Wide Complex Tachycardia 27 avr. 2026 In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the April 2026 Emergency Medicine Practice article, Wide Complex Tachycardia in the Emergency Department: An Updated Approach to Diagnosis and Management .
Introduction – 0:11 Article Overview – 2:02 Top 5 Bedside Steps – 7:54 Sodium Channel Blockade – 9:26 Hyperkalemia – 11:53 SVT with Aberrancy – 12:47 WPW & Accessory Pathway – 13:34 AFib with Accessory Pathway – 14:09 Monomorphic VT – 19:01 Polymorphic VT / Torsades – 20:08 Bidirectional VT – 21:29 Pacemaker-Mediated Tachycardia – 22:30 Pre-Hospital Considerations – 24:52 Stable vs. Unstable Assessment – 27:58 Diagnostic Studies – 29:42 Treatment – 38:00 Risk Management Pitfalls – 44:49 Wrap-Up – 49:44
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Medical AI with Jack Teitel 10 avr. 2026 00:19:10 In this episode, Sam Ashoo, MD interviews Jack Teitel on the topic of AI in medicine.
Introduction & Welcome — 0:17 Jack's Background in Healthcare AI — 0:58 Brief History of AI — 3:57 The "Perfect Storm" That Created Modern AI — 5:48 From General to Specialized: Fine-Tuning AI for Medicine — 7:04 LLM Confidence & the Sycophancy Problem — 13:01 The Benchmark Problem — 14:25 Building Your Own Personal AI Benchmark — 17:44 Can You "Turn Off" AI Sycophancy? — 20:00 RAG Systems & How Specialty AI Tools Work — 22:09 Choosing the Right AI Tool for Clinical Use — 26:18 Why 95% of AI Pilots Fail in Deployment— 28:10 How to Ask AI Questions Well (Prompt Quality) — 31:25 Knowledge Base Currency & Sam's Drug Withdrawal Test — 35:06 Closing & Contact Info — 37:12
For more about Jack Teitel -
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Severe Traumatic Brain Injury with Dr. Dana Klavansky 13 mars 2026 00:22:31 In this episode, Sam Ashoo, MD and Dr. Dana Klavansky, MD discuss the March 2026 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Severe Traumatic Brain Injury
Introduction & Welcome (0:15) Guest Introduction (0:55) Epidemiology of Severe TBI (2:37) Pathophysiology: Primary vs. Secondary TBI (4:24) Types of Hemorrhage and Hematomas (5:25) Classification (7:31) Mild vs. Moderate vs. Severe TBI Impact Loading vs. Inertial Loading Differential Diagnosis (9:22) Prehospital Care (9:42) Emergency Department History (13:33) Diagnostics (15:13) CT Scan and the A-B-B-B-C Approach Repeat CT Timing Bedside Ultrasound for Optic Nerve Sheath Diameter Pupillometry Biomarkers Treatment (24:52) Airway Management Ventilation and CO2 Targets Hyperosmolar Therapy: Hypertonic Saline and Mannitol Cerebral Perfusion Pressure Blood Pressure Goals Temperature Management Coagulopathy Management Seizure Prophylaxis and EEG Monitoring Tiered ICP Management (35:29) Surgical Indications (38:40) Prognosis (40:33) Special Topics (41:30) Sports Injuries and CTE Tranexamic Acid (CRASH-3 Trial) Wrap-Up (43:46)
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Acute Coronary Occlusion 01 mars 2026 00:27:34 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the February 2026 Emergency Medicine Practice article, Emergency Department Diagnosis and Management of Acute Coronary Occlusion
00:00 - Introduction & Welcome
01:21 - Episode Overview: Acute Coronary Occlusion
02:06 - Why This Topic Matters: Statistics & New Guidelines
03:35 - Nomenclature: ACO vs STEMI/NSTEMI
06:15 - Differential Diagnosis for STEMI
07:41 - Pre-Hospital Care & EMS Role
11:37 - Patient History & Presenting Symptoms
12:28 - Physical Examination Findings
14:54 - EKG: The Most Important Test
17:00 - STEMI Definition & Criteria
20:32 - STEMI Equivalents: Scarbosa Criteria
22:40 - Smith Modified Scarbosa Criteria
24:10 - Hyperacute T Waves
25:30 - Posterior STEMI
28:40 - De Winter Sign
29:38 - Non-STEMI EKG Findings
31:30 - AVR ST Elevation
32:47 - Wellens Syndrome
33:54 - Reciprocal ST Segment Changes
36:15 - Inferior MI Patterns
37:54 - Laboratory Testing
39:51 - Imaging: Chest X-Ray & Echocardiography
42:25 - Supplemental Oxygen: What the Evidence Shows
44:50 - Analgesia & Pain Management
46:35 - Pharmacotherapy: Aspirin & Antiplatelet Agents
49:18 - Reperfusion Therapies & Thrombolytics
53:05 - Cardiac Arrest in STEMI Patients
53:55 - Closing Remarks & CME Information
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Being A Pre-Litigation Expert with Jeff Willis, MD 11 févr. 2026 00:24:05 In this episode, Sam Ashoo, MD interviews Jeff Willis, MD on the topic of pre-litigation review, being a medical expert, and common pitfalls leading to medical malpractice cases.
