TheCase.Report
By TheCase.Report
Brought to you by Irish Emergency Medicine Trainees and proudly supported by IEMTA and the Irish Association of Emergency Medicine.
TheCase.ReportMar 25, 2024
S4E11: Bonus - Fergal Hickey Lecture 2023
Let's take a look (or a listen) back to last year's IEMTA ASM, and specifically the inaugural Fergal Hickey lecture, given by none other than Dr Fergal Hickey himself.
Make sure you don't miss out on a ticket for this year's IEMTA ASM in RCSI's Albert Theatre, April 27th.
Ticket info to follow, so keep an eye on our socials!
S4E10: Bonus - Intro to REBOA
This time is always busy for our trainees with interview preparation so Leah took the opportunity to sit down with Dr Andrew Neill, consultant in Emergency and Intensive Care Medicine in the Mater Hospital to discuss the controversial topic of REBOA.
They discuss the UK-REBOA trial and the evidence behind the technique and why we should be cautious about it's used in the Irish trauma system in particular.
As always, don’t forget to follow us on socials on instagram, twitter and facebook to keep updated with all things TCR. Coffee in hand? Right then, let’s get to it!
S4E9: EM fellowships and the Role of the GEM Specialist - GEM bonus with Dr Deirdre Breslin
Ever wondered how to pursue an EM fellowship after finishing your SpR training? Is it worth it, and if so what are the benefits of doing a fellowship? We’re very excited to welcome back a familiar voice to our bonus episode this week to answer these questions and more!
TCR alumnus Dr Deirdre Breslin joined Geriatric Emergency Medicine (GEM) lead Dr Conor O’Gara to chat all things fellowships, frailty and finding out what to do with your interest in GEM.
Dr Breslin is an EM consultant in the Mater Misericordiae University Hospital (MMUH). She has a special interest in GEM, having worked as the TCR production lead in GEM and completed a GEM fellowship prior to taking up her consultant post. Her insights and tips make this both an interesting and important discussion.
As always, don’t forget to follow us on socials on instagram, twitter and facebook to keep updated with all things TCR. Coffee in hand? Right then, let’s get to it!
S4E8: Fractured Neck of Femur - Geriatric EM
With over 3900 neck of femur fractures (NOFs) reported in Ireland in 2021, these fractures represent a significant burden of morbidity and mortality, particularly for our older patients. Early recognition coupled with meticulous management, both in the ED and beyond, is instrumental in ensuring optimal outcomes.
Orla Kelly puts TCR newcomers Conor O’Gara and Jane Cassidy through their paces with today’s case before we sit down with our Adult in the Room - Dr Mustafa Mehmood, Consultant in Emergency Medicine in St James’s Hospital, and architect of the department’s ‘Code Hip 240’ protocol.
As always, don’t forget to follow us on socials on instagram, twitter and facebook to keep updated with all things TCR. Coffee in hand? Right then, let’s get to it!
S4E7: Paediatric Retrieval Medicine - PEM bonus with Dr Conor Davis
Ever wondered how to make a referral to The Irish Paediatric Acute Transport Service (IPATS) when working in a tertiary hospital? What is the criteria for transferring a child, when can it be done by IPATS and when should the transfer be organised by the referring hospital? What do you need to have prepared before sending a child and how should you prepare to expect the unexpected?
We thought we’d start off the new year as we mean to go on with a paeds bonus episode on the first day of 2024! In this episode EM consultant Dr Conor Davis talks all things paediatric transfers and answers the above questions and more. And seeing as we are thecase.report, we might have even managed to give an EM consultant their own case to tackle!
As always, don’t forget to follow us on socials on instagram, twitter and facebook to keep updated with all things TCR. Coffee in hand? Right then, let’s get to it!
S4E6: Neonatal Sepsis - Paediatrics
We're in the Paediatric section of the TCR Emergency Department where Mo, Stephen and Rachel are concerned about a five day old baby. GBS sepsis is no joke, and our team bring us through the management of one of the most daunting cohorts of all: the septic neonate.
Our Adult in the Room Dr Rasha Sawaya reviews our work, and also talks about feeding issues, what to do when your initial management doesn't work, and gives some tips and tricks for ED NCHDs who are graduating to more senior roles.
