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Latest Episodes:

Dialysis Emergencies Jul 09, 2024

Show notes

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the July 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Dialysis

Overview of Dialysis Complications

Key Dialysis ComplicationsCardiovascular Disease
Congestive Heart Failure
Pericarditis and Cardiac Tamponade
Neurological Sequelae
Gastrointestinal Complications
Hypotension
Dialysis Disequilibrium Syndrome
Air Embolism and Chloramine Toxicity

Disaster Preparedness

Vascular Access ComplicationsHemorrhage risks and treatment
Thrombosis, stenosis, and aneurysms
Infection risks and management

Pre-Hospital Care

ED History Differential diagnosis
Key questions to ask dialysis patients
Examination Physical Exam Tips

Treatments

Risk Management PitfallsCommon Pitfalls to Avoid

Conclusion

Opioid Use Disorder in the ED - An Interview with Corey Hazekamp, MD, MS Jun 12, 2024

Show notes

In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Corey Hazekamp, MD, MS, one of authors of the June 2024 Emergency Medicine Practice article, Managing Emergency Department Patients With Opioid Use Disorder

Current State of Opioid Epidemic

Overview of overdose deaths and trends.
Data and statistics about opioid overdose mortality rates.
Three Waves of Opioid Overdose Deaths in the U.S.

Opioid Classifications and Urine Drug Testing

Types of opioids: synthetic, semi-synthetic, and natural.
Urine drug testing limitations and false positives/negatives.
Practical use and research on co-ingestions

Emergency Medical Services (EMS) and Pre-Hospital Care

Importance of ABCs in acute opioid overdose cases.
Naloxone usage trends and an empirical approach.
Anecdotal insights on changing naloxone administration dosages.

Clinical Management in the Emergency Department

Buprenorphine Initiation

Protocols for initiating buprenorphine in ED settings.
Assessment using the Clinical Opiate Withdrawal Scale (COWS).
Safe dosing procedures for buprenorphine.

Withdrawal and Overdose Care

Laboratory testing recommendations.
Capnography and VBG in overdose management.
The role of end-tidal CO2 monitoring and respirations.

Methadone vs. Buprenorphine Considerations

Methadone to buprenorphine transition protocols.
Personal testimonials and clinical experiences in managing overdoses and withdrawal symptoms.

Patient Discharge and Follow-upPreparation of discharge prescriptions.

Referral to addiction medicine clinics and resources.
Educating patients on continued treatment and harm reduction.

Action Is The Antidote For Rumination - An Interview with Rob Orman, MD May 15, 2024

Show notes

In this episode, Sam Ashoo, MD interviews Rob Orman, MD, founder of Orman Physician Coaching, about routine examination of our careers in emergency medicine.

Understanding Career Cycles and Embracing Change
The Importance of Career Reflection and Making Trades
Navigating Career Satisfaction and Preventing Burnout
Proactive Career Management and Reflection Strategies
Exploring Career Alternatives and Rediscovering Joy in Medicine
Balancing Work, Love, Play, and Health for a Satisfying Life
When to Seek Coaching for Career Guidance
Practical Tools for Self-Reflection and Taking Action
Closing Thoughts and Resources for Emergency Physicians

Ketamine in the ED - An Interview with Reuben Strayer, MD May 01, 2024

Show notes

In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Reuben J. Strayer, MD, author of the May 2024 Emergency Medicine Practice article, Current Concepts in Ketamine Therapy in the Emergency Department

Diving Into Ketamine Use in Emergency Medicine
Understanding Ketamine: From Origins to Emergency Use
Exploring the Ketamine Brain Continuum
Ketamine Dosing and Administration Techniques
Combining Ketamine with Neuroleptic Medications
Practical Approaches to Ketamine for Pain Management
Innovative Pain Management and Ketamine Use
Procedural Sedation with Ketamine: Techniques and Considerations
Addressing Agitation and Sedation in Emergency Situations
Navigating Intubation Strategies: DSI and Ketamine-Only Approaches
Ketamine's Role in Treating Asthma, Status Epilepticus, and Alcohol Withdrawal
Exploring Ketamine for Treatment-Resistant Depression
Concluding Remarks on Ketamine's Versatility in Emergency Medicine

