The Point of Care Podcast: Recent Episodes

RMO Medical Education

The Point of Care Podcast provides high-yield medical information to help clinicians effectively and efficiently manage patients with common medical complaints. The show is based on the templates featured on pointofcaremedicine.com, which aim to standardize common patient encounters and promote evidence-based practices.

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This Quick-Admit episode on acute pancreatitis will focus on only the highest-yield information you need when admitting a patient to the hospital.

To take your understanding of the disease to the next level, check out the full-length episode for more information including a discussion of the most important clinical pearls and literature.

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

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This full-length episode on the inpatient management of acute pancreatitis includes not only the admission framework, but also key clinical pearls on the background, pathophysiology, etiologies, presentation, diagnosis, treatment, and complications associated with the disease to help take your understanding to the next level!

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Timestamps

00:00:00 - Background and Epidemiology

00:01:13 - A Note on Chronic Pancreatitis

00:01:31 - Admission Checklist

00:03:49 - HPI Intake

00:04:33 - Physical Exam

00:05:20 - Etiology and Differential

00:06:20 - Plan - Work Up

00:07:30 - Plan - Treatment

00:09:31 - If You Remember Nothing Else

00:10:04 - Pearls - Pathophysiology

00:11:15 - Pearls - Etiology and Risk Factors

00:12:56 - Pearls - Presentation and Diagnosis

00:15:56 - Pearls - Treatment

00:18:08 - Pearls – Complications

Show Notes

Reviews

  • Acute Pancreatitis: A Review ⁠(JAMA, 2021)⁠
  • Acute Pancreatitis ⁠(NEJM, 2016)

Trials

  • WATERFALL Trial - Aggressive (20 ml/kg bolus + 3 ml/kg/hr) vs Non-Aggressive (10 ml/kg bolus + 1.5 ml/kg/hr) fluid resuscitation in acute pancreatitis - fluid overload resulted in 20.5% vs 6.3% of patients but no difference in the development of moderately severe or severe pancreatitis ⁠(NEJM, 2022)

Other Literature

  • Enteral versus parenteral nutrition for acute pancreatitis ⁠(Cochrane, 2010)⁠
  • A Critical Evaluation of Laboratory Tests in Acute Pancreatitis ⁠(Am J Gastroenterol, 2002)

Blogs and Summaries

  • Clinical Problem Solvers - Acute Pancreatitis Illness Script
  • Internet Book of Critical Care - Pancreatitis
  • Radiopaedia - Imaging Findings in Acute Pancreatitis
  • Pathway Guidelines Summary - Acute Pancreatitis

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Timestamps:

00:00:07 - Background and Epidemiology

00:00:42 - Pathophysiology

00:02:29 - Admission Checklist

00:04:29 - HPI Intake

00:05:15 - To Note on Exam

00:05:25 - Etiology and Differential

00:06:10 - Plan - Treatment

00:07:56 - If You Remember Nothing Else

00:08:40 - Pearls - Etiology

00:09:44 - Pearls - Presentation and Diagnosis

00:12:03 - Pearls - Treatment

Trials and LiteratureClinical Management of Hyperkalemia (Mayo Clin Proc, 2021)An Integrated View of Potassium Homeostasis (NEJM, 2015)Risk of Hospitalization for Serious Adverse Gastrointestinal Events Associated With Sodium Polystyrene Sulfonate Use in Patients of Advanced Age (JAMA, 2019) - Kayexalate is associated with serious GI adverse events over 30 days (0.2% of people who take vs. 0.1% who don’t) - NNH is 1000; intestinal ischemia is the most commonSodium zirconium cyclosilicate in hyperkalemia(NEJM 2015) - reduces K over placeboOther Resources:Clinical Problem Solvers - Hyperkalemia SchemaCore EM - Hyperkalemia (good EKG change images)

Life in the Fastlane - EKG Features of Hyperkalemia

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care without getting bogged down by unnecessary details or trivia.

Timestamps

00:00:08 – Background

00:01:12 – Pathophysiology

00:01:55 – Admission Checklist

00:03:29 – HPI Intake

00:04:19 – To Note on Exam

00:04:58 – Plan: Workup

00:05:40 – Plan: Treatment

00:07:28 – If You Remember Nothing Else

00:08:28 – Pearls

00:10:43 – Literature

Literature

IWGDF/IDSA Guidelines on Diagnosis and Treatmentof Diabetes-Related Foot Infections (Diabetes Metab Res Rev, 2023)

Diabetic Foot Ulcers and Their Recurrence (NEJM, 2017)

Diabetic Foot Ulcers: A Review (JAMA, 2023)

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Time Stamps:

00:00:08 - Background and Definitions

00:01:39 - Pathophysiology

00:03:22 - Admission Checklist

00:04:25 - HPI Intake

00:05:51 - Physical Exam

00:06:06 - Differential Diagnosis

00:06:38 - Plan - Workup and Treatment

00:08:54 - If You Remember Nothing Else

00:10:14 - Pearls - Etiology

00:11:00 - Pearls - Presentation and Diagnosis

00:13:07 - Pearls - Treatment

00:15:20 - Literature and Trials

00:15:56 - Wrap Up

Show Notes:

Gout Review (NEJM, 2022)STOP Gout Trial (NEJM, 2022) - allopurinol non-inferior to febuxostat for preventing flares and for reaching target urate concentrations at 48 weeksCARES Trial (NEJM, 2018) suggested an increased risk of mortality in febuxostat from cardiac events, but a follow-up FAST Trial (Lancet, 2020) showed no difference compared to allopurinol - FDA still has a black box warningCalcium Pyrophosphate Deposition Disease (CPPD) Review (NEJM, 2016)

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Today's episode is on the inpatient workup and management of Community-Acquired Pneumonia featuring an admission checklist, HPI intake, differential, plan, and high-yield clinical pearls.

