Podcasts about ama pra category

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-476 Overview: Melatonin is widely used and often perceived as a safe, natural solution for insomnia. However, a new preliminary study raises concerns about long-term melatonin use and increased risk of heart failure, hospitalization, and all-cause mortality in patients with chronic insomnia. In this episode, we review the findings, discuss how they fit with existing evidence, explore limitations, and offer practical guidance for clinicians counseling patients about sleep supplements. Episode resource links: American Heart Association Scientific Sessions 2025 – Abstract 4371606 AHA Scientific Statement: Multidimensional Sleep Health and Cardiometabolic Risk (Circulation, 2025) Li et al. Lancet Diabetes & Endocrinology, 2024 American Academy of Sleep Medicine Clinical Practice Guidelines AHA Life's Essential 8 & Sleep Health Resources Guest: Mariyan Montaque, DNP, FNP-BC   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

In this episode of our Poison Control series, host, Paul Wirkus, MD, FAAP and guest Michael Moss, MD, focus on several high-risk exposures commonly encountered in pediatrics. Our guests review toxic thresholds for medications such as acetaminophen, discuss the dangers of prescription medication ingestions, and highlight particularly hazardous household items, including button batteries, magnets, hydrocarbons, and cleaning agents. The conversation emphasizes early recognition, appropriate initial management, and when to seek expert guidance. Listeners will gain practical insights to help prevent serious injury and respond effectively when exposures occur.If there is ever a concern about a possible poisoning, contact Poison Control at 1-800-222-1222 for immediate guidance anywhere in the United States.Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-475 Overview: A prescribing cascade occurs when adverse effects of a medication are mistaken for a new condition and treated with additional drugs. Older adults experiencing polypharmacy are most at risk. The impact of prescribing cascades can be substantial, leading to falls, organ injury, unnecessary imaging and tests, and more. Join us as we explore how to recognize and prevent these harmful cascades in your patients. Episode resource links: Adrien  O, Mohammad  AK, Hugtenburg  JG,  et al.  Prescribing cascades with recommendations to prevent or reverse them: a systematic review.   Drugs Aging. 2023;40(12):1085-1100. doi:10.1007/s40266-023-01072-yPubMedGoogle ScholarCrossref   Brath  H, Mehta  N, Savage  RD,  et al.  What is known about preventing, detecting, and reversing prescribing cascades: a scoping review.   J Am Geriatr Soc. 2018;66(11):2079-2085. doi:10.1111/jgs.15543PubMedGoogle ScholarCrossref   Daunt R, McGettigan S, Kelly L, Curtin D, O'Mahony D. Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study. Drugs Aging. 2025;42(6):535-546. doi:10.1007/s40266-025-01201-9   Growdon ME, Tjota N, Campbell R, et al. Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade. JAMA Netw Open. 2025;8(12):e2545274. doi:10.1001/jamanetworkopen.2025.45274   McCarthy  LM, Savage  R, Dalton  K,  et al.  ThinkCascades: a tool for identifying clinically important prescribing cascades affecting older people.   Drugs Aging. 2022;39(10):829-840. doi:10.1007/s40266-022-00964-9PubMedGoogle ScholarCrossref   O'Mahony, D., Cherubini, A., Guiteras, A.R. et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 14, 625–632 (2023). https://doi.org/10.1007/s41999-023-00777-y   Rochon, P.A., O'Mahony, D., Cherubini, A. et al. International expert panel's potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16, 1573–1584 (2025). https://doi.org/10.1007/s41999-025-01215-x   Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS One. 2021;16(8):e0255642. Published 2021 Aug 3. doi:10.1371/journal.pone.0255642 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-475 Overview: A prescribing cascade occurs when adverse effects of a medication are mistaken for a new condition and treated with additional drugs. Older adults experiencing polypharmacy are most at risk. The impact of prescribing cascades can be substantial, leading to falls, organ injury, unnecessary imaging and tests, and more. Join us as we explore how to recognize and prevent these harmful cascades in your patients. Episode resource links: Adrien  O, Mohammad  AK, Hugtenburg  JG,  et al.  Prescribing cascades with recommendations to prevent or reverse them: a systematic review.   Drugs Aging. 2023;40(12):1085-1100. doi:10.1007/s40266-023-01072-yPubMedGoogle ScholarCrossref   Brath  H, Mehta  N, Savage  RD,  et al.  What is known about preventing, detecting, and reversing prescribing cascades: a scoping review.   J Am Geriatr Soc. 2018;66(11):2079-2085. doi:10.1111/jgs.15543PubMedGoogle ScholarCrossref   Daunt R, McGettigan S, Kelly L, Curtin D, O'Mahony D. Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study. Drugs Aging. 2025;42(6):535-546. doi:10.1007/s40266-025-01201-9   Growdon ME, Tjota N, Campbell R, et al. Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade. JAMA Netw Open. 2025;8(12):e2545274. doi:10.1001/jamanetworkopen.2025.45274   McCarthy  LM, Savage  R, Dalton  K,  et al.  ThinkCascades: a tool for identifying clinically important prescribing cascades affecting older people.   Drugs Aging. 2022;39(10):829-840. doi:10.1007/s40266-022-00964-9PubMedGoogle ScholarCrossref   O'Mahony, D., Cherubini, A., Guiteras, A.R. et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 14, 625–632 (2023). https://doi.org/10.1007/s41999-023-00777-y   Rochon, P.A., O'Mahony, D., Cherubini, A. et al. International expert panel's potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16, 1573–1584 (2025). https://doi.org/10.1007/s41999-025-01215-x   Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS One. 2021;16(8):e0255642. Published 2021 Aug 3. doi:10.1371/journal.pone.0255642 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

