puncture

In this episode, I speak with Patty Stirling, writer and co-founder (along with editor-in-chief Katherine Spielman) of the zine Puncture. We talk about her initial experiences with the Bay Area punk/hardcore zine, her involvement with Puncture; her impressions of Toiling Midgets, Black Humor, Mark Pauline/Survival Research Laboratories, and Courtney Love (among others); her memories of various San Francisco music venues; and her travels to Australia and other far-flung locales from the late '80s onward.

Show notes, links, and music credits: https://whocaresanywaysf.wordpress.com/2023/06/22/wca-podcast-ep-9-patty-stirling-puncture-zine/

Kevin and Shelly answer listener email questions about medical mission trips and dural puncture headaches/Epidural Blood Patches. Join the hosts for great stories and management tips/tricks they've heard about.

Podcast summary of articles from the September 2017 edition of Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include rapid chest pain rule out, pediatric extremity pain and fever, disaster management, CT brain before lumbar puncture, intranasal midazolam, and board review on syncope and lacerations.  Guest speakers include Dr. Ken Iserson from the University of Arizona and Dr. Mengda Zhang of the MetroHealth Emergency Medicine Residency Program.

This is an article published in the last year in the British Medical Journal that looked at the sensitivity of modern CT scanners in detecting subarachnoid hemorrhage. This article made a lot of waves because it suggested that a head CT within 6 hours of headache onset is 100% sensitive for subarachnoid hemorrhage.  Some have called it a practice changer that allows us to avoid doing a lumbar puncture so its important to read it for yourself and decide if it should change your practice.

Infants with fever present a special challenge in the emergency department. Most of these children require large workups and admission to be sure that we aren't missing serious bacterial infections or meningitis. The risks are high here and we need to make sure that we do the right thing for our smallest and youngest patients. We'll talk about how to assess infants from the foot of the bed, how to get an effective history and physical, how to do a sepsis workup in this age group, and some tricks of the trade for how to do an LP on an infant.

There's also a bonus section on pediatric UTIs and how to use a glidescope.

We see patients with headache all the time in the ED. Most patients with headache don't have a life threatening diagnosis but its our job to pick up that small percentage of patients that do. In this episode we'll go through how to take a good headache history, how to catch the red flags, the workup, and treatment of headache in the ED. There's also an extended bonus section that will review how to do an LP along with a few tricks of the trade.