Podcast EMplify by EB Medicine by EB Medicine Episodes

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	Title	Pub. Date	Duration
	EM Innovation Collaborative - An interview with Nicholas Stark, MD, MBA & Zaid Altawil, MD	07 Jan 2025	00:15:08
In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1. Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. Growth of EMIC - Expansion from three members to over 500 - Focus areas: Education, mentorship, opportunity 3. Achievements of EMIC - Examples of innovations and initiatives born from EMIC - Pitch event at ACEP annual conference and other engagements 4. Importance of Physicians in Innovation - Internal and external factors - Benefits of physicians leading innovation efforts in healthcare 5. Opportunities for Collaboration - Engaging with healthcare startups and companies - Expanding collaborations and growing the network 6. EMIC Fellowship - Ideal candidates - Application process and benefits - Success stories and projects undertaken 7. Long-Term Vision for EMIC - Goals for future growth and expansion - Bridging gaps between industry and physicians for better patient care 8. Membership Details - How to join EMIC - Benefits of membership For more about the EM Innovation Collaborative... https://www.eminnovationcollaborative.org/
	Acute Mesenteric Ischemia	17 Dec 2024	00:20:13
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2024 Emergency Medicine Practice article, Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department Introduction to Acute Mesenteric Ischemia Statistics on prevalence and mortality Pathophysiology and EtiologyMesenteric artery embolism Mesenteric artery thrombosis Mesenteric venous thrombosis Non-occlusive mesenteric ischemia Diagnosis Management and Treatment Special Populations Pediatric patients Pregnant patients Elderly patients Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
	Dialysis Emergencies	09 Jul 2024	00:45:22
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	12 Jun 2024	00:44:10
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	15 May 2024	00:40:13
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	01 May 2024	00:53:23
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	17 Apr 2024	00:55:57
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)	01 Apr 2024	00:47:49
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	01 Mar 2024	00:50:37
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	18 Feb 2024
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	01 Feb 2024	01:11:29
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	18 Jan 2024	00:32:21
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
	Low Back Pain	15 Nov 2024	00:57:01
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence Prevalence and Importance of Back Pain in the ED Differential Diagnosis and Serious Pathologies Patient Expectations and Management Strategies Missed Serious Pathologies and Their Implications Conflicting Evidence and Treatment Protocols Pathologies Causing Low Back Pain Mechanical and Infectious Causes Red Flags and Risk Factors Pre-Hospital Care and EMS Considerations History and Physical Examination Laboratory Testing and Inflammatory Markers Introduction to Imaging in Back Pain Common Findings in Imaging Choosing Wisely Campaign and Imaging Guidelines Patient Expectations and Imaging CT and MRI: When and Why Ultrasound in Back Pain Diagnosis Treatment Options for Back Pain NSAIDs and Other Pharmacologic Treatments Non-Pharmacologic Management Risk Management and Pitfalls Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
	Pediatric UTI and Pneumonia	02 Jan 2024	00:46:47
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the January 2024 Pediatric Emergency Medicine Practice article, Management of Pediatric Urinary Tract Infections in the Emergency Department, and the January 2024 Evidence Based Urgent Care article on Pediatric Community-Acquired Pneumonia: Diagnosis and Management in the Urgent Care Setting. UTI Epidemiology and Nomenclature Prehospital Care ED History and Physical Exam Infants Age <2 Months Children Age 2 Months to 2 Years Children >2 Years Adolescents Urinalysis Clean Catch Protocol Catheterization Suprapubic Aspiration Blood Cultures and CSF Biomarkers (CRP and ESR) Treatment Community Acquired Pneumonia Distinguishing Viral vs Bacterial Pneumonia Imaging Antibiotic Treatment Vaccination Steroids Atypical Presentations Check out the clinical pathways at https://www.ebmedicine.net/pathways
	Pediatric Toxic Ingestions	01 Dec 2023	01:06:56
