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Emergency Medicine Cases

EM Quick Hits 39 Overdiagnosis, Lytics for Submassive PE, Pericardial Effusion, Hemophilia Treatment

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7602 Ratings

🗓️ 21 June 2022

⏱️ 52 minutes

🧾️ Download transcript

Summary

In this month's EM Quick Hits podcast Justin Morgenstern & Eddy Lang discuss the problem of overdiagnosis in EM, Anand Swaminathan's approach to indications and dosing of thrombolytics for submassive (intermediate risk) pulmonary embolism, Tahara Bhate's QI Corner on a patient with unexplained shortness of breath, Brit Long on emergency treatment of the bleeding hemophilia patient...

Transcript

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0:00.0

EM cases is part of Shremie, the Schwartz-Riseman Emergency Medicine Institute.

0:19.6

That's the nonprofit organization dedicated to improving EM care through high-quality research and education. The opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases.

0:43.7

All right, here's a question. Have you ever been diagnosed with the medical condition yourself?

0:55.7

If you have, think for a moment about how you felt at the time you found out the diagnosis and what kind of psychological impact it had on you and your loved ones and the impact of any treatments you may have received. Now think about the possibility that that diagnosis was an

1:02.2

over-diagnosis, an over-diagnosis. In other words, a diagnosis that would never have caused

1:09.7

any symptoms or problems, the kind of

1:12.1

diagnosis that can be harmful if it leads to psychological stress and unnecessary treatments.

1:17.8

This special EM Quick Hits features our own Justin Morganstern interviewing Eddie Lang, the academic

1:23.1

department head and professor in the Department of Emergency Medicine at the Cunning School of

1:27.7

Medicine, University of Calgary, and the Clinical Department Head for Emergency Medicine,

1:31.8

Calgary Zone, Alberta Health Services. He's also a senior researcher at Alberta Health Services.

1:37.8

You may remember him from our latest main episodes on PE. Let's hear more about the problem

1:42.7

of overdiagnosis in emergency medicine.

1:47.3

Overdiagnosis. This is a concept that I think every doctor must know. Preventing overdiagnosis

1:54.4

is what drives a lot of my philosophical approach to medicine. Overdiagnosis is one of the

2:00.5

core reasons that we spend so

2:02.0

much time on EM cases trying to bring you evidence-based medicine. Whether it's our journal

2:07.7

jam episode on stress testing or our main episode on UTI, if you listen carefully, overdiagnosis

2:13.3

is a key theme. But despite its importance, we haven't spent much time talking about it directly.

2:20.0

And I want a remedy yet. So to help, I've invited Dr. Eddie Lang, a name known to everybody in

2:25.2

Canadian emergency medicine, one of the true leaders in our field, because he just published

2:29.3

an excellent paper on the topic. Eddie, thanks for joining us.

...

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