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Matt DeLaney has always gravitated toward edgier humor. So when he went through medical school and residency, the doctors grading his performance told him to make sure his humor always stayed ‘professional.' But what constitutes 'professional' humor, especially when it veers into the realm of gallows humor? In this episode of Only Human: Real Clinician Stories, Unfiltered, we explore the shadowy sides of humor in medicine. Listen as we dissect the complexities of what makes us laugh, why, and when it might be too much, all while navigating the high stakes of healthcare. At the end of the episode, we lift up and reflect on what we've learned from the Only Human series as a whole. We would love to hear from you! You can write us or send a voice memo with thoughts, reactions, questions, or ideas for future episodes to podcasts@hippoeducation.com. Explore more of what Hippo Education has to offer by clicking here.
For this episode, Patricia and John are joined by Tarlan Hedayati and Matt Delaney to discuss obtaining histories from difficult situations. Don't forget, that we are the official podcast of the American College of Osteopathic Emergency Physicians. Visit acoep.org today to learn more.
Generations upon generations have enjoyed America's Favorite Pastime through the gates of Fenway Park. Opened April 20, 1912, Fenway is the second oldest park that still exists behind Wrigley Field, home of the Chicago Cubs. Please join us for a walk through the park with a guided tour and history lesson from one of Fenway's finest guides, Matt Delaney!
28 years ago, the die was cast for how emergency department encounters were documented. Since then, we've had note bloat, click fatigue, and too much attention placed on things that really didn't matter. All of that is slated to change in 2023 with dramatic new documentation guidelines (that today's guest calls ‘refreshing') are implemented. When was the last time you heard the word ‘refreshing' used when it came to charting? And a massive thank you and hat tip to my friend Matt DeLaney who now runs ERcast - he was the first to alert us to these guidelines and interviewed Jason when they were first announced. Episode Sponsor: Ivy Clinicians. Curious if there's a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free. Guest bio: Jason Adler, MD is a clinical assistant professor of emergency medicine at the University of Maryland where he is also the director of compliance and reimbursement. He is also the vice president of acute care solutions at LogixHealth. Mentioned in this episode: The Awake and Aware Physician conference sponsored by Wild Health. Jan 13-15 Sedona Arizona. Use the code CONSCIOUSPHYSICIAN for 15% off (that's 15% off the whole package – lodging, meals, the course) Interested in one-on-one coaching? Learn more at roborman.com To support the show - visit our Patreon site and help keep the wind in the sails. For full show notes visit our podcast page We Discuss: History and physical documentation are now at your discretion; Heavy value is placed on cognitive work and medical decision making; History from a non-patient source is valued in these guidelines; Ordering a test is equally valued as not ordering a test; Consideration of escalation or deescalation of care; In addition to documenting your shared-decision making conversations, your MDM should include; Population health - Stable means something different when it comes to documentation; Social determinants of health; There is a heightened emphasis of independent interpretations of separately billable procedures (EKGs, X-ray, CT, U/S); Jason's take home points; And More.
28 years ago, the die was cast for how emergency department encounters were documented. Since then, we've had note bloat, click fatigue, and too much attention placed on things that really didn't matter. All of that is slated to change in 2023 with dramatic new documentation guidelines (that today's guest calls ‘refreshing') are implemented. When was the last time you heard the word ‘refreshing' used when it came to charting? And a massive thank you and hat tip to my friend Matt DeLaney who now runs ERcast - he was the first to alert us to these guidelines and interviewed Jason when they were first announced. Episode Sponsor: Ivy Clinicians. Curious if there's a better clinical opportunity out there? Ivy is the simplest way for physicians, PAs, and nurse practitioners to match with jobs they love. With Ivy, you can find all 5,549 emergency departments, filter by your preferences, and connect securely with the right employers. All for free. Guest bio: Jason Adler, MD is a clinical assistant professor of emergency medicine at the University of Maryland where he is also the director of compliance and reimbursement. He is also the vice president of acute care solutions at LogixHealth. Mentioned in this episode: The Awake and Aware Physician conference sponsored by Wild Health. Jan 13-15 Sedona Arizona. Use the code CONSCIOUSPHYSICIAN for 15% off (that's 15% off the whole package – lodging, meals, the course) Interested in one-on-one coaching? Learn more at roborman.com To support the show - visit our Patreon site and help keep the wind in the sails. For full show notes visit our podcast page We Discuss: History and physical documentation are now at your discretion; Heavy value is placed on cognitive work and medical decision making; History from a non-patient source is valued in these guidelines; Ordering a test is equally valued as not ordering a test; Consideration of escalation or deescalation of care; In addition to documenting your shared-decision making conversations, your MDM should include; Population health - Stable means something different when it comes to documentation; Social determinants of health; There is a heightened emphasis of independent interpretations of separately billable procedures (EKGs, X-ray, CT, U/S); Jason's take home points; And More.
