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Explorez tous les épisodes du podcast The Podcasts of the Royal New Zealand College of Urgent Care

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The Night Before - An Ode to Urgent Care24 Dec 202400:03:32

If you are working in urgent care over the holiday period, thank you.

 

 

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This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor

A Christmas Bite - Myocardial Infarction at Christmas20 Dec 202400:05:59

While the Christmas period is supposed to be a happy holiday for all, there are many increased stressors at this time of year.  These papers give food for thought for the season.  

 

Mohammad MA, Karlsson S, Haddad J, Cederberg B, Jernberg T, Lindahl B, Fröbert O, Koul S, Erlinge D. Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 199 8-2013. BMJ. 2018 Dec 12;363:k4811. doi: 10.1136/bmj.k4811. PMID: 30541902; PMCID: PMC6289164.  Link to paper

 

Olsson A, Thorén I, Mohammad MA, Rylance R, Platonov PG, Sparv D, Erlinge D. Christmas holiday triggers of myocardial infarction. Scand Cardiovasc J. 2021 Dec;55(6):340-344. doi: 10.1080/14017431.2021.1983638. Epub 2021 Sep 29. PMID: 34585998.  - Link to paper

 

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Music licensed from www.premiumbeat.com

Christmas Elves by - Francesco D'Andrea

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor

Urgent Bite 235 - Tendon injuries around the Patella18 Oct 202400:15:11

What should you look for in quadriceps tendon and patella tendon ruptures?

 

Check out the Orthobullets pages

Patella Tendon by Ben Sharareh MD - https://www.orthobullets.com/knee-and-sports/3024/patellar-tendon-rupture

Quadriceps Tenson by Jason McKean MD - https://www.orthobullets.com/knee-and-sports/3023/quadriceps-tendon-rupture 

 

Check out the video by Loz and Liz discussing the injury which is mentioned in the podcast - https://www.youtube.com/watch?v=Qwbni5qEPr8 

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 234 - The Felon11 Oct 202400:12:33

What is a Felon and what should we do about it?

 

Check out the papers and pages mentioned.

Nardi NM, McDonald EJ, Syed HA, et al. Felon. [Updated 2024 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430933/ 

Orthobullets page by Leah Ahn MD

Koshy JC, Bell B. Hand Infections. J Hand Surg Am. 2019 Jan;44(1):46-54. doi: 10.1016/j.jhsa.2018.05.027. Epub 2018 Jul 14. PMID: 30017648.

Clark DC. Common acute hand infections. Am Fam Physician. 2003 Dec 1;68(11):2167-76. PMID: 14677662. https://pubmed.ncbi.nlm.nih.gov/14677662/ 

Tannan SC, Deal DN. Diagnosis and management of the acute felon: evidence-based review. J Hand Surg Am. 2012 Dec;37(12):2603-4. doi: 10.1016/j.jhsa.2012.08.002. PMID: 23174075.

Proegler C. The Panaritium (Felon)-Consequences and Treatment. Chic Med J. 1872 Nov;29(11):656-660. PMID: 37413177; PMCID: PMC9802920. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9802920/ 

Billroth T. Panaritium. Atlanta Med Surg J (1884). 1884 Mar;1(1):35-37. PMID: 35827592; PMCID: PMC8925372.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8925372/ 

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 233 - Thoracic Aneurysm considerations04 Oct 202400:12:02

Some important considerations when working up chest pain that will make us think of a thoracic aneurysm.  

 

Check out the paper mentioned

Habib M, Lindström D, Lilly JB, D'Oria M, Wanhainen A, Khashram M, Dean A, Mani K. Descending thoracic aortic emergencies: Past, present, and future. Semin Vasc Surg. 2023 Jun;36(2):139-149. doi: 10.1053/j.semvascsurg.2023.04.009. Epub 2023 Apr 30. PMID: 37330228.

 

Check out the MDCalc page for ADDRS

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 232 - Kehr's Sign27 Sep 202400:08:10

What is Kehr's sign?  

 

Check out the paper mentioned

Rastogi V, Singh D, Tekiner H, Ye F, Mazza JJ, Yale SH. Abdominal Physical Signs of Inspection and Medical Eponyms. Clin Med Res. 2019 Dec;17(3-4):115-126. doi: 10.3121/cmr.2019.1420. Epub 2019 Jul 15. PMID: 31308022; PMCID: PMC6886890.  

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 231 - Drug induced tendinopathy20 Sep 202400:12:36

Drug-induced tendinopathy can occur early, and late in a person's usage.  So we must consider a patient's medication history closely whenever they have symptoms of tendinopathy or rupture.   

