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Sherry Y. -

Hi Mel -
I've seen some young girls in the ER who are "cutters" and come in after cutting their wrists, but have no SI. Just looking for attention? Any thoughts on what to do? Do others get psych team involvement? Do you suture their lacs? Or let them live with the reminder? I would be interested in what the approach other people take. Thank you.

John C. -


I have one request. Can you please come up with a consistent naming convention for your files? I copy them to a USB to listen to in my car and unless I rename them they are in the wrong order. Also, I often put several months worth on a stick so I can listen for a longer drive. May I suggest a format something like 2014_01_CD1_01_What it is.

John Cunningham, MPAS, CCPA

Mel H. -

John here is the answer from our PRODUCER Josh K:

Yup. Starting in December this is the naming convention:


Dean A. -

Since you guys are starting a new naming system, might I suggest a different one? John's idea would actually work better for those of us that listen to MP3s. If you create the title as "2013_12..." rather than "2013_December..." our playlists would be in order chronologically without having to rename our files. Josh K's way, December comes before January in the playlist and my brain simply explodes.

Chandra A. -

Ditto what Dean said!

Brian B. -

Agreed. "EMRAP_2013_12_EpsiodeName" works much better than naming the month.

David M. -

Phillip A. -

I agree with naming the audio files with number of the month vice the name of the month. We all would appreciate it, too, if it was possible to download CME certificates as PDFs instead of having to print them. Grazie!

Jane D., PA-C -

Hey, thanks for including NON evidence based medicine on HA’s. :) Anecdotal information isn't just gossip from a clinician with over 20 years experience and I enjoyed his reminders of a good exam. I thought I was one of the few that always goes for pressure in LPs…I get a heads up when I see an elevated pressure as I wait for the lab. After all, time is metrics, sigh.
I very much enjoy our time together riding in the car.
thx for all you do

Justin A. -

Good EMRAP as always. Does anyone else find it extremely difficult to do a LP in the lateral decubitis position on obese patients, which are the ones you usually want to check opening pressures on to rule out pseudotumor (or idiopathic intracranial hypertension if you want to sound smart)? I can never feel the landmarks and feel like I'm just stabbing in the dark! Plus their skin folds over making mid line impossible to appreciate. Maybe I just have insensitive fingers or something.... This makes me resort to upright position, but then I am scared to lay them over with a needle in their back. I did this once and the needle came out so bent, I thought it was going to break off in their back!

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Episode 147 Full episode audio for MD edition 275:31 min - 130 MB - M4AResumen del EM:RAP Diciembre 2013 Español 83:52 min - 115 MB - MP3EM:RAP 2013 December Bonus MP3 47 MB - ZIPEM:RAP 2013 December MP3 272 MB - ZIPEM:RAP 2013 December - Summary 1 MB - PDFEM:RAP December 2013 Board Review Questions 594 KB - PDFEM:RAP December 2013 Board Review Answers 456 KB - PDF