Suicidal Ideation and Self-Harm in Children Apr 17, 2024

Show notes

In this episode, Sam Ashoo, MD interviews Ashley A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A. Hoffmann, MD, MS on the March 2024 Pediatric Emergency Medicine Practice article, Evaluation and Management of Suicidal Ideation and Self-Harm in Children in the Emergency Department

Introduction
Understanding Suicidal Ideation and Self Harm in Youths
Screening Tools and Approaches
Ask Suicide-Screening Questions (ASQ) Toolkit
Columbia Suicide Severity Rating Scale (C-SSRS)
Prehospital Care
Managing Patients in the ED
Dealing with Challenging Populations
Lethal Means Counseling
Emerging Tools in Suicide Risk Identification
Suicide Risk Screening Pathway
Disposition and Referrals
National 988 Suicide & Crisis Lifeline

Brief Resolved Unexplained Events (BRUE) Apr 01, 2024

Show notes

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2024 Pediatric Emergency Medicine Practice article, Brief Resolved Unexplained Events: Practical Evaluation and Management in the Emergency Department

Introduction
The Evolution of BRUE
Understanding BRUE Guidelines
The Importance of Pre-Hospital Care in BRUE Cases
Investigating the Event: Questions to Ask
Medical and Family History: Key Factors
Environmental and Social Considerations
Definitions and Risk Assessment
Physical Examination
Risk Stratification: Low Risk vs. High Risk Patients
Management: What to Do and What Not to Do
High Risk Population: Studies and Recommendations
The Importance of Communication and Decision Making
5 Things That Will Change Your Practice

Constipation Mar 01, 2024

Show notes

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2024 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Constipation

Prevalence and Impact

Understanding the Causes

Medications That Can Cause Constipation

Dealing with Fecal Impaction

Understanding Stercoral Colitis

Pre-Hospital Care

ED History and Physical Exam

Diagnostic Studies and Imaging

X-Ray
CT Scans
Advanced Testing

Treatment Options for Constipation

Enemas
Osmotic Laxatives and Stool Softeners

Special Considerations: Pregnant, Pediatric, and Hospice Patients

Prescription Medications for Constipation

Clinical Pathway for Constipation Management

Febrile Infants Aged ≤60 Days - An Interview With Dr Paul Aronson Feb 18, 2024

Show notes

In this episode, Sam Ashoo, MD interviews Paul Aronson, MD, MHS, one of the authors of the February 2024 Pediatric Emergency Medicine Practice article, Febrile Infants Aged ≤60 Days: Evaluation and Management in the Emergency Department

Guideline Changes

Pathophysiology

Etiology and Definitions

Prehospital Care

ED History and Physical

Diagnostic StudiesAge 0-21 Days
Age 22-28 Days
Age 29-60 Days

Lumbar Puncture

Viral Testing

Urinalysis

Shared Decision Making

Disposition

Right Ventricular Heart Failure Feb 01, 2024

Show notes

In this episode, Sam Ashoo, MD, and T.R. Eckler MD interview Nick Harrison, MD and Daniel Brenner, MD, two of the authors of the February 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Right Heart Failure

Pathophysiology
Presenting Symptoms
Differential Diagnosis
Specific Acute Causes
PE
Sepsis
RVMI
PPV
ARDS
COVID-19
Specific Chronic Causes
CTEPH
Left Heart Failure
Congenital Heart Disease
LVAD
Lung Disease Group 3 Pulmonary Hypertension
Pulmonary Arterial Hypertension
Prehospital Care
ED history and Physical
Biomarkers
ECG (table 5)
Imaging
Echo
CT
MRI
Treatment
Revascularization
Respiratory Support
Vasopressors and Inotropes

Stroke In Pregnant and Postpartum Patients- An Interview With Dr Srinivansan Jan 18, 2024

Show notes

In this episode, Sam Ashoo, MD, interviews Vasisht Srinivasan, MD, FACEP one of the authors of the December 2023 Emergency Medicine Practice EXTRA article, Emergency Department Management of Stroke in Pregnant and Postpartum Patients

Epidemiology
Evidence
Causes
Risk Factors
Differential Diagnosis
Prehospital Care
ED History and Physical Exam
Labs
Imaging
ED BP Management
Specific Ischemic Stroke Therapies
Specific Hemorrhagic Stroke Therapies

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