Rural EM Podcast

I am Carl Richards, MD. I am the founder of Rural EM Podcast. I love EM and practicing in the smaller environment.

[Ryan JJ Buckley @Ryan_jjb]

Interested in the experiences of Native and Rural Emergency Departments in the setting of COVID-19?

Attend the (free, virtual) 2nd Annual Native and Rural Emergency Medicine Conference August 27th-28th!

https://t.co/ATAxSlIaQS

[Rural EM Podcast @RuralEMPodcast]

@beakerdan @RealCedricDark @ebtapper @BCMEmergencyMed That XKCD is brilliant (as always).

[Rural EM Podcast @RuralEMPodcast]

@jmugele I have seen this twice. Once was a nut allergy with isolation to the uvula and another was infection.

[Rural EM Podcast @RuralEMPodcast]

@cjm2791 @SkinnyOrthopod @DGlaucomflecken I was forced to buy them too.

You know what? I never did. Best decision I ever made. I would sneak hospital ones into my pocket or grab ones from friends so I didn't fail. I saved hundreds of dollars (even more after compound interest!) doing that. I always put them back too.

[Rural EM Podcast @RuralEMPodcast]

@DrGolfShirt I did that exact thing leaving a voicemail when trying to get ahold of a patient!

[Rural EM Podcast @RuralEMPodcast]

@TheSGEM @KirstyChallen @MaxHockstein @PulmCrit @reverendofdoubt @CAEP_Docs @ALiEMteam @stemlyns @EMSwami @srrezaie @AliRaja_MD @meganranney @EMNerd_ I'm going to have to read this article!

[Rural EM Podcast @RuralEMPodcast]

@RuralEDPA @hawkvox @dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh Agreed. I've seen the reperfusion arrhythmias and have had patients where their ST elevaron had resolved by the time they get to the receiving hospital. I've also had a few fail and the patient still had a 100% occlusion on cath a few hours later. But largely good, as you said.

[Rural EM Podcast @RuralEMPodcast]

@JSmith522 @dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA The joys of night shift. I should get to bed though...

[Rural EM Podcast @RuralEMPodcast]

@hawkvox @dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA Absolutely. Lytics are still alive in the rural area. I typically give them in my shop unless I can get quick transport arranged.

[Rural EM Podcast @RuralEMPodcast]

@dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA Heck, I've done 3 since residency. There have only been perhaps 4 done in our ED in the past 6 years and 3 of them were mine. Weird luck...

[Rural EM Podcast @RuralEMPodcast]

@dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA It is crazy, but I think I have done about 10 of them. I did 7 in residency where everybody seems was lucky to get one. I don't know why I seem to get all of them...

[Rural EM Podcast @RuralEMPodcast]

@dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA Another trauma topic is crystaloid vs blood products for trauma resuscitation. Many small/rural EDs have limited or no blood available. Is crystaloid better than nothing?

[Rural EM Podcast @RuralEMPodcast]

@dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA In trauma there is a lot of talk about permissive hypotension. If I tangent correctly the studies were in a location with a trauma surgeon nearby. Is there anything showing this is beneficial or harmful when you are transferring and surgery is delayed for a few hours?

[Rural EM Podcast @RuralEMPodcast]

@dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA My area has 2 EMS systems: volunteer and paid. The volunteer system covers the more rural area with longer transport times. Most are first responders. I have wondered if there is literature on the differences between paid EMS with medics vs volunteer crews with first responders.

[Rural EM Podcast @RuralEMPodcast]

@hawkvox @dorojustin @TheSGEM @LWestafer @srrezaie @ketaminh @RuralEDPA This is definitely intriguing to me. I will think about it and see if I can come up with some ideas.

[Rural EM Podcast @RuralEMPodcast]

History lessons at home have been amazing. I guess COVID isn't all that bad... #COVID19

[Rural EM Podcast @RuralEMPodcast]

@RyanMarino I say the same thing about negative tests with high pretest prob. Our county's 1st reported case had symptoms with CLOSE contact to COVID patient but no test. Nobody here understands you can't rely on a negative test with high pretest prob. I TRIED explaining likelihood ratios...

[Rural EM Podcast @RuralEMPodcast]

@DGlaucomflecken This is awesome. I do surgery on my daughters' stuffed animals all the time. I personally use a subcuticular stitch so the suture doesn't show. It may not be as strong, but the cosmetic outcome is fantastic!