This episode we dive deep on diltiazem, talk about clot busting in PE smart and silly things to do in airway management and Justin informs us about New World screw worms #FOAMed
Justin and i are back fro the first episode of the Journal Jam for 2025. we discuss a lot of stuff about TXA, adrenaline, salt correction, dissection and infections! Lots of great #FOAMed for the month of January.
This month we cover a few out-of-hospital arrest trials. More PECARN goodness and we answer the question: are ants better doctors than human doctors?
This episode Justin and I explore another epi in OOHCA trial, dog bites, the latest PECARN paediatirc neck trauma study and some bougie pearls... and a whole lot more!
In this episode Justin and I are joined by a bunch of the local trainee doctors in Broome to discuss a set of 6 papers, mostly new, on hot-of the press and one 100 years old!
This month Justin and I review a cluster of eclectic articles covering the gamut of ED and critical care and one very primary care paper!
On this episode of the JC we discuss the PREOXI trial, also some stuff on NGT tricks, methylene blue in sepsis and yet another STEMI-equivalent pattern..
Justin and I are back for another monthly journal club... this time we intubate in space badly and explore medieval placebo trails in France... there is also some get EBM sprinkled in there!
This month we tackle some airways and resus topics then slide into a whole heap of dermatology... that is something we probably don't cover enough in ED teaching.
Lots of stuff, papers and critical analysis for ED care.
In this episode we look at bag size in Resus, GTN dose for SCAPE (O), button battery honey fixes and ask the question: is pregnancy a disease? There is a ton of other topics to make you tink about what we do in the ED..
Welcome back tot he podcast journal club with Justin and Casey.
This month we chat about a lot of life threatening stuff and some really not dangerous things. There is a heap on acute Mental Health evidence too.
A busy journal club in which Justin and I discuss 13 papers that might help you on your next shift in the Emergency department.
On this episode I discuss the modern scientific and practical approach to massive haemorrhage in trauma with Dr Justin Morgenstern
Are Clinical Decision Rules (Tools) helping us make better calls in the ED? Are they making us better? Do they lead to better outcomes for our patients? Dr Justin Morgenstern and I go over the evidence and the future of ED decision making.
A special episode of the podcast in which Justin travels to Perth to join a bunch of fellow EBM nerds to discuss a bunch of old and new papers.
This month's journal club features many trails - each with their own unique questions and qualities. We look at herbs for sepsis, steroids in pneumonia, metformin for long-Covid and a heap of other ideas in the world of ED science in 2023.
This month on the Journal Club we tackle a lot of PAeds - croup, HFNC, sepsis and buckle injury. There is some old stuff about CT Head rules and some fascinating oddball papers.
This month we try to answer some of the big questions in ED practice... we do not necessarily succeed...
This month we discuss "breaking good news"; less is more in temperature management, IV fluids, gloves... basically everything!
Up your EBM game with some hands on data dissection! #FOAMed
On this months epic journal club we cover small PEs, small Dimers, CT-contrast, genomics, injecting spider juice and a whole bunch of stuff in between...
The nerdy goodness of #FOAMed #EBM is back with @First10EM and @broomedocs discussing a lot of papers - PE, COvID, flaming fingers, diverticulitis, overdiagnosis, more PEs, vitamin C, fraud and some myth busting
This month Justin and I tackle non-fatal MI, AF drugs, the worlds most deadly jewellery, some serious ethical questions and why tramadol is even worse than codeine! We also put the final nail in the saline vs. Ringers debate
Welcome to another research roundup with Justin and Casey. This month we cover the COCA trial, bougie v stylet, Raptor ring cutters and more...
Another set of evidence papers to discuss with Dr Morgenstern.
We tackle hypothermia, malaria, Covid-bum, ketamine for ED take down and a whole heap more...
Another set of evidence papers to discuss with Dr Morgenstern.
We tackle hypothermia, malaria, Covid-bum, ketamine for ED take down and a whole heap more...
The Journal Club is back... Basics, TTM, ear tubes, delayed antibiotics and a lot on semantics, medical metaphors... LP on anticoagulants ... all the good stuff
This month we cover kangaroo trauma, Bell's palsy, HEAR(T) scores, Covid, Adrenaline (again), PPIs (Again) and how sex can improve your nasal function.