Join the conversation on X, Instagram, and Facebook. We've got some great infographics and notes to compliment your learning that you can find at thecase.report.
This will be our last episode of 2023, but we've got an incredible PEM bonus episode coming early in the new year.
And as always:
"May your coffee be strong, and your rounds grand."
S4E5: Trauma Bonus - eFAST with Dr. Mai Nguyen - The Echo Chamber
Time to enter the Echo Chamber! Dr Mai Nguyen joins Callum to discuss eFAST in Trauma in this bonus episode. Following on from a very detailed discussion of all things trauma in lasts week's main episode, we're diving into the specifics of using POCUS in trauma, and importantly how to do it effectively and efficiently.
Dr Nguyen is a Consultant in Emergency Medicine at University Hospital Limerick where she is the Director of Ultrasound Training for Emergency Medicine, an EGLS instructor and a Level 1 Ultrasound Trainer. In short, the perfect guest to run through all things eFAST. If you didn’t want to build your POCUS skills before, you sure will after this episode!
Listen along with the show notes and get involved in the conversation on Twitter and Instagram.
S4E4: Road Traffic Collision - Trauma
From the seatbelt sign and it’s association with intra-abdominal pathology to the “Hateful Eight” to the electrolyte breakdown in red cells, Callum, Eoghan and our AITR Dr Sean Croughan are doing a deep dive of managing the unstable trauma patient in this month's episode of thecase.report. Oh, and don't forget about distracting injuries!
Following on from our second South African Special Episode last month, we’re back in Ireland in a rural ED. Eoghan, the only Reg working in ED this evening gets a pre-alert about a female involved in a single vehicle road traffic collision. Follow the case from zero-point survey to a detailed debrief with the show notes online.
As always, don’t forget to follow us on socials on instagram, twitter and facebook to keep updated with all things TCR. Right then, let’s get to it!
S4E3: "Pivot. And Pivot Fast." Experience of a Trauma Fellowship - South Africa Special II
Improvisation is the buzz word in this thrilling second bonus episode centred on South Africa (you can find the first here). We were delighted to sit down with TCR veteran Dr Jimmy Lee, Consultant in Emergency Medicine in University Hospital Galway. With a passion for Global Health & Humanitarian Medicine, Dr Lee recalls his unforgettable experience completing his Trauma and Resuscitation fellowship in Chris Hani Baragwanath Hospital in Soweto, South Africa.
With over 2,000 inpatient beds and a dedicated trauma unit, Barra hospital ranks as the 5th largest hospital in the world. Coupled with its location in an area with unfortunately high rates of violent crime, and variable reliability and access to resources, working in the trauma unit poses unique challenges not often faced here in Irish EDs.
Dr Lee’s experience and pearls of wisdom are not to be missed. Right then, let’s get to it. Get ready to pivot, and pivot fast!
S4E2: Bonus - Acute Injuries and Imaging Insights with Dr Jamie Kearns - Sports Medicine
In our first bonus of the season, Leah sits down with Dr Jamie Kearns and peppers him with questions. Can he withstand the onslaught?
Jamie is a Consultant in Sports and Exercise Medicine at UPMC Sports Surgery Clinic and Head of Medical at Munster Rugby. He was awarded FFSEM (Irl) in 2017 and was elected to the Board of the FSEM in 2018.
S4E1: A Tri-oww-thalon of injuries - Sports Medicine
Welcome back to a brand new season of TheCase.Report! As we continue to grow into our fourth season, so too does our team - a big welcome to our many new members who are taking TCR to new heights. The team have been working all throughout our summer hiatus to deliver what promises to be an incredibly exciting season 4!
Many thanks as always to IAEM who make this podcast possible - at our heart, we are a community of learning and it is humbling to see how the podcast has evolved over time. But enough of the soppiness, we’re starting the season as we mean to go on - with a bang. Literally.
We’re kick starting this new Case.Report marathon with the golden triad - Leah, Liam and Carl.... oh and also swimming, cycling and running. It’s triathlon time! Treating you to a trio of interesting cases, increasingly relevant to EM, we’re delving into some presentations to watch out for, how to manage them and tips to keep your patients off the bench.