0:15 Introduction 0:51 Guest Introduction 1:20 Jeff's Background 2:00 Current Work 3:37 How He Got Started 6:57 Pre-Litigation vs. Expert Witness 8:01 Four Components of Malpractice Cases 13:55 Case Review Statistics 17:11 When Cases Get Filed 18:58 Common Patterns in Cases 19:55 Documentation Best Practices 22:06 Shift Handoff Problems 25:56 Bounce Backs 27:25 Medical Record Volume 30:00 Audit Trails 32:53 Communication with Consultants 41:35 Conflicting Documentation 43:46 Getting Started in This Work 47:37 Closing
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Syphilis: The Great Masquerader 30 janv. 2026 00:21:48 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the Januray 2026 Emergency Medicine Practice article,
Emergency Department Diagnosis and Management of Patients With Syphilis
Syphilis cases have surged 42% in the US, making it critical for emergency physicians to recognize and treat this "great masquerader." In this episode, hosts Sam Ashoo and Dr. T.R. Eckler break down the January 2026 Emergency Medicine Practice article on syphilis diagnosis and management. They cover the rising prevalence in high-risk populations, the four clinical stages (primary, secondary, latent, and tertiary), special presentations like neurosyphilis and congenital syphilis, and practical diagnostic approaches. With a national penicillin shortage, they discuss alternative treatment options including doxycycline and post-exposure prophylaxis. The conversation also addresses the dark history of the Tuskegee Study and its lasting impact on medical ethics. Whether you're seeing more cases in your ED or want to sharpen your diagnostic skills, this episode provides actionable insights for frontline providers.
Timestamps
[0:00] Opening/Introduction
[0:11] Host Welcome & Resources
[0:50] Episode Introduction
[1:30] Epidemiology & Rising Cases
[4:30] Risk Factors & Screening
[6:30] Pathophysiology & Transmission
[9:30] Primary Syphilis
[12:30] Secondary Syphilis
[15:30] Tertiary & Latent Syphilis
[18:30] Neurosyphilis
[22:30] Congenital Syphilis
[25:30] Ocular & Otic Syphilis
[28:30] Differential Diagnosis & Pre-hospital Care
[31:30] History & Physical Examination
[34:30] Diagnostic Testing Overview
[38:30] Testing Details & Titers
[41:30] Treatment: Penicillin & Alternatives
[43:30] Closing
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Cannabis Related Emergencies 28 déc. 2025 00:20:46 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2025 Emergency Medicine Practice article, Diagnosis and Management of Cannabis-Related Emergencies
Episode Outline:
[0:00] Introduction Welcome and show overview by Sam Ashoo Mention of resources at ebmedicine.net [0:46] Episode Start Hosts introduce themselves: Sam Ashoo and Dr. T.R. Eckler Dr. Eckler’s background and experience with cannabis cases in Colorado [1:16] Topic Introduction Focus on diagnosis and management of cannabis-related emergencies Prevalence and importance in emergency medicine [1:34] Legal Landscape Overview of cannabis legality across states Medicinal vs. non-medicinal use [3:03] Increase in ED Visits Statistics: ~1 million cannabis-related ED visits annually Demographics: younger population most affected [3:52] Synthetics and Challenges Discussion of synthetic cannabinoids and their risks Issues with detection and legality [4:50] Clinical Spectrum Range of presentations: from nausea/vomiting to psychosis and seizures Impact on different age groups [6:34] FDA-Approved Uses Cannabis-derived products approved for specific medical conditions [7:20] Physiology and Pathophysiology Cannabinoid receptors (CB1 and CB2) and their effects Differences between plant-derived and synthetic cannabinoids [9:10] Chronic Use and Withdrawal Downregulation of receptors, withdrawal symptoms, and persistent nausea [10:20] Product Forms and Delivery Methods Smoking, edibles, oils, tinctures, suppositories, topicals, etc. Risks associated with concentrated forms (e.g., wax, oils) [12:00] Clinical Effects by System Psychiatric: anxiety, psychosis, paranoia Cardiovascular: tachycardia, MI risk, QT prolongation Pulmonary, renal, metabolic, dental, and ocular effects [13:50] Cannabinoid