This month we are covering another Dexamethasone trial, magnesium vs. morphine in the renal colic showdown and exactly how to do CPR in zero gravity... Justin even rants about stuff as banal as burn blisters!
Justin and I discuss a dozen recent papers from the acute care literature and beyond. This month we cover: TXA for brain trauma, Paediatric COVID complications, Warfarin reversal, poultrasound and plenty more.
Welcome back for another month of nerdy Nirvana with Dr Justin Morgenstern. This month on the journal club we cover TXA for GI, Dex for COVID, pinky ladies (again) and haloperidol for headaches... plus a bunch of other goodies that ust might make your job easier.
The journal jam is back in June with Justin.
Vertigo, Renal colic, Vit C, thiamine and other nutritious stuff
This is the conclusion to the discussion with Dr Anand Senthi about EBM and how we can make it better.
EBM is broken. It needs an update to become a useful tool to further medical science.
Dr Anand Senthi joins Justin and I for a deep dive into the problems with EBM and the way forward.
Justin and I discuss the latest literature on the Covid Crisis and how we can try and apply some loose science to hard medicine.
This is a rapid review of a dozen papers out of the SARS COV2 epidemic....
Justin and I discuss the evidence and the practicality of applying it in this rapidly evolving epidemic.
Hold onto your hats, it is hot off the press.
This special episode is all about safety, planning and airway strategy in the current epidemic.
Dr Tim Leeuwenburg is an author of the Safe Airways Society paper that hit the MJA this week
Welcome once again to the journal club. Justin is back with TEN papers to discuss. There are a few practice changers in here and some serious acronyms to digest
The Journal Club is back with Justin Morgenstern and I dissecting and disputing 10 papers over an hour.
Lots of Cardiology, some fractures, we answer that question: "Does saying 'QUIET' in ED make it louder?"...
#FOAMed
We are back! Another journal club with Dr Justin Morgenstern. This month we have a really diverse bunch of papers that take a look at CRASH-3, distraction techniques for kids in ED, making the patient experience better, wound closure and syncope workup (Spoiler: CTs ain't that great).
Welcome back. Another instalment of the EBM Journal Club with Dr. Justin Morgenstern.
Topics include NSAID dosing, moose attacks, COACT trial, snowfall impact on ED, conflicts of interest in FOAMed and a bunch of other stuff
This is a clinical case discussion I participated in for the RVTS Grand Rounds.
Thanks to the team for inviting me and providing the audio
tough case with lots of pearls to take away
I have learned a lot about the rational prescribing of vancomycin in the last few years and have read literally hundreds of papers on the topic. In true "Broome Docs" style I have dived deep down the rabbit hole of pharmacological, microbiological and clinical literature to bring you what I think is a 'better way' to use vancomycin in small, rural hospitals.
I have learned a lot about the rational prescribing of vancomycin in the last few years and have read literally hundreds of papers on the topic. In true "Broome Docs" style I have dived deep down the rabbit hole of pharmacological, microbiological and clinical literature to bring you what I think is a 'better way' to use vancomycin in small, rural hospitals.
Dr Justin Morgenstern and Damian Roland do a deep dive into the latest data around Paeds Seizure management after Eclipse and Consept trials were published.
Or maybe there is a better way?
Another instalment of the journal jam with Justin Morgenstern.
This month we talk neonatal sepsis, nocebos, Pink Ladies, fever, tramadol, chin lacs and drinking strategies....
This is a discussion on the recent CREDENCE trial for canagliflozin in diabetics with nephropathy.
This is a discussion with Dr Roger Browning (Obstetric Anaesthetist) about his approach to the crashing GA Caesarean scenario.
You can hear more of his pearls at the ObsGynae CritCare podcast
Sadly, the final SMACC conference danced its last moves on Friday. It was an amazing week with lots of learning, inspiration and camaraderie. After the last SMACC in Berlin Justin and I resolved to try and create the best journal club ever at the final SMACC in Sydney.... and I reckon we have done it!
Dr Adam O'Brien and Claire Lissaman are the authors of a new study looking at the diagnostic characteristics of lung US for Paediatric pneumonia.
In this interview we talk about the study and how to scan kids with chest disease.
