Episoder
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The rapid evolution of digital health is transforming emergency care, but how do we design and implement technologies that truly meet patient needs? This session will explore the landscape of digital health tools and unpack how user-centered design ensures their effectiveness. Using a phased approach to development, Dr. Lauren Chernick from Columbia emergency medicine will discuss key strategies for integrating technology into engaging mobile health interventions. She will also share insights from three real-world sexual health interventions designed for adolescents in the EDâhighlighting both successes and challenges. Join us for a discussion on digital health in emergency medicine and its potential to enhance patient care.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
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Alex and Venk discuss the fundamental differences of caring for people during an in-flight emergency: what changes with oxygen and pressure, what is available to you, what are the expectations, and more. Both have been teaching about this scenario to others and have been present for several such encounters. They bring their expertise and the available literature to establish this level-setting chapter of the Always on EM Podcast. By the end of this, hopefully, you'll have zero hesitation standing with confidence that you can provide assistance in any event that arises and be as well prepared as anyone to do it. So, buckle up, put your seatbacks up, stow your laptops, and tune in to this high-flying chapter of Always on EM!
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
REFERENCES & LINKS
Kim Y, Bae SC, Song YS. Exploring the potential of telehealth in-flight medical emergencies. Digit Health. 2025 Mar 13;11:20552076251326666. doi: 10.1177/20552076251326666. PMID: 40093698; PMCID: PMC11907535.Hawati SM, Binobaid F, Alsaeigh A, Alameer W, Al Ajmi AM, Alghamdi MK, Alqarni AA, Al-Harthi SN, Almelaifi A, Al Shehri AA. Assessing Emergency Medicine, Family Medicine, and ICU Doctors' Knowledge, Confidence, and Attitude in Managing In-Flight Medical Emergencies in the Kingdom of Saudi Arabia Hospitals: A Cross-Sectional Study. Cureus. 2025 Feb 1;17(2):e78359. doi: 10.7759/cureus.78359. PMID: 40046350; PMCID: PMC11880637.Hu JS, Smith JK. In-flight Medical Emergencies. Am Fam Physician. 2021 May 1;103(9):547-552. PMID: 33929167.Martin-Gill C, Doyle TJ, Yealy DM. In-Flight Medical Emergencies: A Review. JAMA. 2018 Dec 25;320(24):2580-2590. doi: 10.1001/jama.2018.19842. PMID: 30575886. -
Mangler du episoder?
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In this Grand Rounds chapter, Dr. Alex Ginsburg, board certified in both emergency medicine and palliative care, and physician leader practicing in both specialties at Mayo Clinic in Rochester, Minnesota discusses a pragmatic way to incorporate palliative care into a busy and complicated emergency medicine practice. Beginning with why this is important and highlighting the challenges and barriers to making this happen, Dr. Ginsburg then proceeds to talk through approaches that are patient-centric while simultaneously feasible for a busy emergency physician. He will call out specific patients and scenarios that would benefit from consulting palliative care if possible and then cover optimal practices in how to clarify the goals of care of your patient. Tune in for this incredibly important Mayo Clinic Emergency Medicine Grand Rounds!
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
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The variety of practice models in the United States emergency healthcare system is numerous and most of them involve both physicians as well as advanced practice providers (physician assistants and nurse practitioners). Yet, the preparation for how to supervise an APP from a physician perspective, or what to expect from a physician colleague from the APP perspective is not standardized. In this chapter, we sit down with Dr. Eric Boie who is the current medical director for the APP practice at Mayo Clinic in Rochester, Minnesota, as well as Mr. Jeff Wood, PA-C who has been the supervisor of the APPs both in our health system as well in Rochester for nearly a decade until just recently - to discuss our current model of practice, how it supports resident education, how to support APPs autonomy and optimize patient care, how to handle when things don't go as planned and more.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
RELATED READING
