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

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.

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

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

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

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

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

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