2 View: Emergency Medicine PAs & NPs The Center for Medical Education

Welcome to Episode 34 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!


Show Notes for Episode 34 of “The 2 View” – pertussis, computer interpretation of EKGs, TB, FQ side effects, and incidental findings


Pertussis


Best Practices for Healthcare Professionals on the Use of Polymerase Chain Reaction (PCR) for Diagnosing Pertussis. Pertussis: Use of PCR for diagnosis. Cdc.gov. Published January 12, 2023 https://www.cdc.gov/pertussis/clinical/diagnostic-testing/diagnosis-pcr-bestpractices.html


Specimen Collection and Diagnostic Testing. Cdc.gov. Published October 11, 2023 https://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection-diagnosis.html


Treatment. Cdc.gov. Published September 16, 2022 https://www.cdc.gov/pertussis/clinical/treatment.html


Computer Interpretation of EKGs


Bracey A, Meyers HP, Smith SW. Emergency physicians should interpret every triage ECG, including those with a computer interpretation of “normal.” Am J Emerg Med. PubMed. National Library of Medicine: National Center for Biotechnology Information. Published May 2022 https://pubmed.ncbi.nlm.nih.gov/35361516/


Deutsch A, Poronsky K, Westafer L, Visintainer P, Mader T. Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in Emergency Department Triage Patients. West J Emerg Med. PubMed. National Library of Medicine: National Center for Biotechnology Information. Published January 2024 https://pubmed.ncbi.nlm.nih.gov/38205978/


Tuberculosis


CDCTB. TB Testing & Diagnosis. cdc.gov Published July 26, 2022 https://www.cdc.gov/tb/topic/testing/default.htm


Global Tuberculosis Institute. Treating Latent TB Infection (LTBI). YouTube. Published November 29, 2022 https://www.youtube.com/watch?v=Udq-65YuLlo


Niknejad M, Gaillard F. Tuberculosis (pulmonary manifestations). In: Radiopaedia.org. Radiopaedia.org; 2010. Revised January 5, 2024 https://radiopaedia.org/articles/tuberculosis-pulmonary-manifestations-1?lang=us


Fluoroquinolone Antibiotic Side Effects


Farkas J. PulmCrit - Six reasons to avoid fluoroquinolones in the critically ill. PulmCrit (EMCrit). Published August 1, 2016 https://emcrit.org/pulmcrit/fluoroquinolone-critical-illness/


FDA Drug Safety Podcast: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects. U.S. fda.gov Published January 19, 2022 https://www.fda.gov/drugs/fda-drug-safety-podcasts/fda-drug-safety-podcast-fda-updates-warnings-oral-and-injectable-fluoroquinolone-antibiotics-due


Highlights of Prescribing Information: CIPRO. fda.gov https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019537s086lbl.pdf


Stanley I. Mother is left unable to walk after taking just three ANTIBIOTIC pills to treat a UTI: Disabled vet husband she previously cared for is also in a wheelchair. DailyMail.com. Published February 22, 2024 https://www.dailymail.co.uk/health/article-13111327/young-mother-unable-walk-antibiotic-pills-uti.html


Tilley C. “Killer” antibiotic that’s STILL being prescribed to 15m Americans a year: Widow of singer Bobby. DailyMail.com. Published March 2, 2024 https://www.dailymail.co.uk/health/article-13115607/Bobby-Caldwell-wife-fluoroquinolone-antibiotics.html


Incidental Findings


Incidental Findings. acr.org. American College of Radiology https://www.acr.org/Clinical-Resources/Incidental-Findings


Schleicher S. DermDx: Suspicious Mole on Sole of Foot. Clinical Advisor. Published February 16, 2024 https://www.clinicaladvisor.com/slideshow/derm-dx/dermdx-suspicious-mole-foot/?elqtrack=True&hmemail=1f%2FJfEV7hN5vJr6vg%2FQRqK0NA6IXtyO3&hmsubid&nid=1639413404&sha256email=092493d8223fdfa40d9e995176d13e5fc5b5211674db9deb440c025fd462c80c


Viennet M, Tapia S, Cottenet J, Bernard A, Ortega-Deballon P, Quantin C. Increased risk of colon cancer after acute appendicitis: a nationwide, population-based study. EClinicalMedicine. Published August 30,

Welcome to Episode 33 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!