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care without getting bogged down by unnecessary details or trivia.

Show Notes:

00:00:08 - Background and Definitions

00:01:13 - Etiology and Pathophysiology

00:02:49 - Admission Checklist

00:05:16 - HPI Intake

00:06:38 - Physical Exam Findings

00:07:30 - Differential

00:08:48 - Treatment Plan

00:10:15 - If You Remember Nothing Else

00:11:47 - Clinical Pearls - Etiology

00:13:47 - Clinical Pearls - Presentation and Diagnosis

00:16:53 - Clinical Pearls - Treatment

00:19:52 - Clinical Pearls - Complications

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

00:00:07 - Historical Background and Definitions

00:01:56 - Admitting a Patient with Sepsis

00:05:29 - Plan for Workup and Management of Sepsis

00:07:41 - Clinical Pearls

00:16:07 - If You Remember Nothing Else

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Show Notes:

00:00:15 - Introduction and Terminology

00:01:51 - Beta Blockers

00:02:47 - ACE/ARB/ARNI

00:04:30 - MRA's

00:05:28 - SGLT2i's

00:06:12 - Nitrates and Hydralazine

00:08:41 - Loop Diuretics

00:09:25 - Initiating and Titrating GDMT

00:11:18 - Barriers and Other Considerations

00:13:44 - Resources for Use at the Point of Care

Other Resources and References:

GDMT for Everyone – https://www.gdmt.org/HFrEF.php

Table of all the Sacubitril/Valsartan Trials Published to Date (2023) - https://twitter.com/jaycvance/status/1660732176999108623

An elegant graphic showing how the hazard ratios with confidence intervals for all-cause mortality improve based on adding on each extra GDMT medication; brought to my attention by a tweet from Dr. Scott Cameron - ⁠https://twitter.com/2Scottish/status/1556798319996932096⁠

Heart Failure with Reduced Ejection Fraction: A Review (JAMA, 2020) - https://pubmed.ncbi.nlm.nih.gov/32749493/

A Systematic Review and Network Meta-Analysis of Pharmacological Treatment of Heart Failure With Reduced Ejection Fraction (JACC, 2022) - ⁠https://www.jacc.org/doi/full/10.1016/j.jchf.2021.09.004

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Show Notes:

00:00:38 - Background and terminology

00:02:22 - Checklist for Admitting a Patient with ADHF

00:05:40 - Crafting your Assessment

00:08:56 - Creating a Plan for ADHF - Diuresis and GDMT

00:13:12 - Clinical Pearls

00:16:48 - A note on HFpEF

00:17:15 - If you remember nothing else

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Show Notes:

00:00:00 First steps and communicating with the ED

00:01:05 - Following up after dosing

00:02:02 - Troubleshooting resistance - drips, other loops, thiazides

00:03:35 - Monitoring while diuresis - labs and exam

00:06:09 - Switching to PO and guidance for discharge

00:07:19 - Presenting patients who are being diuresed

00:08:12 - If you remember nothing else

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

00:00:00 - First Things First

00:01:01 - Assessment of post-cardiac arrest patients, including the likely etiology, duration of CPR, and relevant medical tests.

00:01:46 - Plan for working up and treating post-arrest patients.

00:04:00 - Pearls for post-cardiac arrest care, including treating shivering, aspirational pneumonia prophylaxis, and looking for complications.

00:06:11 - Trials and literature related to post-cardiac arrest care

00:06:58 - If you remember nothing else

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

Timestamps:

00:00:00 - Initial Steps and Delegation: Starting chest compressions, confirming code status, calling for help, delegating tasks, and gathering data. (Includes information on rhythm and pulse check, patient access, labs, and involving family members.)

00:02:21 - ACLS Protocol and Rhythm-Specific Interventions: Explains the procedure for rhythm checks, pulse checks, use of POCUS, intubation, and treatment based on shockable and non-shockable rhythms. Discusses medications and adjuncts for different rhythms and scenarios.

00:05:28 - Reversible Causes and Post-Cardiac Arrest Care: Covers the differential for reversible causes of arrest (H's and T's), treatment options, and considerations for post-cardiac arrest care. Includes targeted temperature management and decision-making based on patient condition.

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Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

At Point of Care Medicine, our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed on this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed in this episode.

Our mission is to create accessible and easy-to-use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.

View Details

Visit pointofcaremedicine.com to see the templates, pearls, literature, and other resources discussed on this episode.  

Our mission is to create accessible and easy to use digital resources that help healthcare professionals tackle common clinical presentations at the point of care, without getting bogged down by unnecessary details or trivia.