Emergency Medicine News - EMN Live

Drs. Raja and Pescatore wrap up their tenure on the podcast with a discussion of the future of the specialty.

Drs. Pescatore and Raja talk about how they treat shoulder dislocations and the results of the KetaBAN trial, which uses breath-actuated nebulized ketamine for pain.

Drs. Pescatore and Raja review the latest evidence on whether emergency physicians should initiate therapeutic hypothermia after cardiac arrest and also talk about patient awareness during sedation while on mechanical ventilation and how much information is retained from listening to podcasts.

Should you do a pan scan on patients who have a cardiac arrest? Drs. Pescatore and Raja weigh in on that and on AEDs in the community, head-up CPR, an elevated position to facilitate venous return, and impedance threshold devices.

All emergency physicians know the specialty's 10 commandments, written in 1991 by Corey Slovis, MD, and Keith Wrenn, MD, but now Dr. Slovis and Christopher Evans, MD, formerly a resident at Vanderbilt and now a clinical informatics fellow at the University of North Carolina, have updated them. Drs. Raja and Pescatore review all 10 and add their own take.

Drs. Pescatore and Raja talk about an unexpected effect of COVID-19 and why TXA doesn’t change the need for nasal packing in their latest podcast. Bonus! An interview with Daniel Boron-Brenner, DO, on push-dose pressors.

Drs. Pescatore and Raja talk about what to do when patients present after unprotected sex, and Dr. Pescatore’s wife, Jessica Pescatore, DO, an OB-Gyn, joins them to teach them all about ulipristal. Bonus: A discussion about TXA for subarachnoid hemorrhage.

Changes were made to the pediatric ALS guidelines, say Drs. Raja and Pescatore, not the least of which was the number of breaths to give per minute. They also discuss the updated dosing for gonorrhea treatment. Learn more in their latest EMN Live podcast.

Drs. Raja and Pescatore say the evidence is in for cannabinoid hyperemesis syndrome: Haloperidol is more effective, leads to faster discharge, and requires less rescue medicine. Tune into their latest EMN Live podcast for this and more.

Drs. Pescatore and Raja celebrate the end of 2020 and discuss antigen testing for COVID-19, and trichomonas testing in men.

Drs. Raja and Pescatore talk about the Figs scrubs ad controversy that showed a female physician reading a book upside down. Also this month: The STEMI paradigm to AMI and TXA in trauma.

Drs. Pescatore and Raja talk about using vasopressorsin patients with septic shock and antimicrobial therapy for otitis externa.

Drs. Raja and Pescatore talk about antacid monotherapy, airway checklists, and how to cope with lower volume because of the pandemic.

Drs. Pescatore and Raja talk about palliative care teams in the ED for COVID-19 patients, figuring out whether patients want a full code, and how you should stop using TXA for GI bleeds, even though Dr. Pescatore supported its use two years ago. Find the Lancet article they discuss at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30848-5/fulltext.

Drs. Raja and Pescatore talk about cyanide toxicity from house fires (it will be on the boards!) and what to do if you don’t have hydroxocobalamin, and about how to manage peritonsillar abscess.

Drs. Pescatore and Raja delve into simulated training for using tourniquets and saline and methylene blue.

Drs. Pescatore and Pescatore talk more about COVID-19 and the hydroxychloroquine debacle.

Drs. Raja and Pescatore talk about COVID-19 in their EDs and how medical students are being given the option to graduate early.

Drs. Raja and Pescatore explore two studies: One compares colchicine with naproxen for relieving gout pain (read the study here: https://bit.ly/2QKwEXD), and the other examines the use of coloring books for alleviating anxiety in adults waiting in the ED (read the study here: https://bit.ly/33HCY7D).

Drs. Raja and Pescatore explore the roc v. sux trial that didn’t help at all, high-flow nasal cannula for palliative care patients, and the benefits of intermittent fasting.

Drs. Pescatore and Raja tackle colchicine for inflammation after cardiovascular events, steroids for the flu, and intraarticular injections for joint dislocations.

Drs. Raja and Pescatore at first made fun of a recommendation of antibiotics for low back pain, but now think it’s mind-blowing stuff. Listen in as they discuss that and new updates for CA-pneumonia that will change what you do in the ED.

Drs. Pescatore and Raja talk about three important studies: the CRASH-3 trial about TXA for TBI patients, the CITRIS-ALI trial on using a vitamin C cocktail for sepsis, and the Hyperion trial looking at targeted temperature management.

Drs. Raja and Pescatore are calling this one their poop-and-pain podcast. We’ll let you draw your own conclusions, but it is worth a listen!

Drs. Pescatore and Pescatore talk about how to prepare for mass casualty trauma cases that could be coming to the ED. Read the white paper they discuss at http://bit.ly/2ZrYpuz.