In this episode Justin and I cover bad science about Xa reversal, good science about sharks, syncope and how to cheat Death.... amongst other random serious stuff
The latest instalment of the RADU / Broomedocs podcast.
GA Caesarean thoughts
Minimalist desert island appendix anaesthesia
Frusemide mythology
A tricky case for the team
The year is drawing to a close and we have just one more chance to learn from my very wise, ex-Canadian friend Dr Justin Morgenstern. In this month's episode, Justin and I discuss a bunch of papers. Topics include:
The 3rd instalment of the journal club for rural GP Anaesthetists.
This month we look at papers on medication safety, midazolam as a premed, URTI in kids for elective surgery and lignocaine infusions
This is a story that I told at the DFTB18 storytelling event.
The theme was about kindness, justice and hope.
It is a personal, non-clinical story that I hope can help others out there.
The latest episode of the EBM journal club with Dr Justin Morgenstern
This month we cover a lot of fluids - saline, balance, FFP as well as some penile fractures and Justin explain why he is a great driver.
This month we cover bougies, brain-bleeds and the best Paeds DKA paper ever. We also degenerate into the recent and remote evolutionary history of hiccoughs... fun times are to be had!
This podcast contains a discussion on the How, Why, where and Who of central line insertion...
This is the second instalment of the Rural Anaesthesia Journal Club.
I am joined by Drs Alex Harris and Mel Little to discuss:
NAP6, soiled airways, Caesar spinal dose adjustments and the RELIEF trial.
This is the second instalment of the Rural Anaesthesia Journal Club.
I am joined by Drs Alex Harris and Mel Little to discuss:
NAP6, soiled airways, Caesar spinal dose adjustments and the RELIEF trial.
This month we cover biases, show our biases about bronchiolitis therapy, cute scrotums, judging and dealing with capacity and how butt-slapping might help you delouse your colleagues....
[DISCLAIMER: we do not recommend that extradural hemorrhage ever be treated with an Ezy-IO drill, it is silly and dangerous.]
If any of that sounds like your deal then have a listen. If you are super patient and listen all the way through there is a real treat for you....
... a world premiere musical parody song by Dr. Gerry Considine and yours truly. ( we are kinda like Elton & Bernie)
In this month's episode Justin and I cover chest pain, LPs, nebulised furosemide and of course the sport of Quidditch
A new project - a Rural Anaesthesia Journal Club. Bringing the gas data to the bush.
This episode features Dr Alex Harris
We are back! Yes, once again I am joined by my Canadian buddy Dr Justin Morgenstern to bring you a rough guide to Justin's favourite papers of the month. #FOAMed
This episode I reflect upon a really tough airway case.
I have asked a number of airway gurus from the FOAMed community to comment on the logistics and plan to manage this case.
Enjoy
Welcome back to the Journal Club with Dr Justin Morgenstern. It has been 2 months since we last dusted off the papers on Justin's bedside table... but like a mythical (nerdy) Sisyphus Justin must push another load of evidence out into the ether in order to go back and start the whole process again.
This episode is on steroids. I mean it is largely about steroids, not actually "on steroids" but there is a sprinkling of other stuff and a bit of philosophical banter about machine learning at the end.
So sit back, grab a beverage and tune in for another hour of evidence and education from our corners of the world.
NEWS: I am launching a new podcast segment
The working Title is: Rob's Probs and Casey's Cases (Ed: may change if we come up with something better)
The new podcast series is all about CLINICAL REASONING. Exploring how we think through a diagnosis or problem. In order to do this I have teamed up with Dr Rob Park, a Queensland GP from the "Sunny Coast"
Here is episode 1.
Hi all
The latest episode of the journal club features an ecclectic bunch of papers of variable quality presented by two minds of variable quality!!
We cover alcohol levels, ear tubes, eyelid injuries and HUGS!
Enjoy, Casey
This is the vodcast version of a talk I am giving at the Australian College of Dermatology meeting next week.
Why am I speaking at a Derm conference? Who knows! My knowledge of skin is superficial at best....
Anyway they wanted to know about things that might kill you in Broome... so apart from humans, this is the most dangerous things I can think of at short notice.
I am joint don this episode by my favourite marine biology enthusiast - Julius Parker, he is 7 years old, in Year 2 and knows more about animals than most postdoc students!
