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Clinical reviews of how to approach and take care of patients with the most serious and common ED and Urgent care complaints.

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C3 - Seizures ArtworkAugust 2017

C3 - Seizures

Seizures frighten everybody. They can be distressing not only for patients but also for their families, public bystanders and even emergency providers. Because the convulsions associated with seizures can be so dramatic, we tend to lose our ability to think in a logical manner when a patient is actively seizing. In this episode of C3, we cover the initial approach to the seizing patient, how to manage status epilepticus and how to disposition these patients from the emergency department.

1hr 3min
C3 - Bradycardia ArtworkJuly 2017

C3 - Bradycardia

In last month’s C3, we discussed the concept of primacy of rate. Simply stated, the more abnormal the heart rate, the more likely that it is responsible for the patient’s symptoms. In most cases (but not all - e.g. not in hypothermia and myxedema coma) intervening to correct the rate is a high priority in the resuscitation.

C3 - Tachyarrhythmias ArtworkJune 2017

C3 - Tachyarrhythmias

Managing patients with tachycardia is as central to emergency medicine as airway, breathing, and circulation. In many cases, a rapid heart rate is the most prominent and obvious part of a patient’s presentation – and in some cases it demands immediate action from the treatment team. In this episode of C3, we have attempted to make the approach to patients with tachyarrhythmias simple “but not too simple”, as a great man (Albert Einstein!) once said.

1hr 9min
C3 - Epistaxis ArtworkMay 2017

C3 - Epistaxis

Epistaxis, or nosebleed, is among the commonest presentations to the emergency department. Although epistaxis occurs in the majority of people at some point during their lives, most are minor and self-limited. Those patients who arrive to the ED represent a specific subset of nosebleeds - ones that won’t stop. These patients may be quite anxious and fearful. In some cases there are underlying reasons why the bleeding won’t stop. Fortunately, we have a wealth of tools, tips, and procedures to stop the bleeding.

C3 - Dizziness ArtworkApril 2017

C3 - Dizziness

Dizziness is a poorly defined symptom that plagues both patients and clinicians. It is one of the most common chief complaints in both emergency and outpatient settings, accounting for millions of visits to each annually in the U.S. alone. There is often uncertainty surrounding the clinical approach to the dizzy patient and the wide variation in practices is what makes it particularly difficult for new and seasoned practitioners alike.

1hr 30min
C3 - Chest Pain ArtworkMarch 2017

C3 - Chest Pain

Chest pain is the second most common chief complaint in the ED, with over 8 million visits annually in the U.S. alone. Chest pain evaluation is challenging but very manageable with the current systems and protocols in place in many hospitals

1hr 35min
C3 - Pediatric Abdominal Pain ArtworkFebruary 2017

C3 - Pediatric Abdominal Pain

As with the elderly, children with abdominal pain are special and require a different diagnostic approach. In this episode of C3, we will consider the general approach to abdominal pain in children.

1hr 31min
C3 - Elderly Abdominal Pain ArtworkJanuary 2017

C3 - Elderly Abdominal Pain

Elderly patients with abdominal pain represent a special population that is much more likely to have a serious life-threatening cause than almost any other presenting complaint.

1hr 10min
C3 - Back Pain ArtworkDecember 2016

C3 - Back Pain

Most patients with back pain do not require extensive diagnostic evaluation in the ED. The role of the emergency provider is twofold – to help alleviate pain and to consider the life-threatening diagnoses that may present with back pain.

C3 - Syncope ArtworkNovember 2016

C3 - Syncope

The majority of patients who present after a syncopal episode are safe for discharge from the ED after a focused history, physical examination and ECG. In some cases, a life-threatening cause will be found in the ED. In others, such as those with other cardiac symptoms and implantable cardiac devices, the risk for adverse events is too high and patients are admitted to a monitored setting for further evaluation. The C3 team discuss a practical step-by-step approach to the patient with syncope.

Bonus ShortC3 October 2016 Letters Comments and Rants Artwork

C3 October 2016 Letters Comments and Rants

Mel discusses some important questions from the C3 audience on vag bleeding in the pregnant and non-pregnant patient and the use of TXA, bed and pelvic rest. He also discusses reversing beta-blockers in the asthma patient and goes deep philosophical about C3 vs EMRAP main show. Enjoy.

C3 - Non Pregnant Vaginal Bleeding ArtworkOctober 2016

C3 - Non Pregnant Vaginal Bleeding

After pregnancy has been ruled out, the differential diagnosis of patients with abnormal vaginal bleeding can be divided into structural and non-structural causes. Most are stable and can be managed safely as outpatients. The C3 team discuss a practical step-by-step approach to the non-pregnant patient with vaginal bleeding.

C3 - First Trimester Vaginal Bleeding ArtworkSeptember 2016

C3 - First Trimester Vaginal Bleeding

The C3 gang discusses management of both the stable and unstable patient who presents with vaginal bleeding in the first trimester.

1hr 24min
C3 - Asthma ArtworkAugust 2016

C3 - Asthma

This month Mel & Stuart discuss the "Crashing" & "Stable" asthmatic.

1hr 9min
C3 - Dyspnea Part II ArtworkJuly 2016

C3 - Dyspnea Part II

Most patients with dyspnea will have a common cardiopulmonary cause (i.e.: pneumonia, CHF, pulmonary embolism, MI, asthma, COPD etc.). The C3 team discusses a practical step-by-step approach to your patient with dyspnea, to help you determine what is their underlying cause of shortness of breath and what to do about it.

1hr 57min
Bonus ShortC3 - Dyspnea - Part1 Artwork

C3 - Dyspnea - Part1

Most patients with dyspnea will have a common cardiopulmonary cause (i.e.: pneumonia, CHF, pulmonary embolism, MI, asthma, COPD etc.). For the sake of our learning, in Part 1 we are going to deal with all of the other major causes of dyspnea that are often missed when we assume a cause in the heart and lungs.

Bonus ShortC3 - Minor/Stable GI Bleeding Artwork

C3 - Minor/Stable GI Bleeding

In last month’s episode, we dealt with patients who were obviously bleeding to death. Most patients with GI bleeding present with far less drama. The stakes here are high because the mortality of patients with GI bleeding are substantial.

Bonus ShortC3 - Massive GI Bleed Artwork

C3 - Massive GI Bleed

The unstable patient with massive gastrointestinal (GI) bleeding is one of the most dramatic things we will encounter in the ED.

Bonus ShortC3 - Altered Mental Status - Part 2 Artwork

C3 - Altered Mental Status - Part 2

Stuart and Mizuho continue their discussion about AMS, and discuss less common but interesting causes of AMS, including clinical findings, workup and management of these various diagnoses.

Bonus ShortC3 - Altered Mental Status - Part 1 Artwork

C3 - Altered Mental Status - Part 1

The differential diagnosis for altered mental status is extremely broad. Stuart Swadron MD and Mizuho Spangler DO discuss the most common causes of AMS and review a practical approach to initially assessing a patient with undifferentiated AMS.

Bonus ShortC3 - Headache Artwork

C3 - Headache

A unique approach to the patient with headache with an emphasis on “Red Flag” symptoms and signs

36min · Free Episode