Corals Soapbox EP 1Welcome to Episode 1 of Corals Soapbox. Coral Drouyn was the Script Writer/Script Editor/Storyliner and Story Editor on Prisoner. Coral has been involved in the entertainment industry since a young child and is also an actress and singer. Coral is a huge part of the Australian TV industry working on shows such as Neighbours, Home and Away, Blue Heelers, Streetsmartz, Pacific Drive, Chuck Finn. In this episode Matt dropped a surprise question on Coral about the character Cynthia Leach who was played by the late great Beverley Dunn. Matt was curious to find out why we never saw more of Cynthia Leach on Prisoner and why we never saw Cynthia at Blackmoor which Coral explains to us why. This episode is focused on characters and the characters that Coral created on Prisoner, why she created them, why some don't have a happy ending, how she structures characters, why we need that character, background story, emotional investment in a character and why some must be written out. Coral spoke with Matt why she had to write out Maurie Fields character Len Murphy and how characters like Len could start to overshadow the main characters like Joan Ferguson. Coral talks about the creation of Marlene Warren played by Genevieve Lemon, Coral talks about where the idea came from for creating Marlene, and why Coral gave Marlene the perfect ending with the marriage to Matt Delaney who was played by Peter Bensley. Coral wrote the wedding vows for the wedding and has a story behind where the vows came from and how popular the vows were at the time. The subject of this character also brings up important discussion between Matt and Coral about body shaming. Coral and Matt spoke about the three male Prisoners coming into the show and why they came into the show. Coral talks about why fans either love or hate a character. Coral and Matt then discuss the creation of Lexi Patterson who was played by Pepe Trevor, Coral spoke about Marie Trevor's thoughts on Pepe being cast for the part. Coral tells why she had Lexie dressed as Boy George and where the idea came from, Matt asked Coral's thoughts on the escape storyline for Lexie as Coral had left Prisoner by that stage. The next character Coral talks about is Reb Kean who was played by Janet Andrewartha which was one of Corals favourite characters. Coral drew inspiration from James Dean and the movie Rebel Without a Cause and even had Janet have her hair cut to look like James and where the idea for Reb to be holding a comb with her. Coral tells a story that she has never told before about what the original storyline was meant to be for Trevor Kent played by Frank Burke and why Grundy's would not allow Corals idea for her storyline. Please like and subscribe to our YouTube channel. Small Error – Matt introduced this Episode as 44 when in fact it is Episode 1 #cellblockh #prisoner #homeandaway #coraldrouyn
Throughout the month of January, Jacob Pearo is leading us through a series on discipleship. In this newest episode launching today, we have Matt Delaney join the Pod. We unpack some of the challenges the world throws at us in our journey of apprenticeship, including an online world that lets you 'build your own theology.' This ever-present online environment affirms and re-affirms convictions, and skirts the need to actually dig into God's Word.
So you're headed to college and you have a bleeding disorder. Need some advice? In this episode, former HFA Policy and Government Education Summer Intern, Will Hubert, chats with Matt Delaney and Chantel Winslow about their experiences navigating college with a bleeding disorder. For more information contact Kimberly Ramseur, Senior Manager for Policy & Advocacy at advocacy@hemophiliafed.org or check out the Hemophilia Federation of America website at hemophiliafed.org.
