Emerge in EM

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In this episode of EMERGE in EM, Dr. Mohamed Hagahmed sits down with cardiology fellow Dr. Njeri Kuria to discuss Spontaneous Coronary Artery Dissection (SCAD)—an often underrecognized cause of acute myocardial infarction that predominantly affects young and otherwise healthy women.

Through a real clinical case, they explore how SCAD presents, why it's frequently mistaken for more common conditions, how it's diagnosed, and what makes its management fundamentally different from traditional heart attacks. They also discuss pregnancy-associated SCAD, recurrence, long-term follow-up, and the critical role of recognizing cognitive biases when evaluating chest pain.

Whether you're an emergency clinician, cardiologist, paramedic, nurse, medical student, or simply interested in understanding heart health, this episode offers practical insights that could change the way you think about chest pain—and perhaps even save a life.

In this episode, you'll learn:

• Why SCAD is one of the leading causes of heart attacks in women under 50
• How to recognize high-risk patients in the emergency setting
• Why PCI isn't always the best treatment
• The role of fibromuscular dysplasia and pregnancy
• Long-term management, recurrence, and patient counseling
• Key clinical pearls for healthcare professionals

🎧 Tune in for an engaging conversation that challenges common assumptions about heart disease and highlights the importance of listening to patients, recognizing bias, and delivering thoughtful, evidence-based care.

Resources

📖 New England Journal of Medicine Review: Spontaneous Coronary Artery Dissection
https://www.nejm.org/doi/full/10.1056/NEJMra2001524

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📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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Welcome to Public Health Briefs — a new series from EMERGE in EM where we break down the public health stories shaping our world through the lens of emergency medicine, critical care, and frontline science.

In this episode, we tackle the growing public concern surrounding hantavirus after recent viral headlines and online speculation sparked fear across social media. Joined by infectious disease specialist Dr. Yassin, I take a deep dive into what hantavirus actually is, how it spreads, why certain strains raise concern for person-to-person transmission, and what clinicians and the public truly need to know.

We discuss rodent exposure, incubation periods, cardio-pulmonary syndrome, ECMO considerations, diagnostic challenges, public health response, quarantine recommendations, and the dangers of misinformation during emerging infectious disease events.

This conversation is not about panic — it’s about perspective, preparedness, and evidence-based medicine.

Because in public health, the goal is always the same: awareness over fear, science over speculation, and protecting communities through accurate information.

Thank you for listening to Public Health Briefs on EMERGE in EM.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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What happens after the pulse comes back?

In this episode, we dive into one of the most practical — and controversial — questions in post-cardiac arrest care: Which vasopressor should clinicians reach for first after ROSC? Epinephrine or norepinephrine?

Joining me is Dr. Nathalie Van Der Rijst, pulmonary and critical care physician from Philadelphia, for an energetic and evidence-driven debate exploring the physiology, pharmacology, real-world logistics, and limitations of current research surrounding post-cardiac arrest hypotension.

Together, we tackle:

• Why post-ROSC hypotension remains so deadly
• The physiologic argument for epinephrine vs. norepinephrine
• Myocardial stunning, vasoplegia, and recurrent arrest
• What observational studies and limited randomized data actually show
• Why prehospital realities matter when choosing vasopressors
• The challenges EMS agencies face with pumps, medications, and resources
• How ICU and emergency medicine perspectives sometimes differ — and where they align

Along the way, expect spirited Pittsburgh vs. Philadelphia banter, ICU vs. ER jabs, practical resuscitation pearls, and an honest discussion about the gap between ideal medicine and real-world medicine.

Whether you work in EMS, emergency medicine, critical care, anesthesia, or hospital medicine, this conversation will challenge the way you think about post-cardiac arrest shock and the critical minutes after ROSC.

As always, thank you for listening, sharing feedback, and helping grow this community focused on resuscitation, emergency medicine, critical care, and public health.

If you enjoy the episode, please share it with a colleague and send along topics you’d like covered in future episodes.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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As an emergency physician and someone who loves EMS, I’ve always believed that we should understand the history of the systems we work in. But the truth is, many clinicians today don’t realize how modern paramedicine actually began.

Before paramedics existed, an ambulance call in many cities meant a police wagon. There were no trained providers in the back, no oxygen, no medications—just a ride to the hospital.

That changed in Pittsburgh in the late 1960s with the creation of the Freedom House Ambulance Service.

In this episode, I had the incredible honor of sitting down with Chief John Moon, one of the original Freedom House paramedics. Alongside pioneers like Dr. Peter Safar and Dr. Nancy Caroline, these men helped build the very foundation of modern EMS—bringing advanced medical care directly to patients long before it became standard practice.

But this story is about more than the birth of paramedicine.

It’s about a group of young Black men from Pittsburgh’s Hill District who were given an opportunity to serve their community—and in doing so changed emergency medicine forever.

Chief Moon shares powerful stories about the early days of Freedom House, the groundbreaking training they received, the lives they saved, and the challenges they faced along the way.

For me, this conversation is also deeply personal. The story of Freedom House is one of the reasons I came to Pittsburgh and pursued EMS and emergency medicine here.

If you are a paramedic, EMT, nurse, physician, or anyone who works in emergency care, this is a piece of history that belongs to all of us.

I’m truly honored to share Chief Moon’s story with you.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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What happens when life-saving care collides with deeply held faith?

As Ramadan begins this month, millions of patients around the world will be fasting—and many of them will still come to the emergency department sick, unstable, and in need of urgent care. In this episode of EMERGE, we dive into the real-world challenges of caring for the fasting patient, from hypotension and sepsis to IV fluids, medications, and shared decision-making in high-acuity settings.

