In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the May 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Chronic Neurologic Disease: Parkinson Disease, Myasthenia Gravis, and Multiple Sclerosis

• Importance of maintaining medication schedule for Parkinson's patients
• Strategies for ensuring patients receive their medications promptly
• Overview of Carbidopa Levodopa's mechanism of action

• Description of the disease mechanism
• Importance of assessing respiratory function
• Diagnostic alternatives like the negative inspiratory force test and counting test
• Discussion on appropriate emergency department actions and treatments including steroids, plasmapheresis, and IVIG

• Description of the disease mechanism
• Description of the typical patient demographic
• Discussion on the varied presentation of MS
• Treatment strategies including high-dose steroids and Baclofen

Emergency Medicine Residents, get your free subscription by writing [email protected] 

In this episode, Sam Ashoo, MD interviews Rob Orman, MD about ways to manage the trauma inflicted by the ER.

• Discussing Trauma in Emergency Medicine
• Personal Experiences with Trauma
• The Impact of Suppression
• Defining Trauma and Its Effects
• Integration vs. Disintegration
• Debriefing and Coping Mechanisms
• The Driveway Debrief
• Nurse and Physician Dynamics
• Reflective Solitude vs. Isolation
• Creating Narratives During Trauma
• Dropping Anchor Technique
• Body-Oriented Resets
• Post-Incident Rituals
• Addressing Lowercase t Traumas
• Therapy and Trauma Pathways

For more about Rob Orman and physician coaching: https://roborman.com/

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2025 Emergency Medicine Practice article, Sodium Disorders in the Emergency Department: A Review of Hypernatremia and Hyponatremia

Hypernatremia (High Sodium Levels)

• Definition: Sodium level greater than 145 mEq/L
• Breakdown into three categories based on total body water status
• Hypovolemic Hypernatremia
• Euvolemic Hypernatremia
• Hypervolemic Hypernatremia
• Common causes and conditions associated

Hyponatremia (Low Sodium Levels)

• Definitions: Mild (130-135 mEq/L), Moderate (125-129 mEq/L), Profound (< 125 mEq/L)
• Breakdown into three categories
• Pseudo Hyponatremia
• Hypovolemic Hyponatremia
• Euvolemic Hyponatremia
• Hypervolemic Hyponatremia
• Common causes and conditions associated

Treatment Guidelines and Strategies

• Emphasizing slow correction to avoid complications like cerebral edema and osmotic demyelination syndrome
• Suggested treatment rates for acute and chronic conditions

Special Considerations

• Addressing severe cases and the importance of proper diagnostics
• Pre-hospital care considerations and scenarios
• Pediatrics and consideration of child abuse in sodium disorders

Five Things That Will Change Your Practice

• Central lab sodium values over point-of-care for accuracy
• Rectal temperature checks in endurance athletes
• Loop diuretics for hypervolemic hyponatremia (e.g., CHF patients)
• Enteral treatment for hypernatremia, if possible
• Considering COVID-19 as a possible cause for new onset SIADH

In this episode, Sam Ashoo, MD interviews Patrick O'Malley MD about his career in emergency medicine, The Laceration Course, and the power of connection with our patients.

• Dr. Patrick O'Malley's Journey in Emergency Medicine
• The Laceration Course: Origins and Evolution
• The EM Docs Side Hustle Facebook Group
• The Patient That Changed My Life

• The Laceration Course, The Abscess Course, and more...
• EM Docs Side Hustle Facebook Group
• Patrick O'Malley, MD: LinkedIn

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2025 Emergency Medicine Practice article, Emergency Department Management of Knee Pain

• Common Etiologies of Knee Pain
• Risk Factors and Statistics
• Infectious Causes of Knee Pain
• Pre-Hospital Care and EMS
• History and Physical Exam
• Imaging Guidelines
• Ottawa Knee Rule and X-Ray Necessity
• Imaging Modalities for Knee Effusion
• Ultrasound for Tendon Injury and Arthrocentesis
• CT and MRI in Knee Injury Diagnosis
• Lab Tests for Septic Knee Diagnosis
• Treatment Options for Knee Conditions
• Knee Immobilizers: When and How to Use Them
• Steroid Injections in the Emergency Department
• Managing Traumatic Knee Injuries

Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD interviews Ashley Weisman, MD about her career in rural emergency medicine, and the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department 

Interview with Dr. Ashley Wiseman

• Introduction of Dr. Wiseman: Emergency physician specializing in rural ER.
• Dr. Wiseman’s Background: Overview of her work and responsibilities in rural hospitals and academia.
• Experience in Rural Medicine: 
• Contrast with urban and academic practice.
• Stories of practical challenges and learning experiences in remote areas like Kotzebue, Alaska.

Practicing Skills in Rural Medicine

• Discussion of skill retention: Importance of continuously applying and practicing critical skills.
• Resources and Training: Role of fellowship, networking, and practical experiences for skill enhancement.

