Always On EM - Mayo Clinic Emergency Medicine

Dr. Mark Mannenbach, emeritus pediatric emergency physician, former chairperson of pediatric emergency medicine at Mayo Clinic and career long advocate for children comes back on the show to talk through nonaccidental trauma in children in a two part series. 

In this first part, we talk through the approach to sharing the concern that you have with the family, keys to the physical examination, the role of additional testing such as serum, urine, and radiograph. 

CONTACTS

x- @AlwaysonEM; @VenkBellamkonda

YouTube - @AlwaysonEM; @VenkBellamkonda

Instagram - @AlwaysonEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

Dr. Pritish Tosh, consultant physician in Infectious Diseases, and Supply Chain Management specialist for Mayo Clinic talks through the relationship between our clinical delivery of care and the strength of our supply chain practices. Our recent experiences with facemasks in the pandemic, the daily threats to medication access, and the events of recent longshoreman strike as well as Hurricane Helene damage to saline production locations has shown us how valuable it is to understand our supply chain. In this chapter, Alex and Venk, get schooled on the importance of this understanding, the basics of how to assess the stability of supply chain, and how to be advocates for a healthy supply chain infrastructure moving forward.

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

• Tosh PK, Schafer JM, Harvieux TP, Hall BL. Medical Supply Shortages - We are part of the problem...and solution. Mayo Clin Proc. 2023 Dec; 98(12):1763-1766Associated Press. (2024, October 1). US port strike: Over 45,000 dockworkers from Maine to Texas hit picket lines. AP News. Retrieved from https://apnews.com/article/port-strike-ila-dockworkers-begins-e5468e760f46a64e4322d1702beb1f72[1](https://apnews.com/article/port-strike-ila-dockworkers-begins-e5468e760f46a64e4322d1702beb1f72).

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. Sarayna McGuire is an emergency physician who has been investigating workplace violence in the ED and in the prehospital setting. She and Dr. Casey Clements, who is the chief safety officer for Rochester Mayo Clinic campus talk with Venk and Alex about the violence in the emergency department. The scope of the problem is staggering, the impact ripples broadly into the community, and we all have the opportunity to intervene and change the trajectory of how life unfolds – learn the what, the why, and the how in this cant-miss chapter of Always on EM

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda;

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

LinkedIn - Sarayna McGuire

Email - [email protected]

• Pompeii LA, Schoenfisch AL, Lipscomb HJ, Dement JM, Smith CD, Upadhyaya M. Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six U.S. hospitals. Am J Ind Med. 2015 Nov;58(11):1194-204

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

Ischemic heart disease is a leading cause of morbidity and mortality. While atherosclerotic coronary artery disease (CAD) is the focus of most outpatient and inpatient evaluations for cardiovascular symptoms, up to two thirds of patients suffer from myocardial ischemia with non-obstructive coronary arteries (INOCA). Patients with INOCA have unique symptoms and are more likely to have functional limitation and repeat presentations for cardiovascular evaluation. While there has been increasing recognition of INOCA there is no specific functional status measure, limiting our ability to evaluate the course of illness or effectiveness of therapies. In this presentation, Dr. Samit Shah, interventional cardiologist at Yale New Haven Hospital who recently gave grand rounds recently to the Mayo Clinic Department of Emergency Medicine, reviews the causes of ischemic heart disease, challenges with current symptom assessment, and proposes a new path for better diagnosis and treatment of heart disease.

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda; @SamitShahMD

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

Dr. Adela Cope breaks down pelvic inflammatory disease, tubo-ovarian abscess, ovarian torsion, ectopic pregnancy and more in this densely packed chapter of Always on EM. Tune in as Alex and Venk also try to figure out which one has the correct mental model of PID and who will ask the first stupid question. 

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

LEARN MORE ABOUT RESIDENCY:

• https://youtu.be/gCQ0zimhhhY?si=NpsyTruGM9N_UpVM

REFERENCES:

• Williams T, Mortada R, Porter S. Diagnosis and Treatment of Polycystic Ovary Syndrome. Am Fam Physician. 2016;94(2):106-113

This past winter, Dr. Rich Griffey, healthcare quality leader from Washington University School of Medicine and Emergency Medicine, came to present grand rounds on a new way to care for patients with mild to moderate DKA, which they call the SQuID protocol. This talk serves to inspire us to look even at some of our well established conditions and see what we could do differently, as well as appreciate the value that healthcare quality improvement integrated with research methods and implementation science thinking can do when they all come together for the improvement of patient care. Come be inspired with us!

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

Dr. Ronna Campbell, professor of emergency medicine, and passionate anaphylaxis researcher schools Alex and Venk on several issues related to contrast-related anaphylaxis. She helps clarify an approach to managing ED situations where a contrasted CT is desired yet the patient has documented anaphylaxis to iodine, or how to treat a patient who returns with unexpected reaction after receiving contrasted imaging. Can you be allergic to Iodine? What is the relationship between shellfish allergy history and contrast? What is the role of steroids in anaphylaxis management? These are just some of the questions that we answer in this discussion. 

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

Dr. Ken Milne presents his talk entitled, “Old Fashioned Doctors,” to Mayo Clinic Emergency Medicine as our keynote speaker for our annual research day. In this talk, he goes through 10 ideas that were proposed in an article by Dr. Herbert Fred as potential ways that old-fashioned doctors may practice medicine more effectively or more palatably than younger counterparts. In this talk, he challenges those ten ideas while offering insights and reflections founded from his experiences before that can help guide or shape the way people can practice tomorrow. This is all done through the use of story and humor as he does in all of his other public speaking opportunities.

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda; @KenMilne4234

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

TikTok - @Dr_Venk

Email - [email protected]

• Skeptics guide to emergency medicine: https://thesgem.com/ 

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. Lacey Shiue, emergency ultrasound faculty, sits down with Alex and Venk to talk through ultrasound guided nerve blocks and plane blocks. We talk through key differences in commonly used medications, how to manage toxicity from those medications as well as a detailed discussion of several different specific blocks including: Erector Spinae Plane Block, Fascia Iliaca Compartment Block, Supraclavicular Block, Interscalene Block among others. In addition, she discusses the keys to advancing an emergency regional anesthesia program.

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

RESOURCES FOR PRACTICE:

• MDCALC for anesthetic dose calculation: https://www.mdcalc.com/calc/10205/local-anesthetic-dosing-calculator 

REFERENCES:

1. American College of Emergency Physicians Policy Statements: Ultrasound-Guided Nerve Blocks, published April 2021. Document accessed June 20, 2024 via: https://www.acep.org/patient-care/policy-statements/ultrasound-guided-nerve-blocks

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 final chapter of the academic year 2023-2024, we celebrate our graduating EM class of residents by spotlighting a senior capstone presentation by Dr. Matthew Hamilton covering the intersection of homosexuality and medicine. In this presentation, he aims for the learner to be able to recognize pivotal movements in LGBTQ+ history and civil rights; describe structural mechanisms that excluded gay people from medicine for over 150 years; and to be able to recognize and mitigate ongoing threats to the health and wellbeing of LGBTQ+ people. Please tune in to learn more from one the great graduating senior emergency medicine resident physicians at Mayo Clinic!

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]