In this episode, Sam Ashoo, MD interviews Ashley A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A. Hoffmann, MD, MS on the March 2024 Pediatric Emergency Medicine Practice article, Evaluation and Management of Suicidal Ideation and Self-Harm in Children in the Emergency DepartmentIntroductionUnderstanding Suicidal Ideation and Self Harm in YouthsScreening Tools and ApproachesAsk Suicide-Screening Questions (ASQ) ToolkitColumbia Suicide Severity Rating Scale (C-SSRS)Prehospital CareManaging Patients in the EDDealing with Challenging PopulationsLethal Means CounselingEmerging Tools in Suicide Risk IdentificationSuicide Risk Screening PathwayDisposition and ReferralsNational 988 Suicide & Crisis Lifeline
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2024 Pediatric Emergency Medicine Practice article, Brief Resolved Unexplained Events: Practical Evaluation and Management in the Emergency DepartmentIntroductionThe Evolution of BRUEUnderstanding BRUE GuidelinesThe Importance of Pre-Hospital Care in BRUE CasesInvestigating the Event: Questions to AskMedical and Family History: Key FactorsEnvironmental and Social ConsiderationsDefinitions and Risk AssessmentPhysical ExaminationRisk Stratification: Low Risk vs. High Risk PatientsManagement: What to Do and What Not to DoHigh Risk Population: Studies and RecommendationsThe Importance of Communication and Decision Making5 Things That Will Change Your Practice
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2024 Emergency Medicine Practice article, Emergency Department Evaluation and Management of ConstipationPrevalence and ImpactUnderstanding the CausesMedications That Can Cause ConstipationDealing with Fecal ImpactionUnderstanding Stercoral ColitisPre-Hospital CareED History and Physical ExamDiagnostic Studies and ImagingX-RayCT ScansAdvanced TestingTreatment Options for ConstipationEnemasOsmotic Laxatives and Stool SoftenersSpecial Considerations: Pregnant, Pediatric, and Hospice PatientsPrescription Medications for ConstipationClinical Pathway for Constipation Management
In this episode, Sam Ashoo, MD interviews Paul Aronson, MD, MHS, one of the authors of the February 2024 Pediatric Emergency Medicine Practice article, Febrile Infants Aged ≤60 Days: Evaluation and Management in the Emergency DepartmentGuideline ChangesPathophysiologyEtiology and DefinitionsPrehospital CareED History and Physical Diagnostic StudiesAge 0-21 Days Age 22-28 Days Age 29-60 DaysLumbar PunctureViral TestingUrinalysisShared Decision MakingDisposition
In this episode, Sam Ashoo, MD, and T.R. Eckler MD interview Nick Harrison, MD and Daniel Brenner, MD, two of the authors of the February 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Right Heart FailurePathophysiologyPresenting SymptomsDifferential DiagnosisSpecific Acute CausesPESepsisRVMIPPVARDSCOVID-19Specific Chronic CausesCTEPHLeft Heart FailureCongenital Heart DiseaseLVADLung Disease Group 3 Pulmonary HypertensionPulmonary Arterial HypertensionPrehospital CareED history and PhysicalBiomarkersECG (table 5)ImagingEchoCTMRITreatmentRevascularizationRespiratory SupportVasopressors and Inotropes
In this episode, Sam Ashoo, MD, interviews Vasisht Srinivasan, MD, FACEP one of the authors of the December 2023 Emergency Medicine Practice EXTRA article, Emergency Department Management of Stroke in Pregnant and Postpartum PatientsEpidemiologyEvidenceCausesRisk FactorsDifferential DiagnosisPrehospital CareED History and Physical ExamLabsImagingED BP ManagementSpecific Ischemic Stroke TherapiesSpecific Hemorrhagic Stroke Therapies
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the January 2024 Pediatric Emergency Medicine Practice article, Management of Pediatric Urinary Tract Infections in the Emergency Department, and the January 2024 Evidence Based Urgent Care article on Pediatric Community-Acquired Pneumonia: Diagnosis and Management in the Urgent Care Setting.UTIEpidemiology and NomenclaturePrehospital CareED History and Physical ExamInfants Age <2 Months Children Age 2 Months to 2 Years Children >2 Years AdolescentsUrinalysisClean Catch Protocol Catheterization Suprapubic AspirationBlood Cultures and CSFBiomarkers (CRP and ESR)TreatmentCommunity Acquired PneumoniaDistinguishing Viral vs Bacterial PneumoniaImagingAntibiotic TreatmentVaccinationSteroidsAtypical PresentationsCheck out the clinical pathways at https://www.ebmedicine.net/pathways