Drs. Raja and Pescatore sing the praises of A-lines in cardiac arrest, rail about a New Jersey rule requiring EMS to give buprenorphine in the field, and debate risk stratification for PE. Listen in as they cover the game-changers for emergency medicine practice.

Does honey prevent burns in kids who swallow button batteries? Drs. Pescatore and Raja have a surprising answer. They also talk about using vasopressors in cardiogenic shock and regional anesthesia for rib fractures. Plus Dr. Pescatore interviews Mark Ramzy, MD, an emergency medicine resident at Drexel University, about double external defibrillation.

Drs. Raja and Pescatore dig into whether FOAM deserves its recent criticism and the startling news that many patients don’t fill their prescriptions for STIs.

Drs. Pescatore and Raja discuss the hype around bicarbonate’s effectiveness, whether to give antibiotics for dog bites, and what to do about assaults against medical professionals in their latest podcast.

Drs. Raja and Pescatore admit it’s cool to do hands-on defibrillation, but does that mean you should do it? They also talk about a new device to treat CO poisoning when the hyperbaric chamber isn’t available, and whether EPs should be cardioverting every AF patient.

What’s the common thread among the topics Drs. Pescatore and Raja tackle this month? Tune in to find out when they talk about patients who want a second opinion in the ED, apneic preoxygenation, and techniques for shoulder reduction.

Dr. Raja rants about the Rhode Island EPs who are being blamed for the flaws in their hospital’s EMR, Dr. Pescatore fumes about how saying children aren’t little adults creates problems, and they discuss the nuances of the high-flow nasal cannula for patients in respiratory distress. They top that off with an interview with emergency medicine pain expert Sergey Motov, MD, to learn more his ED Opioid Stewardship Pathway 2.0, with its surprises about morphine sulfate and TENS. See the pathway at http://bit.ly/2S2nwLL.

Drs. Raja and Pescatore are in sync about the HEART score for patients with chest pain and when it’s OK to use nonsterile gloves for lacerations, and but they lock horns a little over loop drainage. Tune in to their latest podcast for that and an interview with medical student Joshua Niforatos, a medical student with an interesting background and an interesting outlook on Step 1.

Drs. Pescatore and Raja say antibiotics are not the panacea you think they are for appendicitis, they talk about how EPs can help patients with opioid use disorder by starting medication-assisted treatment in the ED, and much more!

Drs. Raja and Pescatore admit they’re scared and know you are too. Listen in to hear their ideas for lessening their own anxiety about diagnosing pulmonary embolism in pregnancy and treating patients who used cannabinoids laced with superwarfarins. They also talk about a truly portable handheld ultrasound machine that will probably soon be standard of care.

Drs. Pescatore and Raja provide news you can use in your practice right now! Listen in to hear their takes on these hot topics: - Do you really need to send a troponin for your asymptomatic afib patient with RVR? What happens when it comes back elevated? - The obstruction series’ sensitivity is 30-50 percent for obstruction and worse for anything else in the belly. Why are you ordering it? - You can handle that distal finger amputation yourself. The evidence says ED revision yields good patient outcomes and no significant rate of adverse events.

Drs. Pescatore and Raja provide news you can use in your practice right now! Listen in to hear their takes on these hot topics: Probiotics and Antibiotics: Should you give probiotics to a patient you gave antibiotics? Theevidence is overwhelming! Corneal Abrasions and Topical Anesthetics: Worried about sending your corneal abrasion patients home with topical anesthetics? This idea will provide pain relief for your patients. ETI vs laryngeal airways in OHCA: This is the most controversial topic in emergency medicine right now: whether to intubate in field for out-of-hospital cardiac arrest patients. Two new studies provide the answer. Bonus Interview: Dr. Pescatore talks with Laura Bontempo, MD, an expert in managing atrial fibrillation, about using beta blockers and calcium channel blockers together and rate v. rhythm control.

Drs. Pescatore and Raja tackle some controversial topics in this episode of the newly revamped EMN Live: the PARAMEDIC-2 trial, magnesium to treat atrial fibrillation, and tamsulosin for renal stones.

Drs. Raja and Pescatore tackle some controversial topics in this episode of the newly revamped EMN Live: outpatient management of PE, skipping the pelvic exam, and antibiotics after I&D for cutaneous abscesses.

Drs. Pescatore and Raja discuss procalcitonin for guiding antibiotic cessation, what to do about ED patients with asymptomatic hypertension, and why you should learn about REBOA. Keep listening after their talk for Dr. Pescatore’s interview with Amy Ho, MD, and why she says “The Resident” isn’t as bad as you think.