Coaching us through it we have our Adult in the Room, Patrick Martin. Paddy is one of our amazing Emergency Advanced Nurse Practitioners and we are very lucky to have us join us this month. Don’t forget to download the incredible infographics that accompany the show notes made by our fantastic new junior producers!
Bonus! Professor Seamus Morris
Leah sat down with Professor Seamus Morris, Consultant Orthopaedic and Spinal Trauma surgeon at the National Spinal Injuries Unit as a follow up to our case. They go through all things cervical spinal collars, MRIs, ASIA scores and discuss the development of the trauma system for Ireland.
Prof Morris is a specialist in spinal trauma surgery and after finishing his orthopaedic specialty training in RCSI, travelled to London and New York for fellowships. He is course director on a number of widely accredited trauma training courses including the European Trauma Course and is Clinical Professor of Surgery in UCD.
Don't miss this as Leah put's the controversies to Prof Morris and gets some well needed answers.
Spinal Cord Trauma
We’re back with some more spinal trauma for you. Orla re-joins us this month along with Liam and Marike to discuss an unusual case of spinal injury in the ED today. It’s one not to miss.
We then catch up with Dr. Deirdre Glynn, Consultant in Emergency Medicine at St. James’s Hospital and trauma and POCUS enthusiast to discuss spinal cord syndromes and their management in the Emergency Department settings including the all important secondary prevention.
South Africa Special
Our very own Callum Swift is in South Africa gaining some valuable out of programme experience, and has put together this excellent episode over there with some excellent EM colleagues.
For the case, Callum is joined by Dr Heounohu Hessou. Their work is looked over by the Adult in the Room, Dr Martin de Man.
Callum is then joined by Dr Katya Evans, who discusses palliative care in EM.
Let's get to it!
Sports Bonus! Dr Siobhan Statuta
Carl sat down this month with Dr Siobhan Statuta, an incredible Sports Medicine Primary Care specialist based in the University of Virginia. She started her career working as a surgical technologist for an orthopaedic practice that specialises in sports injuries. She undertook her residency in Family Medicine and continued on to complete a fellowship in Sports Medicine and Faculty Development. She has multiple publications in the world of female athletic medicine and concussion.
Dr Statuta has taken time out from her work touring with the US women's development football team to join us on TheCase.Report to discuss all things RED-S and female athlete health.
Check out the poll below on Spotify and let us know what you think of our new split episodes and whether the lengths work for you! We want to tailor more content to make it better for you.
As always, if you liked the episode, be sure to subscribe and drop us a rating on Spotify, Apple Podcasts or wherever you get your podcasts.
Sports Medicine: Concussion
We’ve something new! Leah is entering the world of Sports and Exercise Medicine with Dr Carl Byrne, Emergency Medicine SpR and sports med fanatic. Aoife joins them from behind the scenes of TCR to discuss all things concussion.
Professor John Ryan, Head of Medicine in Leinster Rugby and Consultant in Emergency Medicine in St. Vincent’s University Hospital is our Adult in the Room this month and helps us along our way.
On balance, we’ve decided to start splitting our cases to give you even more content to look forward to throughout the month. Our bonus Sports Medicine segment will be released in two weeks time so don’t worry, you can have even more TCR to listen to.
AND… We’re introducing some fun new show notes which can be used as infographics and posters for teaching cases within your department. Catch the start of them on our website https://thecase.report and watch our Twitter space where we will start to release ones for old cases.
PEM
Mohammed is joined by Karl and Stephen who have got an intoxicating case from the paeds ED for you this month!
Our Adult in the Room Dr Eleanor Ryan isn't far off and is at hand to help with this sticky case.
Karl also sat down with Dr Gergana Semova to chat about how to manage the scariest of all patients... the neonate!
Be sure to head over to IPEM.ie to check out the exciting upcoming conference.
Right, let's get to it!
RCSI Charter Meeting
RCSI's annual Charter Meeting is back this week, with the theme of "Shaping the Future". The EM session on Friday will be looking at the digital transformation we're in the midst of and will be chaired by Prof Conor Deasy.