Advocacy for Rural Emergency Medicine

• Work with ACEP: Dr. Wiseman’s efforts in advocating for rural EM at the national level.
• Collaboration Between Rural and Academic Centers: Importance of knowledge exchange and mutual support.

Focus on Traumatic Intracranial Hemorrhage (ICH)

• Introduction to the February Article: Traumatic ICH in rural settings.
• Key Points from the Article:
• Importance of basic neurocritical care practices.
• Practical adjustments and simplified approaches in care.
• Dr. Wiseman’s Contribution: How her experiences shaped the content and practical advice for rural medicine.

Conclusion

• Upcoming Contributions: Announcing more contributions and resources from Dr. Wiseman.
• Access the In Rural Life (IRrL*) content here.
• Emergency Medicine Residents, get your free subscription by writing [email protected]

If you practice in a rural environment, you know that managing a patient with traumatic ICH can present challenges with diagnostic and treatment resources, personnel, training, and transport. Dr. Weisman has created resources for emergency clinicians, IRrL* (In Rural Life*) that EB Medicine is proud to share with subscribers.   

Resources for emergency clinicians managing patients with traumatic ICH in rural settings include: 

• Checklist for Managing Traumatic Intracranial Hemorrhage in Rural Life (IRrL): 7 steps to providing neurocritical care in resource-limited settings.
• Simulation for Critical Access Neurocritical Care: Saving Brain Hours from Tertiary Care: A customizable simulation designed for you and your team to practice managing patients with brain injury.

In this episode, Sam Ashoo, MD interviews Erin D'Agostino, MD about the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department 

• Pathophysiology
• Types of Traumatic Brain Injuries
• Pre-Hospital Care
• Critical History and Physical Examination
• Neurological Assessment and Monitoring
• Laboratory and Imaging Studies
• Emergency Department Treatment
• Surgical Interventions and Considerations
• Patient DemographicsSummary of major points discussed
• Reminder for continued vigilance and the importance of early consultation

Emergency Medicine Residents, get your free subscription by writing [email protected] 

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the January 2025 Emergency Medicine Practice article, Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment

• Patient Demographics and Case Scenarios:
• Types of patients prone to alkali exposure
• Causes and scenarios leading to alkali exposure (e.g., accidental, intentional, social media challenges)
•  Poison control reports and statistics
• Types and Effects of Exposure: 
• Different types of exposure: ingestion, ocular, dermal
• Effects of ingestion, particularly in children and young adults
• Pre-hospital Care and First Response:
• Importance of decontamination
• Safety measures for EMS personnel
• Steps to take in pre-hospital care
• History and Physical Examination: 
• Key points to focus on during history taking
• Important signs and symptoms to check
• Laboratory and Diagnostic Testing: 
• Overview of useful lab tests and imaging
• Role of EKG and chest x-ray
• Importance of early consultation with poison control
• Endoscopy and CT Imaging: 
• Use of endoscopy to classify injuries and guide treatment
•  Role of CT imaging
•  Complementary use of endoscopy and CT
• Treatment Approaches:
• Initial resuscitation and airway management
• Use of steroids and other medications like antibiotics, H2 antagonists, and topical mitomycin C
• When and how to use NG tubes
• Special Populations and Long-term Considerations: 
• Special considerations for children
• Risks associated with laundry detergent pods
• Long-term complications, including strictures and increased risk of esophageal cancer
• Conclusion: 
• Summary of major points discussed
• Reminder for continued vigilance and the importance of early consultation

Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative

1. Discussion on EMIC

  - Overview of the collaborative

  - Background and formation during the pandemic in late 2021

2. Growth of EMIC

  - Expansion from three members to over 500

  - Focus areas: Education, mentorship, opportunity

3. Achievements of EMIC

  - Examples of innovations and initiatives born from EMIC

  - Pitch event at ACEP annual conference and other engagements

4. Importance of Physicians in Innovation

  - Internal and external factors

  - Benefits of physicians leading innovation efforts in healthcare

5. Opportunities for Collaboration

  - Engaging with healthcare startups and companies

  - Expanding collaborations and growing the network

6. EMIC Fellowship

  - Ideal candidates

  - Application process and benefits

  - Success stories and projects undertaken

7. Long-Term Vision for EMIC

  - Goals for future growth and expansion

  - Bridging gaps between industry and physicians for better patient care

8. Membership Details

  - How to join EMIC

  - Benefits of membership

For more about the EM Innovation Collaborative... https://www.eminnovationcollaborative.org/

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2024 Emergency Medicine Practice article, Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department

• Introduction to Acute Mesenteric Ischemia
• Statistics on prevalence and mortality
• Pathophysiology and EtiologyMesenteric artery embolism
• Mesenteric artery thrombosis
• Mesenteric venous thrombosis
• Non-occlusive mesenteric ischemia
• Diagnosis
• Management and Treatment
• Special Populations
• Pediatric patients
• Pregnant patients
• Elderly patients

Emergency Medicine Residents, get your free subscription by writing [email protected]