 

Check out the September 2024 Prescriber update, Vol 5, No 3.

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 230 - Dry Socket13 Sep 202400:07:12

Dry socket might present to urgent care.  What is it and what should we do about it?

 

Check out the papers mentioned

Chemaly D. How do I manage a patient with dry socket? J Can Dent Assoc. 2013;79:d54. PMID: 23763736.  https://pubmed.ncbi.nlm.nih.gov/23763736/ 

Mamoun J. Dry Socket Etiology, Diagnosis, and Clinical Treatment Techniques. J Korean Assoc Oral Maxillofac Surg. 2018 Apr;44(2):52-58. doi: 10.5125/jkaoms.2018.44.2.52. Epub 2018 Apr 25. PMID: 29732309; PMCID: PMC5932271.

https://pubmed.ncbi.nlm.nih.gov/29732309/ 

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

 

 

 

Urgent Bite 229 - Listening to the Caddy06 Sep 202400:14:33

A caddy offers words of wisdom to their golfer.  Some of their advice is relevant to urgent care.  

 

Check out the paper mentioned

Gotlieb R, Praska C, Hendrickson MA, Marmet J, Charpentier V, Hause E, Allen KA, Lunos S, Pitt MB. Accuracy in Patient Understanding of Common Medical Phrases. JAMA Netw Open. 2022 Nov 1;5(11):e2242972. doi: 10.1001/jamanetworkopen.2022.42972. PMID: 36449293; PMCID: PMC9713608.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713608/ 

 

Check out the LITFL article, by Chris Nickson, Nov 2020 

https://litfl.com/communication-in-a-crisis/ 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 228 - Thinking about the Sail Sign30 Aug 202400:08:12

We always look for the sail sign when reviewing radiographs of the elbow, but how often are they associated with occult fractures?

 

Check out the papers mentioned

Skaggs DL, Mirzayan R. The posterior fat pad sign in association with occult fracture of the elbow in children. J Bone Joint Surg Am. 1999 Oct;81(10):1429-33. doi: 10.2106/00004623-199910000-00007. PMID: 10535592.

https://pubmed.ncbi.nlm.nih.gov/10535592/

Al-Aubaidi Z, Torfing T. The role of fat pad sign in diagnosing occult elbow fractures in the pediatric patient: a prospective magnetic resonance imaging study. J Pediatr Orthop B. 2012 Nov;21(6):514-9. doi: 10.1097/BPB.0b013e328355e5d8. PMID: 22735922.

https://pubmed.ncbi.nlm.nih.gov/22735922/

Kappelhof B, Roorda BL, Poppelaars MA, The B, Eygendaal D, Mulder PGH, van Bergen CJA. Occult Fractures in Children with a Radiographic Fat Pad Sign of the Elbow: A Meta-Analysis of 10 Published Studies. JBJS Rev. 2022 Oct 24;10(10). doi: 10.2106/JBJS.RVW.22.00114. PMID: 36326720.

https://pubmed.ncbi.nlm.nih.gov/36326720/ 

Scheier E, Fuchs L, Taragin BH, Balla U, Shavit I. Children With Elbow Injuries and Sonographic Elevated Posterior Fat Pad but No Identifiable Posterior Fat Pad on Lateral Radiographs: A Case Series. J Ultrasound Med. 2023 Jul;42(7):1617-1624. doi: 10.1002/jum.16173. Epub 2023 Jan 12. PMID: 36633969.

https://pubmed.ncbi.nlm.nih.gov/36633969/

 

Check out the Radiopaedia Article on the Sail Sign

Gaillard F, Feger J, Ismail M, et al. Sail sign (elbow). Reference article, Radiopaedia.org (Accessed on 29 Aug 2024) https://doi.org/10.53347/rID-2014

Check out the original paper by Norell

NORELL HG. Roentgenologic visualization of the extracapsular fat; its importance in the diagnosis of traumatic injuries to the elbow. Acta radiol. 1954 Sep;42(3):205-10. doi: 10.3109/00016925409174478. PMID: 13206822.

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 227 - The Cluster Headache23 Aug 202400:12:11

Cluster headaches present through urgent care and it is important to differentiate them correctly.

 

Check out the paper on which Lisa Kudrow has a credit

Messinger HB, Messinger MI, Kudrow L, Kudrow LV. Handedness and headache. Cephalalgia. 1994 Feb;14(1):64-7. doi: 10.1046/j.1468-2982.1994.1401064.x. PMID: 8200028.

