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This episode of the EMERGE, join me and Dr. Mike Lynch, an expert in emergency medicine, medical toxicology, and addiction medicine. The discussion delves into the public health emergency of medetomidine-related toxicity and withdrawal. Dr. Lynch shares insights from real cases, emphasizing the clinical red flags and management strategies for medetomidine withdrawal. We discuss the transition from Xylazine to medetomidine in the drug supply, the role of naloxone, and the risks of misidentifying opioid-related cases. Key points include the need for extended observation in the ED, the potential requirement for ICU care, and the effectiveness of dexmedetomidine in managing severe withdrawal symptoms. The episode also highlights the importance of medication for opioid use disorder (MOUD) and the evolving drug supply landscape.

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

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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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🎙️ Podcast Episode Intro – DDX:SCAPE | Picklesburgh Pulmonary Panic

What happens when a 50-year-old man suddenly can’t breathe—right in the middle of the Picklesburgh festival? 🥒😯

Join Dr. Hagahmed and Dr. Addy as they walk through a high-stakes emergency case of acute dyspnea in a patient with a history of hypertension, hyperlipidemia, and diabetes. From scene safety and rapid assessment to high-flow oxygen, CPAP, and beyond, they break down the critical steps in recognizing and managing SCAPE—Sympathetic Crashing Acute Pulmonary Edema—a diagnosis that goes beyond your typical CHF flare.

You’ll hear key insights into:

• How to prioritize ABCs under pressure
• When to think SCAPE vs. CHF
• The role of nitroglycerin and non-invasive ventilation
• Why early recognition saves lives

By the end, the patient stabilizes—but not before offering powerful teaching points for every emergency provider.

🎥 Want to see the case play out?
Watch the full video on our YouTube channel: EMERGE in EM
👉 https://youtube.com/@emergeinem?si=27-MFKEHQKRXGVhH

Subscribe, listen, and always be ready to ask:
What would you do?

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
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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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Understanding Measles: Recognition, Pathophysiology, and Management in Emergency Settings

Join Dr. Mohamed Hagahmed and Dr. Sylvia Owusu-Ansah in this essential discussion on measles. They cover critical topics such as recognizing measles in emergency settings, understanding its presentation and pathophysiology, and the latest strategies in treatment and prevention. This episode is packed with vital information for healthcare providers, especially in the context of a resurgence in measles cases due to declining immunization rates. Learn about the role of vaccinations, complications like ADEM and SSPE, and the importance of PPE in practice. This conversation is recorded live from the SNMA AMEC conference, addressing both clinical knowledge and public health awareness.

Find pictures of measles rash and how it looks in dark skin individuals in my social media post: https://www.instagram.com/reel/DHLaF4Lxjef/?igsh=Y205enNpeDJzbTM4

00:00 Introduction to Measles
00:41 Current Measles Outbreaks and Concerns
02:03 Understanding Measles Pathophysiology
06:05 Recognizing Measles Symptoms
09:56 Treatment and Prevention Strategies
11:22 Pre-Hospital Care for Measles
16:27 Prophylaxis and Final Thoughts

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
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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, I'm  joined by Dr. Chris Martin-Gill to discuss the critical evaluation of the correlation between end-tidal CO2 and partial pressure of CO2 (PCO2) in acutely ill patients. The episode covers the importance of end-tidal CO2 in the prehospital setting, primarily for verifying airway placement and assessing ventilation adequacy. Dr. Martin-Gill discusses a significant study that he co-authored that analyzed data from over 6,400 patients, finding large discrepancies between end-tidal CO2 and PCO2, particularly in critically ill patients. The discussion highlights the implications of these findings on EMS protocols and the importance of considering patient subpopulations. The episode concludes with recommendations for EMS agencies on how to use end-tidal CO2 readings effectively and the need for further research.