To get you warmed up for it, we've got a panel discussion from last year's Charter Meeting for you to enjoy.
Make sure you head over to the RCSI website to check out the whole programme and register to attend.
Right, let's get to it!
IAEM ASM 2022
Welcome back to another episode of TheCase.Report
For our last show this year, we've got a retrospective from this year's IAEM Annual Scientific Meeting in the Slieve Russell Hotel in Cavan.
This year, TCR had our reporters on the ground, interviewing some of the wonderful speakers and delegates. And we've got a little selection of those kerbside interviews for you here!
Behind the mic we had Mohammed, Saf, Liam and the newest member of our team, Amy.
Right, let's get to it!
Major Incident
Leah is joined by Deirdre and Joe to talk through the case, with the one and only Dr Jason Vandervelde making a return as our Adult in the Room.
Mohammed is joined by Prof. Simon Carley for our segment, talking about what we've learned from recent experiences in this field.
Right, let's get to it!
GeriEM 1: CGA
Find the corresponding GeriEM poster here.
GeriEM 7: End of Life Care
Dr Santiago Castejón and Dr Vojtěch Mezera discuss end of life care.
Find the corresponding GeriEM poster here.
GeriEM 6: Silver Trauma
Dr Sarah Turpin is joined by Prof Tim Coats to discuss silver trauma.
Find the corresponding GeriEM poster here.
GeriEM 5: Polypharmacy
Prof Katrin Singler is joined by Dr Stephen Lim to discuss medication reviews and polypharmacy.
Find the corresponding GeriEM poster here.
GeriEM 4: Delirium
Dr Elizabeth Moloney is joined by Prof Daniel Davis and Karianne Melkert to discuss delirium.
Find the corresponding GeriEM poster here.
GeriEM 3: Environment
Kara McLoughlin and Dr Áine Mitchell talk about environmental considerations.
Find the corresponding GeriEM poster here.
GeriEM 2: Frailty & Risk Stratification
Find the corresponding GeriEM poster here.
Teaser: TCRxGeriEM
Fantastic collaboration to be launched at EUSEM... watch this space!
In the meantime, check out the fantastic posters.
Liver Cirrhosis
This month, we're tackling one of the most complex medical conditions that can frequent the Emergency Department- liver cirrhosis.
Leah sat down with Liam Loughrey and Etimbuk Umana to go through our case of the undifferentiated septic patient and to talk all things SBP.
Kindly, Dr Iomhar O'Sullivan of CUH ED and EMed.ie, has agreed to correct our homework as the AITR.
And finally, the Echo Chamber is back with Callum and Cian exploring the ways in which ultrasound can be used to help guide your management of patients who are simultaneously hypovolaemic and fluid overloaded.
Check out the show notes on thecase.report!
VTE
Welcome to a new season of TheCase.Report!
We're kicking off Season 3 with a very special episode on VTE, ahead of next month's VTE Dublin Conference... Don't forget to register!
Deirdre is at the helm for this episode and is joined by Leah and Bibi.
Our Adult in the Room Dr Tomás Breslin brought along his colleagues Prof John Moriarty and Dr Cian McDermott to comment on the case.
And finally, Bibi sat down with Prof Fionnuala Ní Áinle and Dr Barry Kevane for our segment.
Many thanks once again to IAEM for supporting this podcast and making all of this possible.
Bonus: In conversation with...
Last month, Mohammed sat down with 2 legends of EM and spoke to them about a wide range of topics.
After speaking at dotMD in Galway, Dr Jay Baruch and Dr Chris Luke reflected on the day, on careers in EM, and on the writing of their recent excellent books.
PEM
Welcome back to another PEM episode on TheCase.Report!
Orla is joined by Karl and Stephen, who take us through an important presentation. Thankfully our Adult in the Room Dr Paddy Fitzpatrick is close at hand to keep an eye on their work.
Then the Echo Chamber is back, with Dr Emma Fauteux joining Callum to speak on uses (and limitations) of POCUS in PEM.
Right. Let’s get to it!
dotMD22
dotMD is a 2 day festival of curiosity for doctors and healthcare practitioners looking for more from medicine.