Hyperemesis Syndrome (CHS) Phases: prodrome, hyperemesis, recovery Hot showers as a diagnostic clue [16:00] Withdrawal Syndrome Symptoms and timeline Exacerbation with synthetic cannabinoids [18:15] Counseling and Management Importance of cessation and patient education Timeline for symptom improvement [18:42] Differential Diagnosis Broad differential for persistent nausea/vomiting and abdominal pain Importance of considering other causes [20:55] Diagnostics and Testing Limitations of drug screens (false positives/negatives) Importance of EKG, labs, and imaging as indicated [23:10] Treatment Approaches First-line: benzodiazepines, antiemetics (ondansetron, metoclopramide) Second-line: butyrophenones (haloperidol, droperidol), olanzapine Capsaicin as adjunct therapy [29:50] Complications and Special Considerations Risks of undertreatment (e.g., Boerhaave syndrome, aspiration) Pediatric and pregnant populations: unique risks and reporting requirements [36:00] Five Practice-Changing Takeaways Elicit cannabis use history Know testing limitations Consider ECG and appropriate labs Use butyrophenones when indicated Admit if symptoms are refractory [39:00] Conclusion
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Measles, Mumps, Rubella, and Varicella with Dr Tim Horeczko 11 déc. 2025 00:34:30 In this episode, Sam Ashoo, MD and Tim Horeczko, MD discuss the November 2025 Pediatric Emergency Medicine Practice article, Emergency Department Management of Measles, Mumps, Rubella, and Varicella in Pediatric Patients
00:00 Introduction to Emergency Medicine
00:21 Welcome and Holiday Greetings
01:16 Special Guest Introduction
01:41 Discussion on Pediatric Emergency Medicine
04:55 Epidemiology of Measles
08:16 Challenges in Diagnosing Measles
14:27 Mumps: Symptoms and Complications
27:36 Rubella: Risks and Symptoms
29:28 Varicella: Symptoms and Precautions
33:12 Differential Diagnosis and Conclusion
35:14 Using Inductive Reasoning in Medical Diagnosis
35:40 Recognizing Purpuric Rash and Its Implications
36:22 Guidance for EMS Colleagues on Handling Fever and Rash
37:14 Importance of Communication and Relationships with EMS
39:12 Decontamination and PPE Protocols for EMS
42:34 Detailed Patient Assessment in the ED
46:06 Diagnostic Testing and Clinical Diagnosis
49:20 Reporting Responsibilities and Treatment Protocols
01:01:19 Addressing Vaccine Controversies and Public Trust
01:06:25 Conclusion and Additional Resources
Check out Dr Horeczko's podcast - Pediatric Emergency Playbook
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Alcohol Withdrawal 21 nov. 2025 00:32:01 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2025 Emergency Medicine Practice article, Diagnosis and Management of Emergency Department Patients With Alcohol Withdrawal Syndrome
Epidemiology & Background Rising ED visits related to alcohol use. Mortality rates and spectrum of patient presentations. Importance of high suspicion and complexity of cases. Pathophysiology & Mechanisms Alcohol metabolism and neurochemical changes. Differential diagnosis: Conditions that mimic alcohol withdrawal. Prehospital & EMS Considerations Role of EMS in triage and initial management. Use of sobering centers vs. ED transport. Prehospital administration of benzodiazepines (IM midazolam). History & Risk Assessment Key questions to assess risk for alcohol withdrawal syndrome. Importance of patient history, medication use, and comorbidities. Discussion on patient honesty and rapport. Physical Exam & Scoring Systems DSM-5 criteria for alcohol withdrawal. Use of CIWA-AR, BAWS, and PAWSS scoring systems. Importance of objective measurement for monitoring and disposition. Complications & Special Presentations Complicated alcohol withdrawal: Hallucinosis, seizures, delirium tremens. Diagnostic workup: Labs, imaging, and co-ingestions. Special populations: End-stage liver disease, pregnancy, intubated patients. Treatment Strategies Mainstay: Benzodiazepines (types, dosing, and protocols). Phenobarbital: Indications, dosing, and evidence. Adjunctive therapies: Thiamine, glucose, magnesium. Alternative/adjunct medications: Gabapentin, ketamine, dexmedetomidine, baclofen. Clinical Pearls & Practice Changes Early, aggressive therapy to prevent complications. Symptom-based vs. fixed-schedule treatment. Gabapentin as an alternative or adjunct. Anti-craving medications for relapse prevention. Disposition & Protocols Use of scoring systems for safe discharge, observation, or admission. Importance of protocolized approaches and community resources. Summary & Take-Home Points Five key practice-changing points. Clinical pathway.