The Essentials of MHT and Menopause  Evaluation and Credit:  https://www.surveymonkey.com/r/medchat88 Target AudienceThis activity is targeted toward primary care physicians and advanced providers. Statement of Need Research indicates that MHT is the most effective therapy for symptoms of menopause (vasomotor symptoms & genitourinary syndrome) but its use is low and inconsistent. Physicians may be unaware of the latest research regarding the safety and application of MHT and therefore prescribing patterns are inconsistent for treatment of menopausal symptoms.  This podcast will discuss the essentials of MHT (formerly referenced as HRT) for the treatment of menopause. This program will address the latest treatment guidelines and research updates as information continues to evolve. Objectives Describe the current evidence supporting menopause hormone therapy (MHT), including risks and benefits, and the implications of the recently updated FDA safety communications. Outline evidence-based strategies to individualize MHT treatment for patients as well as determination criteria for when to initiate or discontinue treatment. Moderator Kris E. Barnsfather, M.D. Obstetrician and Gynecologist Women's Care Physicians of Louisville Norton Women's Care Louisville, KY Speaker Anna K. Feitelson, M.D. Gynecologist Associates in Obstetrics and Gynecology Norton Women's Care Louisville, KY Planners, Moderator and Speaker Disclosure  The planners, moderator and speaker of this activity do not have any relevant financial relationships with ineligible companies to disclose. Commercial Support  There was no commercial support for this activity.  Physician Credits Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing Credits Norton Healthcare Institute for Education and Development is approved as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This continuing professional development activity has been approved for 0.75 ANCC CE contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org. Resources for Additional Study/References The Art of Hormone Replacement Therapy (HRT) in Menopause Management https://pubmed.ncbi.nlm.nih.gov/37002679/ The mental health challenges, especially suicidality, experienced by women during perimenopause and menopause: A qualitative study https://pubmed.ncbi.nlm.nih.gov/40626330/ Date of Original Release | March 2026; Information is current as of the time of recording. Course Termination Date | March 2028 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Also listen to Norton Healthcare's podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. More information about Norton Healthcare is available at NortonHealthcare.com.  

We apologize for the break in our regularly scheduled programming! This is a reboot of Episode 77, originally posted in September 2023, which asked: why is hyperthyroidism associated with atrial fibrillation? We will return with an adjacent thyroid-related topic in 2 weeks! Read the show notes here. Click here to obtain AMA PRA Category 1 Credits™ (0.5 hours), Non-Physician Attendance (0.5 hours), or ABIM MOC Part 2 (0.5 hours). Audio edited by Clair Morgan of Nodderly.com.

We explore how to refine and optimize care in the vital minutes following ROSC. Hosts: Jonathan Elmer, MD, MS Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Post-ROSC_care.mp3 Download Leave a Comment Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 I. Phase 1: Stabilization (Minutes 0–10) The “Rearrest” Window & Pathophysiology High-Risk Period: Rearrest rates reach 30% within the first minutes post-ROSC. Shock Incidence: Two-thirds of patients develop profound hypotension/shock as initial resuscitative efforts subside. Catecholamine Washout: Super-physiologic “code-dose” epinephrine (1mg IV) typically wears off within ~3 minutes post-ROSC, leading to predictable hemodynamic collapse. Secondary Injuries: Evaluate for “CPR-induced trauma” (blunt thoracic trauma, rib fractures, pneumothorax, liver/splenic lacerations). Immediate Resuscitative Actions Vascular Access: Transition rapidly from IO to reliable IV access within 1–2 minutes. Prioritize Intraosseous (IO) placement within 5 minutes if IV attempts fail; intra-arrest data suggests no significant difference in early outcomes. Vasoactive “Bridge”: Maintain a “bolus-dose” pressor at the bedside for immediate push-dose titration. Options: Phenylephrine, dilute Epinephrine, or dilute Norepinephrine (titrated to effect rather than rigid dosing). Physician-Specific Task: Arterial Line: Goal: Placement within 5 minutes of ROSC. Preferred Site: Femoral (by landmarks/blind if necessary) for speed; should be a 80 mmHg. The BOX Trial Nuance: While the BOX trial showed no difference between MAP 63 vs. 77, its cohort (Denmark) had exceptionally high survival rates (70% back to work) and short response times, which may not generalize to North American populations with lower shockable rhythm incidence. Permissive Hypertension: If the patient is “self-driving” to higher pressures, do not aggressively lower them, as this may be a physiologic demand for cerebral blood flow. Ventilation and Oxygenation PaCO2 Management: Target: High-normal to slightly hypercarbic (45–55 mmHg). Rationale: Avoid accidental hyperventilation (PaCO2

This month we turn our attention to Poison Control, beginning with an overview of why children are uniquely vulnerable to toxic exposures. In this episode, our host, Paul Wirkus, MD, FAAP and guest Michael Moss, MD review common pediatric ingestions, household risks, and explain factors that increase children's vulnerabilities.We also take a behind-the-scenes look at how the nation's poison control system works - how calls are triaged, who provides guidance, and how centers collaborate across the country to deliver real-time, evidence-based recommendations. Most importantly, we emphasize when and how to use this invaluable resource.If you have a concern about a possible poisoning, call 1-800-222-1222 to reach your local poison control center anywhere in the United States.Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-474 Overview: Depression affects many people with dementia, but some evidence suggests certain antidepressants may accelerate cognitive decline. This episode explores the potential risks of antidepressants in people with dementia, which medications require careful consideration, and how to make informed prescribing decisions that optimize patient outcomes while minimizing potential cognitive harm. Episode resource links: Mo M, Abzhandadze T, Hoang MT, et al. Antidepressant use and cognitive decline in patients with dementia: a national cohort study. BMC Med. 2025;23(1):82.  Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-474 Overview: Depression affects many people with dementia, but some evidence suggests certain antidepressants may accelerate cognitive decline. This episode explores the potential risks of antidepressants in people with dementia, which medications require careful consideration, and how to make informed prescribing decisions that optimize patient outcomes while minimizing potential cognitive harm. Episode resource links: Mo M, Abzhandadze T, Hoang MT, et al. Antidepressant use and cognitive decline in patients with dementia: a national cohort study. BMC Med. 2025;23(1):82.  Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Liu, MD, MS, MPH, from the Department of Surgery, Harbor UCLA Medical Center. They discuss Dr Liu's recent article, “Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review,” in which the authors identified the current diagnostic issues, clinical tools, and clinician feedback strategies in the older adult emergency general surgery (EGS) setting. While challenges unique to older adults exist, variability in the use of tools to improve identification of older adult conditions in EGS and gaps in feedback to improve diagnosis remain.   Disclosure Information: Drs Erdahl and Liu have nothing to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Liu, Jessica K MD, MS, MPH; Peters, Xane D MD, MS; Remer, Sarah L MD; Beestrum, Molly MLIS; Cooper, Zara MD, FACS, MPH; Russell, Marcia M MD, FACS; Hall, Bruce L MD, FACS, PhD; Ko, Clifford Y MD, FACS, MSHS, MS. Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review. Journal of the American College of Surgeons 241(5):p 904-916, November 2025. | DOI: 10.1097/XCS.0000000000001480   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord   Copyright © 2026 by the American College of Surgeons (ACS). All rights reserved.   The contents of these materials may be cited in academic publications but otherwise may not be reproduced, disseminated, or transmitted in any form by any means without the express written permission of ACS. These materials may not be resold nor used to create revenue-generating content by any entity other than the ACS without the express written permission of the ACS. The contents of these materials are strictly prohibited from being uploaded, shared, or incorporated in any third-party applications, platforms, software, or websites without prior written authorization from the ACS. This restriction explicitly includes, but is not limited to, the integration of ACS content into tools leveraging artificial intelligence (AI), machine learning, large language models, or generative AI technologies and infrastructures. 

