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

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

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

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

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