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Diphtheria, Pertussis, and Tetanus with Dr Lara Zibners 07 nov. 2025 00:20:44 In this episode, Sam Ashoo, MD and Lara Zibners, MD discuss the August 2025 Pediatric Emergency Medicine Practice article, Diphtheria, Pertussis, and Tetanus: An Update of Evidence-Based Management of Pediatric Patients in the Emergency Department
Introduction and guest background Host welcome, show context Dr. Lara Zibners’ credentials EB Medicine involvement Personal stories and clinical experience Memorable tetanus and pertussis cases Vaccine advocacy Rare disease encounters Diphtheria: overview, presentation, treatment Toxigenic vs. non-toxigenic, “bull neck” Cardiac, neurologic complications Antitoxin, antibiotics, public health Pertussis: symptoms, vaccine, treatment “100-day cough,” apnea in infants Waning immunity, boosters Azithromycin, treat contacts Tetanus: risk, presentation, management Clostridium ubiquity, no outbreaks Muscle spasms, autonomic instability Airway, sedation, antibiotics Key ED takeaways and pearls Early suspicion, isolation ICU admission for severe cases Vaccination, reporting Resources and article summary Appendix, clinical pathway ebmedicine.net reference CME, further reading Guest’s podcast plug and closing remarks “Unstable Vitals” podcast Where to listen Thank you, sign-off
Check out Dr Zibner's podcast Unstable Vitals
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Adrenal Insufficiency 21 oct. 2025 00:25:55 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the October 2025 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Patients With Adrenal Insufficiency
Introduction
Welcome and host introductions Brief overview of the episode’s topic Resources and CME reminder Article Overview
Source: Emergency Medicine Practice, October 2025 Authors: The Simcoes Importance of evidence-based review Clinical Context & Epidemiology
Frequency and rarity of adrenal insufficiency Diagnostic challenges and statistics Importance of recognizing adrenal crisis Pathophysiology
Primary, secondary, and tertiary adrenal insufficiency Causes and mechanisms Key anatomical and physiological concepts Differential Diagnosis
Overlap with other diseases (infections, autoimmune, endocrine, psychiatric, cardiac, GI, etc.) Importance of considering adrenal crisis in complex cases Prehospital Care
EMS recognition and limitations Importance of medication history and emergency kits Legal and logistical barriers to prehospital hydrocortisone Emergency Department Evaluation
Recognizing symptoms and prioritizing care Role of EMR and clinical decision support Key history and risk factors (medications, steroid use, opioid use, comorbidities) Physical Examination
Specific and nonspecific findings Cushingoid features vs. primary adrenal insufficiency signs Diagnostic Workup
Laboratory studies (cortisol, ACTH, renin, aldosterone, TSH, etc.) Imaging considerations Gold standard tests and their limitations in the ED Treatment
Immediate administration of hydrocortisone Dosing for adults and pediatrics Supportive care (fluids, glucose, treating underlying cause) Sick day dosing and home management Special Populations
Pregnancy considerations Septic shock and adrenal crisis Common Pitfalls & Takeaways
Delaying steroids for labs/diagnosis Importance of high suspicion and early treatment Key trivia and learning points ClosingSummary and final thoughts
Reminders for further reading and CME Farewell and next episode teaser
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Steroid Use – An Interview with Dr. Evan Dvorin 06 oct. 2025 00:18:57 In this episode, Sam Ashoo, MD interviews Evan Dvorin, MD about the dangers of short term steroid use.