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2023 Pediatric Emergency Medicine Practice article, Management of Pediatric Toxic Ingestions in the Emergenc y Department. Need help now? Call the Poison Help Line at: 1‑800‑222‑1222 Epidemiology Prehospital Care ED History and Physical Exam Diagnostic Studies Labs EKG Imaging Urine Toxicology Testing Treatment Hemodialysis Activated Charcoal Whole Bowel Irrigation Gastric Lavage Ipecac Drug Specific Therapies Acetaminophen Alcohols Anticholinergics Beta Blockers Calcium Channel Blockers Cholinergic Agents Digoxin Iron Opioids Salicylates Sedative Hypnotics Sulfonylureas Laundry Pods Check out the clinical pathways at https://www.ebmedicine.net/pathways
	Pediatric DKA and HHS	01 Nov 2023	01:06:02
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the November 2023 Pediatric Emergency Medicine Practice article, Pediatric Diabetes: Management of Acute Complications in the Emergency Department and some of the highlights from the other EB Medicine articles published in November. Epidemiology Differential diagnosis Prehospital care ED history and physical exam Diagnostic studies Point of care testing Labs Imaging Treatment IV fluids, the 2-bag system Mild DKA Moderate to severe DKA Potassium and phosphate supplementation Magnesium and calcium Sodium bicarbonate Hypoglycemia HHS Monitoring Complications Cerebral edema Intubation Insulin pumps Disposition Summary Highlights EBUC - Management of Acute Asthma Exacerbations in Urgent Care EMP - Evidence-Based Emergency Department Management of Methamphetamine Toxicity PEMP - Trauma Extra - Blunt Thoracic Injuries (coming Nov. 15th) Check out the clinical pathways at https://www.ebmedicine.net/pathways
	Substance Use in Adolescents	02 Oct 2023	00:52:06
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the October 2023 Pediatric Emergency Medicine Practice article, Substance Use in Adolescents: Recognition and Management in the Emergency Department and the October 2023 Emergency Medicine Practice article, Evidence-Based Emergency Department Management of Migraine and Other Primary Headaches Substance Use In Adolescents Epidemiology Risk Factors Differential Diagnosis Prehospital Care ED History and Physical Exam Urine Drug Screen Treatment Marijuana Alcohol Methaphetamines MDMA Cocaine Opioids Disposition Migraine and Other Primary Headaches Epidemiology Cluster Headaches Medication Overuse Headache Nerve Blocks Greater Occipital Sphenopalatine Ganglion Pregnant Patients Disposition Check out the clinical pathway at https://clinicalpathways.ebmedicine.net
	Rectal Bleeding	01 Sep 2023	00:49:23
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the September 2023 Emergency Medicine Practice article, Emergency Department Management of Patients With Rectal Bleeding Etiology/pathophysiology Risk factors Differential diagnosis Prehospital care ED history and physical exam Diagnostic studies Laboratory testing Imaging studies Treatment Transfusion Coagulation reversal Embolization Special Populations Pediatrics Pregnant patients Elderly patients Scoring systems Disposition Check out the clinical pathway at https://clinicalpathways.ebmedicine.net
	Pulmonary Embolism with Al Sacchettii, MD	01 Aug 2023	00:55:27
In this episode, Sam Ashoo, MD, and TR Eckler, MD, interview Al Sacchetti, MD, about the August 2023 Emergency Medicine Practice article, Evidence-Based Management of Pulmonary Embolism in the Emergency Department Etiology/pathophysiology Risk factors Differential diagnosis Prehospital care ED history and physical exam Diagnostic scoring systems Pregnant patients Diagnostic studies ECG D-Dimer Troponin & BNP Chest x-ray CT V/Q scans MRI US Treatment IV fluids Anticoagulation Vasopressors Thrombolytics Thrombectomy ECMO Disposition Check out the clinical pathway at https://clinicalpathways.ebmedicine.net
	Acute Pericarditis & Myocarditis	05 Jul 2023	00:59:25
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2023 Emergency Medicine Practice article, Diagnosing and Treating Pericarditis and Myocarditis in the Emergency Department Epidemiology Nomenclature Etiology Differential diagnosis Prehospital care ED history and physical Diagnostics ECG Labs Imaging (X-ray, CT, US, MRI) Treatment Special populations COVID-19 Athletes MIS-C
	Hypertensive Emergencies	01 Jun 2023	01:09:14
