Épisodes

  • Thyroid Emergencies
    Jun 17 2025
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    In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the June 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Thyroid Emergencies

    • Introduction to Thyroid Emergencies
    • Understanding Decompensated Hypothyroidism
    • Thyroid Storm: The Other Extreme
    • Differential Diagnosis and Complications
    • Medication Triggers and Patient History
    • Physical Examination Findings
    • Laboratory Analysis
    • Scoring Systems and Risk Assessment
    • Introduction to Treatment Approaches
    • Managing Decompensated Hypothyroidism
    • Treating Thyroid Storm
    • Special Considerations and Populations
    • Risk Management Pitfalls

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    21 min
  • Parkinson's, Myasthenia Gravis, and MS in the ED
    May 16 2025

    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

    Parkinson's Disease
    • 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
    Myasthenia Gravis
    • 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
    Multiple Sclerosis
    • 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

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    21 min
  • Strategies for Keeping Trauma at Bay with Rob Orman, MD
    May 2 2025

    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/

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    25 min
  • Sodium Disorders
    Apr 18 2025

    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

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    27 min
  • An Interview with Dr. Patrick O'Malley
    Apr 8 2025

    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
    For More Information:

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

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    32 min
  • Knee Pain
    Mar 12 2025

    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 resident@ebmedicine.net

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    44 min
  • Rural EM and Traumatic ICH – An Interview with Ashley Weisman, MD
    Feb 18 2025

    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 resident@ebmedicine.net

    Managing Traumatic Intracranial Hemorrhage in the Rural Setting: EMP: IRrL*

    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.
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    10 min
  • Traumatic ICH - An Interview with Erin D'Agostino, MD
    Feb 5 2025

    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 resident@ebmedicine.net

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    34 min