EMplify by EB Medicine

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] 

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence

• Prevalence and Importance of Back Pain in the ED
• Differential Diagnosis and Serious Pathologies
• Patient Expectations and Management Strategies
• Missed Serious Pathologies and Their Implications
• Conflicting Evidence and Treatment Protocols
• Pathologies Causing Low Back Pain
• Mechanical and Infectious Causes
• Red Flags and Risk Factors
• Pre-Hospital Care and EMS Considerations
• History and Physical Examination
• Laboratory Testing and Inflammatory Markers
• Introduction to Imaging in Back Pain
• Common Findings in Imaging
• Choosing Wisely Campaign and Imaging Guidelines
• Patient Expectations and Imaging
• CT and MRI: When and Why
• Ultrasound in Back Pain Diagnosis
• Treatment Options for Back Pain
• NSAIDs and Other Pharmacologic Treatments
• Non-Pharmacologic Management
• Risk Management and Pitfalls

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

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Emergency Department Management of Acute Scrotal Pain in Pediatric Patients

• 00:00 Welcome and Introduction
• 00:13 Free Subscription for Emergency Medicine Residents
• 01:05 Introduction to Pediatric Emergency Medicine Practice
• 01:37 Discussion on Acute Scrotal Pain
• 02:35 Testicular Torsion: Key Insights
• 09:50 Differential Diagnosis for Acute Scrotal Pain
• 17:21 Diagnostic Indicators of IgA Vasculitis
• 17:44 Pre-Hospital Care for Severe Pain
• 18:13 The Twist Score for Torsion
• 18:44 Emergency Department Evaluation
• 20:04 Ultrasound in Diagnosing Torsion
• 29:44 Operative Management and Other Conditions
• 31:41 Manual Detorsion Techniques
• 32:37 Risk Management and Key Takeaways
• 34:19 Conclusion and Final Thoughts

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

In this special episode Sam Ashoo, MD interviews Ryan Johnson, Pharm. D. who shares strategies to address the recent IV fluid shortage caused by Hurricane Helene.

00:00 Introduction and Episode Overview

01:10 Meet Ryan Johnson: Clinical Pharmacist

02:06 Role of Clinical Pharmacists in Emergency Medicine

05:03 IV Fluid Shortage: Causes and Impact

05:56 Institutional Strategies to Mitigate IV Fluid Shortages

14:52 Provider-Level Solutions for Fluid Conservation

22:11 Pharmacy and Nursing Staff Roles in Fluid Management

26:34 Advanced Measures and Federal Guidelines

34:40 Conclusion and Final Thoughts

Resources mentioned in the podcast:

• (Brigham and Women's Protocol) Patiño, A. M., Marsh, R. H., Nilles, E. J., Baugh, C. W., Rouhani, S. A., & Kayden, S. (2018). Facing the shortage of IV fluids — a Hospital-Based Oral Rehydration strategy. New England Journal of Medicine, 378(16), 1475–1477. https://doi.org/10.1056/nejmp1801772
• Vizient shares conservation strategies for potential IV fluid supply disruption caused by Hurricane Helene https://newsroom.vizientinc.com/en-US/releases/releases-vizient-shares-conservation-strategies-for-potential-iv-fluid-supply-disruption-caused-by-hurricane-helene

In this episode, Dr. Julia Draper shares her firsthand account of managing a crisis during a hurricane in Asheville, North Carolina. As the area faced unprecedented flooding, Dr. Draper describes the challenges faced at Mission Hospital, including loss of power and water. She details the innovative solutions the hospital implemented and highlights the tireless efforts of staff during a natural disaster of this magnitude.

00:00 Introduction to Dr. Julia Draper

01:03 Experiencing the Hurricane

03:19 Immediate Aftermath and Hospital Challenges

11:22 Dealing with Water and Supply Shortages

20:48 Community and External Support

24:10 Ongoing Efforts and Future Plans

27:51 Conclusion and Final Thoughts

In this special episode, Sam Ashoo MD and Rob Orman MD discuss the concept of Maladaptive Perfectionism and its application to emergency medicine.

• Understanding Maladaptive Perfectionism
• Case Example and Discussion
• Adaptive vs Maladaptive Perfectionism
• Personal Experiences and Legal Challenges
• Dealing with Negative Outcomes
• Strategies for Managing Perfectionism in the ED
• Handling Overwhelming Shifts
• Managing Expectations in the ED
• A Soul-Crushing Day in the ED
• Finding Meaning in Moments of Crisis
• The Importance of Meaningful Work
• Operationalizing Meaning in Your Shift
• The Driveway Debrief: Transitioning from Work to Home
• Preparing for the Next Shift
• Conclusion and Next Episode Teaser

For more from Rob Orman, MD check out Orman Physician Coaching

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department

•  Introduction and Announcements
• Elder Abuse and Neglect: An Overview
• Risk Factors and Reporting
• Pre-Hospital and Emergency Department Considerations
• Screening Tools and Physical Examination
• Documentation and Disposition
• Cultural Considerations and Future Directions
• Conclusion and Resources

Suspected Elder Abuse should be reported to one of these organizations:

• ADULT PROTECTIVE SERVICES - Living at home
• LONG-TERM CARE OMBUDSMAN - Living in a long term care facility