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the June 2023 Emergency Medicine Practice article, Hypertensive Emergencies: Guidelines and Best Practice Recommendations Epidemiology Etiology Differential diagnosis Prehospital care History and physical Diagnostics Treatment Acute decompensated heart failure Acute ischemic stroke Acute coronary syndrome Intracerebral hemorrhage Subarachnoid hemorrhage Aortic dissection Hypertensive encephalopathy Severe pre-eclampsia and eclampsia Controversies Arterial line placement Beta blockers and cocaine Risk management caveats Summary
	GI Foreign Body Ingestion	03 May 2023	00:53:12
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the May 2023 Emergency Medicine Practice article on Emergency Department Management of Gastrointestinal Foreign Body Ingestion Epidemiology Etiology - types of ingestions Anatomy - common locations by age Food impaction Sharp objects Button batteries Magnets Colorectal foreign bodies Prehospital care History and Physical Imaging Expectant management Endoscopic removal Non-endoscopic techniques Body Packing Glucagon Gastric button batteries Summary
	Career Longevity	13 Apr 2023	00:53:56
In this episode, Sam Ashoo, MD, talks with Rob Orman, MD, founder of Orman Physician Coaching, about longevity in emergency medicine. Personal foundation Regular check-ins Becoming an expert in… Job stress Living beneath your means Recharging and shift work Bad outcomes Physician lounge Learning to say no Set a reminder More at Orman Physician Coaching
	Pediatric Scrotal Pain	21 Oct 2024	00:17:44
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Emergency Department Management of Acute Scrotal Pain in Pediatric Patients 00:00 Welcome and Introduction 00:13 Free Subscription for Emergency Medicine Residents 01:05 Introduction to Pediatric Emergency Medicine Practice 01:37 Discussion on Acute Scrotal Pain 02:35 Testicular Torsion: Key Insights 09:50 Differential Diagnosis for Acute Scrotal Pain 17:21 Diagnostic Indicators of IgA Vasculitis 17:44 Pre-Hospital Care for Severe Pain 18:13 The Twist Score for Torsion 18:44 Emergency Department Evaluation 20:04 Ultrasound in Diagnosing Torsion 29:44 Operative Management and Other Conditions 31:41 Manual Detorsion Techniques 32:37 Risk Management and Key Takeaways 34:19 Conclusion and Final Thoughts Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
	Infective Endocarditis-Associated Stroke	03 Apr 2023	00:43:12
Announcements: The interactive Clinical Pathways have launched and they are available for free! In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the March 2023 Emergency Medicine Practice article on Emergency Department Management of Infective Endocarditis-Associated Stroke Epidemiology Pathophysiology Populations at Risk Complications Intracranial hemorrhage Aneurysms Heart block Prehospital Care ED History and Examination Imaging Antibiotic Therapy Surgical Treatment Special Populations Summary
	Pediatric Electrolyte Emergencies	02 Mar 2023	00:53:02
Announcements: The interactive Clinical Pathways have launched and they are available for free! — In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the February 2023 Pediatric Emergency Medicine Practice article on Pediatric Electrolyte Emergencies: Recognition and Management in the Emergency Department — History Point-of-care testing I/O lines Presentation, differential, and treatment of: Hyponatremia Hypernatremia Hypokalemia Hyperkalemia Hypocalcemia Hypercalcemia Hypomagnesemia Hypophosphatemia
	Opioids in Children and Adolescents	02 Feb 2023	00:44:33
Announcements: The interactive Clinical Pathways have launched and they are available for free! ___ In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the January 2023 Pediatric Emergency Medicine Practice article on the Responsible and Safe Use of Opioids in Children and Adolescents in the Emergency Department DEA-X Waiver Repeal: The Mainstreaming Addiction Act The Medication Access and Training Expansion Act (MATE) FOAMed post Opioids in Children and Adolescents: Introduction Epidemiology and Statistics Medication safety at home Escalation of pain meds at home Naloxone prescriptions Medications in children Codeine Tramadol NSAIDs Local anesthetics and nerve blocks Intranasal meds: Ketamine and fentanyl Opioids and sedation Regional anesthesia Chronic pain
	Allergic Reactions and Anaphylaxis	17 Jan 2023	00:50:51