Background & Regional Differences
Dr. Dvorin’s clinical journey from New England to New Orleans. Noticing increased use of corticosteroids for common conditions in the Southeast. Discussion of how steroid prescribing practices vary by region and setting. Inappropriate Steroid Use
Common conditions where steroids are often inappropriately prescribed (sinus infections, bronchitis, sciatica, rashes, plantar fasciitis, etc.). Trends showing increased steroid prescribing over time. Similar patterns observed in emergency, urgent care, and primary care settings. Risks and Side Effects of Short-Term Steroid Use
Short-term steroids can cause significant side effects: infection, sepsis, bone fractures, thromboembolism, psychiatric effects, hyperglycemia. Dose-response relationship: higher doses and repeated use increase risks. Some side effects (e.g., bone loss) may persist beyond two months. Patient Communication & Shared Decision-Making
Importance of discussing risks with patients, tailored to individual risk factors (e.g., diabetes, psychiatric history, age). Strategies for educating patients and managing expectations. The role of patient education videos and resources. Impact of Provider Education & Quality Metrics
Ochsner Health’s initiatives to reduce inappropriate steroid use. Use of CME, quality dashboards, and feedback to clinicians. Evidence that education and reporting can reduce unnecessary prescriptions. Special Populations & Scenarios
Considerations for pediatric patients and repeated dosing. Challenges when specialists recommend steroids for certain conditions (e.g., sciatica, neurosurgery cases). The need for evidence-based practice and inter-provider communication. Medical-Legal Considerations
Lawsuits related to steroid side effects (e.g., fat atrophy, infection). Importance of documentation and informed consent. Alternatives & Symptom Management
Focusing on treating the patient’s most bothersome symptoms. Non-steroid options and the value of patient education about illness duration and expectations. Resources
Mention of Dr. Dvorin’s educational video on corticosteroid side effects (available on YouTube). Reminder of EB Medicine’s journals and resources for further learning. Conclusion
Key takeaway: “Do no harm” and practice evidence-based medicine. Encouragement for clinicians to review their prescribing habits and educate patients.
Ochsner "Side effects from corticosteroids" Video: https://www.youtube.com/watch?v=PdMJ9HYxkck
Adult Status Epilepticus 21 sept. 2025 00:25:35 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Status Epilepticus
Topic Introduction
Focus: Status Epilepticus in Adults Reference to recent pediatric episode Article authors: Dr. Marquez, Dr. Kaur, Dr. Lay Why Status Epilepticus Matters
Teaching value and clinical challenge Team-based care and multidisciplinary involvement Guidelines and Evidence
Review of major guidelines (International League Against Epilepsy, Neurocritical Care Society, American Epilepsy Society) Key trials: EcLiPSE, ConSEPT, ESETT Updated definition of status epilepticus Classification and Diagnosis
Convulsive vs. non-convulsive status Importance of repeated neurologic exams Diagnostic challenges and mimics (e.g., syncope, psychogenic seizures) Etiology and Workup
Acute vs. non-acute causes Common triggers: medication noncompliance, metabolic issues, infections, trauma Importance of sleep patterns and ammonia levels The NORSE acronym (new onset refractory status epilepticus) Prehospital and ED Management
Airway, breathing, circulation priorities Early pharmacologic intervention (IM midazolam preferred in prehospital) Gathering history and medication information Positioning and airway protection Diagnostics
Laboratory workup: glucose, CBC, metabolic panel, drug levels, pregnancy test Imaging: non-contrast CT, MRI, ultrasound, lumbar puncture EEG: spot vs. continuous monitoring Treatment Approach
First-line: Benzodiazepines (lorazepam, midazolam) Second-line: Levetiracetam, valproate, fosphenytoin, phenobarbital, lacosamide Third-line: Continuous infusions (midazolam, propofol, pentobarbital, thiopental, ketamine) Dosing pearls and importance of rapid escalation Special Populations
Pregnancy (eclampsia: magnesium as first-line) Substance-induced status epilepticus (e.g., isoniazid toxicity and pyridoxine) Brief mention of pediatric management and the PD stat app Risk Management Pitfalls
Non-convulsive status is common and easily missed Importance of weight-based dosing Need for formal EEG in ambiguous cases Don’t assume non-adherence is the only cause in known epileptics Always consider higher level of care for status patients Clinical Pathway
Stepwise approach to medication and escalation Emphasis on having a pathway/checklist for these high-stress cases Conclusion
Recap of key points Thanks to authors and listeners Reminder to visit ebmedicine.net for CME and resources
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The Locums Life with Ali Chaudhary, MD 09 sept. 2025 00:16:40 In this episode, Sam Ashoo, MD interviews Ali Chaudhary, MD about the benefits of working Locum Tenens in Emergency Medicine.