Clark A, Amanti C, Sheng AY. Supervision of Advanced Practice Providers. Emerg Med Clin North Am. 2020 May;38(2):353-361. doi: 10.1016/j.emc.2020.02.007. PMID: 32336330.Rainer R, Bambach K. Navigating Supervision of Advanced Practice Providers. Emerg Med Clin North Am. 2025 Feb;43(1):131-138. doi: 10.1016/j.emc.2024.05.030. Epub 2024 Aug 1. PMID: 39515936.Lowery B, Scott E, Swanson M. Nurse practitioner perceptions of the impact of physician oversight on quality and safety of nurse practitioner practice. J Am Assoc Nurse Pract. 2016 Aug;28(8):436-45. doi: 10.1002/2327-6924.12336. Epub 2015 Dec 29. PMID: 26712306.Haslam-Larmer L, Krassikova A, Wojtowicz E, Vellani S, Feldman S, Katz P, Robert B, Heer C, Martin-Misener R, May K, McGilton KS. Nurse Practitioner and Physician Collaboration in the Long-Term Care Setting: Secondary Analysis of a Scoping Review. J Am Med Dir Assoc. 2025 Feb;26(2):105418. doi: 10.1016/j.jamda.2024.105418. Epub 2024 Dec 27. PMID: 39701552.McGilton KS, Haslam-Larmer L, Wills A, Krassikova A, Babineau J, Robert B, Heer C, McAiney C, Dobell G, Bethell J, Kay K, Keatings M, Kaasalainen S, Feldman S, Sidani S, Martin-Misener R. Nurse practitioner/physician collaborative models of care: a scoping review protocol. BMC Geriatr. 2023 Feb 16;23(1):98. doi: 10.1186/s12877-023-03798-1. PMID: 36797669; PMCID: PMC9934505.Guidelines Regarding the Role of Physician Assistants and Nurse Practitioners in the Emergency Department. American College of Emergency Physicians Policy Statement Approved June 2023. -
Legendary emergency medicine educator, Dr. Brit Long, gave grand rounds in Rochester in a highly interactive experience covering high risk, yet low frequency conditions that we need to watch for on shift. He uses an engaging style filled with cases to drill home key points related to these conditions. Enjoy this Valentine's Day chapter of Always on EM-Grand Rounds for a fun and engaging reminder of what our specialty is all about!
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda; @Long_Brit
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
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Dr. Henry Schiller, Professor of Surgery, Liutenant Colonel in the US Army Reserve, and Mayo Clinic Teaching Hall of Fame inductee rejoins the show to talk about gallbladders. We review the distinction between the evaluation and management of cholelithiasis, choledocolithiasis, the role of different imaging modalities, and much more in this awesome chapter of the show - dont miss this!
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
REFERENCES & LINKS & ADDITIONAL READING
Childs DD, Lalwani N, Craven T, Arif H, Morgan M, Anderson M, Fulcher A. A meta-analysis of the performance of ultrasound, hepatobiliary scintigraphy, CT and MRI in the diagnosis of acute cholecystitis. Abdom Radiol (NY). 2024 Feb;49(2):384-398. doi: 10.1007/s00261-023-04059-w. Epub 2023 Nov 20. PMID: 37982832.de Oliveira GS, Torri GB, Gandolfi FE, Dias AB, Tse JR, Francisco MZ, Hochhegger B, Altmayer S. Computed tomography versus ultrasound for the diagnosis of acute cholecystitis: a systematic review and meta-analysis. Eur Radiol. 2024 Nov;34(11):6967-6979. doi: 10.1007/s00330-024-10783-8. Epub 2024 May 17. PMID: 38758253. -
Dr. Lekshmi Kumar, Associate Professor of Emergency Medicine at Emory University / Grady Hospital system in Atlanta, Georgia and the EMS director or the city of Atlanta presents grand rounds to kick off the 2025 calendar year! She talks about their collaborative work to create a prehospital blood transfusion program to uplift the trauma care in their region. Tune in to learn about the method for handling the change, the specifics for implementation and to learn the difference that this is making for their patients.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
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Dr. Trina Augustin, assistant professor of both anesthesiology and perioperative medicine as well as emergency medicine takes us on a deep dive into the care of persons with aortic stenosis. In this chapter, Alex and Venk learn about how to use ultrasound to diagnose AS, the keys to resuscitation, the pathophysiology of this condition, as well as the value of consultative services and the potential interventions that they may unlock for these patients. Kickoff season 4 with this in depth reminder that sometimes the heart has many hidden perils beyond ACS.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @KatrinaJoyAugustin
Email - [email protected]
REFERENCES & LINKS
Lichtenstein DA, Meziere GA. Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure. Chest 2008; 134:117-125Walsh MH, Smyth LM, Desy JR, Fischer EA, Goffi A, Li N, Lee M, St-Pierre J, Ma IWY. Lung Ultrasound: A Comparison of image interpretation accuracy between curvillinear and phased array transducers. Australia J Ultrasound Med, 26:150-156Alzahrani H, Woo MY, Johnson C, Pageau P, Millington S, Thiruganasambandamoorthy V. Can severe aortic stenosis be identified by emergency physicians when interpreting a simplified two-view echocardiogram obtained by trained echocardiographers? Crit Ultrasound J. 2015 Apr 18;7:5. doi: 10.1186/s13089-015-0022-8. PMID: 25932319; PMCID: PMC4409610.Furukawa A, Abe Y, Morizane A, Miyaji T, Hosogi S, Ito H. Simple echocardiographic scoring in screening aortic stenosis with focused cardiac ultrasonography in the emergency department. J Cardiol. 2021 Jun;77(6):613-619. doi: 10.1016/j.jjcc.2020.12.006. Epub 2020 Dec 29. PMID: 33386216.Lin J, Drapkin J, Likourezos A, Giakoumatos E, Schachter M, Sarkis JP, Moskovits M, Haines L, Dickman E. Emergency physician bedside echocardiographic identification of left ventricular diastolic dysfunction. American Journal of Emergency medicine Ehrman RR, Russell FM, Ansari AH, Margeta B, Clary JM, Christian E, Cosby KS, Bailitz J. Can emergency physicians diagnose and correctly classify diastolic dysfunction using bedside echocardiography? Am J Emerg Med. 2015 Sep;33(9):1178-83. doi: 10.1016/j.ajem.2015.05.013. Epub 2015 May 21. PMID: 26058890.2021;44:20-25Del Rios M, Colla J, Kotini-Shah P, Briller J, Gerber B, Prendergast H. Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study. Crit Ultrasound J. 2018 Jan 25;10(1):4. doi: 10.1186/s13089-018-0084-5. PMID: 29372430; PMCID: PMC5785451.Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, de Waha A, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Lauer B, Böhm M, Ebelt H, Schneider S, Werdan K, Schuler G; Intraaortic Balloon Pump in cardiogenic shock II (IABP-SHOCK II) trial investigators. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet. 2013 Nov 16;382(9905):1638-45. doi: 10.1016/S0140-6736(13)61783-3. Epub 2013 Sep 3. PMID: 24011548.Aksoy O, Yousefzai R, Singh D, Agarwal S, O'Brien B, Griffin BP, Kapadia SR, Tuzcu ME, Penn MS, Nissen SE, Menon V. Cardiogenic shock in the setting of severe aortic stenosis: role of intra-aortic balloon pump support. Heart. 2011 May;97(10):838-43. doi: 10.1136/hrt.2010.206367. Epub 2010 Oct 20. PMID: 20962337.Karatolios K, Chatzis G, Luesebrink U, Markus B, Ahrens H, Tousoulis D, Schieffer B. Impella support following emergency percutaneous balloon aortic valvuloplasty in patients with severe aortic valve stenosis and cardiogenic shock. Hellenic J Cardiol. 2019 May-Jun;60(3):178-181. doi: 10.1016/j.hjc.2018.02.008. Epub 2018 Mar 21. PMID: 29571667.Gottlieb M, Long B, Koyfman A. Evaluation and Management of Aortic Stenosis for the Emergency Clinician: An Evidence-Based Review of the Literature. J Emerg Med. 2018 Jul;55(1):34-41. doi: 10.1016/j.jemermed.2018.01.026. Epub 2018 Mar 7. PMID: 29525246. -
In this final episode of the third season of the Always on EM podcast, we share a grand rounds recording of Dr. Adiba Matin, former resident at Mayo Clinic giving her senior capstone presentation on climate change and emergency medicine. In this visionary presentation, she projects physiologic consequences of the climate change on human health, as well as discusses adaptations for clinical practices, highlights how environmental change might impact social determinants of health, and touches on ways to become advocates for climate protective practices. Close out the new year with the hottest presentation in the grand rounds offerings so far!
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Dr. David Turay, trauma consultant physician at Mayo Clinic, sits down with Alex and Venk to talk about appendicitis! Have you wondered about ultrasound vs CT imaging? antibiotics only vs operative care? what labs to order? we will go over it in this chapter of Always on EM!
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
REFERENCES & LINKS
2013 British Journal of Surgery - C-W Yu, Systematic reivew and meta-analysis of the diagnostic accuracy of procalcitonin, C-reactive protein, and white blood cell count for suspected acute appendicitis -
Dr. Mark Mannenbach, emeritus pediatric emergency physician, former chairperson of pediatric emergency medicine at Mayo Clinic and career long advocate for children comes back on the show to talk through nonaccidental trauma in children in a two part series.