In this Q&A episode of our neonatal opioid withdrawal syndrome (NOWS) series, we address challenging and nuanced clinical questions surrounding withdrawal, toxicology testing, and newborn exposures. Our host, Paul Wirkus, MD, FAAP, and guest Camille Fung, MD, review the early signs of withdrawal and discuss the process of obtaining consent for neonatal toxicology screening, clarifying when testing is considered diagnostic and how results may have reporting implications.We also explore common clinical scenarios, including the impact of maternal fentanyl administered via epidural on newborn toxicology results, and how in utero SSRI exposure may present with symptoms such as apnea, posturing, or seizure-like activity. The conversation further examines the effects of prenatal THC exposure, addressing common misconceptions, potential neonatal impacts, and the persistence of THC in breastmilk.Throughout the discussion, the emphasis remains on careful clinical assessment, clear communication with families, and a nonjudgmental, evidence-based approach to care.Have a question? Email questions@vcurb.com.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Evie Hobbs, MD, Hematology Oncology Specialist, Providence Cancer Center Oncology and Hematology Care ClinicCME Credit Available for all Providence ProvidersIn order to claim CME credit, please click on the following link:⁠ https://forms.office.com/r/tuZUy0Zswj o⁠⁠⁠r copy & paste into your browser)Accreditation Statement: Providence Oregon Region designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1  creditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Providence Oregon Region is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.Planning Committee & Faculty Disclosure:  The Planning Committee have no relevant financial relationships with ineligible companies to disclose. The speaker has indicated relevant financial relationships with ACCME-defined ineligible companies: Avenzo Therapeutics –Principal Investigator (Institution receives funding). The speaker's presentation will be evidence-based and unbiased.All relevant financial relationships have been mitigated.Original Date: February 24, 2026End Date: February 24, 2027

Evie Hobbs, MD, Hematology Oncology Specialist, Providence Cancer Center Oncology and Hematology Care ClinicCME Credit Available for all Providence ProvidersIn order to claim CME credit, please click on the following link:⁠ https://forms.office.com/r/tuZUy0Zswj o⁠⁠⁠r copy & paste into your browser)Accreditation Statement: Providence Oregon Region designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1  creditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Providence Oregon Region is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.Planning Committee & Faculty Disclosure:  The Planning Committee have no relevant financial relationships with ineligible companies to disclose. The speaker has indicated relevant financial relationships with ACCME-defined ineligible companies: Avenzo Therapeutics –Principal Investigator (Institution receives funding). The speaker's presentation will be evidence-based and unbiased.All relevant financial relationships have been mitigated.Original Date: February 24, 2026End Date: February 24, 2027

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-473 Overview: Join us as we review long-term outcomes from a recently published trial on prostate-specific antigen (PSA) testing and prostate cancer mortality. Learn how updated evidence informs shared decision-making and balances early detection with potential harms. Equip yourself to guide patients through nuanced discussions on PSA testing's limitations, mortality data, and meaningful clinical impact. Episode resource links: N Engl J Med 2025;393:1669-80. DOI: 10.1056/NEJMoa2503223 Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-473 Overview: Join us as we review long-term outcomes from a recently published trial on prostate-specific antigen (PSA) testing and prostate cancer mortality. Learn how updated evidence informs shared decision-making and balances early detection with potential harms. Equip yourself to guide patients through nuanced discussions on PSA testing's limitations, mortality data, and meaningful clinical impact. Episode resource links: N Engl J Med 2025;393:1669-80. DOI: 10.1056/NEJMoa2503223 Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472 Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes. Episode resource links: Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association. Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.   Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272. Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472 Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes. Episode resource links: Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association. Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.   Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272. Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

In this episode, we continue our discussion of neonatal opioid withdrawal syndrome (NOWS), focusing on clinical features, treatment, and care after discharge. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the signs and symptoms clinicians use to recognize and assess withdrawal, along with current approaches to medication management and supportive care in the hospital setting. The conversation also addresses discharge planning, including criteria for safe transition home and coordination with caregivers. Finally, we explore the important role of the primary care pediatrician in follow-up—monitoring growth and development, supporting families, and coordinating ongoing services to promote the best possible outcomes for these infants. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this episode of Rounding@IOWA, Dr. Gerry Clancy sits down with breast cancer experts Dr. Katherine Huber‑Keener and Dr. Nicole Fleege for a discussion of modifiable and non‑modifiable risk factors, modern screening tools, and practical strategies clinicians can use to guide prevention and early detection. CME Credit Available:  https://uiowa.cloud-cme.com/course/courseoverview?P=0&EID=82146  Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Nicole Fleege, MD Clinical Assistant Professor of Internal Medicine-Hematology, Oncology, and Blood and Marrow Transplantation University of Iowa Carver College of Medicine Kathryn Huber-Keener, MD PhD Clinical Associate Professor of Obstetrics and Gynecology - General Obstetrics and Gynecology University of Iowa Carver College of Medicine Financial Disclosures:  Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 0.75 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 0.75 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-035-H99 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.)      