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2023 Pediatric Emergency Medicine Practice article, Management of Pediatric Toxic Ingestions in the Emergency Department.Need help now? Call the Poison Help Line at: 1‑800‑222‑1222EpidemiologyPrehospital CareED History and Physical ExamDiagnostic StudiesLabsEKGImagingUrine Toxicology TestingTreatmentHemodialysisActivated CharcoalWhole Bowel IrrigationGastric LavageIpecacDrug Specific TherapiesAcetaminophenAlcoholsAnticholinergicsBeta BlockersCalcium Channel BlockersCholinergic AgentsDigoxinIronOpioidsSalicylatesSedative HypnoticsSulfonylureasLaundry PodsCheck out the clinical pathways at https://www.ebmedicine.net/pathways
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the November 2023 Pediatric Emergency Medicine Practice article, Pediatric Diabetes: Management of Acute Complications in the Emergency Department and some of the highlights from the other EB Medicine articles published in November.EpidemiologyDifferential diagnosisPrehospital careED history and physical examDiagnostic studiesPoint of care testing Labs ImagingTreatmentIV fluids, the 2-bag system Mild DKA Moderate to severe DKA Potassium and phosphate supplementation Magnesium and calcium Sodium bicarbonate Hypoglycemia HHS MonitoringComplicationsCerebral edema IntubationInsulin pumpsDispositionSummaryHighlightsEBUC - Management of Acute Asthma Exacerbations in Urgent CareEMP - Evidence-Based Emergency Department Management of Methamphetamine ToxicityPEMP - Trauma Extra - Blunt Thoracic Injuries (coming Nov. 15th)Check out the clinical pathways at https://www.ebmedicine.net/pathways
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the October 2023 Pediatric Emergency Medicine Practice article, Substance Use in Adolescents: Recognition and Management in the Emergency Department and the October 2023 Emergency Medicine Practice article, Evidence-Based Emergency Department Management of Migraine and Other Primary HeadachesSubstance Use In Adolescents EpidemiologyRisk FactorsDifferential DiagnosisPrehospital CareED History and Physical ExamUrine Drug ScreenTreatmentMarijuana Alcohol Methaphetamines MDMA Cocaine OpioidsDispositionMigraine and Other Primary HeadachesEpidemiologyCluster HeadachesMedication Overuse HeadacheNerve BlocksGreater Occipital Sphenopalatine GanglionPregnant PatientsDispositionCheck out the clinical pathway at https://clinicalpathways.ebmedicine.net
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the September 2023 Emergency Medicine Practice article, Emergency Department Management of Patients With Rectal BleedingEtiology/pathophysiologyRisk factorsDifferential diagnosisPrehospital careED history and physical examDiagnostic studiesLaboratory testingImaging studiesTreatmentTransfusionCoagulation reversalEmbolizationSpecial PopulationsPediatricsPregnant patientsElderly patientsScoring systemsDispositionCheck out the clinical pathway at https://clinicalpathways.ebmedicine.net
In this episode, Sam Ashoo, MD, and TR Eckler, MD, interview Al Sacchetti, MD, about the August 2023 Emergency Medicine Practice article, Evidence-Based Management of Pulmonary Embolism in the Emergency DepartmentEtiology/pathophysiologyRisk factorsDifferential diagnosisPrehospital careED history and physical examDiagnostic scoring systemsPregnant patients Diagnostic studiesECGD-DimerTroponin & BNPChest x-rayCT V/Q scansMRIUSTreatmentIV fluidsAnticoagulationVasopressorsThrombolyticsThrombectomyECMODispositionCheck out the clinical pathway at https://clinicalpathways.ebmedicine.net
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2023 Emergency Medicine Practice article, Diagnosing and Treating Pericarditis and Myocarditis in the Emergency DepartmentEpidemiologyNomenclatureEtiologyDifferential diagnosisPrehospital careED history and physicalDiagnosticsECGLabsImaging (X-ray, CT, US, MRI)Treatment Special populationsCOVID-19AthletesMIS-C