Show Notes for Episode 33 of “The 2 View” – Walking Boots, Jones Fracture: A Review, and a Few Procedures: Penile Foreign Body Removal and Keloid Removal.


Walking Boots


Infraorbital Nerve Block Courtesy of Jessica Mason MD. Dropbox. Accessed January 24, 2024. https://www.dropbox.com/scl/fi/r6ite1ior1wdcg63jcect/Infraorbital-Nerve-Block-Courtesy-of-Jessica-Mason-MD.mp4?rlkey=o5aiz60qmcvpqlnz2z62q8vkz&dl=0


Jones Fracture: A Review


Jones J, Datir A. Jones fracture. In: Radiopaedia.org. Radiopaedia.org; 2008. Revised October 20, 2023. Accessed January 24, 2024. https://radiopaedia.org/articles/jones-fracture-1?lang=us


Metzl JA, Bowers MW, Anderson RB. Fifth Metatarsal Jones Fractures: Diagnosis and Treatment. J Am Acad Orthop Surg. Published February 15, 2022. Accessed January 24, 2024. https://journals.lww.com/jaaos/Fulltext/2022/02150/Fifth_Metatarsal_Jones_Fractures__Diagnosis_and.6.aspx


Michigan Foot Doctors. 5th Metatarsal Jones Fracture [Recovery, Treatment & Surgery]. YouTube. Published April 22, 2020. Accessed January 24, 2024. https://www.youtube.com/watch?v=8f0ECP1FtCc


A Few Procedures: Penile Foreign Body Removal and Keloid Removal


Memariani H, Memariani M, Moravvej H, Shahidi-Dadras M. Emerging and Novel Therapies for Keloids: A compendious review. Sultan Qaboos Univ Med J. NIH: National Library of Medicine, National Center for Biotechnology Information. Published February 2021. Accessed January 24, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968901/


Roberts JR. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care, 7th Edition; 2018. Accessed January 24, 2024. https://www.us.elsevierhealth.com/roberts-and-hedges-clinical-procedures-in-emergency-medicine-and-acute-care-9780323354783.html


Roberts JR, Roberts M. The Curse of the Keloid. Emergency Medicine News. Published February 28, 2018. Accessed January 24, 2024. https://journals.lww.com/em-news/blog/theproceduralpause/pages/post.aspx?PostID=79


The Proceduralist. Foreign body in the shaft of the penis removal using dorsal nerve block. YouTube. Published January 11, 2024. Accessed January 24, 2024. https://www.youtube.com/watch?v=71PesnLDl-0


The Proceduralist. Keloid. YouTube. Published February 9, 2018. Accessed January 24, 2024. https://www.youtube.com/watch?v=wRBstgCULBc


Weech D, Ameer MA, Ashurst JV. Anatomy, Abdomen and Pelvis, Penis Dorsal Nerve. StatPearls Publishing. NIH: National Library of Medicine, National Center for Biotechnology Information. Updated August 8, 2023. Accessed January 24, 2024. https://www.ncbi.nlm.nih.gov/books/NBK525966/


Recurring Sources


Center for Medical Education. Ccme.org. http://ccme.org


The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org


The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx


The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com


Trivia Question: Send answers to 2viewcast@gmail.com


Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

Welcome to Episode 32 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!


Show Notes for Episode 32 of “The 2 View” – EMTALA, provider-in-triage positions, head injuries, appendicitis


EMTALA / Head Injuries / Provider In Triage


Latner A. Man Escorted Out of Hospital Without Being Seen: Is This an EMTALA Violation? Clinicaladvisor.com. Published April 11, 2023. Accessed January 21, 2024. https://www.clinicaladvisor.com/home/my-practice/legal-advisor/man-escorted-out-of-hospital-emtala-violation/


Centers for Medicare and Medicaid Services. Emergency Medical Treatment & Labor Act (EMTALA). Cms.gov. Accessed January 21, 2024. https://www.cms.gov/medicare/regulations-guidance/legislation/emergency-medical-treatment-labor-act