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-471 Overview: Discover how flexible physical activity patterns can reduce mortality and cardiovascular risk in patients with diabetes. This episode translates evidence on “weekend warrior” vs regular exercise into practical counseling strategies, empowering you to help time-constrained patients achieve the mortality benefits of weekly moderate-to-vigorous physical activity—regardless of scheduling pattern. Episode resource links: Wu, Z., Sheng, C., Guo, Z., Zheng, Y., Zheng, D., Li, X., Guo, X., & Li, H. (2025). Association of Weekend Warrior and Other Physical Activity Patterns With Mortality Among Adults With Diabetes : A Cohort Study. Annals of internal medicine, 178(9), 1279–1286. https://doi.org/10.7326/ANNALS-25-00640 Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-471 Overview: Discover how flexible physical activity patterns can reduce mortality and cardiovascular risk in patients with diabetes. This episode translates evidence on “weekend warrior” vs regular exercise into practical counseling strategies, empowering you to help time-constrained patients achieve the mortality benefits of weekly moderate-to-vigorous physical activity—regardless of scheduling pattern. Episode resource links: Wu, Z., Sheng, C., Guo, Z., Zheng, Y., Zheng, D., Li, X., Guo, X., & Li, H. (2025). Association of Weekend Warrior and Other Physical Activity Patterns With Mortality Among Adults With Diabetes : A Cohort Study. Annals of internal medicine, 178(9), 1279–1286. https://doi.org/10.7326/ANNALS-25-00640 Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Cardiac Symptoms & Diagnostics: A Practical Guide for Primary Care Evaluation and Credit:  https://www.surveymonkey.com/r/medchat87 Target Audience This activity is targeted toward primary care physicians and advanced providers. Statement of Need This podcast will provide tools for clinicians to interpret cardiac symptoms accurate, utilize the right diagnostic tools resulting in early detection and improved management of cardiovascular disease. Objectives Discuss evidence-based criteria to determine when specific cardiology diagnostic tests are indicated.  Describe red flags that warrant urgent testing or specialty referral Differentiate between cardiac diagnostic testing and clinical indications. Moderator Monalisa Tailor, M.D. Internist Norton Community Medical Associates - Barret Louisville, KY Speaker Mostafa O. El – Refai, M.D., M.Sc., MBA Interventional Cardiologist Norton Heart and Vascular Institute Louisville, KY Medical Director, Norton Brownsboro Hospital System Medical Director for Quality Norton Healthcare Louisville, KY Planners, Moderator and Speaker Disclosure  The planners, moderator and speaker of this activity do not have any relevant financial relationships with ineligible companies to disclose. Commercial Support There was no commercial support for this activity.  Physician Credits Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing Credits Norton Healthcare Institute for Education and Development is approved as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This continuing professional development activity has been approved for 0.75 ANCC CE contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Resources for Additional Study/References Mesa CA Score Calculator https://ebmcalc.com/NoteRight3000/MESA.htm National Heart, Lung and Blood Institute – Coronary Heart Disease Diagnosis https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis Cardiovascular Risk Assessment: Practical Tips for the Internal Medicine Specialist https://pubmed.ncbi.nlm.nih.gov/41285656/   Date of Original Release | Feb. 2026; Information is current as of the time of recording. Course Termination Date | Feb. 2029 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org   Also listen to Norton Healthcare's podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. More information about Norton Healthcare is available at NortonHealthcare.com.

We review diagnosing and managing bacterial meningitis in the ED. Hosts: Sarah Fetterolf, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Meningitis_2_0.mp3 Download Leave a Comment Tags: CNS Infections, Infectious Diseases, Neurology Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 Patient Presentation & Workup Patient: 36-year-old male, currently shelter-domiciled, presenting with 3 weeks of generalized weakness, fevers, weight loss, and headaches. Vitals (Initial): BP 147/98, HR 150s, Temp 100.2°F, RR 18, O2 99% RA. Clinical Evolution: Initial assessment noted cachexia and a large ventral hernia. Following initial workup, the patient became acutely altered (A&O x0) and febrile to 102.9°F. Physical Exam Findings: Brudzinski Sign: Positive (knees flexed upward upon passive neck flexion). Kernig Sign: Discussed as highly specific (resistance/pain during knee extension with hip flexed at 90°). Meningeal Triad: Fever, nuchal rigidity, and AMS (present in 40% of cases; 95% of patients have at least two of the four cardinal symptoms including headache). Imaging: Chest X-ray: Scattered opacities (pneumonia) and a small pneumothorax. CT Abdomen/Pelvis: Confirmed asplenia (secondary to 2011 GSW/exploratory laparotomy). Head CT: Ventricle enlargement concerning for obstructive hydrocephalus and diffuse sulcal effacement. CSF Analysis & Microbiology Bacterial Meningitis Opening Pressure: Elevated (Normal is 1000–2000/mm3 WBC); dominated by neutrophils (>80% PMN). Glucose: Low (