 

Check out the paper mentioned

Weaver-Agostoni J. Cluster headache. Am Fam Physician. 2013 Jul 15;88(2):122-8. PMID: 23939643.

 

This links to the ICHD-3 Cluster Headache page

 

Check out the BPAC article mentioned

 

For Bootcamp details - https://rnzcuc.org.nz/urgent-care-bootcamp-2024/ 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 226 - The Popeye Sign16 Aug 202400:10:30

Don't confuse the Popeye Sign with the reverse Popeye Sign.  

 

Check out the Stat Pearls Page

Hsu D, Anand P, Mabrouk A, et al. Biceps Tendon Rupture. [Updated 2023 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

 

Check out the OrthoBullets Page on distal ruptures.

 

Get Bootcamp tickets here - https://rnzcuc.org.nz/urgent-care-bootcamp-2024/ 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 241 - Reye Syndrome13 Dec 202400:06:53

We should be familiar with Reye Syndrome and its association with aspirin.

Check out the Stat Pearls page

Chapman J, Arnold JK. Reye Syndrome. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526101/ 

 

Check out the original Reye paper

REYE RD, MORGAN G, BARAL J. ENCEPHALOPATHY AND FATTY DEGENERATION OF THE VISCERA. A DISEASE ENTITY IN CHILDHOOD. Lancet. 1963 Oct 12;2(7311):749-52. doi: 10.1016/s0140-6736(63)90554-3. PMID: 14055046. 

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Talking the STUMBL Score with Dr David Sorrell09 Aug 202400:23:06

When do you perform a chest X-ray for chest trauma presenting through urgent care?

This week we chat about this, and the STUMBL score, with Director of Clinical Training Dr David Sorrell.  

 

Check out the STUMBL score on MD Calc - https://www.mdcalc.com/calc/10468/stumbl-battle-score

Check out the paper mentioned by Dave

Galvez, Carlos, Arenas-Jimenez, Juan, Del Campo, Jone, Maroto, Sergio, Sirera, Marina, Lirio, Francisco, 2020.  Diagnostic imaging pathways in the setting of acute chest wall trauma.  Journal of Visualized Surgery; Vol 6 (April 2020): https://jovs.amegroups.org/article/view/34041/html 

 

Details of the Bootcamp 2024 in Wellington - https://rnzcuc.org.nz/urgent-care-bootcamp-2024/ 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 225 - Anticholinergics in the elderly02 Aug 202400:07:24

We need to be aware of medications with anticholinergic effects, especially in the elderly.  

 

Check out the BPAC article mentioned - https://bpac.org.nz/2024/anticholinergic.aspx#tab1

Check out the ACB calculator by Dr Rebecca King and Steve Rabino - https://www.acbcalc.com/ 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 224 - Walking on your ankle injury26 Jul 202400:09:27

Weight-bearing at the time of the injury and assessment forms part of the Ottawa ankle rules.  

 

Check out the paper mentioned

Chien B, Hofmann K, Ghorbanhoseini M, Zurakowski D, Rodriguez EK, Appleton P, Ellington JK, Kwon JY. Relationship of Self-Reported Ability to Weight-Bear Immediately After Injury as Predictor of Stability for Ankle Fractures. Foot Ankle Int. 2016 Sep;37(9):983-8. doi: 10.1177/1071100716648009. Epub 2016 May 9. PMID: 27162225.

 

Check out the original Ottawa ankle paper

Stiell IG, McDowell I, Nair RC, Aeta H, Greenberg G, McKnight RD, Ahuja J. Use of radiography in acute ankle injuries: physicians' attitudes and practice. CMAJ. 1992 Dec 1;147(11):1671-8. PMID: 1362372; PMCID: PMC1336591.

 

Check out the MDCalc page

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 223 - Using smell to diagnose19 Jul 202400:08:53

Smell can be used to diagnose.

 

Check out the paper mentioned

Trivedi DK, Sinclair E, Xu Y, Sarkar D, Walton-Doyle C, Liscio C, Banks P, Milne J, Silverdale M, Kunath T, Goodacre R, Barran P. Discovery of Volatile Biomarkers of Parkinson's Disease from Sebum. ACS Cent Sci. 2019 Apr 24;5(4):599-606. doi: 10.1021/acscentsci.8b00879. Epub 2019 Mar 20. 

https://pubmed.ncbi.nlm.nih.gov/31041379/ 

Check out the BBC interview with Joy Milne

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 222 - Antihistamines use in eczema12 Jul 202400:06:23

Do antihistamines help with the itch of dermatitis?