This is the vodcast version of a talk I am giving at the Australian College of Dermatology meeting next week.
Why am I speaking at a Derm conference? Who knows! My knowledge of skin is superficial at best....
Anyway they wanted to know about things that might kill you in Broome... so apart from humans, this is the most dangerous things I can think of at short notice.
I am joint don this episode by my favourite marine biology enthusiast - Julius Parker, he is 7 years old, in Year 2 and knows more about animals than most postdoc students!
A ripper of a journal club episode. Recorded live in Berlin at the DasSMACC conference last week. Justin and I invited a cast of superstars to share a drink over the mike and discuss an eccectic bunch of papers.
Welcome back to the kinda monthly journal club with Dr Justin Morgenstern and I.
This month we do WOMAN, CO tax, Wellen's and Sarin gas
Casey
This is a deep dive into a recent lung US paper looking at the sensitivity of eFAST exam for pneumothorax in blunt trauma patients.
The conclusion was a really low sensitivity... but as a skeptic and lung scan enthusiast, I have decided to explain how I think we should interpret this paper.
Casey
Hi all
This is a guest vodcast from one of my Obstetric Anaesthesia mentors Dr Roger Browning. Roger is a great bloke and a Consultant Anaesthetist with particular interests in Obstetric haemorrhage and thromboelastography in major haemorrhage.
I have been lucky enough to attend a few of the live teaching sessions that Roger chairs at King Edward's Hospital for Women in Perth. This lecture was taken from that session.
Apologies it is a little longer than the usual podcast, but plenty of food for thought for anyone doing Caesars or Anaesthetics out there.
Another live journal club with Justin M & Casey P
This month we have 11 papers in 3-quarters of an hour. We cover the good, bad and ugly of migraine sprays. How Facebook stats can determine your longevity, Marik's Magic Sepsis Sauce and how to "toughen up" in the face of rudeness mid-Resus!
Enjoy
Dr Resa Lewis @UltrasoundREL is a pioneer of #POCUS
In this podcast she shares a tragic story that changed the lives of a number of people.
The first Journal club episode for 2017 with Dr Justin Morgenstern.
We cover Acute heart failure, anxious chest pain, clavicle fractures and emergency zipper release amongst other topics
Enjoy the FOAM
Casey
Welcome back the the last journal club with Dr Justin Morgenstern for 2016. [Yes, it is now 2017... but that's life.] Another batch of 10 delicious articles to satisfy your post-Christmas cravings for academic nerdiness. There a bit of something for every taste this month.
At the last SMACC outing in Dublin there was a stand-out lecture by Dr Ross Fisher ( @ffoliet ) entitled: Things that Scare Me. Ross is a bit of a presentation guru - and hence he had plenty of pressure on to deliver a great talk.... and he did exactly that. It was a pin-drop-silently, slideless baring of the soul.
This is the back story behind the talk that lead Ross to learn a lot about himself and how doctors sometimes behave towards one another.
This episode of Lessons Hard Learned comes from Johannesburg in South Africa - I am joined by Dr Tori Stephen to discuss a tough trauma case and some pearls from trauma on ultrasound and clinical decision-making in traumatic crises!.
November's edition of the Justin and Casey Journal Club is out!
Have a listen and check out the written notes over at First10EM.com
This is the vodcast version of my SMACCDUB lecture on modern diagnosis using Bayesian reasoning
Welcome back to the podcast for October's Articles of the Month
Another month of interesting reading with Dr Justin Morgenstern. Check out the First10EM blog for full written version.
October 2016 Journa Club
Another month of interesting reading - articles of the month journal club with Dr Justin Morgenstern.
This vodcast is a version of the talk I gave last week at the ACEM Annual Scientific meeting in Perth.
We were asked to present a "challenging case" - I decided to present a trauma case that I think represents the maturation of my trauma practice.
The case is pretty straightforward. However, there are a few concepts thrown in that you may not have heard before. Airway management, massive transfusion, head injury... it is a tough case.
Its a new month and that means a new episode of the First10EM / Broomedocs Journal club.
I have learned so much by just hanging out with Justin and reading the papers he digs up each month. I hope you are learning the easy way too! This month we have 10 papers for you with topics ranging from massive haemoptysis to "Tweeting drunk en route to ED"...