This month we are focusing on neonatal opioid withdrawal syndrome (NOWS), with an emphasis on the underlying physiology and clinical presentation. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the mechanisms of opioid exposure and withdrawal, including neuroexcitability and the gastrointestinal and autonomic manifestations commonly seen in affected newborns. The discussion also highlights the role of specialized clinics and coordinated care models that support mothers during pregnancy and the postpartum period. Together, this episode provides a foundational understanding of NOWS to help clinicians recognize symptoms early and deliver informed, compassionate care to both infants and their families. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-470 Overview: Social media use is nearly ubiquitous among adolescents, raising concern about its role in rising rates of depression, anxiety, insomnia, and suicidality. Although prior evidence has been mixed, emerging studies offer new insights on the relationship between social media use and adolescent mental health. Join us as we review current literature and discuss potential strategies to mitigate negative impacts and improve outcomes. Episode resource links: Calvert E, Cipriani M, Dwyer B, et al. Social Media Detox and Youth Mental Health. JAMA Netw Open. 2025;8(11):e2545245. doi:10.1001/jamanetworkopen.2025.45245 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840489   Clayborne ZM, Capaldi CA, Mehra VM. Associations between digital media use behaviours, screen time and positive mental health in youth: results from the 2019 Canadian Health Survey on Children and Youth. BMC Public Health. 2025;25(1):2303. Published 2025 Jul 3. doi:10.1186/s12889-025-22874-2 Grøntved A, Singhammer J, Froberg K, et al. A prospective study of screen time in adolescence and depression symptoms in young adulthood. Prev Med. 2015;81:108-113. doi:10.1016/j.ypmed.2015.08.009 Nagata JM, Memon Z, Talebloo J, et al. Prevalence and Patterns of Social Media Use in Early Adolescents. Acad Pediatr. 2025;25(4):102784. doi:10.1016/j.acap.2025.102784 Oberle E, Ji XR, Kerai S, Guhn M, Schonert-Reichl KA, Gadermann AM. Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: A population-level study. Prev Med. 2020;141:106291. doi:10.1016/j.ypmed.2020.106291 Pieh C, Humer E, Hoenigl A, et al. Smartphone screen time reduction improves mental health: a randomized controlled trial. BMC Med. 2025;23(1):107. Published 2025 Feb 21. doi:10.1186/s12916-025-03944-z Riehm KE, Feder KA, Tormohlen KN, et al. Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth. JAMA Psychiatry. 2019;76(12):1266–1273. doi:10.1001/jamapsychiatry.2019.2325 Varona MN, Muela A, Machimbarrena JM. Problematic use or addiction? A scoping review on conceptual and operational definitions of negative social networking sites use in adolescents. Addict Behav. 2022;134:107400. doi:10.1016/j.addbeh.2022.107400 Woolf SH. The Youth Mental Health Crisis in the United States: Epidemiology, Contributors, and Potential Solutions. Pediatrics. 2025;156(5):e2025070849. doi:10.1542/peds.2025-070849 Xiang AH, Martinez MP, Chow T, et al. Depression and Anxiety Among US Children and Young Adults. JAMA Netw Open. 2024;7(10):e2436906. doi:10.1001/jamanetworkopen.2024.36906 BBC: Australia has banned social media for kids under 16. How will it work? https://www.bbc.com/news/articles/cwyp9d3ddqyo Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-470 Overview: Social media use is nearly ubiquitous among adolescents, raising concern about its role in rising rates of depression, anxiety, insomnia, and suicidality. Although prior evidence has been mixed, emerging studies offer new insights on the relationship between social media use and adolescent mental health. Join us as we review current literature and discuss potential strategies to mitigate negative impacts and improve outcomes. Episode resource links: Calvert E, Cipriani M, Dwyer B, et al. Social Media Detox and Youth Mental Health. JAMA Netw Open. 2025;8(11):e2545245. doi:10.1001/jamanetworkopen.2025.45245 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840489   Clayborne ZM, Capaldi CA, Mehra VM. Associations between digital media use behaviours, screen time and positive mental health in youth: results from the 2019 Canadian Health Survey on Children and Youth. BMC Public Health. 2025;25(1):2303. Published 2025 Jul 3. doi:10.1186/s12889-025-22874-2 Grøntved A, Singhammer J, Froberg K, et al. A prospective study of screen time in adolescence and depression symptoms in young adulthood. Prev Med. 2015;81:108-113. doi:10.1016/j.ypmed.2015.08.009 Nagata JM, Memon Z, Talebloo J, et al. Prevalence and Patterns of Social Media Use in Early Adolescents. Acad Pediatr. 2025;25(4):102784. doi:10.1016/j.acap.2025.102784 Oberle E, Ji XR, Kerai S, Guhn M, Schonert-Reichl KA, Gadermann AM. Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: A population-level study. Prev Med. 2020;141:106291. doi:10.1016/j.ypmed.2020.106291 Pieh C, Humer E, Hoenigl A, et al. Smartphone screen time reduction improves mental health: a randomized controlled trial. BMC Med. 2025;23(1):107. Published 2025 Feb 21. doi:10.1186/s12916-025-03944-z Riehm KE, Feder KA, Tormohlen KN, et al. Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth. JAMA Psychiatry. 2019;76(12):1266–1273. doi:10.1001/jamapsychiatry.2019.2325 Varona MN, Muela A, Machimbarrena JM. Problematic use or addiction? A scoping review on conceptual and operational definitions of negative social networking sites use in adolescents. Addict Behav. 2022;134:107400. doi:10.1016/j.addbeh.2022.107400 Woolf SH. The Youth Mental Health Crisis in the United States: Epidemiology, Contributors, and Potential Solutions. Pediatrics. 2025;156(5):e2025070849. doi:10.1542/peds.2025-070849 Xiang AH, Martinez MP, Chow T, et al. Depression and Anxiety Among US Children and Young Adults. JAMA Netw Open. 2024;7(10):e2436906. doi:10.1001/jamanetworkopen.2024.36906 BBC: Australia has banned social media for kids under 16. How will it work? https://www.bbc.com/news/articles/cwyp9d3ddqyo Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