Announcements: The interactive Clinical Pathways have launched and they are available for free! — In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2022 Emergency Medicine Practice article on the Management of Allergic Reactions and Anaphylaxis in the Emergency Department. Intro The number of ED visits and hospitalizations Studies show up to 57% of anaphylactic reactions are not recognized, and epinephrine is not administered in up to 80% of cases. Criteria 2006 Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) WAO revised the criteria in 2020 Delphi group and Brown et al Pathophysiology Epidemiology Most common causes in children and adults More than half of deaths from anaphylaxis occur within the first hour of symptom onset Prehospital Care Give epi, H1 blockers Mainstay = recognition ED Care Airway Epinephrine Decontamination H1 and H2 blockers Corticosteroids Biphasic reactions Glucagon Special Cases Alpha-gal Scombroid Kounis syndrome
	Pediatric Septic Shock	03 Jan 2023	01:04:20
Announcements: 1) The interactive Clinical Pathways have launched and they are available for free! 2) 2023 E/M coding guidelines are in effect. See the summary here. ___ In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department Introduction: How common is sepsis in kids and what is the mortality rate in the US? Definitions Septic shock Sepsis associated organ dysfunction Sepsis-3 Compensated vs uncompensated shock Etiology Neonate Central line and VP shunts Asplenia Immunocompromised children Differential Diagnosis Prehospital Care ED Evaluation History Examination Septic shock + cardiogenic shock Warm vs cold shock Evolution of physical exam findings Diagnostics Labs Imaging Treatment IV/IO placement Fluid boluses Antibiotics Pressors Airway management Special Populations Febrile neutropenia Newborns with septic shock Controversies Fluid volume Fluid type Antibiotic timing Corticosteroids
	Influenza	12 Dec 2022	00:46:11
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2022 Evidence-Based Urgent Care article on Influenza in Urgent Care. Epidemiology Historical data Since COVID, tracking "influenza-like illness" has been complicated Influenza deaths and age Annual mortality Outbreaks Transmission Classification Influenza A, B, and C Hemagglutinin and neuraminidase subgroups Antigenic drift and shift Pathophysiology Transmission Incubation Secondary infection H3N2 Vaccines Egg-based, cell-based, and recombinant influenza vaccines CDC recommendations Patients aged >65 years Differential Diagnosis Complications Testing When is it indicated? What types of tests are available? Testing in periods of low and high prevalence Treatment High-risk conditions that suggest treatment Antiviral medications Oseltamivir: NNT and NNH Resistance patterns Billing and Coding
	Angioedema	01 Dec 2022	00:47:53
In this episode, Sam Ashoo, MD, interviews Prayag Mehta, MD, and Nikola Milanko, MD, two of the authors of the October 2022 Emergency Medicine Practice article on Angioedema in the Emergency Department Pathophysiology: Non-pitting edema of respiratory or GI tract Histamine meditated, bradykinin mediated, or idiopathic Acquired, inherited, or idiopathic Do they present differently? (Urticaria, speed of onset) Histamine Mediated Most common form: 40%-70% Can be triggered by NSAIDs Can be induced by physical mechanism like cold, vibration Is rash a reliable method of distinguishing the types? Bradykinin Mediated May progress slowly Can be inherited or acquired Common triggers include ACE inhibitors and TPA Table 1 Differential Diagnosis Prehospital Care Protect airway Epi, steroids, antihistamines Avoid CPAP ED History Figure 2: Distinguishing characteristics of histamine vs bradykinin mediated ED Exam Importance of repetitive exams Airway examination Laryngoscopy? Diagnostics Figure 6: Flow diagram of ED workup Labs Imaging Treatment Airway: Intubation Medication Special Populations Pediatric Pregnant/lactating patients Controversies TXA Disposition
	Pediatric Ocular Trauma	03 Nov 2022	01:11:13
In this episode, Sam Ashoo, MD, interviews Ami Shah, MD, MPH, and Don Walker, MD, about eye injuries in the pediatric population. Why ocular injuries? Why did you pick this topic? What kind of injuries are included and at what age are they most common? Injury zones and terminology Differential Diagnosis What should we keep in mind when we are confronted with an ocular injury? (Table 3) Prehospital Care What do our EMS colleagues need to keep in mind when transporting a child with an ocular injury? How can they help us in the ED? ED Evaluation History: What's important to know? Physical: Visual acuity and eye exam Diagnostics: Slit lamp, ocular pressure, US, CT, MRI Treatment Lid lacerations: Who repairs and when? Orbital fractures: What should we be looking for? Why is it different in children? When does repair typically occur? Corneal abrasions Corneal foreign body Chemical injuries: Irrigate with what and for how long? Traumatic hyphema: Treatment, disposition Traumatic iritis: Treatment, outcome Open globe injuries Retrobulbar hematoma - First 10 EM Special Populations Hemophilia, Von Willebrand disease Sickle cell and trait Neonates and infants Contact lenses Controversies and Cutting Edge Ketamine Tetanus NSAIDs, topical? Topical anesthetics Visual acuity apps