 

Check out the paper mentioned

Nankervis H, Thomas KS, Delamere FM, Barbarot S, Rogers NK, Williams HC. Scoping systematic review of treatments for eczema. Southampton (UK): NIHR Journals Library; 2016 May. PMID: 27280278.

Check out the Dermnet NZ page.

Authors: Dr Amy Stanway, Department of Dermatology, Waikato Hospital, Hamilton, New Zealand, February 2004; Updated: Honorary Associate Professor Paul Jarrett, Dermatologist, Middlemore Hospital and Department of Medicine, The University of Auckland, Auckland, New Zealand, February 2021. Minor internal update May 2023.

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 221 - Overseas medication05 Jul 202400:04:30

When you need help with identifying medications from overseas visitors, you can always call your local pharmacist, or you could try this website.

 

Check out the webpage mentioned - https://www.resourcepharm.com/pharmacist/identification-of-foreign-medicines.html 

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 220 - Helping in an emergency28 Jun 202400:06:29

As medical professionals, we must know our legal and moral obligations to help in case of emergency.

Check out the MCNZ page on helping in an emergency.

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

  

Urgent Bite 219 - Music to help you focus, sleep and relax21 Jun 202400:08:53

Certain music can help improve your concentration, help you relax and improve your sleep.

 

Check out https://www.brain.fm/

Check out their white paper.

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 218 - Thinking about cold and flu remedies14 Jun 202400:08:19

Cold and flu remedies containing pseudoephedrine are now a class C drug in New Zealand and available from pharmacies.  

 

Check out the prescriber update from June 2024.

Check out the Ministry of Health page.

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Dr Tony Smith talks Double Sequential and Vector Change Defibrillation for resistant VF/VT07 Jun 202400:30:16

Dr Tony Smith, Deputy Clinical Director at Hato Hone St John, tells us about Double Sequential and Vector Change Defibrillation for resistant VF/VT.  These new techniques, not currently covered in our NZRC resus algorithms, are being utilised by all ambulance services in New Zealand for patients who do not get ROSC after three shocks.  

Tony can be contacted for questions at - Tony.Smith@stjohn.org.nz 

 

Check out the paper mentioned

Cheskes S, Verbeek PR, Drennan IR, McLeod SL, Turner L, Pinto R, Feldman M, Davis M, Vaillancourt C, Morrison LJ, Dorian P, Scales DC. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. 2022 Nov 24;387(21):1947-1956. doi: 10.1056/NEJMoa2207304. Epub 2022 Nov 6. PMID: 36342151.

https://www.nejm.org/doi/full/10.1056/NEJMoa2207304 

And the editorial - https://www.nejm.org/doi/full/10.1056/NEJMe2213562 

 

Check out the Article from the Conversation - https://theconversation.com/a-new-emergency-procedure-for-cardiac-arrests-aims-to-save-more-lives-heres-how-it-works-221979 

 

Check out the article from the NZMJ

Dicker B, Maessen S, Swain A, Garcia E, Smith T. Are two shocks better than one? Aotearoa New Zealand emergency medical services implement a new defibrillation strategy: implications for around nine patients per week. N Z Med J. 2024 Mar 22;137(1592):105-107. doi: 10.26635/6965.6429. PMID: 38513209. 

 

 

www.rnzcuc.org.nz

podcast@rnzcuc.org.nz

https://www.facebook.com/rnzcuc

https://twitter.com/rnzcuc

 

Music licensed from www.premiumbeat.com

Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Urgent Bite 240 - The Epitrochlear Lymph Node06 Dec 202400:09:23

Do you palpate for the epitrochlear lymph node?

 

Check out the papers mentioned

Selby CD, Marcus HS, Toghill PJ. Enlarged epitrochlear lymph nodes: an old physical sign revisited. J R Coll Physicians Lond. 1992 Apr;26(2):159-61. PMID: 1588523; PMCID: PMC5375540. https://pmc.ncbi.nlm.nih.gov/articles/PMC5375540/ 

 

Catalano O, Nunziata A, Saturnino PP, Siani A. Epitrochlear lymph nodes: Anatomy, clinical aspects, and sonography features. Pictorial essay(). J Ultrasound. 2010 Dec;13(4):168-74. doi: 10.1016/j.jus.2010.10.010. Epub 2010 Nov 18. PMID: 23397026; PMCID: PMC3553226. 

https://pmc.ncbi.nlm.nih.gov/articles/PMC3553226/ 

 

Pannu AK, Prakash G, Jandial A, Kopp CR, Kumari S. Epitrochlear lymphadenopathy. Korean J Intern Med. 2019 Nov;34(6):1396. doi: 10.3904/kjim.2018.218. Epub 2018 Dec 6. PMID: 30514055; PMCID: PMC6823563.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6823563/

 

Freeman AM, Matto P. Lymphadenopathy. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513250/ 

 

 

 

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This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Prof. Bruce Arroll talks anxiety, asthma, breathing techniques and the polyvagal theory31 May 202400:35:44

Professor Bruce Arroll talks to us about a practical technique that can help regulate breathing in people having panic attacks or during an asthma attack.  The conversation then leads into discussing the Polyvagal Theory, physician wellness, and chronic pain.