00:00 Introduction and Welcome 00:54 Meet Dr. Ali Chaudhary 01:41 The State of Emergency Medicine 03:29 Understanding Locum Tenens 05:45 Financial Benefits of Locum Work 08:40 Balancing Family Life with Locum Work 12:54 Locum Work Logistics and Misconceptions 17:34 Maximizing Travel Perks as a Contractor 18:07 Adjusting to New Hospitals and EMRs 19:32 The Hassles of Credentialing 20:48 Navigating Locum Staffing Companies 22:27 Understanding Your Worth and Negotiation 25:14 The Importance of Organization 27:41 About Our Locum Staffing Company 29:59 Practical Tips for Malpractice Insurance 31:09 Final Thoughts and Contact Information
For more about Dr. Ali Chaudhary: https://thelocums.com/
Sepsis & Septic Shock- An Interview with Dr Lauren Black 21 août 2025 00:27:19 In this episode, Sam Ashoo, MD interviews Lauren Black, MD about the August 2025 Emergency Medicine Practice article, Updates and Controversies in the Early Management of Sepsis and Septic Shock
00:00 Introduction and Welcome
01:09 Meet Dr. Lauren Page Black: Sepsis Expert
01:56 Sepsis Statistics and Impact
04:16 Understanding Sepsis Definitions
09:56 Screening Tools for Sepsis
13:57 Pre-Hospital Sepsis Recognition
19:33 Clinical Examination and Diagnostics
24:03 The Role of Lactate and Procalcitonin
27:40 Clinical Gestalt and Imaging in Diagnosis
29:21 CMS Bundle Requirements and Updates
34:02 Fluid Type Preferences in Sepsis
36:49 Antibiotic Timing and Selection
43:43 Vasopressors and Steroids in Sepsis Management
50:18 Special Populations and Future Directions
53:44 Conclusion and Resources
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How To Focus with Christina Shenvi, MD, PhD, MBA 09 août 2025 00:22:25 In this episode, Sam Ashoo, MD interviews Christina Shenvi, MD, PhD, MBA about ways to manage your day and keep distraction at bay.