	Career Disillusionment	18 Oct 2022	00:48:45
In this episode of EMplify: Conversation, Sam Ashoo, MD talks with Rob Orman, MD, founder of Orman Physician Coaching, about career disillusionment. Career Disillusionment: What is it? How do we combat it? Should we combat it? A frog in boiling water... Burnout Two questions to ask yourself How coaching can help The advice trap A framework to explore your career and life goals More at Orman Physician Coaching.
	Pediatric Firearm Injuries to the Extremity	02 Oct 2022	00:45:55
In this episode, Sam Ashoo, MD interviews Rawad Rayes, MD and Eva Tovar Hirashima, MD, MPH – two of the authors of the August 2022 PEMP article on Pediatric Firearm Injuries to the Extremity: Management in the Emergency Department. Episode Outline: How common are pediatric firearm injuries? What is the most common location of these injuries? Is there much literature published on this topic? Epidemiology What’s been the trend in pediatric firearm injuries over the past 10 years? Do we have any idea how/why these are occurring (ie, accidental, intentional, etc) Terminology: For those unfamiliar with firearms (table 1) Ballistics: Mechanisms of damage. Pre-hospital care Trauma center transport Prehospital hemorrhage control -- Combat application tourniquet, anything else? ED Evaluation SIPA -- What is it and why use it? Primary survey -- Tachycardia -> delayed cap refill -> hypotension in children? Secondary Survey Diagnostic Studies: Damage Control Resuscitation Wound Care -- Do we remove projectiles? Can they stay in? Antibiotics Joint Involvement Compartment Syndrome -- 3 As vs 6 Ps Rhabdomyolysis Controversies CTA for all injuries? Hemostatic devices -- Any role for these in the ED?
	Navigating the IV Fluid Shortage - An Interview with Ryan Johnson, Pharm. D.	11 Oct 2024	00:17:47
In this special episode Sam Ashoo, MD interviews Ryan Johnson, Pharm. D. who shares strategies to address the recent IV fluid shortage caused by Hurricane Helene. 00:00 Introduction and Episode Overview 01:10 Meet Ryan Johnson: Clinical Pharmacist 02:06 Role of Clinical Pharmacists in Emergency Medicine 05:03 IV Fluid Shortage: Causes and Impact 05:56 Institutional Strategies to Mitigate IV Fluid Shortages 14:52 Provider-Level Solutions for Fluid Conservation 22:11 Pharmacy and Nursing Staff Roles in Fluid Management 26:34 Advanced Measures and Federal Guidelines 34:40 Conclusion and Final Thoughts Resources mentioned in the podcast: (Brigham and Women's Protocol) Patiño, A. M., Marsh, R. H., Nilles, E. J., Baugh, C. W., Rouhani, S. A., & Kayden, S. (2018). Facing the shortage of IV fluids — a Hospital-Based Oral Rehydration strategy. New England Journal of Medicine, 378(16), 1475–1477. https://doi.org/10.1056/nejmp1801772 Vizient shares conservation strategies for potential IV fluid supply disruption caused by Hurricane Helene https://newsroom.vizientinc.com/en-US/releases/releases-vizient-shares-conservation-strategies-for-potential-iv-fluid-supply-disruption-caused-by-hurricane-helene
	Conversation – Cognitive Reframing	13 Jun 2022	00:45:00
In this episode of EMplify: Conversation, Sam Ashoo, MD and Rob Orman, MD discuss cognitive reframing. What is cognitive reframing you ask? It is a tool for dealing with a particularly difficult event. In our case, we discuss the “near miss” medical case and how it impacted a physician. Then we discuss how the use of cognitive reframing can help improve our perception of these “near miss” events in medicine. We also discuss what this tool can do for our longevity in medicine, regardless of our career choices. So take a listen. You may be surprised how this tool can be used in all aspects of your life. Rob Orman refers to a videos he created for a client for the post-shift power-down. You can find it and other helpful videos on his YouTube channel. Also, if you would like to learn more about Dr Rob Orman’s coaching services, visit his home page . As always, we value your feedback. Please take our listener survey. See the episode page for more details.