 

Check out the Goodfellow unit resources.

The Gem mentioned

The Polyvagal Theory webinar

The Beginners Guide to the Polyvagal Theory

 

 

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Urgent Bite 217 - The ASIS avulsion24 May 202400:06:04

Remember to consider an ASIS avulsion in young athletes who experience pain and a pop around their hip when sprinting.

 

Check out the Orthobullets page

https://www.orthobullets.com/knee-and-sports/3091/anterior-superior-iliac-spine-asis-avulsion 

 

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Urgent Bite 216 - The Carpal Boss17 May 202400:06:24

A differential to consider when examining a dorsal wrist swelling.

 

Check out the Radiopaedia pages

On Ganglion cysts

On Carpal Boss

 

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Urgent Bite 215 - The World's Strongest CPD10 May 202400:13:46

Much like going to the gym, CPD can be a hassle or an imposition, but it can also be fun and hugely rewarding.

 

Check out the paper mentioned

Jeong D, Presseau J, ElChamaa R, Naumann DN, Mascaro C, Luconi F, Smith KM, Kitto S. Barriers and Facilitators to Self-Directed Learning in Continuing Professional Development for Physicians in Canada: A Scoping Review. Acad Med. 2018 Aug;93(8):1245-1254. https://pubmed.ncbi.nlm.nih.gov/29642101/ 

 

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Urgent Bite 214 - Are Borborygmi useful?03 May 202400:11:53

Should we be listening for bowel sounds?  Despite evidence suggesting they are not useful, I still think it is an important part of an urgent care assessment.  

 

Check out the papers mentioned.

Elhardello O, Macfie J. Bowel Sounds: Is it Time for Surgeons to Hang-up their Stethoscopes?. World J Surg Surgical Res. 2018; 1: 1066. Link to paper.

 

Breum BM, Rud B, Kirkegaard T, Nordentoft T. Accuracy of abdominal auscultation for bowel obstruction. World J Gastroenterol. 2015 Sep 14;21(34):10018-24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566372/ 

 

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Urgent Bite 213 - Differentials and the importance of the referral letter26 Apr 202400:12:15

What impact do your acute referral letters have on the admitting team?  

You may have noticed the initial upload contained the wrong audio file of an old podcast.  Sorry, this has been corrected.

 

Check out the papers mentioned

Chauveau P, Mazet-Guillaume B, Baron C, Roy PM, Tanguy M, Fanello S. Impact du contenu du courrier médical sur la qualité du triage initial des patients adultes admis aux urgences [Impact of the referral letter on triage decisions in adult patients admitted to the emergency department]. Sante Publique. 2013 Jul-Aug;25(4):441-51. French. 

https://pubmed.ncbi.nlm.nih.gov/24404726/

 

van den Berge K, Mamede S, van Gog T, Romijn JA, van Guldener C, van Saase JL, Rikers RM. Accepting diagnostic suggestions by residents: a potential cause of diagnostic error in medicine. Teach Learn Med. 2012;24(2):149-54. 

https://pubmed.ncbi.nlm.nih.gov/22490096/

 

Staal J, Speelman M, Brand R, Alsma J, Zwaan L. Does a suggested diagnosis in a general practitioners' referral question impact diagnostic reasoning: an experimental study. BMC Med Educ. 2022 Apr 8;22(1):256

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991944/

 

 

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Urgent Bite 212 - The Cozen Phenomenon19 Apr 202400:08:01

We must be aware of the possibility of Cozen's phenomenon in urgent care.

 

Check out the Radiopedia page by Tim Luijkx

https://radiopaedia.org/articles/cozen-fracture-1

 

Check out the Orthobullets page by Macknett MD et al

https://www.orthobullets.com/pediatrics/4025/proximal-tibia-metaphyseal-fractures--pediatric

 

Check out the obituary of Dr Lewis Cozen

 

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Thinking about Chopart injuries - with Dr Antonio Castro12 Apr 202400:16:16

Today we hear of a case of Chopart injury presenting through urgent care.  Thanks to Dr Antonio Castro.  