In this Q&A episode, Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD address common clinical questions related to pediatric red eye presentations. The discussion covers key elements of the differential diagnosis, including how to approach cloudy corneas and other concerning findings. We also review practical questions pediatricians frequently encounter, such as whether massage is effective for clearing duct obstruction and important considerations for contact lens use in children and adolescents. This episode offers clear, practical guidance to support safe evaluation, counseling, and management of pediatric eye concerns. Have a question? Email questions@vcurb.com. We will have a new topic next week.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-469 Overview: Tune in to hear how self-collected vaginal human papillomavirus (HPV) testing has potential to expand access to cervical cancer screening and reduce barriers for your patients. This episode reviews cervical cancer screening guidelines, follow-up recommendations, and how to consider offering self-collection as an option to increase screening rates and improve preventive care in your practice. Episode resource links: CA CancerJClin.2026;e70041. DOI:10.3322/caac.70041 US Food and Drug Administration (FDA). Device Classification Under Section 513(f)(2)(De Novo). Device for home collection and transport of vaginal specimens by lay users for use in an approved HPV molecular assay. FDA; 2025. FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-469 Overview: Tune in to hear how self-collected vaginal human papillomavirus (HPV) testing has potential to expand access to cervical cancer screening and reduce barriers for your patients. This episode reviews cervical cancer screening guidelines, follow-up recommendations, and how to consider offering self-collection as an option to increase screening rates and improve preventive care in your practice. Episode resource links: CA CancerJClin.2026;e70041. DOI:10.3322/caac.70041 US Food and Drug Administration (FDA). Device Classification Under Section 513(f)(2)(De Novo). Device for home collection and transport of vaginal specimens by lay users for use in an approved HPV molecular assay. FDA; 2025. FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-nutrition-update Overview: In this episode, we explore the latest changes to the USDA's nutrition guidelines, trace the history of the food pyramid, and examine the evidence behind current guidance. Come away with tips to counsel patients on nutrition that supports long-term health and reduces chronic disease risk. Episode resource links: Review the history of nutrition recommendations from the United States Department of Agriculture (USDA) Analyze the USDA's 2026 food guidelines Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-nutrition-update Overview: In this episode, we explore the latest changes to the USDA's nutrition guidelines, trace the history of the food pyramid, and examine the evidence behind current guidance. Come away with tips to counsel patients on nutrition that supports long-term health and reduces chronic disease risk. Episode resource links: Review the history of nutrition recommendations from the United States Department of Agriculture (USDA) Analyze the USDA's 2026 food guidelines Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

In this episode, we turn our focus to allergic conjunctivitis. Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD guests review the clinical features of ocular allergy and discuss how characteristics such as discharge and symptom patterns can help distinguish allergic conjunctivitis from viral, bacterial, and other etiologies. The conversation also covers important mimics and red flags, including chemical conjunctivitis, corneal abrasions, and foreign bodies, with guidance on evaluation and management. This episode equips pediatricians with practical tools to accurately assess red eye complaints and determine when further intervention is needed. Have a question? Email questions@vcurb.com. They will be answered next week.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-468 Overview: We first discussed aspirin use for primary prevention of cardiovascular disease in 2022 when the USPSTF recommended against it. In this follow-up episode, we review new trial data reinforcing that guidance and help you translate the evidence into safer prevention strategies. Build confidence in supporting patients with evidence-based approaches to reduce cardiovascular risk. Episode resource links: Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 2025 Aug 12:ehaf514. doi: 10.1093/eurheartj/ehaf514. Epub ahead of print. PMID: 40796244. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-468 Overview: We first discussed aspirin use for primary prevention of cardiovascular disease in 2022 when the USPSTF recommended against it. In this follow-up episode, we review new trial data reinforcing that guidance and help you translate the evidence into safer prevention strategies. Build confidence in supporting patients with evidence-based approaches to reduce cardiovascular risk. Episode resource links: Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 2025 Aug 12:ehaf514. doi: 10.1093/eurheartj/ehaf514. Epub ahead of print. PMID: 40796244. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

We discuss the diagnosis and management of SCAPE in the ED. Hosts: Naz Sarpoulaki, MD, MPH Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/SCAPEv2.mp3 Download Leave a Comment Tags: Acute Pulmonary Edema, Critical Care Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 The Clinical Case Presentation: 60-year-old male with a history of HTN and asthma. EMS Findings: Severe respiratory distress, SpO₂ in the 60s on NRB, HR 120, BP 230/180. Exam: Diaphoretic, diffuse crackles, warm extremities, pitting edema, and significant fatigue/work of breathing. Pre-hospital meds: NRB, Duonebs, Dexamethasone, and IM Epinephrine (under the assumption of severe asthma/anaphylaxis). Differential Diagnosis for the Hypoxic/Tachypneic Patient Pulmonary: Asthma/COPD, Pneumonia, ARDS, PE, Pneumothorax, Pulmonary Edema, ILD, Anaphylaxis. Cardiac: CHF, ACS, Tamponade. Systemic: Anemia, Acidosis. Neuro: Neuromuscular weakness. What is SCAPE? Sympathetic Crashing Acute Pulmonary Edema (SCAPE) is characterized by a sudden, massive sympathetic surge leading to intense vasoconstriction and a precipitous rise in afterload. Pathophysiology: Unlike HFrEF, these patients are often euvolemic or even hypovolemic. The primary issue is fluid maldistribution (fluid shifting from the vasculature into the lungs) due to extreme afterload. Bedside Diagnosis: POCUS vs. CXR POCUS is the gold standard for rapid bedside diagnosis. Lung Ultrasound: Look for diffuse B-lines (≥3 in ≥2 bilateral zones). Cardiac: Assess LV function and check for pericardial effusion. Why not CXR? A meta-analysis shows LUS has a sensitivity of ~88% and specificity of ~90%, whereas CXR sensitivity is only ~73%. Importantly, up to 20% of patients with decompensated HF will have a normal CXR. Management Strategy 1. NIPPV (CPAP or BiPAP) Start NIPPV immediately to reduce preload/afterload and recruit alveoli. Settings: CPAP 5–8 cm H₂O or BiPAP 10/5 cm H₂O. Escalate EPAP quickly but keep pressures to avoid gastric insufflation. Evidence: NIPPV reduces mortality (NNT 17) and intubation rates (NNT 13). 2. High-Dose Nitroglycerin The goal is to drop SBP to < 140–160 mmHg within minutes. No IV Access: 3–5 SL tabs (0.4 mg each) simultaneously. IV Bolus: 500–1000 mcg over 2 minutes. IV Infusion: Start at 100–200 mcg/min; titrate up rapidly (doses > 800 mcg/min may be required). Safety: ACEP policy supports high-dose NTG as both safe and effective for hypertensive HF. Use a dedicated line/short tubing to prevent adsorption issues. 3. Refractory Hypertension If SBP remains > 160 mmHg despite NIPPV and aggressive NTG, add a second vasodilator: Clevidipine: Ultra-short-acting calcium channel blocker (titratable and rapid). Nicardipine: Effective alternative for rapid BP control. Enalaprilat: Consider if the above are unavailable. Troubleshooting & Pitfalls The “Mask Intolerant” Patient Hypoxia is the primary driver of agitation. NIPPV is the best sedative. * Pharmacology: If needed, use small doses of benzodiazepines (Midazolam 0.5–1 mg IV). AVOID Morphine: Data suggests higher rates of adverse events, invasive ventilation, and mortality. A 2022 RCT was halted early due to harm in the morphine arm (43% adverse events vs. 18% with midazolam). The Role of Diuretics In SCAPE, diuretics are not first-line. The problem is redistribution, not volume excess. Diuretics will not help in the first 15–30 minutes and may worsen kidney function in a (relatively) hypovolemic patient. Delay Diuretics until the patient is stabilized and clear systemic volume overload (edema, weight gain) is confirmed. Disposition Admission: Typically requires CCU/ICU for ongoing NIPPV and titration of vasoactive infusions. Weaning: As BP normalizes and work of breathing improves, infusions and NIPPV can be gradually tapered. Take-Home Points Recognize SCAPE: Hyperacute dyspnea + severe HTN. Trust your POCUS (B-lines) over a “clear” CXR. NIPPV Immediately: Don’t wait. It saves lives and prevents tubes. High-Dose NTG: Use boluses to “catch up” to the sympathetic surge. Don’t fear the dose. Avoid Morphine: Use small doses of benzos if the patient is struggling with the mask. Lasix Later: Prioritize afterload reduction over diuresis in the hyperacute phase. Read More