So sit back, grab a beverage and listen in for the JC with J&C.
This episode of "Lessons" is a little different. My guest is Dr Heidi James, Canadian Primary care doc, and one of the voices of the Primary Care RAP podcast.
Heidi and I have worked together in the Hippo ED shed on the Primary Care RAP for a few years and we seem to have a lot in common when it comes to work, life and the all important balance. So we decided to yarn about how we make it work with family, work and all the other stuff life throws our way. Can we have it all? What advice would we give given what we know now? There is even a tale involving fatherhood, faeces and the fruit section....
Today's "Lesson" is all about knowing one's limitations, scope of practice and appreciating the little voice inside one's noggin.
Dr Andy Buck is an ED Physician who works all over Australia, but is based in Melbourne where he runs the very excellent Emergency Trauma Management course.
This is a case of procedural sedation which goes a little awry. It is a nice counterpoint to all of the stuff we hear about safety, "fasting status" and the classic - "easy intubation, rocky extubation" scenario.
Another lesson Hard Learned episode.
This week I am joined by Dr Anand Swaminathan from Bellevue Hospital in NYC.
Anand shares a tricky case involving the treatment of a VIP patient in his ED.
We discuss a few strategies to help keep both you and the patient safe when we are treating VIPs.
Casey
Another month of rapid fire journal club with Dr Justin Morgenstern and myself.
15 papers in 40 minutes... with free PDFs
Ready, GO!
Casey
This Lessons Hard learned with Dr Seth Trueger in Chicago is all about how we deal with the 'frequent flyers' in our EDs. This group of patients present a myriad of cognitive and clinical challenges.
So have a listen to this case and learn a few lessons, share your experiences too!
I am diving back into the "Lessons" series with my first new guest... actually an old guest returning - Dr PEnny Wilson tells us about how she struggled to make the right call as a junior doctor at a time when supervision and guidance were lacking...
The first ever episode with Dr Justin Morgenstern ( @ First10EM )
We discuss 14 of the papers you ought to read from July 2016.
Dr Bret Batchelor joins me to talk about his work as a rural Canadian surgery, training, doing stuff better etc. @ReallyRuralsurg
This is a discussion of a tough airway case - my mate Dave Forster and I go over a tough case and he tells me the "how", some great tips and tricks and how to run a team in crisi scenario.
This is a discussion on the use of early, peripheral vasopressors in patients with septic shock.
The core messages:
- limit fluids
use vasopressors earlier / synergistically with IV fluids
Use Noradrenaline
use it peripherally (ie. through a good, watched, flowing IVC - idealaly proxiaml to the elbow.
think about the use of CVCs and potential harms / benefits in small hospitals.
My old friend and mentor Dr Airell Hodgkinson has recently completed an audit in his hospital looking at the outcomes for patients with fractured NOF (hips).
He and his fellow GP Anaesthetists wanted to know if they were doing the right thing by their patients - operating on them in a regional town vs. transferring to a tertiary centre with specialists Anesthetists and ICU backup.
So I recorded this chat with Airell about his audit and the bigger picture of "Doing good medicine" as a GP proceduralist in the rural areas.
Its probbly not something many city doctors think about much - but its a concept that we rural generalists think about frequently
This is a talk I produced for the SWEETS 15 conference in Stockholm, Sweden.
The first 15 minutes is about my approach to Suicide risk assessment. Then the last 6 minutes are from my RMO Dr Nick Gilbert on the future of suicide, ketamine and Quinolic acid... are we there yet... not really
This is a podcast that discusses the everyday application of Evidence based medicine into real-world scenarios.
Shared decision making is a simple concept with a lot of dynamic factors to consider - how do we make it work on the floor or in the consult to ensure best outcomes for our patients?
Listen on....
Dr Penny Wilson - regular guest on the podcast nad author of the "bits n Bumps" podcast has recorded this really interresting interview with my old boss, mentor and teacher - Dr Geoff Riley.
Geoff has a practice as a GP and Psychiatrist which includes a large number of health care professionals. He shars his insights on how to be a doctor when your patient is also a doctor.
Thanks Pen
After the recent NEJM paper on the US vs CT for suspected renal colic - I have asked Dr Adrian Goudie to share his thoughts on the modern workup for the patient with possible renal stones.
