In this final chapter of the 2025 season of Always on EM, Alex and Venk are thrilled to share an amazing Grand Rounds recording from the esteemed educator and clinician, Dr. Neha Raukar. She is renowned for her expertise in many areas - among them, concussion and traumatic brain injury, particularly of athletes. She breaks down imaging guidelines, evaluation of TBI, prognosis, counseling of patients and more in this fantastic talk essential for any emergency healthcare professional to hear!

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda; @NehaRaukarMD

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @NehaRaukarMD

Email - [email protected]

WANT TO WORK AT MAYO?

EM Physicians: https://jobs.mayoclinic.org/emergencymedicine

EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs  

Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine

EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice

All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

Dr Sharonne Hayes, Professor of cardiovascular medicine and founding director of Mayo Clinic women’s heart clinic, and Dr. Marysia Tweet, Associate Professor of cardiovascular medicine, and co-leader of the Spontaneous Coronary Artery Dissection Registry and leader in women’s heart health join the show for this amazing November chapter of Always on EM. They are world experts on Spontaneous Coronary Artery Dissection authoring over 60 peer reviewed articles on the topic and in this chapter we explore with them the pitfalls and pearls related to making this diagnosis in the ED. SCAD is an important cause of myocardial infarction especially in patients who would not otherwise seem to be at risk for heart attacks for example active young women without comorbidities, and its imperitive that we as emergency physicians are current on this diagnosis.

DONATE TO DR JIM GREGOIRE SCHOLARSHIP FUND

To honor the life of Dr. Jim Gregoire, dear friend of this show, consider donating to his scholarship fund. Go to https://give.mayoclinic.org/give/616870/#!/donation/checkout

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda; @Marysia_Tweet; @SharonneHayes

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @SharonneHayes

Email - [email protected]

DO YOU HAVE SCAD? DOES YOUR PATIENT HAVE SCAD? WANT TO GET CONNECTED?

SCAD Research: www.scadresearch.org

National Coalition for Women with Heart Disease: www.womenheart.org

Mayo Clinic Womens Heart clinic: https://www.mayoclinic.org/departments-centers/womens-heart-clinic/overview/ovc-20442061

REFERENCES & LINKS

WANT TO WORK AT MAYO?

EM Physicians: https://jobs.mayoclinic.org/emergencymedicine

EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs  

Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine

EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice

All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

In this chapter of Always on EM, Dr. Lacey Shiue, Associate Director of Emergency Ultrasound for Mayo Clinic Emergency Medicine in Rochester, challenges us to recognize the morbidity and mortality associated with rib fractures and to rethink the way we consider pain management for people suffering these injuries.

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @Lacey.Shiue

Email - [email protected]

Dr. Jim Gregoire, consultant nephrologist and master educator, joins the show again to talk about electrolytes this time. He breaks down practicalities in caring for patients with sodium, magnesium, and phosphorus disorders - who is at risk, what history and exam findings to look for, what testing to do and how to correct the problems. Join Alex and Venk as they learn the nuances of care for these conditions that we see every single shift. 

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

In this chapter, Dr. Schupbach analyzes the business of healthcare and a way he believes can let patients wage war on the mis-alligned incentives. This is a continuation of our Grand Rounds sequence. Come join Alex and Venk on this adventure!

TEASER

Specifically, childhood obesity is skyrocketing--1 in 5 children are now above the 95th percentile BMI for age and sex. A recent NEJM article showed Liraglutide (a medication that costs approximately $12,000 per year) was effective in children as young as 6 years old. This is just one example of many where cheap foods, expensive drugs, and band-aid solutions are generating record profits for the most powerful voices at the table. But are we truly acting in the best interests of our patients? What are the unintended consequences of these misaligned incentives? What is our responsibility in all this and where do we start if we want to be part of the solution?

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient’s needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don’t let it take your breath away!

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

WANT TO WORK AT MAYO?

EM Physicians: https://jobs.mayoclinic.org/emergencymedicine

EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs  

Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine

EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice

All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

This is a capstone presentation from Chief Resident of Mayo Clinic Emergency Medicine, Dr. Taylor Christian.

Teaser: Can we fulfill our oath to “do no harm” if we ignore the harm of racial injustice in medicine? Understanding the historical roots and persistent impact of medical racism isn’t just informative; it is a call to action. This presentation is an opportunity to learn, reflect, and act to become better advocates.

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda; @TayMChristian

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @drtaylormonet

Email - [email protected]

REFERENCES & LINKS

Is it possible that the cutting edge therapy for alcohol withdrawal care is one of the older tools in our bag? Possibly! In this chapter, one of the rising stars, Dr. Brandy Hernandez, Emergency Pharmacist, discusses the case for phenobarbital for helping patients for with their acute alcohol withdrawal symptoms. Find out when it may be preferable, what we don’t know yet, what the pitfalls are, and more!

In this grand rounds, Dr. Daniel Fiterman Molinari challenges the status quo of cardiac arrest care with thought provoking takes on the literature. Take a listen to his Capstone presentation and find yourself pondering whether you agree or disagree, and whether you need to go revisit the literature yourself. You may find your own heart skips a beat in this great episode.

Diarrhea is one of the more common concerns in emergency medicine worldwide and in the United States, yet we often do not spend enough time understanding the breadth of causes and considerations for this syndrome. Do you know which patients benefit from Zinc? Would you like to review HUS? Can you mixup Oral Rehydration Solution if you needed to? We cover all of this and more in this “code brown” of a chapter! So come, get dirty with Alex and Venk in this truly crappy chapter of Always on EM!

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

WANT TO WORK AT MAYO?

EM Physicians: https://jobs.mayoclinic.org/emergencymedicine

EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs  

Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine

EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice

All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs