In this episode, Sam Ashoo, MD interviews Lauren Black, MD about the August 2025 Emergency Medicine Practice article, Updates and Controversies in the Early Management of Sepsis and Septic Shock00:00 Introduction and Welcome01:09 Meet Dr. Lauren Page Black: Sepsis Expert01:56 Sepsis Statistics and Impact04:16 Understanding Sepsis Definitions09:56 Screening Tools for Sepsis13:57 Pre-Hospital Sepsis Recognition19:33 Clinical Examination and Diagnostics24:03 The Role of Lactate and Procalcitonin27:40 Clinical Gestalt and Imaging in Diagnosis29:21 CMS Bundle Requirements and Updates34:02 Fluid Type Preferences in Sepsis36:49 Antibiotic Timing and Selection43:43 Vasopressors and Steroids in Sepsis Management50:18 Special Populations and Future Directions53:44 Conclusion and ResourcesEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net 

In this episode, Sam Ashoo, MD interviews Christina Shenvi, MD, PhD, MBA about ways to manage your day and keep distraction at bay.* Introduction to Dr. Christina Shenvi* Why Focus and Time Management MatterExperiences coaching medical students and professionalsThe importance of managing mind, time, and attentionApplicability to both career and personal life* Framework for FocusThree-step framework: Prioritize, Strategize, FocusExplanation of prioritizationMapping personal and professional activities to priorities* Deep Work vs. Shallow WorkDefining deep work and shallow workStrategies for categorizing and scheduling tasksTime-blocking and protecting focus time* Overcoming DistractionThe psychology of distraction and procrastinationThe impact of digital devices and social media on attentionThe variable reward system of social media and its addictive nature* Strategies to Improve FocusClearing mental, physical, and digital environmentsThe importance of a distraction-free workspaceSystems for capturing and organizing tasksThe Pomodoro method and using time pressure* Building a Personal SystemExperimenting with different task management toolsAdapting systems to personal needs and preferences* Daily Practice and Training FocusReviewing and updating task lists dailyChunking email and shallow work to specific timesTraining the brain to focus like a muscleSpecial considerations for people with ADHD* Resources and ContactDr. Shenvi’s website and online course (timeforyourlife.org)Invitation to connect for coaching or further learningFor more about Christina Shenvi : https://timeforyourlife.org/ (https://timeforyourlife.org/)

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the July 2025 Emergency Medicine Practice article, 

Special Offer - EB Medicine is 26 years old! Get 26% off all purchases at ebmedicine.net!In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the June 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Thyroid Emergencies* Introduction to Thyroid Emergencies* Understanding Decompensated Hypothyroidism* Thyroid Storm: The Other Extreme* Differential Diagnosis and Complications* Medication Triggers and Patient History* Physical Examination Findings* Laboratory Analysis * Scoring Systems and Risk Assessment* Introduction to Treatment Approaches* Managing Decompensated Hypothyroidism* Treating Thyroid Storm* Special Considerations and Populations* Risk Management PitfallsEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the May 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Chronic Neurologic Disease: Parkinson Disease, Myasthenia Gravis, and Multiple Sclerosis Parkinson's Disease* Importance of maintaining medication schedule for Parkinson's patients* Strategies for ensuring patients receive their medications promptly* Overview of Carbidopa Levodopa's mechanism of actionMyasthenia Gravis* Description of the disease mechanism* Importance of assessing respiratory function* Diagnostic alternatives like the negative inspiratory force test and counting test* Discussion on appropriate emergency department actions and treatments including steroids, plasmapheresis, and IVIGMultiple Sclerosis* Description of the disease mechanism* Description of the typical patient demographic* Discussion on the varied presentation of MS* Treatment strategies including high-dose steroids and BaclofenEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net 

In this episode, Sam Ashoo, MD interviews Rob Orman, MD about ways to manage the trauma inflicted by the ER.* Discussing Trauma in Emergency MedicinePersonal Experiences with Trauma* The Impact of Suppression* Defining Trauma and Its Effects* Integration vs. Disintegration* Debriefing and Coping MechanismsThe Driveway DebriefNurse and Physician DynamicsReflective Solitude vs. IsolationCreating Narratives During TraumaDropping Anchor TechniqueBody-Oriented ResetsPost-Incident Rituals* Addressing Lowercase t Traumas* Therapy and Trauma PathwaysFor more about Rob Orman and physician coaching: https://roborman.com/ (https://roborman.com/)

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2025 Emergency Medicine Practice article, Sodium Disorders in the Emergency Department: A Review of Hypernatremia and HyponatremiaHypernatremia (High Sodium Levels)* Definition: Sodium level greater than 145 mEq/L* Breakdown into three categories based on total body water statusHypovolemic HypernatremiaEuvolemic HypernatremiaHypervolemic Hypernatremia* Common causes and conditions associatedHyponatremia (Low Sodium Levels)* Definitions: Mild (130-135 mEq/L), Moderate (125-129 mEq/L), Profound (< 125 mEq/L)* Breakdown into three categoriesPseudo HyponatremiaHypovolemic HyponatremiaEuvolemic HyponatremiaHypervolemic Hyponatremia* Common causes and conditions associatedTreatment Guidelines and Strategies* Emphasizing slow correction to avoid complications like cerebral edema and osmotic demyelination syndrome* Suggested treatment rates for acute and chronic conditionsSpecial Considerations* Addressing severe cases and the importance of proper diagnostics* Pre-hospital care considerations and scenarios* Pediatrics and consideration of child abuse in sodium disordersFive Things That Will Change Your Practice* Central lab sodium values over point-of-care for accuracy* Rectal temperature checks in endurance athletes* Loop diuretics for hypervolemic hyponatremia (e.g., CHF patients)* Enteral treatment for hypernatremia, if possible* Considering COVID-19 as a possible cause for new onset SIADH 

In this episode, Sam Ashoo, MD interviews Patrick O'Malley MD about his career in emergency medicine, The Laceration Course, and the power of connection with our patients.* Dr. Patrick O'Malley's Journey in Emergency Medicine* The Laceration Course: Origins and Evolution* The EM Docs Side Hustle Facebook Group* The Patient That Changed My LifeFor More Information:* The Laceration Course, The Abscess Course, and more... (https://www.ebmedicine.net/store/Courses-and-LLSAs)* EM Docs Side Hustle Facebook Group (https://www.facebook.com/share/g/1ATYdpbXJL/)* Patrick O'Malley, MD: LinkedIn (https://www.linkedin.com/in/drpatrickomalley/)

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2025 Emergency Medicine Practice article, Emergency Department Management of Knee Pain* Common Etiologies of Knee Pain* Risk Factors and Statistics* Infectious Causes of Knee Pain* Pre-Hospital Care and EMS* History and Physical Exam* Imaging Guidelines* Ottawa Knee Rule and X-Ray Necessity* Imaging Modalities for Knee Effusion* Ultrasound for Tendon Injury and Arthrocentesis* CT and MRI in Knee Injury Diagnosis* Lab Tests for Septic Knee Diagnosis* Treatment Options for Knee Conditions* Knee Immobilizers: When and How to Use Them* Steroid Injections in the Emergency Department* Managing Traumatic Knee InjuriesEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

In this episode, Sam Ashoo, MD interviews Ashley Weisman, MD about her career in rural emergency medicine, and the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department Interview with Dr. Ashley Wiseman* Introduction of Dr. Wiseman: Emergency physician specializing in rural ER.* Dr. Wiseman’s Background: Overview of her work and responsibilities in rural hospitals and academia.* Experience in Rural Medicine: Contrast with urban and academic practice.Stories of practical challenges and learning experiences in remote areas like Kotzebue, Alaska.Practicing Skills in Rural Medicine* Discussion of skill retention: Importance of continuously applying and practicing critical skills.* Resources and Training: Role of fellowship, networking, and practical experiences for skill enhancement.Advocacy for Rural Emergency Medicine* Work with ACEP: Dr. Wiseman’s efforts in advocating for rural EM at the national level.* Collaboration Between Rural and Academic Centers: Importance of knowledge exchange and mutual support.Focus on Traumatic Intracranial Hemorrhage (ICH)* Introduction to the February Article: Traumatic ICH in rural settings.* Key Points from the Article:Importance of basic neurocritical care practices.Practical adjustments and simplified approaches in care.* Dr. Wiseman’s Contribution: How her experiences shaped the content and practical advice for rural medicine.Conclusion* Upcoming Contributions: Announcing more contributions and resources from Dr. Wiseman.* Access the In Rural Life (IRrL*) content here (https://www.ebmedicine.net/topics/neurologic/emergency-medicine-traumatic-intracranial-hemorrhage#IRrL).* Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.netManaging Traumatic Intracranial Hemorrhage in the Rural Setting: EMP: IRrL* If you practice in a rural environment, you know that managing a patient with traumatic ICH can present challenges with diagnostic and treatment resources, personnel, training, and transport. Dr. Weisman has created resources for emergency clinicians, IRrL* (In Rural Life*) that EB Medicine is proud to share with subscribers.   Resources for emergency clinicians managing patients with traumatic ICH in rural settings include: * Checklist for Managing Traumatic Intracranial Hemorrhage in Rural Life (IRrL): 7 steps to providing neurocritical care in resource-limited settings.* Simulation for Critical Access Neurocritical Care: Saving Brain Hours from Tertiary Care: A customizable simulation designed for you and your team to practice managing patients with brain injury.

In this episode, Sam Ashoo, MD interviews Erin D'Agostino, MD about the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department * Pathophysiology* Types of Traumatic Brain Injuries* Pre-Hospital Care* Critical History and Physical Examination* Neurological Assessment and Monitoring* Laboratory and Imaging Studies* Emergency Department Treatment* Surgical Interventions and ConsiderationsPatient DemographicsSummary of major points discussedReminder for continued vigilance and the importance of early consultationEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net 

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the January 2025 Emergency Medicine Practice article, Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment* Patient Demographics and Case Scenarios:Types of patients prone to alkali exposureCauses and scenarios leading to alkali exposure (e.g., accidental, intentional, social media challenges) Poison control reports and statistics* Types and Effects of Exposure: Different types of exposure: ingestion, ocular, dermalEffects of ingestion, particularly in children and young adults* Pre-hospital Care and First Response:Importance of decontaminationSafety measures for EMS personnelSteps to take in pre-hospital care* History and Physical Examination: Key points to focus on during history takingImportant signs and symptoms to check* Laboratory and Diagnostic Testing: Overview of useful lab tests and imagingRole of EKG and chest x-rayImportance of early consultation with poison control* Endoscopy and CT Imaging: Use of endoscopy to classify injuries and guide treatment Role of CT imaging Complementary use of endoscopy and CT* Treatment Approaches:Initial resuscitation and airway managementUse of steroids and other medications like antibiotics, H2 antagonists, and topical mitomycin CWhen and how to use NG tubes* Special Populations and Long-term Considerations: Special considerations for childrenRisks associated with laundry detergent podsLong-term complications, including strictures and increased risk of esophageal cancer* Conclusion: Summary of major points discussedReminder for continued vigilance and the importance of early consultationEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative1. Discussion on EMIC  - Overview of the collaborative  - Background and formation during the pandemic in late 20212. Growth of EMIC  - Expansion from three members to over 500  - Focus areas: Education, mentorship, opportunity3. Achievements of EMIC  - Examples of innovations and initiatives born from EMIC  - Pitch event at ACEP annual conference and other engagements4. Importance of Physicians in Innovation  - Internal and external factors  - Benefits of physicians leading innovation efforts in healthcare5. Opportunities for Collaboration  - Engaging with healthcare startups and companies  - Expanding collaborations and growing the network6. EMIC Fellowship  - Ideal candidates  - Application process and benefits  - Success stories and projects undertaken7. Long-Term Vision for EMIC  - Goals for future growth and expansion  - Bridging gaps between industry and physicians for better patient care8. Membership Details  - How to join EMIC  - Benefits of membershipFor more about the EM Innovation Collaborative... https://www.eminnovationcollaborative.org/

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2024 Emergency Medicine Practice article, Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department* Introduction to Acute Mesenteric Ischemia* Statistics on prevalence and mortality* Pathophysiology and EtiologyMesenteric artery embolismMesenteric artery thrombosisMesenteric venous thrombosisNon-occlusive mesenteric ischemia* Diagnosis* Management and Treatment* Special PopulationsPediatric patientsPregnant patientsElderly patientsEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net 

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence* Prevalence and Importance of Back Pain in the ED* Differential Diagnosis and Serious Pathologies* Patient Expectations and Management Strategies* Missed Serious Pathologies and Their Implications* Conflicting Evidence and Treatment Protocols* Pathologies Causing Low Back Pain* Mechanical and Infectious Causes* Red Flags and Risk Factors* Pre-Hospital Care and EMS Considerations* History and Physical Examination* Laboratory Testing and Inflammatory Markers* Introduction to Imaging in Back Pain* Common Findings in Imaging* Choosing Wisely Campaign and Imaging Guidelines* Patient Expectations and Imaging* CT and MRI: When and Why* Ultrasound in Back Pain Diagnosis* Treatment Options for Back Pain* NSAIDs and Other Pharmacologic Treatments* Non-Pharmacologic Management* Risk Management and PitfallsEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department* 00:00 Welcome and Introduction* 00:13 Free Subscription for Emergency Medicine Residents* 01:05 Introduction to Pediatric Emergency Medicine Practice* 01:37 Discussion on Acute Scrotal Pain* 02:35 Testicular Torsion: Key Insights* 09:50 Differential Diagnosis for Acute Scrotal Pain* 17:21 Diagnostic Indicators of IgA Vasculitis* 17:44 Pre-Hospital Care for Severe Pain* 18:13 The Twist Score for Torsion* 18:44 Emergency Department Evaluation* 20:04 Ultrasound in Diagnosing Torsion* 29:44 Operative Management and Other Conditions* 31:41 Manual Detorsion Techniques* 32:37 Risk Management and Key Takeaways* 34:19 Conclusion and Final Thoughts* Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net 

In this special episode Sam Ashoo, MD interviews Ryan Johnson, Pharm. D. who shares strategies to address the recent IV fluid shortage caused by Hurricane Helene.00:00 Introduction and Episode Overview01:10 Meet Ryan Johnson: Clinical Pharmacist02:06 Role of Clinical Pharmacists in Emergency Medicine05:03 IV Fluid Shortage: Causes and Impact05:56 Institutional Strategies to Mitigate IV Fluid Shortages14:52 Provider-Level Solutions for Fluid Conservation22:11 Pharmacy and Nursing Staff Roles in Fluid Management26:34 Advanced Measures and Federal Guidelines34:40 Conclusion and Final ThoughtsResources mentioned in the podcast:* (Brigham and Women's Protocol) Patiño, A. M., Marsh, R. H., Nilles, E. J., Baugh, C. W., Rouhani, S. A., & Kayden, S. (2018). Facing the shortage of IV fluids — a Hospital-Based Oral Rehydration strategy. New England Journal of Medicine, 378(16), 1475–1477. https://doi.org/10.1056/nejmp1801772 (https://doi.org/10.1056/nejmp1801772)* Vizient shares conservation strategies for potential IV fluid supply disruption caused by Hurricane Helene https://newsroom.vizientinc.com/en-US/releases/releases-vizient-shares-conservation-strategies-for-potential-iv-fluid-supply-disruption-caused-by-hurricane-helene (https://newsroom.vizientinc.com/en-US/releases/releases-vizient-shares-conservation-strategies-for-potential-iv-fluid-supply-disruption-caused-by-hurricane-helene)

In this episode, Dr. Julia Draper shares her firsthand account of managing a crisis during a hurricane in Asheville, North Carolina. As the area faced unprecedented flooding, Dr. Draper describes the challenges faced at Mission Hospital, including loss of power and water. She details the innovative solutions the hospital implemented and highlights the tireless efforts of staff during a natural disaster of this magnitude.00:00 Introduction to Dr. Julia Draper01:03 Experiencing the Hurricane03:19 Immediate Aftermath and Hospital Challenges11:22 Dealing with Water and Supply Shortages20:48 Community and External Support24:10 Ongoing Efforts and Future Plans27:51 Conclusion and Final Thoughts

In this special episode, Sam Ashoo MD and Rob Orman MD discuss the concept of Maladaptive Perfectionism and its application to emergency medicine.* Understanding Maladaptive Perfectionism* Case Example and Discussion* Adaptive vs Maladaptive Perfectionism* Personal Experiences and Legal Challenges* Dealing with Negative Outcomes* Strategies for Managing Perfectionism in the ED* Handling Overwhelming Shifts* Managing Expectations in the ED* A Soul-Crushing Day in the ED* Finding Meaning in Moments of Crisis* The Importance of Meaningful Work* Operationalizing Meaning in Your Shift* The Driveway Debrief: Transitioning from Work to Home* Preparing for the Next Shift* Conclusion and Next Episode TeaserFor more from Rob Orman, MD check out Orman Physician Coaching (https://roborman.com/)

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department*  Introduction and Announcements* Elder Abuse and Neglect: An Overview* Risk Factors and Reporting* Pre-Hospital and Emergency Department Considerations* Screening Tools and Physical Examination* Documentation and Disposition* Cultural Considerations and Future Directions* Conclusion and ResourcesSuspected Elder Abuse should be reported to one of these organizations:* ADULT PROTECTIVE SERVICES (https://www.napsa-now.org/) - Living at home* LONG-TERM CARE OMBUDSMAN (https://acl.gov/programs/Protecting-Rights-and-Preventing-Abuse/Long-term-Care-Ombudsman-Program) - Living in a long term care facility