 

Check out the paper mentioned

Metcalfe TSN, Aamir J, Mason LW. Chopart dislocations: a review of diagnosis, treatment and outcomes. Arch Orthop Trauma Surg. 2024 Jan;144(1):131-147. doi: 10.1007/s00402-023-05040-4. Epub 2023 Sep 15. PMID: 37715068; PMCID: PMC10774188.

 

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Catching up with Dr Tamsin Lillie05 Apr 202400:19:28

2 years ago we spoke with Dr Tamsin Lillie, a Fellow of the RNZCUC who runs a medical charity that helps fund African students through medical training.    Last time we spoke she was calling in from Malawi, but a chance meeting in person prompted a quick catch-up about what has been going on over the last 2 years and her hopes for the charity moving forward. 

 www.medictomedic.org.nz 

 

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Urgent Bite 211 - Thinking about medication history taking28 Mar 202400:07:39

Some common, non-psychotropic medications can have psychiatric side effects.  

 

Check out the article mentioned

Prescriber Update 45(1): 5-8 March 2024 

https://www.medsafe.govt.nz/profs/PUArticles/March2024/Unexplained-mood-and-behavioural-changes.html

 

 

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Urgent Bite 239 - The Examination Ritual29 Nov 202400:11:02

An interesting and thought-provoking TED talk that argues for the need for clinicians to continue to examine patients thoroughly.  

 

Check out Dr Verghese's TED talk here.

 

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Urgent Bite 210 - Hoffmann's Sign22 Mar 202400:10:50

Hoffmann's sign is a simple test that can help in diagnosing cervical myelopathy and upper motor neurone disease as part of a thorough history and examination. 

 

Check out the paper mentioned

Nemani VM, Kim HJ, Piyaskulkaew C, Nguyen JT, Riew KD. Correlation of cord signal change with physical examination findings in patients with cervical myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):6-10. doi: 10.1097/BRS.0000000000000659. PMID: 25341986. 

https://pubmed.ncbi.nlm.nih.gov/25341986/ 

 

Check out the Stat Pearls page.

Whitney E, Munakomi S. Hoffmann Sign. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545156/ 

 

2 videos from Ortho Eval Pal with Paul Marquis on YouTube that show the sign.

https://www.youtube.com/watch?v=blj6Y0rrmtw

https://www.youtube.com/watch?v=GJ-Q2ibYAHs

 

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Wellens' Syndrome - with Dr Ivan Koay and Dr Yoosuf15 Mar 202400:31:52

Wellens' Syndrome is an ECG finding indicative of critical LAD stenosis.  Recognising this ECG change is vital.  

 

Check out the Life in the Fast Lane post by Dr Mike Cadogan and Dr Robert Buttner from September 2021

https://litfl.com/wellens-syndrome-ecg-library/

 

This is a BMJ case report that is worth reading.

Ramires TG, Sant'Anna J, Pais J, Picarra BC. Wellens' syndrome: a pattern to remember. BMJ Case Rep. 2018 Apr 10;2018:bcr2018224582. doi: 10.1136/bcr-2018-224582. PMID: 29636339; PMCID: PMC5893974.

https://casereports.bmj.com/content/2018/bcr-2018-224582 

 

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Urgent Bite 209 - Abnormal Uterine Bleeding when commencing anticoagulation08 Mar 202400:06:44

We must counsel about the possibility of abnormal uterine bleeding starting, or worsening when commencing oral anticoagulation.  

Check out the Prescriber update - December 2023 edition - https://www.medsafe.govt.nz/profs/PUArticles/PDF/Prescriber-Update-44-No.4-December-2023.pdf

 

Check out the paper mentioned

de Jong CMM, Blondon M, Ay C, Buchmuller A, Beyer-Westendorf J, Biechele J, Bertoletti L, Colombo G, Donadini MP, Hendriks SV, Jara-Palomares L, Nopp S, Ruiz-Artacho P, Stephan P, Tromeur C, Vanassche T, Westerweel PE, Klok FA. Incidence and impact of anticoagulation-associated abnormal menstrual bleeding in women after venous thromboembolism. Blood. 2022 Oct 20;140(16):1764-1773. doi: 10.1182/blood.2022017101. PMID: 35925686.

https://pubmed.ncbi.nlm.nih.gov/35925686/ 

 

 

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Urgent Bite 208 - Poland Syndrome01 Mar 202400:09:45

An interesting eponymous syndrome with a Kiwi connection.  