This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Primary Care RAP show. Earn CME on your commute while getting the latest practice-changing primary care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/PCRAPPOD We have been waiting and waiting and waiting for the new community acquired guidelines. And here they are! Infectious Diseases expert Devang Patel,MD joins Matt DeLaney, MD and Neda Frayha, MD for a conversation on CAP in general and the new guidelines in specific. Pearls: The latest guidelines for community acquired pneumonia now includes amoxicillin or doxycycline for 5-7 days as first-line treatment given the rising rates of macrolide resistance and less emphasis on coverage of atypical pneumonia pathogens. Review of pathophysiology: Lower respiratory tract often preceded by an upper respiratory tract infection, that inhibits ability to clear mucus and pathogens invade the lungs Other risk factors: Smoking Elderly Immune compromise (ie: infection, steroids, cancer) Pathogens: Typical - strep pneumo, haemophilus, staph aureus Atypical (more common) - influenza, parainfluenza, mycoplasma, chlamydia pneumoniae, legionella, coccidioidomycosis (in the southwest) EPIC Study (2015) - study to determine pneumonia pathogens using all the tools we have available (culture, PCR) 62% no pathogen detected 22% viral - most were rhinovirus which does not cause lower respiratory tract infections but predisposes to pneumonia Strep pneumonia was the number one bacterial pathogen Bottomline: we still don’t know what causes most pneumonias but just that our patients get better with antibiotics Differentiating between typical v. atypical pneumonias - there’s no good way to know viral versus bacterial → default is to treat as bacterial pneumonia with antibiotics Diagnosis: Clinical features (cough, fever, sputum production, pleuritic chest pain, crackles) Guidelines recommend a chest x-ray For outpatient uncomplicated pneumonia, don’t get blood or sputum cultures For severe cases (those with risk factors for multidrug resistance, MRSA, or pseudomonas) you still want to get blood and sputum cultures Pearls: No more healthcare-associated pneumonia Emphasis on CURB-65 to assess severity of who does NOT need to be admitted Procalcitonin is NOT endorsed as a way to determine who gets antibiotics and who doesn’t Treatment: Increasing strep pneumo resistance to macrolides so no more monotherapy with macrolide (azithromycin) unless resistance is less than 20% in the area First-line in non-hospitalized adult is amoxicillin or doxycycline for 5-7 days Steroids recommended not use but may be considered in septic shock Commentary from Dr. Patel (ID specialist): Not a major change in practice other than to consider not covering atypicals in an otherwise healthy person REFERENCES: Metlay JP, Waterer GW, Long AC, et al on behalf of the American Thoracic Society and Infectious Diseases Society of America. Diagnosis and Treatment of Adults with Community-Acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST Jain S, Self WH, Wunderink RG, et al for the CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 2015; 373:415-427. Postma DF, van Werkhoven CH, van Elden LJR, et al for the CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med 2015; 372:1312-1323.
We have been waiting and waiting and waiting for the new community acquired guidelines. And here they are! Infectious Diseases expert Dr. Devang Patel, MD joins Matt DeLaney, MD, FACEP, FAAEM and Neda Frayha, MD for a conversation on CAP in general and the new guidelines in specific. For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and earn 42 hours of CME per year. Pearls: The latest guidelines for community acquired pneumonia now includes amoxicillin or doxycycline for 5-7 days as first-line treatment given the rising rates of macrolide resistance and less emphasis on coverage of atypical pneumonia pathogens. Review of pathophysiology: Lower respiratory tract often preceded by an upper respiratory tract infection, that inhibits ability to clear mucus and pathogens invade the lungs Other risk factors: Smoking Elderly Immune compromise (ie: infection, steroids, cancer) Pathogens: Typical - strep pneumo, haemophilus, staph aureus Atypical (more common) - influenza, parainfluenza, mycoplasma, chlamydia pneumoniae, legionella, coccidioidomycosis (in the southwest) EPIC Study (2015) - study to determine pneumonia pathogens using all the tools we have available (culture, PCR) 62% no pathogen detected 22% viral - most were rhinovirus which does not cause lower respiratory tract infections but predisposes to pneumonia Strep pneumonia was the number one bacterial pathogen Bottomline: we still don’t know what causes most pneumonias but just that our patients get better with antibiotics Differentiating between typical v. atypical pneumonias - there’s no good way to know viral versus bacterial → default is to treat as bacterial pneumonia with antibiotics Diagnosis: Clinical features (cough, fever, sputum production, pleuritic chest pain, crackles) Guidelines recommend a chest x-ray For outpatient uncomplicated pneumonia, don’t get blood or sputum cultures For severe cases (those with risk factors for multidrug resistance, MRSA, or pseudomonas) you still want to get blood and sputum cultures Pearls: No more healthcare-associated pneumonia Emphasis on CURB-65 to assess severity of who does NOT need to be admitted Procalcitonin is NOT endorsed as a way to determine who gets antibiotics and who doesn’t Treatment: Increasing strep pneumo resistance to macrolides so no more monotherapy with macrolide (azithromycin) unless resistance is less than 20% in the area First-line in non-hospitalized adult is amoxicillin or doxycycline for 5-7 days Steroids recommended not use but may be considered in septic shock Commentary from Dr. Patel (ID specialist): Not a major change in practice other than to consider not covering atypicals in an otherwise healthy person REFERENCES: Metlay JP, Waterer GW, Long AC, et al on behalf of the American Thoracic Society and Infectious Diseases Society of America. Diagnosis and Treatment of Adults with Community-Acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST Jain S, Self WH, Wunderink RG, et al for the CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 2015; 373:415-427. Postma DF, van Werkhoven CH, van Elden LJR, et al for the CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med 2015; 372:1312-1323.