Introduction to Dr. Christina Shenvi Why Focus and Time Management Matter Experiences coaching medical students and professionals The importance of managing mind, time, and attention Applicability to both career and personal life Framework for Focus Three-step framework: Prioritize, Strategize, Focus Explanation of prioritization Mapping personal and professional activities to priorities Deep Work vs. Shallow Work Defining deep work and shallow work Strategies for categorizing and scheduling tasks Time-blocking and protecting focus time Overcoming Distraction The psychology of distraction and procrastination The impact of digital devices and social media on attention The variable reward system of social media and its addictive nature Strategies to Improve Focus Clearing mental, physical, and digital environments The importance of a distraction-free workspace Systems for capturing and organizing tasks The Pomodoro method and using time pressure Building a Personal System Experimenting with different task management tools Adapting systems to personal needs and preferences Daily Practice and Training Focus Reviewing and updating task lists daily Chunking email and shallow work to specific times Training the brain to focus like a muscle Special considerations for people with ADHD Resources and Contact Dr. Shenvi’s website and online course (timeforyourlife.org) Invitation to connect for coaching or further learning
For more about Christina Shenvi : https://timeforyourlife.org/
Pediatric Status Epilepticus 23 juil. 2025 00:21:42 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the July 2025 Emergency Medicine Practice article, Emergency Department Management of Status Epilepticus in Pediatric Patients
Introduction
Why Pediatric Status Epilepticus Matters
Seizures make up ~1% of ED visits and ~3% of EMS calls High-risk and high-stakes condition requiring rapid action Status epilepticus now defined as ≥5 minutes of seizure activity ILAE’s T1 and T2 timelines help define when to treat and when damage begins Common Causes
Top contributors: Fever/infection Structural CNS abnormalities Toxic ingestions Genetic/metabolic disorders Additional factors by age: Infants: febrile seizures, chromosomal issues, trauma School-age: autoimmune disorders Adolescents: eclampsia, hypertension, functional disorders Always consider non-accidental trauma Prehospital Care
IM midazolam is effective and recommended (RAMPART trial) Other options: intranasal, rectal, or IV benzodiazepines Early benzodiazepine administration improves outcomes Importance of airway support, glucose check, and EMS flexibility Parent-administered home meds (e.g. rectal diazepam) can be helpful ED Evaluation and Initial Management
Prioritize ABCs: Airway, Breathing, Circulation, Consciousness Use end-tidal CO₂ to monitor ventilation if available Point-of-care glucose is essential Labs: CMP, Mg, Phos, lactate, drug levels, pregnancy test (when indicated) Imaging: Head CT if concern for trauma, shunt malfunction, or focal signs Case examples highlight pitfalls and diagnostic delays First-Line Treatment
Benzodiazepines remain the cornerstone Lorazepam preferred IV agent (0.1 mg/kg) Midazolam preferred if no IV access (IN, IM, or IO) Diazepam is also effective, especially rectally Be mindful of respiratory depression and the need for airway control Second- and Third-Line Therapies
Based on ESETT trial: Levetiracetam, fosphenytoin, and valproate have similar efficacy Levetiracetam favored for safety and ease of use Fosphenytoin may be avoided in trauma or toxicity Valproate not recommended in mitochondrial disease Phenobarbital reserved for refractory cases only Refractory Status Epilepticus
Definition: persistent seizures despite first- and second-line agents Requires sedation and likely intubation Infusion options: Midazolam (preferred for flexibility) Propofol (short-term use only due to risk of infusion syndrome) Pentobarbital (rare, ICU-level care) Need for continuous EEG to assess seizure activity Special Scenarios
Neonates: Watch for subtle signs (lip smacking, bicycling, tongue thrusting) Broad differential includes asphyxia, infection, metabolic errors Febrile Status Epilepticus: Higher risk of CNS infections, especially if unvaccinated Consider lumbar puncture if indicated Electrolyte/Metabolic Triggers: Treat hypoglycemia, hyponatremia, and hypocalcemia directly Use 3% saline or dextrose as appropriate Disposition and Discharge Considerations
Many children will require ICU-level care Some known epilepsy patients may go home if back to baseline Ensure rescue medications are up to date (rectal/intranasal benzos) Consider “clonazepam bridge” for short-term seizure prevention Collaborate with neurology for medication adjustment and follow-up Final Thoughts
Keep treatment tables and dosing references accessible Early, aggressive treatment can prevent long-term harm Episode closes with gratitude to article authors and a reminder to visit EBMedicine.net Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
Thyroid Emergencies 17 juin 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
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Parkinson's, Myasthenia Gravis, and MS in the ED 16 mai 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
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Strategies for Keeping Trauma at Bay with Rob Orman, MD 02 mai 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 avr. 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 avr. 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:
Knee Pain 12 mars 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
Rural EM and Traumatic ICH – An Interview with Ashley Weisman, MD 18 févr. 2025 00:10:07 In this episode, Sam Ashoo, MD interviews Ashley Weisman, MD about her career in rural emergency medicine, and the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department