Paper reference: 

PMID: 39546437 DOI: 10.1080/10903127.2024.2430394

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
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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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🚑 PICO Breakdown: The HAPPEN Trial on NPPV for COPD 🫁

P - Population:
Patients with acute exacerbation of COPD and persistent hypercapnia (PaCO₂ > 45 mmHg) after 6 hours of low-intensity NPPV.
👥 300 patients (Mean Age: 73 years, 68% Male)

I - Intervention:
High-Intensity NPPV - Tidal volume of 10-15 mL/kg using higher inspiratory positive airway pressure (IPAP).

C - Comparison:
Low-Intensity NPPV - Tidal volume of 6-10 mL/kg using lower IPAP.

O - Outcome:

• 🌟 65% ↓ Risk of meeting criteria for intubation (4.8% vs. 13.7%, p=0.004)
• ❌ No significant difference in actual intubation rates (3.4% vs. 3.9%)
• 🤢 More abdominal distension with high-intensity NPPV (37% vs. 25%)

💡 Clinical Pearl:
High-intensity NPPV may delay progression to severe respiratory failure but requires careful monitoring of side effects.

Reference: Luo Z, Li Y, Li W, et al. Effect of High-Intensity vs Low-Intensity Noninvasive Positive Pressure Ventilation on the Need for Endotracheal Intubation in Patients With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease: The HAPPEN Randomized Clinical Trial. JAMA. 2024;332(20):1709-1722. doi:10.1001/jama.2024.15815.

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
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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 am joined by Dr. Frank Guyette, an emergency physician and EMS expert from the University of Pittsburgh and the medical director of STAT Medevac. Dr. Guyette offers insights into pre-hospital trauma care, discussing critical topics such as the trauma triad and diamond of death, the complexities of hypocalcemia in trauma patients, and evolving practices in fluid management. He also delves into the latest research and protocols, including the controversial use of TXA and the challenges of resuscitating trauma patients with advanced techniques. Looking towards the future, Dr. Guyette explores the promising role of artificial intelligence and cutting-edge medical devices like REBOA in advancing trauma care. This episode is packed with vital information for EMS providers, medical professionals, and anyone interested in the latest trends in emergency care.

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
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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 the EMERGE Podcast, I'm joined by Dr. Jon McMahon, an EMS fellow, to discuss the significance of a paper analyzing the impact of prehospital stroke severity scales in stroke patients. Dr. McMahon shares his background and highlights the importance of EMS in improving door-to-puncture times for stroke patients. We delve into the details of the study, which uses the Cincinnati Prehospital Stroke Scale and MRACE score to assess stroke severity and prioritize treatment. The discussion emphasizes the importance of rapid intervention to save neurons in stroke patients, the challenges of maintaining staff readiness, and the need for consistent training and documentation in EMS. The episode underlines the critical role of EMS in early stroke assessment and the call for continual quality improvement in prehospital care.

Paper source: https://jnis.bmj.com/content/early/2024/09/18/jnis-2024-022122

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
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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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Critical Urologic Emergencies Explained: Insights with Dr. Joseph Acquaye

In this insightful episode of EMERGE, I'm honored to host Dr. Joseph Acquaye as he delves into common urologic emergencies encountered in the emergency department and ICU. Dr. Acquaye shares his journey into urology, the significance of men's health, and the importance of addressing healthcare disparities. The discussion covers detailed protocols and techniques for managing acute urinary retention, kidney stones, penile emergencies, priapism, and testicular torsion. Tune in for actionable tips, clinical pearls, and practical advice to enhance patient care in urgent urologic scenarios.

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

• Instagram: @HagahmedMD
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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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🚨 Submerge into the complexities of fluid resuscitation in septic patients with heart failure! 🩺 

Join me and Dr. Addy Kothare as we dissect an #EmergencyMedicine paper that challenges our current practice when caring for these patients.

📚 https://doi.org/10.1016/j.ajem.2023.08.006

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
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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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Have you ever felt anxious dealing with pediatric seizures? Get expert guidance on our latest EMERGE episode with Dr. Sylvia Owusu-Ansah! Tune in for essential tips on pre-hospital and in-hospital seiures management. Don't miss out on boosting your emergency care skills!

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.