MDCalc. Canadian CT Head Injury/Trauma Rule. Mdcalc.com. Accessed January 21, 2024. https://www.mdcalc.com/calc/608/canadian-ct-head-injury-trauma-rule


Appendicitis


Latner A. PA and NP Fail to Diagnose Appendicitis. Clinicaladvisor.com. Published December 6, 2023. Accessed January 21, 2024.
https://www.clinicaladvisor.com/home/my-practice/legal-advisor/pa-np-fail-appendicitis/


Roberts M, Sharma M. 29 - Toxoplasmosis, the OPAL trial, medical marijuana, appendicitis, and colchicine. The 2 View: EM PA & NP Podcast. Published November 20, 2023. Published October 13, 2023. Accessed January 21, 2024. https://2view.fireside.fm/29


Recurring Sources


Center for Medical Education. Ccme.org. http://ccme.org


The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org


The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx


The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com


Trivia Questions: Send answers to 2viewcast@gmail.com


Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

Dengue


CDC. Clinical assessment. Centers for Disease Control and Prevention. Cdc.gov. https://www.cdc.gov/dengue/training/cme/ccm/page73112.html


CDC. Dengue. Centers for Disease Control and Prevention. Published August 15, 2023. https://www.cdc.gov/dengue/index.html


Rigby J. First Pill for Dengue Shows Promise in Human Challenge Trial. Medscape: Emergency Medicine. Published October 23, 2023. https://www.medscape.com/s/viewarticle/997558?ecd=wnl_sci_tech_231101_MSCPEDIT_etid6007373&uac=255848DR&impID=6007373


Schnirring L. California confirms 2nd local dengue case. Center for infectious disease research and policy. University of Minnesota. Umn.edu. Published November 2, 2023. https://www.cidrap.umn.edu/dengue/california-confirms-2nd-local-dengue-case


Penis Pain


Lizza E. Peyronie Disease. Medscape.com. Published August 17, 2023. https://emedicine.medscape.com/article/456574-overview


Malloy M, Sinert R. Dysuria and Discharge After a New Sexual Partner. Medscape. Published November 20, 2023. https://reference.medscape.com/viewarticle/847159


Promethazine


2018-2019 Targeted Medication Safety Best Practices for Hospitals. Ismp.org. https://www.ismp.org/sites/default/files/attachments/2019-01/TMSBP-for-Hospitalsv2.pdf


Drug Shortage Detail: Promethazine Injection. Ashp.org. Updated November 21, 2023. https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=872


Fass O. Antiemetics and QT prolongation. Clinicalcorrelations.org. Published January 15, 2021. https://www.clinicalcorrelations.org/2021/01/15/antiemetics-and-qt-prolongation/


Ozempic


Korte C. Ozempic side effects could lead to hospitalization — and doctors warn that long-term impacts remain unknown. CBS News. Published June 10, 2023. https://www.cbsnews.com/news/ozempic-side-effects-weight-loss-drugs-wegovy-mounjaro-doctors-warn/


Krishnan L, Dhatariya K, Gerontitis D. No clinical harm from a massive exenatide overdose – a short report. Clin Toxicol (Phila). Clinical Toxicology. Published December 11, 2012. https://www.tandfonline.com/doi/pdf/10.3109/15563650.2012.752495


MedWatch: The FDA Safety Information and Adverse Event Reporting Program. FDA: U.S. Food and Drug Administration. Published September 15, 2022. https://www.fda.gov/medwatch


Nakanishi R, Hirose T, Tamura Y, et.al. Attempted suicide with liraglutide overdose did not induce hypoglycemia. Diabetes Research and Clinical Practice. Diabetesresearchclinicalpractice.com. Published November 12, 2012. https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(12)00384-1/fulltext


Ozempic® (semaglutide) injection for Type 2 Diabetes. Ozempic.com. https://www.ozempic.com/


Hearing Loss


Ahmed OH, Gallant SC, Ruiz R, Wang B, Shapiro WH, Voigt EP. Validity of the Hum Test, a Simple and Reliable Alternative to the Weber Test. Ann Otol Rhinol Laryngol. NIH: National Library of Medicine: National Center for Biotechnology Information. Published June 2018.
https://pubmed.ncbi.nlm.nih.gov/29776326/#:~:text=Results%3A%20When%20examining%20the%20ability,respectively%2C%20with%20low%20pitched%20humming.