Interview with Dr. Ashley Wiseman
Introduction of Dr. Wiseman: Emergency physician specializing in rural ER. Dr. Wiseman’s Background: Overview of her work and responsibilities in rural hospitals and academia. Experience in Rural Medicine: Contrast with urban and academic practice. Stories of practical challenges and learning experiences in remote areas like Kotzebue, Alaska. Practicing Skills in Rural Medicine
Discussion of skill retention: Importance of continuously applying and practicing critical skills. Resources and Training: Role of fellowship, networking, and practical experiences for skill enhancement. Advocacy for Rural Emergency Medicine
Work with ACEP: Dr. Wiseman’s efforts in advocating for rural EM at the national level. Collaboration Between Rural and Academic Centers: Importance of knowledge exchange and mutual support. Focus on Traumatic Intracranial Hemorrhage (ICH)
Introduction to the February Article: Traumatic ICH in rural settings. Key Points from the Article: Importance of basic neurocritical care practices. Practical adjustments and simplified approaches in care. Dr. Wiseman’s Contribution: How her experiences shaped the content and practical advice for rural medicine. Conclusion
Upcoming Contributions: Announcing more contributions and resources from Dr. Wiseman. Access the In Rural Life (IRrL*) content here . Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
Managing Traumatic Intracranial Hemorrhage in the Rural Setting: EMP: IRrL*
If you practice in a rural environment, you know that managing a patient with traumatic ICH can present challenges with diagnostic and treatment resources, personnel, training, and transport. Dr. Weisman has created resources for emergency clinicians, IRrL* (In Rural Life*) that EB Medicine is proud to share with subscribers.
Resources for emergency clinicians managing patients with traumatic ICH in rural settings include:
Traumatic ICH - An Interview with Erin D'Agostino, MD 05 févr. 2025 00:34:20 In this episode, Sam Ashoo, MD interviews Erin D'Agostino, MD about the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department
Pathophysiology Types of Traumatic Brain Injuries Pre-Hospital Care Critical History and Physical Examination Neurological Assessment and Monitoring Laboratory and Imaging Studies Emergency Department Treatment Surgical Interventions and Considerations Patient DemographicsSummary of major points discussed Reminder for continued vigilance and the importance of early consultation
Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
Alkali Exposure 25 janv. 2025 00:20:31 In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the January 2025 Emergency Medicine Practice article, Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment
Patient Demographics and Case Scenarios: Types of patients prone to alkali exposure Causes and scenarios leading to alkali exposure (e.g., accidental, intentional, social media challenges) Poison control reports and statistics Types and Effects of Exposure: Different types of exposure: ingestion, ocular, dermal Effects of ingestion, particularly in children and young adults Pre-hospital Care and First Response: Importance of decontamination Safety measures for EMS personnel Steps to take in pre-hospital care History and Physical Examination: Key points to focus on during history taking Important signs and symptoms to check Laboratory and Diagnostic Testing: Overview of useful lab tests and imaging Role of EKG and chest x-ray Importance of early consultation with poison control Endoscopy and CT Imaging: Use of endoscopy to classify injuries and guide treatment Role of CT imaging Complementary use of endoscopy and CT Treatment Approaches: Initial resuscitation and airway management Use of steroids and other medications like antibiotics, H2 antagonists, and topical mitomycin C When and how to use NG tubes Special Populations and Long-term Considerations: Special considerations for children Risks associated with laundry detergent pods Long-term complications, including strictures and increased risk of esophageal cancer Conclusion: Summary of major points discussed Reminder for continued vigilance and the importance of early consultation
Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net
EM Innovation Collaborative - An interview with Nicholas Stark, MD, MBA & Zaid Altawil, MD 07 janv. 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 déc. 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
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 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
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
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
Maladaptive Perfectionism with Rob Orman, MD 29 sept. 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 sept. 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:
Physicians on Social Media 29 août 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 août 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
Dialysis Emergencies 09 juil. 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 juin 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 mai 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 mai 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 avr. 2024 00:55:57 Brief Resolved Unexplained Events (BRUE) 01 avr. 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 mars 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 févr. 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 févr. 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 janv. 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
Pediatric UTI and Pneumonia 02 janv. 2024 00:46:47 Pediatric Toxic Ingestions 01 déc. 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
Check out the clinical pathways at https://www.ebmedicine.net/pathways
Substance Use in Adolescents 02 oct. 2023 00:52:06