Mohammed sat down with Dr Ronan Kavanagh to chat about what this entails, and to look ahead to this years offering.
dotMD22 is back in Galway this year on the 17th and 18th of June and will be running as a hybrid event.
Listen to the end to hear about how to attend, and for a very special treat from dotMD to TCR listeners.
Let's get to it!
#StandingUp4NCHDs
We interrupt our regular programming with this very special bonus episode of TheCase.Report.
This Monday, April 11th, sees an emergency meeting being held by the IMO to address the working conditions NCHDs have had to endure.
Ahead of this historic meeting, Orla is joined by 4 NCHD leaders to discuss these issues: Dr Kirsten Joyce, Dr Rachel McNamara, Dr Conor Malone and Dr Carol Norton.
The meeting is open to all NCHDs - whether they are members of the IMO or not - and is at 19:30.
If you're interested in attending, follow this link.
Trauma
We're back with a fiery trauma special, guaranteed to take your breath away!
Mohammed is joined by Marike and Marcus to explore our case, with our Adult in the Room Dr Robyn Powell on hand to check their work.
Orla then sits down with Mr Fergal Hickey to talk training for trauma as we look forward to ATLS courses coming back this year.
Right, let's get to it!
Aortic Dissection
After a well deserved break in January, our team are back and have outdone themselves with our first episode of 2022.
Firstly discussing the case we have Leah, Orla and Timbs.
Our Adult In The Room Dr John Cronin will be reviewing our work and delves into the challenge of differentiating chest pain.
Callum and Timbs talk all things ultrasound in the Echo Chamber
Finally, Orla is joined by Catherine Fowler of the Aortic Dissection Charitable Trust to talk about the amazing, important work they do.
Listen in with the show notes at TheCase.Report.
Right… let’s get to it!
Winter Special
It’s that fuzzy time of year again. Wrap up warm… it’s our winter special.
Mohammed is joined by Jimmy, Callum and Peter for a case that had their teeth chattering.
Thankfully, our Adult in the Room this month Dr Michael Dunphy was there to check their work!
Mohammed sat down with Prof. Conor Deasy then to chat about getting the department ready for the winter.
Find the show notes over here.
Right, let’s get to it!
GEM II
Welcome back! Thanks for tuning in to our November episode of TheCase.Report! We’re bringing you our second Geriatric EM episode, and we hope you’ll enjoy this one as much as the first.
For this case, Orla is joined by Deirdre and Lorcán who take us to “dizzying” heights in our latest episode detailing the management of our most complex and common patient cohort.
Our adult in the room is Dr Mustafa Mehmood, an emergency medicine consultant with a special interest in geriatric EM — he’s correcting our homework this month!
We’re also joined by Dr Áine Mitchell, emergency medicine consultant in Sligo University Hospital, who’s here to share some pearls of wisdom on the geriatric emergency department.
Ready? Let’s go!
PHEM
Welcome back to TheCase.Report!
We’re back with our very first PHEM episode, a long overdue milestone.
For the case, Mohammed is joined by Jamie and AP extraordinaire, Joe Mooney.
Our Adult in the Room, Dr Jason van der Velde, then reviews our work and adds some pearls.
Callum is back with The Echo Chamber, where he’s joined by Dr Florian Pracher, who takes us through the use of POCUS in his practice as a retrievalist, and the importance of structured training and accreditation.
Right, let’s get to it!
Inclusion Health
Welcome back to a new season of TheCase.Report
We're back and we're better than ever!
Special thanks is due to IAEM, the Irish Association for Emergency Medicine for their kind support. Make sure you register for the ASM next month, on October 14th and 15th.
But look, we know it's been a long dry summer for you all without us, so we'll get to the matter at hand.
For our case, Mohammed was joined by his esteemed trainee colleagues, Orla and Karl… (Who let those 3 at it?!)
Thankfully our Adult in the Room Dr Darren McLoughlin was close at hand to check their work!
Mohammed was then Joined by Dr Eamon Keenan for a chat ahead of the release of the report of the Emerging Drug Trends and Drug Checking Working Group.
Right, let's get to it!
Season 2: Coming Soon
We're but a few short weeks away from a return to your speakers/headphones. Mohammed and Orla would like to invite you to join our "Community of Learning"
BonusCast: New to EM
Changeover is upon us again! (Already??!!)