 

Check out the Stat Pearls Page

Tafti D, Cecava ND. Poland Syndrome. [Updated 2023 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532259/

https://www.ncbi.nlm.nih.gov/books/NBK532259/

 

Read more about Patrick Clarkson, MBE, FRCS - https://en.wikipedia.org/wiki/Patrick_Clarkson

Read more about Jeremy Beadle, MBE - https://en.wikipedia.org/wiki/Jeremy_Beadle 

 

 

 

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Urgent Bite 207 - Dunbar Syndrome23 Feb 202400:10:10

In cases of ongoing post-prandial epigastric pain and sitophobia despite endoscopy work up and treatment perhaps we should remember to recall Dunbar Syndrome to our differential list.

 

Check out the paper mentioned

Li J, Tan XY, Megahed A, Evangelista A. Dunbar syndrome: An unusual cause of chronic postprandial abdominal pain. Radiol Case Rep. 2020 Aug 2;15(10):1747-1749. doi: 10.1016/j.radcr.2020.07.016. PMID: 32774573; PMCID: PMC7397697. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7397697/ 

Check out the Radiopedia page

Gaillard F, Moore C, Glick Y, et al. Celiac artery compression syndrome. Reference article, Radiopaedia.org (Accessed on 22 Feb 2024) https://doi.org/10.53347/rID-1143 

 

 

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Urgent Bite 206 - Grover Disease16 Feb 202400:08:13

Grover disease might present through your urgent care.  While not a critical or life-threatening condition, recognising it so we can advise and support your patient is important.  To help us consider differentials for various presenting complaints there is a useful website you can use.

 

Check out the Cunneliffe (TP) General Dermatology Diagnostic Tool - https://www.pcds.org.uk/general-dermatology-table

 

Check out the Dermnet page on Grover disease - authored by Prof Amanda Oakley and Dr Ian Coulson- https://dermnetnz.org/topics/transient-acantholytic-dermatosis 

 

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Urgent Bite 205 - The Böhler angle and angle of Gissane09 Feb 202400:10:36

When considering calcaneal fractures we must remember the Böhler angle and the angle of Gissane.

 

Check out the Orthobullets page written by Crag Forsthoefel MD.

https://www.orthobullets.com/trauma/1051/calcaneus-fractures

 

Check out the Radiopaedia articles 

Benoudina S, Worsley C, Knipe H, et al. Gissane angle. Reference article, Radiopaedia.org (Accessed on 08 Feb 2024) https://doi.org/10.53347/rID-40094

Amini B, Worsley C, Weerakkody Y, et al. Böhler angle. Reference article, Radiopaedia.org (Accessed on 08 Feb 2024) https://doi.org/10.53347/rID-1002 

 

 

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The Corona Mortis - with Dr Tim Brabants01 Feb 202400:14:07

Do you know about the Corona Mortis?  Today with chat to Dr Tim Brabants who has seen a case and feels we should be aware of its potential in urgent care.  

Tim is a UK-trained doctor who has worked in the UK and South Africa, predominantly in emergency medicine.  Now based in New Zealand, he is a senior Registrar with the RNZCUC

 

Check out these resources on the Corona Mortis.  

Radiopaedia - Hsu C, Ismail M, Furaiji H, et al. Corona mortis. Reference article, Radiopaedia.org (Accessed on 30 Jan 2024) https://doi.org/10.53347/rID-39319  https://radiopaedia.org/articles/39319

 

Garrido-Gómez J, Pena-Rodríguez C, Martín-Noguerol T, Hernández-Cortes P. Corona mortis artery avulsion due to a stable pubic ramus fracture. Orthopedics. 2012 Jan 16;35(1):e80-2. doi: 10.3928/01477447-20111122-25. PMID: 22229619.  https://pubmed.ncbi.nlm.nih.gov/22229619/ 

 

Sealy EB, Schammel CM, Varma R, Devane AM. Corona mortis in the setting of pelvic trauma: Case series and review of the literature. Am J Interv Radiol 2023;7:9.  https://americanjir.com/corona-mortis-in-the-setting-of-pelvic-trauma-case-series-and-review-of-the-literature/ 

 

Cardoso GI, Chinelatto LA, Hojaij F, Akamatsu FE, Jacomo AL. Corona Mortis: A Systematic Review of Literature. Clinics (Sao Paulo). 2021 Apr 16;76:e2182. doi: 10.6061/clinics/2021/e2182. PMID: 33886786; PMCID: PMC8024925.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024925/ 

 

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Urgent Bite 204 - Thinking about caffeine withdrawal26 Jan 202400:07:39

Could caffeine withdrawal result in an urgent care visit?