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-vaccine-update Overview: In this episode, we discuss the recently updated US childhood vaccine schedule, including key changes and the rationale behind these recommendations. We also talk about the risks of vaccine-preventable illnesses and review vaccine efficacy and safety considerations—helping you navigate evolving guidance and protect patients in primary care. Episode resource links: RSV:  Pediatrics. 2024. Curns AT, Rha B, Lively JY, et al. J Infect Dis. 2022 Aug 15;226(Suppl 2):S154-S163. doi: 10.1093/infdis/jiac120 Hep B: N Engl J Med 2019;380:2041-2050  DOI: 10.1056/NEJMra181047 Clin Infect Dis. 2021 Nov 2;73(9):e3317-e3323. doi: 10.1093/cid/ciaa898.  Meningococcal Vaccines and disease: MMWR. Morbidity and Mortality Weekly Report. 2024. Collins JP, Crowe SJ, Ortega-Sanchez IR, et al. Vaccine. 2019. Wang B, Santoreneos R, Giles L, Haji Ali Afzali H, Marshall H. Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-vaccine-update Overview: In this episode, we discuss the recently updated US childhood vaccine schedule, including key changes and the rationale behind these recommendations. We also talk about the risks of vaccine-preventable illnesses and review vaccine efficacy and safety considerations—helping you navigate evolving guidance and protect patients in primary care. Episode resource links: RSV:  Pediatrics. 2024. Curns AT, Rha B, Lively JY, et al. J Infect Dis. 2022 Aug 15;226(Suppl 2):S154-S163. doi: 10.1093/infdis/jiac120 Hep B: N Engl J Med 2019;380:2041-2050  DOI: 10.1056/NEJMra181047 Clin Infect Dis. 2021 Nov 2;73(9):e3317-e3323. doi: 10.1093/cid/ciaa898.  Meningococcal Vaccines and disease: MMWR. Morbidity and Mortality Weekly Report. 2024. Collins JP, Crowe SJ, Ortega-Sanchez IR, et al. Vaccine. 2019. Wang B, Santoreneos R, Giles L, Haji Ali Afzali H, Marshall H. Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

This week's episode focuses on bacterial conjunctivitis and practical considerations for pediatric care. Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD discuss key principles of infection control, how to recognize concerning findings and distinguish uncomplicated conjunctivitis from more serious conditions such as orbital cellulitis, and when escalation of care is necessary. We also review the appropriate use of antibiotics, including selection, administration, and common pitfalls—highlighting how improper dosing or technique can limit effectiveness. This discussion is designed to support evidence-based decision-making and safe, effective management of bacterial conjunctivitis in children. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-467 Overview: Join us as we discuss recent changes to newborn hepatitis B vaccination recommendations and review the risks, benefits, and rationale for immunizing this patient population. Come away with confidence to navigate new guidance, thoughtfully address parental concerns, and provide evidence-based care that promotes both infant and public health. Episode resource links: N Engl J Med 2019;380:2041-2050  DOI: 10.1056/NEJMra181047 Clin Infect Dis. 2021 Nov 2;73(9):e3317-e3323. doi: 10.1093/cid/ciaa898.  Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-467 Overview: Join us as we discuss recent changes to newborn hepatitis B vaccination recommendations and review the risks, benefits, and rationale for immunizing this patient population. Come away with confidence to navigate new guidance, thoughtfully address parental concerns, and provide evidence-based care that promotes both infant and public health. Episode resource links: N Engl J Med 2019;380:2041-2050  DOI: 10.1056/NEJMra181047 Clin Infect Dis. 2021 Nov 2;73(9):e3317-e3323. doi: 10.1093/cid/ciaa898.  Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

This week, Hannah shares the story of an overlooked piece of the coagulation cascade, beginning with a 1950s medical mystery: Why didn't John Hageman bleed? Click here to obtain AMA PRA Category 1 Credits™ (0.5 hours), Non-Physician Attendance (0.5 hours), or ABIM MOC Part 2 (0.5 hours). Audio edited by Clair Morgan of Nodderly.com. Resident Giancarlo Buonomo and medical student Millennium Manna are our producers.