	Conversation – Ukraine with Dr. JP McBryde	03 Jun 2022	00:23:50
The war in Ukraine has now been ongoing for 100 days. In today’s episode of EMplify: Conversations we hear from Dr. J.P. McBryde about his experience as an emergency physician volunteering in Ukraine. You can read more about Med Global and their efforts in Ukraine, on their home page: https://medglobal.org/ukraine/ We would love to have your feedback. Please take the listener survey: https://www.surveymonkey.com/r/ZQRWQFW Thanks for being a listener.
	Chaos and Resilience: Surviving a Hurricane in Asheville, NC	07 Oct 2024	00:15:21
In this episode, Dr. Julia Draper shares her firsthand account of managing a crisis during a hurricane in Asheville, North Carolina. As the area faced unprecedented flooding, Dr. Draper describes the challenges faced at Mission Hospital, including loss of power and water. She details the innovative solutions the hospital implemented and highlights the tireless efforts of staff during a natural disaster of this magnitude. 00:00 Introduction to Dr. Julia Draper 01:03 Experiencing the Hurricane 03:19 Immediate Aftermath and Hospital Challenges 11:22 Dealing with Water and Supply Shortages 20:48 Community and External Support 24:10 Ongoing Efforts and Future Plans 27:51 Conclusion and Final Thoughts
	Conversation- Airway Management	18 May 2022	00:19:46
This is the second episode of Conversation, an EMplify podcast series. Episodes are shorter, more conversational, and cover a single topic relevant to practice in Emergency Medicine. This episode is a conversation between Dr. T.R. Eckler and Dr. Sam Ashoo about airway management and how it has changed in their practice over the last decade. This podcast makes reference to the EB Medicine course – Current Topics in Airway Management: Mechanical Ventilation, Supraglottic Airway Devices, and Intubating Patients With COVID-19, which can be found here: https://www.ebmedicine.net/airway-training We would love to have your feedback. Please take the listener survey: https://www.surveymonkey.com/r/ZQRWQFW Thanks for being a listener.
