Welcome to the Emergency Medicine Cases podcast.

I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.

EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research

and education. The opinions expressed on this podcast are intended for information and education

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 and qualified practicing physician.

STIs do not receive the attention they require for excellent care in the ED. There are 20 million

STIs identified each year in the United

States alone. But this, I didn't know until recently, only 30% of patients are symptomatic.

So that means what? That there's more than like 60 million people in the U.S. alone with

STIs every year. So if you've ever had sex, there's not an

insignificant chance you've had an STI, even if you've always used some kind of protection.

It's no surprise then that there's an under-recognition of STIs in the ED. The question is,

which STIs do we need to assess for and treat in the ED to improve

outcomes? There's some recent trends in SCI epidemiology that we really need to be aware of.

There's syphilis, which is on the rise, which can be life-threatening, like a 58% mortality,

I read in one source when it's unrecognized and untreated.

And there's an increasing recognition that mycoplasma genitalia is a cause of STIs and PID.

In this part one of this two-part series on STI recognition and management in the ED,

we'll talk about a general approach to servicitis,

vulva vaginitis, and urethritis, elucidate some key historical features, debate who needs a pelvic

exam in the ED, understand who needs what testing when, debate self-swabs versus physician-taking

...