In this second part, we talk through mimics of abuse, second victim syndrome related to caring for children of abuse, some aspects of neglect, and more.
CONTACTS
x- @AlwaysonEM; @VenkBellamkonda
YouTube - @AlwaysonEM; @VenkBellamkonda
Instagram - @AlwaysonEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
REFERENCES
1. Sugar NF, Taylor JA, Feldman KW. Bruises in infants and toddlers: those who don't cruise rarely bruise. Puget Sound Pediatric Research Network. Arch Pediatr Adolesc Med. 1999 Apr; 153(4):399-403
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Dr. Mark Mannenbach, emeritus pediatric emergency physician, former chairperson of pediatric emergency medicine at Mayo Clinic and career long advocate for children comes back on the show to talk through nonaccidental trauma in children in a two part series.
In this first part, we talk through the approach to sharing the concern that you have with the family, keys to the physical examination, the role of additional testing such as serum, urine, and radiograph.
CONTACTS
x- @AlwaysonEM; @VenkBellamkonda
YouTube - @AlwaysonEM; @VenkBellamkonda
Instagram - @AlwaysonEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
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Dr. Pritish Tosh, consultant physician in Infectious Diseases, and Supply Chain Management specialist for Mayo Clinic talks through the relationship between our clinical delivery of care and the strength of our supply chain practices. Our recent experiences with facemasks in the pandemic, the daily threats to medication access, and the events of recent longshoreman strike as well as Hurricane Helene damage to saline production locations has shown us how valuable it is to understand our supply chain. In this chapter, Alex and Venk, get schooled on the importance of this understanding, the basics of how to assess the stability of supply chain, and how to be advocates for a healthy supply chain infrastructure moving forward.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
REFERENCES & LINKS
Tosh PK, Schafer JM, Harvieux TP, Hall BL. Medical Supply Shortages - We are part of the problem...and solution. Mayo Clin Proc. 2023 Dec; 98(12):1763-1766Associated Press. (2024, October 1). US port strike: Over 45,000 dockworkers from Maine to Texas hit picket lines. AP News. Retrieved from https://apnews.com/article/port-strike-ila-dockworkers-begins-e5468e760f46a64e4322d1702beb1f72[1](https://apnews.com/article/port-strike-ila-dockworkers-begins-e5468e760f46a64e4322d1702beb1f72).Harris, R. (2018, March 31). Why did sterile salt water become the IV fluid of choice? NPR. Retrieved from https://www.npr.org/sections/health-shots/2018/03/31/597666140/why-did-sterile-salt-water-become-the-iv-fluid-of-choice[1](https://www.mybib.com/tools/apa-citation-generator).WANT TO WORK AT MAYO?
EM Physicians: https://jobs.mayoclinic.org/emergencymedicine
EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs
Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine
EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice
All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs
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Dr. Sarayna McGuire is an emergency physician who has been investigating workplace violence in the ED and in the prehospital setting. She and Dr. Casey Clements, who is the chief safety officer for Rochester Mayo Clinic campus talk with Venk and Alex about the violence in the emergency department. The scope of the problem is staggering, the impact ripples broadly into the community, and we all have the opportunity to intervene and change the trajectory of how life unfolds â learn the what, the why, and the how in this cant-miss chapter of Always on EM
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda;
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
LinkedIn - Sarayna McGuire
Email - [email protected]
REFERENCES & LINKS
Pompeii LA, Schoenfisch AL, Lipscomb HJ, Dement JM, Smith CD, Upadhyaya M. Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six U.S. hospitals. Am J Ind Med. 2015 Nov;58(11):1194-204McGuire SS, Finley JL, Gazley BF, Mullan AF, Clements CM. The team is not okay: Violence in emergency departments across disciplines in a health system. West J Emerg Med. 2023 Feb 1;24(2):169-177Speroni KG, Fitch T, Dawson E, Dugan L, Atherton M. Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors. J Emerg Nurs. 2014 May;40(3):218-28McGuire SS, Mullan AF, Clements CM. Unheard victims: multidisciplinary incidence and reporting of violence in an emergency department. West J Emerg Med. 2021 May 7;22(3):702-709WANT TO WORK AT MAYO?