Clinical Practice Guideline: Sudden Hearing Loss (Update). American Academy of Otolaryngology – Head and Neck Surgery. Entnet.org. https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/sudden-hearing-loss-update/


Hearing loss in adults: assessment and management. National Guideline Centre (UK). Immediate, Urgent and Routine Referral. National Institute for Health and Care Excellence; 2018. NIH: National Library of Medicine: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK536553/#:~:text=If%20the%20hearing%20loss%20developed,service%20or%20an%20emergency%20department.


Mroz M. Do you know the three main types of hearing loss? Healthy Hearing. Published April 17, 2014.
https://www.healthyhearing.com/help/hearing-loss/types


Recurring Sources


Center for Medical

Welcome to Episode 30 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!


Show Notes for Episode 30 of “The 2 View” – oral phenylephrine, visual diagnosis plans, and NSVT.


Oral Phenylephrine


Myers Z. FDA panel: Many oral allergy meds don’t work. WTTV CBS4Indy. Published October 15, 2023. Accessed October 17, 2023. https://cbs4indy.com/news/fda-panel-many-oral-allergy-meds-dont-work/


Neurosyphilis Review


Hamill MM, Ghanem KG, Tuddenham S. State of the art review: neurosyphilis. Clin Infect Dis. Published August 18, 2023. Accessed November 1, 2023. doi: 10.1093/cid/ciad437


Visual Diagnosis - Behcet’s Disease


Behcet’s Disease. Vasculitis Foundation. Published July 18, 2012. Accessed October 17, 2023. https://www.vasculitisfoundation.org/education/behcets-disease/


ACEP Clinical Policy on Ischemic Stroke


Clinical Policies – Acute Ischemic Stroke. ACEP. Published May 2023. Accessed November 2, 2023. https://www.acep.org/patient-care/clinical-policies/acute-ischemic-stroke


The VAN Assessment to Identify Large Vessel Occlusion Strokes. Core EM. Published May 17, 2018. Accessed November 2, 2023. https://coreem.net/journal-reviews/the-van-assessment/


Los Angeles Motor Scale (LAMS). MDCalc. Accessed November 2, 2023. https://www.mdcalc.com/calc/3959/los-angeles-motor-scale-lams


Rapid Arterial oCclusion Evaluation (RACE) Scale for Stroke. MDCalc. Accessed November 2, 2023. https://www.mdcalc.com/calc/3941/rapid-arterial-occlusion-evaluation-race-scale-stroke


NSVT: Non-Sustained Ventricular Tachycardia


Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. Published August 1, 2018. Accessed October 17, 2023. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549


Farzam K, Tivakaran VS. QT Prolonging Drugs. StatPearls Publishing; 2023. Accessed October 17, 2023. https://www.ncbi.nlm.nih.gov/books/NBK534864/


Foth C, Gangwani MK, Ahmed I, Alvey H. Ventricular Tachycardia. StatPearls Publishing; 2023. Accessed October 17, 2023. https://www.ncbi.nlm.nih.gov/books/NBK532954/


Ep 1 Lady G and Courage Under Fire. Burnt. Published January 27, 2021. Accessed November 2, 2023. https://podcasts.apple.com/us/podcast/ep-1-lady-g-and-courage-under-fire/id1551194920?i=1000506903956


Glaucomflecken. Will and Kristin’s Cardiac Arrest Story with Paramedic Lieutenant Aaron Gregg. Published August 22, 2023. Accessed October 17, 2023. https://www.youtube.com/watch?v=CQtYoKPNsrM


Laslett DB, Cooper JM, Greenberg RM, et al. Electrolyte Abnormalities in Patients Presenting With Ventricular Arrhythmia (from the LYTE-VT Study). Am J Cardiol. PubMed. NIH: National Library of Medicine: National Center for Biotechnology Information. Published August 15, 2020. Accessed October 17, 2023. https://pubmed.ncbi.nlm.nih.gov/32565090/