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the June 2023 Emergency Medicine Practice article, Hypertensive Emergencies: Guidelines and Best Practice RecommendationsEpidemiologyEtiologyDifferential diagnosisPrehospital careHistory and physical DiagnosticsTreatmentAcute decompensated heart failureAcute ischemic strokeAcute coronary syndromeIntracerebral hemorrhageSubarachnoid hemorrhageAortic dissectionHypertensive encephalopathySevere pre-eclampsia and eclampsiaControversiesArterial line placementBeta blockers and cocaineRisk management caveatsSummary
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the May 2023 Emergency Medicine Practice article on Emergency Department Management of Gastrointestinal Foreign Body IngestionEpidemiologyEtiology - types of ingestionsAnatomy - common locations by ageFood impactionSharp objectsButton batteriesMagnetsColorectal foreign bodiesPrehospital careHistory and PhysicalImagingExpectant managementEndoscopic removalNon-endoscopic techniquesBody PackingGlucagonGastric button batteriesSummary
In this episode, Sam Ashoo, MD, talks with Rob Orman, MD, founder of Orman Physician Coaching, about longevity in emergency medicine.Personal foundation Regular check-insBecoming an expert in… Job stressLiving beneath your meansRecharging and shift workBad outcomesPhysician loungeLearning to say noSet a reminderMore at Orman Physician Coaching
Announcements: The interactive Clinical Pathways have launched and they are available for free! In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the March 2023 Emergency Medicine Practice article on Emergency Department Management of Infective Endocarditis-Associated StrokeEpidemiologyPathophysiologyPopulations at RiskComplicationsIntracranial hemorrhageAneurysmsHeart blockPrehospital CareED History and ExaminationImagingAntibiotic TherapySurgical TreatmentSpecial PopulationsSummary
Announcements: The interactive Clinical Pathways have launched and they are available for free! — In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the February 2023 Pediatric Emergency Medicine Practice article on Pediatric Electrolyte Emergencies: Recognition and Management in the Emergency Department — History Point-of-care testing I/O lines Presentation, differential, and treatment of:HyponatremiaHypernatremiaHypokalemiaHyperkalemiaHypocalcemiaHypercalcemiaHypomagnesemiaHypophosphatemia
Announcements: The interactive Clinical Pathways have launched and they are available for free! ___In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the January 2023 Pediatric Emergency Medicine Practice article on the Responsible and Safe Use of Opioids in Children and Adolescents in the Emergency DepartmentDEA-X Waiver Repeal:The Mainstreaming Addiction ActThe Medication Access and Training Expansion Act (MATE)FOAMed postOpioids in Children and Adolescents: IntroductionEpidemiology and Statistics Medication safety at homeEscalation of pain meds at homeNaloxone prescriptionsMedications in childrenCodeineTramadolNSAIDsLocal anesthetics and nerve blocksIntranasal meds: Ketamine and fentanylOpioids and sedationRegional anesthesiaChronic pain
Announcements: The interactive Clinical Pathways have launched and they are available for free! — In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2022 Emergency Medicine Practice article on the Management of Allergic Reactions and Anaphylaxis in the Emergency Department. IntroThe number of ED visits and hospitalizationsStudies show up to 57% of anaphylactic reactions are not recognized, and epinephrine is not administered in up to 80% of cases. Criteria2006 Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN)WAO revised the criteria in 2020 Delphi group and Brown et alPathophysiology EpidemiologyMost common causes in children and adultsMore than half of deaths from anaphylaxis occur within the first hour of symptom onsetPrehospital CareGive epi, H1 blockersMainstay = recognitionED CareAirwayEpinephrineDecontaminationH1 and H2 blockersCorticosteroidsBiphasic reactionsGlucagonSpecial CasesAlpha-galScombroidKounis syndrome