Joined by Dr. Laila Abubshait, we unpack common myths, high-stakes cases, and practical strategies for clinicians navigating faith, culture, and emergency medicine—without compromising resuscitation or trust. This conversation builds on our ALiEM article “Caring for the Fasting Patient” and translates it into bedside wisdom every resuscitationist and clinician can use.

This isn’t just about Ramadan. It’s about seeing the whole patient, asking better questions, and recognizing that sometimes the most powerful intervention in the ED is curiosity, humility, and listening first.

👉 Read the companion article: https://www.aliem.com/caring-for-the-fasting-pt/

🎙️ We want to hear from you—share your experiences, questions, and reflections as we continue this essential conversation.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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Immigration enforcement doesn’t just shape borders—it shapes health outcomes.

In this episode of Emerge in EM, Dr. Mohamed Hagahmed is joined by Dr. Italo Brown for a candid, clinician-to-clinician conversation about how immigration enforcement affects patient care, trust, and public health.

Originally recorded as a live Instagram discussion, this conversation was brought to the podcast because the issues raised were too important to disappear after a moment on social media. From emergency departments to outpatient clinics, fear of immigration enforcement is changing how and when patients seek care—often leading to delayed presentations, worse outcomes, and preventable harm.

Together, Dr. Hagahmed and Dr. Brown unpack:

• How fear of enforcement becomes a barrier to care
• What clinicians are seeing at the bedside when patients delay treatment
• Why immigration enforcement is a public health issue—not just a policy debate
• How trust, or lack of it, directly impacts health outcomes
• Practical steps healthcare workers and institutions can take to protect patients

This episode challenges the idea that healthcare is neutral in the face of fear and structural harm. It reframes immigration enforcement as a patient safety issue and calls on clinicians, health systems, and public health professionals to acknowledge their role in protecting access to care.

As the first episode of 2026, this conversation sets the tone for the year ahead—centering equity, courage, and accountability in emergency medicine and beyond.

Care without fear should never be controversial.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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In this episode of 'EMERGE in EM,' Dr. Mohamed Hagahmed and ICU doctor Dr. Obi Anozie discuss the critical neurological emergency of benzodiazepine-refractory status epilepticus (BRSE). They explore the pathology behind why BRSE occurs, the necessary aggressive treatment strategies, and second-line agent options including levetiracetam, valproic acid, fosphenytoin, propofol, and ketamine. They emphasize the importance of correct dosing, timely escalation of treatment, and thorough patient examination. The conversation also covers the need for a comprehensive approach to non-convulsive status epilepticus and the practical aspects of pre-hospital and ED management, including the use of paralytic agents like rocuronium over succinylcholine.

Paper reference: Pelletier J, Merriman W, Koyfman A, Long B. Benzodiazepine-refractory status epilepticus: A narrative review. Am J Emerg Med. 2025;81:228-235. doi:10.1016/j.ajem.2025.01.046.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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In this episode of EMERGE, I sit down with Dr. Ricky Tripp to dive deep into the challenges and best practices of managing trauma in pregnancy. As your host, I guide the conversation through the latest evidence and NAEMSP guidance, real-life stories, and practical pearls that every clinician should know when faced with these high-risk, low-frequency events.

We discuss the unique physiology of pregnancy, how to spot and manage shock, and the critical nuances of trauma assessment in pregnant patients. Dr. Tripp shares her expertise from the field, her work with AKOMA United, and her perspective as an emergency physician and EMS medical director.

I also highlight the importance of community, communication, and understanding the psychosocial factors that impact patient care. Whether you work in the field or in the hospital, this episode will help you feel more prepared and confident when caring for pregnant trauma patients. Join me for expert insights, actionable tips, and a reminder of the power of teamwork and compassion in emergency medicine.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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In this episode of EMERGE, I sit down with my friend and colleague, Dr. Tony Pizon, Chief of Medical Toxicology at UPMC, to dive into a topic that’s been showing up more and more in our emergency departments: 7-Hydroxymitragynine (7-OH).

I wanted to understand what 7-OH is, how it’s connected to Kratom, and why it’s suddenly making headlines. Tony and I break down the science, discuss the clinical effects, and talk about why products like vapes and gummies containing 7-OH are so concerning—especially when they’re packaged to look like candy and marketed as “natural.”

We share real cases, practical management tips (including when and how to use naloxone), and highlight the risks for kids and the importance of public health reporting. My goal with this conversation is to give you the latest insights, actionable advice, and a better understanding of how to recognize and manage this emerging toxicology threat.

Whether you’re a fellow healthcare professional or just want to stay informed about what’s happening in emergency medicine, I hope you find this episode as eye-opening and useful as I did.

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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In this episode of EMERGE, I had the pleasure of speaking with Zaf Qassim, an associate professor of emergency medicine, about critical interventions in trauma care. We discussed the TRAUMOX2 trial, which questions the reflexive use of high-flow oxygen in trauma patients and suggests that a restrictive oxygen strategy can reduce atelectasis without increasing other complications. We then contrasted delayed sequence intubation (DSI) with rapid sequence intubation (RSI) in trauma patients, highlighting how DSI can significantly reduce peri-intubation hypoxia. Lastly, we explored a study comparing non-invasive blood pressure monitoring to arterial BP monitoring in critically ill patients, emphasizing the inaccuracies of non-invasive methods, especially in severe cases, and the value of using arterial lines. The episode aims to encourage clinicians to reexamine traditional practices and adopt evidence-based approaches for better patient outcomes.

Links to papers discussed in this episode:

https://jamanetwork.com/journals/jama/fullarticle/2827980

https://pubmed.ncbi.nlm.nih.gov/37058727/

https://pubmed.ncbi.nlm.nih.gov/39192296/

If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.

📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:

• Instagram: @HagahmedMD
• YouTube: @HagahmedMD

Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.