Nonsustained ventricular tachycardias. Bmj.com. BMJ Best Practice. Accessed October 25, 2023. https://bestpractice.bmj.com/topics/en-us/831


PVCs and Nonsustained VT: When to Worry? How to Treat? - Penn Physician VideoLink.; 2015. Published January 7, 2015. Accessed October 17, 2023. https://videolink.pennmedicine.org/videos/pvcs-and-nonsustained-vt-when-to-worry-how-to-treat


TualatinValleyFire. Dr. Will Flanary - Cardiac Arrest Survivor. Published February 16, 2021. Accessed October 17, 2023. https://www.youtube.com/watch?v=wu9uAwnSrJU


Recurring Sources


Center for Medical Education. Ccme.org. http://ccme.org


The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org


The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx


The Skeptics Gui

Show Notes for Episode 29 of “The 2 View” – Toxoplasmosis, the OPAL trial, medical marijuana, appendicitis, and colchicine.


CDC - Toxoplasmosis


CDC – Parasites – Toxoplasmosis (Toxoplasma infection). Cdc.gov. Published June 9, 2023. Accessed September 26, 2023. https://www.cdc.gov/parasites/toxoplasmosis/index.html


OPAL RCT for Opioids in Back Pain


Jones C, O’Day R, Koes B, et. al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. The Lancet. Thelancet.com. Published July 22, 2023. Accessed September 26, 2023. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext


Sikina M, Kiel J. Re-evaluating Red Flags for Back Pain. Acep.org. Sports Med. Published August 17, 2022. Accessed September 26, 2023. https://www.acep.org/sportsmedicine/newsroom/newsroom-articles/august2022/re-evaluating-red-flags-for-back-pain


Medical Marijuana


Brooks M. Is Medical Cannabis the Answer to the Opioid Crisis? Medscape Emergency Medicine. Published October 3, 2022. Accessed September 26, 2023. https://www.medscape.com/viewarticle/981767?ecd=wnl_infocu4_broad_broad_persoexpansion-editorial_20230603&uac=106964SV&impID=5490911


Novak S. Physicians Aren’t Asking Enough Questions About Cannabis Use. Medscape Emergency Medicine. Published August 29, 2023. Accessed September 26, 2023. https://www.medscape.com/viewarticle/995954?ecd=WNL_trdalrt_pos1_230904_etid5820671&uac=106964SV&impID=5820671


Appendicitis


Appendicitis. Acep.org. Accessed September 26, 2023. https://www.acep.org/patient-care/clinical-policies/appendicitis


Dora-Laskey A. Acute pain control. EM. Accessed September 26, 2023. https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m3-curriculum/group-acute-pain-control/acute-pain-control


Hidayat AI, Purnawan I, Mulyaningrat W, et al. Effect of Combining Dhikr and Prayer Therapy on Pain and Vital Signs in Appendectomy Patients: A Quasi-Experimental Study. NIH: National Library of Medicine. J Holist Nurs. Accessed September 26, 2023. https://pubmed.ncbi.nlm.nih.gov/37277995/


Smink D, Soybel D. Management of acute appendicitis in adults. UpToDate. Uptodate.com. Updated February 15, 2023. Accessed September 26, 2023. https://www.uptodate.com/contents/management-of-acute-appendicitis-in-adults


Colchicine


Chiabrando JG, Bonaventura A, Vecchié A, et al. Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. ScienceDirect. Published January 2020. Accessed September 26, 2023. https://www.sciencedirect.com/science/article/pii/S0735109719384840?via%3Dihub


Gout clinical practice guidelines. American College of Rheumatology. Rheumatology.org. Accessed September 26, 2023. https://rheumatology.org/gout-guideline


Telmesani A, Moss E, Chetrit M. The Use of Colchicine in Pericardial Diseases. American College of Cardiology. Published December 5, 2019. Accessed September 26, 2023. https://www.acc.org/Latest-in-Cardiology/Articles/2019/12/04/08/22/The-Use-of-Colchicine-in-Pericardial-Diseases


Recurring Sources


Center for Medical Education. Ccme.org. http://ccme.org


The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org


The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx


The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com


Trivia Question: Send answers to 2viewcast@gmail.com


Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!