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