	Episode 69 – Cellulitis and Other Skin and Soft Tissue Infections	09 May 2022	00:48:05
In this episode, Sam Ashoo, MD interviews Kyle Howarth, MD and Joby Thoppil, MD, PhD – two of the authors of the May, 2022 EMP article on Cellulitis and Skin and Soft Tissue Infections. Listen to the discussion to hear more about the emergency department management of cellulitis and necrotizing skin infections. Episode 69 – Emergency Department Management of Cellulitis and Other Skin and Soft-Tissue Infections (https://www.ebmedicine.net/topics/infectious-disease/emergency-medicine-skin) EMplify – May 2022 Episode Outline: 1. Why cellulitis/skin infections? 2. Terminology Erysipelas vs cellulitis vs fasciitis Purulent cellulitis 3. Most common pathogens 4. Special situations 5. Necrotizing infection classification system – is this helpful in the ED, and if so, why? 6. Differential – unilateral vs bilateral presentation 7. Prehospital care 8. ED evaluation History – what should we be asking? Examination: SSTI vs NSTI 9. Diagnostics POCUS: “cobblestoning” and fluid collection Xray: subcutaneous gas CT: when is this helpful? 10. Labs Blood cultures – if given the option, are they helpful? Wound cultures – any role for these? Routine labs (CBC, BMP, etc) – are they helpful? LRINEC score – what is it and should we be using it? 11. Treatment NSTI antibiotics Abscesses 12. Special populations IV drug users Diabetic patients Immunocompromised patients 13. Wound irrigation and loop drainage 14. Disposition
	Maladaptive Perfectionism with Rob Orman, MD	29 Sep 2024	00:38:17
In this special episode, Sam Ashoo MD and Rob Orman MD discuss the concept of Maladaptive Perfectionism and its application to emergency medicine. Understanding Maladaptive Perfectionism Case Example and Discussion Adaptive vs Maladaptive Perfectionism Personal Experiences and Legal Challenges Dealing with Negative Outcomes Strategies for Managing Perfectionism in the ED Handling Overwhelming Shifts Managing Expectations in the ED A Soul-Crushing Day in the ED Finding Meaning in Moments of Crisis The Importance of Meaningful Work Operationalizing Meaning in Your Shift The Driveway Debrief: Transitioning from Work to Home Preparing for the Next Shift Conclusion and Next Episode Teaser For more from Rob Orman, MD check out Orman Physician Coaching
	Elder Abuse and Neglect	13 Sep 2024	00:32:13
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department Introduction and Announcements Elder Abuse and Neglect: An Overview Risk Factors and Reporting Pre-Hospital and Emergency Department Considerations Screening Tools and Physical Examination Documentation and Disposition Cultural Considerations and Future Directions Conclusion and Resources Suspected Elder Abuse should be reported to one of these organizations: ADULT PROTECTIVE SERVICES - Living at home LONG-TERM CARE OMBUDSMAN - Living in a long term care facility
	Physicians on Social Media	29 Aug 2024	00:37:53
In this episode, Sam Ashoo, MD interviews social media marketing expert Adam Goodcoff, DO, Founder and CEO of MedFluencers. Meet Dr. Adam Goodcoff The Role of Physicians on Social Media Legal Considerations for Physicians on Social Media Employer Policies and Social Media Creating Engaging Content Balancing Professionalism and Personal Life on Social Media Navigating Negative Comments and Trolls Handling Low Engagement and Negative Feedback Becoming a Medfluencer: Tips and Strategies Connecting with Adam and Final Thoughts
	Sickle Cell Disease in the ED	14 Aug 2024	00:56:08
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the August 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Sickle Cell Disease Epidemiology Common Presentation of Sickle Cell Disease in the ED Screening and Diagnosis Differences Epidemiology: 200,000 ED Visits Annually, 85% for Pain Pathophysiology Life Expectancy and Complications Vado-Occlusive Crises and Pathophysiology Sequestration Crisis in Sickle Cell Patients Acute Chest Syndrome and Priapism Clinical Management Treatment Advocacy and Pain Management Patient History and Examination Importance Imaging Recommendations Laboratory Studies and Findings Emergency Department Care Protocols Advanced Treatment Options Intravenous (IV) Fluids Guideline Management of Priapism Role of Exchange Transfusion Acute Chest Syndrome Details Approach in Rural and Critical Access Hospitals Special Populations Pregnant Patients with Sickle Cell Disease Increased Risks and Complication Management
	Thyroid Emergencies	17 Jun 2025	00:20:46
Special Offer - EB Medicine is 26 years old! Get 26% off all purchases at ebmedicine.net! In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the June 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Thyroid Emergencies Introduction to Thyroid Emergencies Understanding Decompensated Hypothyroidism Thyroid Storm: The Other Extreme Differential Diagnosis and Complications Medication Triggers and Patient History Physical Examination Findings Laboratory Analysis Scoring Systems and Risk Assessment Introduction to Treatment Approaches Managing Decompensated Hypothyroidism Treating Thyroid Storm Special Considerations and Populations Risk Management Pitfalls Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
