career as an emergency physician.   Intro Music: Backbay Lounge Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/

Contributor :  Don Stader, MD Educational Pearls: Seymour fracture is an eponym for a Salter-Harris I/II fracture of the distal phalanx of the finger or toe in children, associated with a nailbed inury These may present and subtle as a subungal hematoma with a fracture on x-ray but carry a significant risk of complications While in adults a hammer-finger deformity indicates an avulsion injury of t...

Contributor: Don Stader, MD Educational Pearls: Only 10% of patients receiving antibiotics for strep throat actually have the diesease Treatment of strep with antibiotics only slightly reduces the duration of illness. Most studies say the reduction is between 16 and 24 hours Antibiotic treatment may reduce complications such as peritonsilar abscess and otitis media but antibiotics also increase th...

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