In recent years, we have seen tremendous growth not just in the popularity of anti-obesity medications, but also in the medications themselves, how effective they are, how many there are. What exactly has changed during this rapid evolution? How safe and effective are these medications today? What challenges still exist in using them? To help answer these questions, host Aaron Lohr speaks with Gitanjali Srivastava, MD, professor of medicine, medical director of Vanderbilt Obesity Medicine, and founding program director of the Obesity Medicine Fellowship at Vanderbilt University Medical Center. Dr. Srivastava presented at the Endocrine Society’s Obesity Fellows Conference in September 2025. The title of her presentation was “Pharmacological Approaches to Treating and Understanding Complicated Obesity.” Listening to this episode can earn you 0.5 ABIM MOC points and 0.5 AMA PRA Category 1 credits. If you are interested in those points and credits, you will need to take a pre-test on the Endocrine Society Center for Learning before listening to this episode. You can find a link in this episode’s show notes. After that pre-test, listen to this episode in the Center for Learning, then take the post-test. This episode is made possible by educational grants from Lilly and Novo Nordisk. Show notes are available at https://www.endocrine.org/podcast/enp109 — for helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

This month we begin a new series on common pediatric eye issues, starting with viral conjunctivitis. In this episode, host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD review the clinical features that help distinguish viral conjunctivitis from other causes of red and pink eye, discuss typical disease course, and address common misconceptions around treatment and contagion. They also explore practical counseling points for families, including symptom management, infection control, and guidance on school and daycare attendance. This discussion is designed to help pediatricians confidently diagnose viral conjunctivitis and provide clear, evidence-based reassurance to families. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-466 Overview: Concerns over eating carbohydrate-rich potatoes have been raised over the last decade with numerous studies suggesting worrisome effects on health. Tune in as we unpack findings from a large study that examined the relationship between potato intake and the risk of developing type 2 diabetes mellitus (T2DM), helping you apply evolving nutrition science to patient counseling. Episode resource links: BMJ 2025;390:e082121 http://dx.doi.org/10.1136/bmj-2024‑082121 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-466 Overview: Concerns over eating carbohydrate-rich potatoes have been raised over the last decade with numerous studies suggesting worrisome effects on health. Tune in as we unpack findings from a large study that examined the relationship between potato intake and the risk of developing type 2 diabetes mellitus (T2DM), helping you apply evolving nutrition science to patient counseling. Episode resource links: BMJ 2025;390:e082121 http://dx.doi.org/10.1136/bmj-2024‑082121 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

We discuss the shift to prehospital blood to treat shock sooner. Hosts: Nichole Bosson, MD, MPH, FACEP Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Prehospital_Transfusion.mp3 Download Leave a Comment Tags: EMS, Prehospital Care, Trauma Show Notes Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below.  Course Highlights: Credit: 12.5 AMA PRA Category 1 Credits™ Curriculum: Comprehensive coverage of Core Emergency Medicine,  with 12 modules spanning from Critical Care to Pediatrics. Cost: Free for NYU Learners $250 for Non-NYU Learners Click Here to Register and Begin Module 1 What is prehospital blood transfusion Administration of blood products in the field prior to hospital arrival Aimed at patients in hemorrhagic shock Why this matters Traditional US prehospital resuscitation relied on crystalloid ED and trauma care now prioritize early blood Hemorrhage occurs before hospital arrival Delays to definitive hemorrhage control are common Earlier blood may improve survival Supporting rationale ATLS and trauma paradigms emphasize blood over fluid National organizations support prehospital blood when feasible EMS already manages high risk, time sensitive interventions Evidence overview Data are mixed and evolving COMBAT: no benefit PAMPer: mortality benefit RePHILL: no clear benefit Signal toward benefit when transport time exceeds ~20 minutes Urban systems still experience long delays due to traffic and geography LA County median time to in hospital transfusion ~35 minutes LA County program ~2 years of planning before launch Pilot began April 1 Partnerships: LA County Fire Compton Fire Local trauma centers San Diego Blood Bank 14 units of blood circulating in the field Blood rotated back 14 days before expiration Ultimately used at Harbor UCLA Continuous temperature and safety monitoring Indications used in LA County Focused rollout Trauma related hemorrhagic shock Postpartum hemorrhage Physiologic criteria: SBP < 70 Or HR > 110 with SBP < 90 Shock index ≥ 1.2 Witnessed traumatic cardiac arrest Products: One unit whole blood preferred Two units PRBCs if whole blood unavailable Early experience ~28 patients transfused at time of discussion Evaluating: Indications Protocol adherence Time to transfusion Early outcomes Too early for outcome conclusions California collaboration Multiple active programs: Riverside (Corona Fire) LA County Ventura County Additional programs planned: Sacramento San Bernardino Programs meet monthly as CalDROP Focus on shared learning and operational optimization Barriers and concerns Trauma surgeon concerns about blood supply Need for system wide buy in Community engagement Patients who may decline transfusion Women of childbearing age and alloimmunization risk Risk of HDFN is extremely low Clear communication with receiving hospitals is essential Future direction Rapid national expansion expected Greatest benefit likely where transport delays exist Prehospital Blood Transfusion Coalition active nationally Major unresolved issue: reimbursement Currently funded largely by fire departments Sustainability depends on policy and payment reform Take-Home Points Hemorrhagic shock is best treated with blood, not crystalloid Prehospital transfusion may benefit patients with prolonged transport times Implementation requires strong partnerships with blood banks and trauma centers Early data are promising, but patient selection remains critical National collaboration is key to sustainability and future growth Read More

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-465 Overview: Many patients with coronary artery disease take aspirin, but how should clinicians navigate management when an anticoagulant is also needed? In this episode, we review indications for therapy, explore evidence on dual use, and discuss how to counsel patients on balancing cardiovascular benefits with the risks of combination therapy. Episode resource links: Lemesle G, Didier R, Steg PG, et al. Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. N Engl J Med. Published online August 31, 2025. https://www.nejm.org/doi/full/10.1056/NEJMoa2507532 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com