 

Check out the paper mentioned

Sajadi-Ernazarova KR, Anderson J, Dhakal A, et al. Caffeine Withdrawal. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430790/

https://www.ncbi.nlm.nih.gov/books/NBK430790/#article-18757.s2

 

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Urgent Bite 203 -The Hoagland Sign19 Jan 202400:11:22

An eponymous sign that helps in the diagnosis of glandular fever.  

 

Check out the paper mentioned.  

Otsuki T, Ishizuka K, Hirose M, Ie K. Hoagland sign in infectious mononucleosis. BMJ Case Rep. 2022 Nov 16;15(11):e252839. https://pubmed.ncbi.nlm.nih.gov/36384885/ 

 

Check out the obituary of Colonel Robert. J. Hoagland MD - https://courierpostonline.newspapers.com/article/the-charlotte-observer-robert-j-hoagland/82137229/

 

Check out the Patient.info page on glandular fever, written by Dr Colin Tidy - https://patient.info/ears-nose-throat-mouth/sore-throat-2/glandular-fever-infectious-mononucleosis 

 

Check out the book review of Hoagland's book.

Moser RH. Infectious Mononucleosis. Arch Intern Med. 1968;121(6):572. doi:10.1001/archinte.1968.03640060086018 

 

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Urgent Bite 238 - Possible Assistance Needed22 Nov 202400:08:29

Do you have a way to quickly and succinctly indicate that there is a possible patient of clinical concern within your clinic?

 

Read about Pan-pan on Wikipedia.

 

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Urgent Bite 202 - Thinking about Neuroendocrine Tumours12 Jan 202400:12:48

This week, the world's best snooker players are competing for the Paul Hunter Trophy at the Masters in London.  Paul sadly died of neuroendocrine tumours in 2006 whilst in his snooker prime.  

 

Check out the paper mentioned

Ahmed M. Gastrointestinal neuroendocrine tumors in 2020. World J Gastrointest Oncol. 2020 Aug 15;12(8):791-807. doi: 10.4251/wjgo.v12.i8.791. PMID: 32879660; PMCID: PMC7443843.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443843/

 

Check out this blog page detailing Paul Hunter's diagnosis.  This is from the Ronny Allan blog, someone also diagnosed with neuroendocrine cancer.  

https://ronnyallan.net/2020/10/09/paul-hunter-snooker-champion-and-neuroendocrine-cancer-patient-died-9th-october-2006/ 

 

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Urgent Bite 201 - Thinking about referrals from UC05 Jan 202400:10:36

What is your acute referral rate from UC to secondary care?

 

Check out the paper mentioned.

Blinkenberg J, Hetlevik Ø, Sandvik H, Baste V, Hunskaar S. The impact of variation in out-of-hours doctors' referral practices: a Norwegian registry-based observational study. Fam Pract. 2023 Dec 22;40(5-6):728-736.

https://pubmed.ncbi.nlm.nih.gov/36801994/ 

 

 

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Thinking about Jean Batten and Empyema29 Dec 202300:10:42

Jean Batten was a New Zealand pioneering aviatrix who died of empyema.

 

Check out Jean Batten's history.

From the NZ History website - https://nzhistory.govt.nz/people/jean-batten

From Te Ara, the Encyclopedia of New Zealand - https://teara.govt.nz/en/biographies/4b13/batten-jean-gardner

From Wikipedia - https://en.wikipedia.org/wiki/Jean_Batten#

 

Check out the paper mentioned - Dyrhovden R, Nygaard RM, Patel R, Ulvestad E, Kommedal Ø. The bacterial aetiology of pleural empyema. A descriptive and comparative metagenomic study. Clin Microbiol Infect. 2019 Aug;25(8):981-986. https://pubmed.ncbi.nlm.nih.gov/30580031/ 

Check out the Stat Pearls page - Garvia V, Paul M. Empyema. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459237/ 

 

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Full Grip by Score Squad

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

A Bite of Christmas - The Ice Cream Headache22 Dec 202300:04:38

You might encounter an Ice Cream Headache over Christmas.   

 

Check out the International Classification of Headaches - Third Edition)

Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658. PMID: 23771276.

https://pubmed.ncbi.nlm.nih.gov/23771276/

 

Check out the paper mentioned

Özyürek H, Koray Bayrak I, Yayici Köken Ö. Ice Cream Headache: Cerebral Blood Flow Evaluation. Turk Arch Pediatr. 2021 Jul 1;56(4):405-406. doi: 10.5152/TurkArchPediatr.2021.20247. PMID: 35005742; PMCID: PMC8655974.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655974/

 

 

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Christmas Elves by - Francesco D'Andrea

 

This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor

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