We've got a different outlook here at TheCase.Report though. We cannot wait to welcome our new EM colleagues to the fold!
Mohammed and Orla sat down to chat about some top tips to get started.
PEM II
Look at that sun!
Welcome back to our June episode of TheCase.Report, and it’s our long awaited return to PEM.
Orla is joined by the trio of Anna, Roy and Andrew who take us through some tricky twists in the case of a tender tot.
Then Anna sits down with Dr Dani Hall talking about what true allyship for our patients means.
Finally, Dr Rory O’Brien joins us to talk about the PEM journey in the People’s Republic. Any of you out there interested in PEM in CUH, shoot Rory an email and he’ll be happy to chat.
Let’s get to it!
RVF
Happy birthday to us!
A whole year since that first episode dropped. What a year it’s been!
Callum’s taking the lead on our birthday special this May, with a great episode all about The People’s Ventricle!
He joins Mohammed in resus, where we’ll meet Eoghan, our AP colleague who’s brought us in a bit of a handful. Thankfully our Adult in The Room Dr Andy Neill is there to lend us a dig out.
What does RVF mean for our POCUS assessment? Dr Nicolas Lim joins Callum in The Echo Chamber to discuss this.
Finally, Callum sits down with Dr Pun Tong who gives us his perspective on how to go about honing your clinical acumen.
Alright, let’s get to it!
BonusCast: Consultant Interviews
It's the big one. Whether you're a first or final year trainee, it's never too soon to start thinking about the destination - while enjoying the journey of course!
Orla sits down with our Adult in the Room to talk about the most adult of things - the consultant interview.
Dr Des Fitzgerald of University Hospital Waterford takes us through what we need to know for before, during and after what could be the most important exam we may ever sit.
Let's get to it!
GEM
Welcome back everyone, and thanks for joining us again for April’s episode, our first Geriatric EM special! Some stellar material in here that I think you’ll find very useful - I know I have!
Orla’s back and she’s joined by Deirdre and Barry for the case.
Our Adult in the Room, Dr Vinny Ramiah of the Mater Hospital Emergency Department is there then to not only check their work, but to give an absolute masterclass in delirium in the ED.
Dr Rosa McNamara joins Barry to chat about ED in the Home (EDITH), and Mary Dawood sits down with Deirdre for a conversation about death and dying in the ED.
Lots of fantastic material, you may want to take it in a few bites this time though.
Let’s get to it!
FemInEM: Presidents
We’re rounding off this month’s series of FemInEM conversations with a whopper discussion!
It’s a veritable buffet of leadership as IAEM’s immediate past president Dr Emily O’Conor and RCEM’s current president Dr Katherine Henderson sit down to talk to our own Orla Kelly, current IEMTA president.
FemInEM: Dr Sinéad NÍ Bhraonáin
Deirdre's back and this time she's talking to Dr Sinéad Ní Bhraonáin, one of Irish EM's greats who has completed a difficult airway fellowship, a pre hospital and critical care fellowship with NSW Ambulance Service Sydney HEMS and an Emergency Medicine fellowship in Australia. She's currently in Sydney, busy being an exemplary leader in the Royal Prince Alfred Hospital and the Sydney Local Health District at large.
FemInEM: Dr Kirsty Challen
In celebration of International Women’s Month, we’ve got a series of interviews with some of our fantastic female EM colleagues from around the country. Throughout March, we will be dropping these short episodes in order to give you even more TCR to get your teeth into.
Slightly further afield, Deirdre sat down with Dr Kirsty Challen for a chat for this episode. Dr Challen is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England), and the chair of RCEM's Women in Emergency Medicine Special Interest Group
FemInEM: Dr Karen Harris
In celebration of International Women’s Month, we’ve got a series of interviews with some of our fantastic female EM colleagues from around the country. Throughout March, we will be dropping these short episodes in order to give you even more TCR to get your teeth into.
We're staying out West with our second interview of the month! Dr Karen Harris, consultant in Emergency Medicine in Sligo University Hospital, sat down with Deirdre, talking about the journey and the destination.