	Parkinson's, Myasthenia Gravis, and MS in the ED	16 May 2025	00:21:05
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the May 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Chronic Neurologic Disease: Parkinson Disease, Myasthenia Gravis, and Multiple Sclerosis Parkinson's Disease Importance of maintaining medication schedule for Parkinson's patients Strategies for ensuring patients receive their medications promptly Overview of Carbidopa Levodopa's mechanism of action Myasthenia Gravis Description of the disease mechanism Importance of assessing respiratory function Diagnostic alternatives like the negative inspiratory force test and counting test Discussion on appropriate emergency department actions and treatments including steroids, plasmapheresis, and IVIG Multiple Sclerosis Description of the disease mechanism Description of the typical patient demographic Discussion on the varied presentation of MS Treatment strategies including high-dose steroids and Baclofen Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
	Strategies for Keeping Trauma at Bay with Rob Orman, MD	02 May 2025	00:25:02
In this episode, Sam Ashoo, MD interviews Rob Orman, MD about ways to manage the trauma inflicted by the ER. Discussing Trauma in Emergency Medicine Personal Experiences with Trauma The Impact of Suppression Defining Trauma and Its Effects Integration vs. Disintegration Debriefing and Coping Mechanisms The Driveway Debrief Nurse and Physician Dynamics Reflective Solitude vs. Isolation Creating Narratives During Trauma Dropping Anchor Technique Body-Oriented Resets Post-Incident Rituals Addressing Lowercase t Traumas Therapy and Trauma Pathways For more about Rob Orman and physician coaching: https://roborman.com/
	Sodium Disorders	18 Apr 2025	00:26:57
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2025 Emergency Medicine Practice article, Sodium Disorders in the Emergency Department: A Review of Hypernatremia and Hyponatremia Hypernatremia (High Sodium Levels) Definition: Sodium level greater than 145 mEq/L Breakdown into three categories based on total body water status Hypovolemic Hypernatremia Euvolemic Hypernatremia Hypervolemic Hypernatremia Common causes and conditions associated Hyponatremia (Low Sodium Levels) Definitions: Mild (130-135 mEq/L), Moderate (125-129 mEq/L), Profound (< 125 mEq/L) Breakdown into three categories Pseudo Hyponatremia Hypovolemic Hyponatremia Euvolemic Hyponatremia Hypervolemic Hyponatremia Common causes and conditions associated Treatment Guidelines and Strategies Emphasizing slow correction to avoid complications like cerebral edema and osmotic demyelination syndrome Suggested treatment rates for acute and chronic conditions Special Considerations Addressing severe cases and the importance of proper diagnostics Pre-hospital care considerations and scenarios Pediatrics and consideration of child abuse in sodium disorders Five Things That Will Change Your Practice Central lab sodium values over point-of-care for accuracy Rectal temperature checks in endurance athletes Loop diuretics for hypervolemic hyponatremia (e.g., CHF patients) Enteral treatment for hypernatremia, if possible Considering COVID-19 as a possible cause for new onset SIADH
	An Interview with Dr. Patrick O'Malley	08 Apr 2025	00:32:15
In this episode, Sam Ashoo, MD interviews Patrick O'Malley MD about his career in emergency medicine, The Laceration Course, and the power of connection with our patients. Dr. Patrick O'Malley's Journey in Emergency Medicine The Laceration Course: Origins and Evolution The EM Docs Side Hustle Facebook Group The Patient That Changed My Life For More Information: The Laceration Course, The Abscess Course, and more... EM Docs Side Hustle Facebook Group Patrick O'Malley, MD: LinkedIn
	Knee Pain	12 Mar 2025	00:43:38
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2025 Emergency Medicine Practice article, Emergency Department Management of Knee Pain Common Etiologies of Knee Pain Risk Factors and Statistics Infectious Causes of Knee Pain Pre-Hospital Care and EMS History and Physical Exam Imaging Guidelines Ottawa Knee Rule and X-Ray Necessity Imaging Modalities for Knee Effusion Ultrasound for Tendon Injury and Arthrocentesis CT and MRI in Knee Injury Diagnosis Lab Tests for Septic Knee Diagnosis Treatment Options for Knee Conditions Knee Immobilizers: When and How to Use Them Steroid Injections in the Emergency Department Managing Traumatic Knee Injuries Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

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