FOAM [free open access medical education] is growing at an amazing rate (we are actually using FOAM now to talk about FOAM). Like most powerful tools, this resource has both its pro and cons. To review FOAM and its use in Graduate Medical Education, we sat down with Matt Delaney. Check out our post on the Down East EM blog for shownotes, references, and more. To hear more on FOAM, check out Dave Mackenzie's talk at the Sugarloaf Conference Author: Jason Hine MD Peer Review: Jeff Holmes MD
Hoarseness is a common complaint in the primary care setting. Our ENT colleague, Dr. Elizabeth Guardiani, sits down with Drs. Matt DeLaney and Neda Frayha to discuss how we can approach this in primary care as well as when to refer to a specialist. For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and you'll stay up-to-date on all the latest with your favorite Primary Care RAP hosts and contributors.
Patients who have cellulitis should have antibiotics selected based on potential for treatment of the cellulitis as well as risks of side effects of the antibiotic. Fluoroquinolone antibiotics have come under increasing scrutiny as we have become more aware of the growing list of possible adverse reactions. In this segment, Mike Weinstock, MD and Matt DeLaney, MD discuss a lawsuit that resulted from questionable use of a fluoroquinolone and offer several lessons surrounding prescription of these antibiotics. There is so much more to Urgent Care RAP each month? Click Here to hear more of what you need to be ready each day and stay in touch with your favorite hosts and contributors.
“Doc, my shoulder hurts.” We hear this all the time. But how often do we have a thoughtful, stepwise approach to diagnosing and managing rotator cuff disease? Dr. Matt Baird, an EM and Sports Medicine specialist, gives our own Matt DeLaney the lowdown on rotator cuff injuries and how we can diagnose and treat them like experts. Thanks for listening to Urgent Care RAP on iTunes. We hope you've learned some fantastic pearls so far from the free chapter segments. How would you like to listen to 6 months of full episodes for free? For the month of September, when you refer a friend to sign up for Urgent Care RAP, you'll get 6 free months of Urgent Care RAP for yourself--on top of the $25 Amazon gift card you get for every friend who signs up! Start sharing below! Refer a friend
When a patient comes into your practice with blood pressures of 180/100 but they feel totally fine, what should you do? How much evaluation should they undergo? Should they be treated in the office? Or should they be referred to the ED? In this segment, Dr. Joseph Martinez chats with our own Mizuho Morrison and Matt DeLaney about the outpatient management of severe asymptomatic hypertension.
When a patient comes into your practice with blood pressures of 180/100 but they feel totally fine, what should you do? How much evaluation should they undergo? Should they be treated in the office? Or should they be referred to the ED? In this segment, Dr. Joseph Martinez chats with our own Mizuho Morrison and Matt DeLaney about the outpatient management of severe asymptomatic hypertension.
In Season 2 Episode 10, Lemnos’s Eric Klein speaks with Matt Delaney, co founder and CEO; Kevin Peterson, co-founder and software lead; and Jason Calaiaro, co-founder and hardware lead at Marble, a Lemnos portfolio company. Marble is creating a fleet of intelligent courier robots to reliably and securely transport goods people need and want.