Dr. Pescatore and Ms. Roberts talk about what’s coming up in the June issue, including an article Dr. Pescatore says is the best article he ever read in EMN. Hint: Graham Walker, MD, wrote it. PLUS an also interview with Seth Collings Hawkins, MD, about how dry drowning is just not a thing. And much more!

Ms. Roberts talks with Dr. Lee about two pediatric patients with difficult airways.

Ms. Roberts, Dr. Pescatore, and special guest James Roberts, MD, talk about what’s coming up in the May issue, but also interview noted emergency physician Jerry Hoffman, MD, about the controversial article in the NY Times about tPA. And much more!

Ms. Roberts and Dr. Pescatore not only dissect the April issue, but also call on the knowledge of pain expert Sergey Motov, MD, to discuss these game-changing articles: “The Cure for Back Pain Is Biting the Bullet” by Graham Walker, MD “Is Phenobarbital for Alcohol Withdrawal Ready for the Big Time?” by Leon Gussow, MD “TXA Superior to Packing for Epistaxis, and Patients Like It Better” by Dustin Ballard, MD, & David Vinson, MD “Rage against Renal Colic: Keep the Ketorolac, Maybe Morphine, Leave the Lido for Last” by Dan Runde, MD “Three Things You Should Know about Sickle Cell Disease” by EMedHome.com And much more!

Dr. Pescatore and Ms. Roberts discuss practice-changing articles from the March issue: Topic of the Month: "Once Stuck in a Therapeutic Fog, Abnormal Uterine Bleeding Finds Clarity" by none other than Rick Pescatore, DO Article of the Month: "Fatigue, Cough, Night Sweats, Gum Bleeding" by Katherine Wurlitzer, MD, & Taylor Burkholder, MD, MPH This Month's Game Changer: "The Patient Call-Back Goes High Tech" by Alex Mohseni, MD Maximum Medicine: "To Give or Not to Give Activated Charcoal, That’s Not the Real Question" by Leon Gussow, MD The "As If" Segment: "The Dos and Don’ts of Sign-Out Etiquette" by Alberto Hazan, MD, & Jordana Haber, MD And much more!

BONUS PODCAST! Dr. Pescatore and Ms. Roberts set up a recording studio at the EMN booth during the ACEP Scientific Assembly to interview some of the top names in emergency medicine. In this one, Ms. Roberts interviews Seth Collings Hawkins, MD, about his new book, Wilderness EMS, and why wilderness care is not just for hikers and spelunkers anymore.

Ms. Roberts and Dr. Pescatore discuss practice-changing articles from the January issue: Editorial Topic of the Month: “A Dangerous Game of Bias” by Mark Mosley, MD Article of the Month: “The Epidemic of Cripping Anxiety, Literally” by Graham Walker, MD This Month’s Game Changer: “Tissue over Time: The DAWN of a New Era” by Evie Marcolini, MD The “As If” Segment: “Beware the Snake (Head) in the Grass” by Leon Gussow, MD Maximum Medicine: “PCI Fails to Reduce Death or MI in Stable Angina, So Why Is It Still Being Used?” by Rory Spiegel, MD And much more!

BONUS PODCAST! Dr. Pescatore and Ms. Roberts set up a recording studio at the EMN booth during the ACEP Scientific Assembly to interview some of the top names in emergency medicine. In this one, Dr. Pescatore interviews Amy Ondeyka, MD, about her work with ACEP and CORD on wellness initiatives and mental health in emergency medicine.

BONUS PODCAST! In this bonus podcast from the ACEP Scientific Assembly, Dr. Pescatore interviews Zinta Zapp, MD, about opioids, medication-assisted therapy, and a special curriculum for residents. Watch this space for more bonus podcasts with Rick and Martha.

BONUS PODCAST! Dr. Pescatore and Ms. Roberts set up a recording studio at the EMN booth during the ACEP Scientific Assembly to interview some of the top names in emergency medicine. In this one, they talk to Sandra Scott Simons, MD, best known in EMN and Twitter as the ER Goddess (@ERGoddessMD), about how she juggles being an EP, a mom of two, a column author, and a marathon runner.

Ms. Roberts and Dr. Pescatore discuss practice-changing articles from the January issue: - “Even if Stress Tests Found Patients at High Risk for MI (They Don’t), To What End?” by Rory Spiegel, MD - “The Best Three Treatments for Migraine” by James R. Roberts, MD - “Ultrasound Discerns Cardiac Standstill from Good Contractility and the Nebulous Findings in Between” by Christine Butts, MD - “Resuscitative Transesophageal Echocardiography: A Game Changer for Cardiac Arrest,” by Patrick Ockerse, MD, & Jimmy Fair, MD And much more!