This is an introduction to the basics of lung ultrasound. It focusses on the "how to" of setting up your machine, probe use and position as well as some pearls for young players.
Dr Baker is an ED Doc from Queensland, Australia who has researched the use of bedside US for the Dx of acute heart failure in ED
This is a chat I recorded with my mate and mentor Dr Jim McDonald.
Jim is a 45 year veteran of GP, and has worked all over Australia in family, Aboriginal health, Anaesthesia and Obstetrics. He is based in Melbourne but spends his time doing locum work with us in Broome.
In 2015 Jim was awarded the Order of Australia for his contributions to MEdicine.
Hi All
After the recent blog post on Strept throat and swabbing with a look at the sequelae of this common disease I have recored a chat with some gurus.
The PAeds Hangout team joins me to dissect the practice from all over the world
A quick Brome Pearl rant on the perils of confusing the biostats we use when we describe the effects of screening.
Use mortality (all cause) not 5 year survival.
C
Are you planning to go to the USA for SMACC Chicago.
Well we have the ultimate pre-SMACC workshop for you. And it is all in a good cause - help us help out a brother Ultrasound lover.
This is my response to Scott Weingart's Emcrit post on Errors of Commission vs Omission.
It s a Broome pearl for you
Here is the latest office Gynae podcast from Broome Docs favourite Gynae guru - Dr Penny Wilson
The use of Optic Nerve Shaeth Diameter measurement for assessment of patients with potentially raised ICP has been a contentious area of practice for a few years.
The studies look good at first read, but then when you stand back and look at them all - something is wrong - they all disagree on the norms, the cut-offs and the anatomy.
So I have enlisted the help of Dr LEanne Hartnett - US-wielding ED Physician from Fremantle Hospital in WA.
Leanne helps us sort out the facts and form an idea of where we need to go to make this potentially beautiful use of US really work on the floor.
Casey
This is the audio from a recent hangout chat about the common problems we face when trying to assess and manage small children with fever in the ED.
Teething, UTIs,, otitis media, pneumonia and all the ways we can get it wrong are discussed.
After the recent publication of the process trial in the NEJM and discussion all over the FOAM forums - I have been contemplating how we might apply the findings in our smaller EDs, in the small rural towns where patients still get sepsis, and I believe should get world's best care.
PROCESS has many helpful findings that I think we can utilise... despite being a negative trial!
Here's my thoughts in the first "Broome Pearl" podcast - its just me, solo with my thoughts....
A few links that I mention:
The ProCess trial in NEJM and supplementary data are HERE
The New York STOP SEPSIS collaboration has info on EMCRIT HERE
Simon Carley's piece on St Emlyn's looking at our outcomes with Sepsis over the past dozen years
Seth Trueger's analysis on MDAware is here
A discussion about the practicality and logistics of dealing with trauma in the field, in a small ED and in transit.
Lots of pearls from a guy who does this sort of thing a lot! Dr Tim
Another in the Lessons Hard Learned series
Another Irishman in Australia telling us about a moment in medicine where he learned a few tough lessons and shares them with you.
C
This is the ultimate Lessons Hard Learned!
Ever considered getting out of Medicine - changing you life for a different trade - losing the identity of "Doctor"
Here is a candid chat with my friend who did just that.
Hear how it goes. Casey
Aimed at primary care, but a fascinating look at a worls of gnarly evidence, confusing confounders and fundamentally flawed research. Vit amin D deficiency, overdiagnosis, debate and practice tips.
See the foam4gp.com website for refernces here: foam4gp.com
Dr Penny is back with a quick chat about contraception
We cover the best resources to tackle this complex and common presentation.
We then discuss the recent controversy around the OCP and DVT - what are the real numbers and how to discuss the risks with women.
Another Irishman delivering a lesson in medicine.
Andy tells us about a case that might have helped shape his future career!
Enjoy
Recorded at BCC4 conference in Cairns. I caught up with the lads for a chat in the garden - apologies for all the birds and kids! It is that sorta conference, that sort of place!
Lessons learned from about semantics - using words with precision and meaning. We touch on some tough tips for communictaing in critical moments - with colleagues and patient's or their families
Casey