EM Physicians: https://jobs.mayoclinic.org/emergencymedicine
EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs
Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine
EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice
All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs
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Ischemic heart disease is a leading cause of morbidity and mortality. While atherosclerotic coronary artery disease (CAD) is the focus of most outpatient and inpatient evaluations for cardiovascular symptoms, up to two thirds of patients suffer from myocardial ischemia with non-obstructive coronary arteries (INOCA). Patients with INOCA have unique symptoms and are more likely to have functional limitation and repeat presentations for cardiovascular evaluation. While there has been increasing recognition of INOCA there is no specific functional status measure, limiting our ability to evaluate the course of illness or effectiveness of therapies. In this presentation, Dr. Samit Shah, interventional cardiologist at Yale New Haven Hospital who recently gave grand rounds recently to the Mayo Clinic Department of Emergency Medicine, reviews the causes of ischemic heart disease, challenges with current symptom assessment, and proposes a new path for better diagnosis and treatment of heart disease.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda; @SamitShahMD
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
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Dr. Adela Cope breaks down pelvic inflammatory disease, tubo-ovarian abscess, ovarian torsion, ectopic pregnancy and more in this densely packed chapter of Always on EM. Tune in as Alex and Venk also try to figure out which one has the correct mental model of PID and who will ask the first stupid question.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
LEARN MORE ABOUT RESIDENCY:
https://youtu.be/gCQ0zimhhhY?si=NpsyTruGM9N_UpVMhttps://college.mayo.edu/academics/residencies-and-fellowships/emergency-medicine-residency-minnesota/REFERENCES:
Williams T, Mortada R, Porter S. Diagnosis and Treatment of Polycystic Ovary Syndrome. Am Fam Physician. 2016;94(2):106-113Rutz M, Boulger C. Early Pregnancy. Sonoguide - American College of Emergency Physicians. Accessed 8/20/2024 (https://www.acep.org/sonoguide/basic/early-pregnancy) Rodgers SK, et al. A lexicon for first-trimester US: Society of radiologists in ultrasound consensus conference recommendations. Radiology. 2024; 312(2):e240122Kreisel K, Flagg EW, Torrone E. Trends in pelic inflammatory disease emergnecy department visits, United STates, 2006-2013. Am J Obstet Gynecol 2018;218:117e1-e10Adhikari S, Blaivas M, Lyon M. Role of bedside transvaginal ultrasonography in the diagnosis of tubo-ovarian abscess in the emergency department. JEM 2008. 34(4):429-433Mohseni M, Simon LV, Sheele JM. Epidemiologic and clinical characteristics of tubo-ovarian abscess, hydrosalpinx, pyosalpinx, and oophoritis in emergency department patients. Cureus. 2020;12(11):e11647CDC sexually transmitted infections treatment guidelines, 2021 - Pelvic Inflammatory Disease (PID) accessed 8-20-24Linden JA. et al. Is the pelvic examination still crucial in patients presenting to the emergency department with vaginal bleeding or abdominal pain when an intrauterine pregnancy is identified on ultrasonography? A randomized tli. Annals of Emerg Med 2017(70):825-834Stein JC, et al. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: A Meta-Analysis. Annals of Emerg Med. 2010;56:674-683Robertson JJ, Long B, Koyfman A. Emergency Medicine Myths: Ectopic pregnancy, evaluation, risk factors, and presentation. JEM. 2017(53)6819-828Brown J, Fleming R, Aristizabal J, Rocksolana G. Does pelvic exam in the emergency department add useful information? West J Emerg Med. 2011;12(2):208-212Lee R, Dupuis C, Chen B, Smith A, Kim YH. Diagnosing ectopic pregnancy in the emergency setting. Ultrasonography. 2018;37:78-87 -
This past winter, Dr. Rich Griffey, healthcare quality leader from Washington University School of Medicine and Emergency Medicine, came to present grand rounds on a new way to care for patients with mild to moderate DKA, which they call the SQuID protocol. This talk serves to inspire us to look even at some of our well established conditions and see what we could do differently, as well as appreciate the value that healthcare quality improvement integrated with research methods and implementation science thinking can do when they all come together for the improvement of patient care. Come be inspired with us!
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
WANT TO WORK AT MAYO?
EM Physicians: https://jobs.mayoclinic.org/emergencymedicine
EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs
Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine
EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice
All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs
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Dr. Ronna Campbell, professor of emergency medicine, and passionate anaphylaxis researcher schools Alex and Venk on several issues related to contrast-related anaphylaxis. She helps clarify an approach to managing ED situations where a contrasted CT is desired yet the patient has documented anaphylaxis to iodine, or how to treat a patient who returns with unexpected reaction after receiving contrasted imaging. Can you be allergic to Iodine? What is the relationship between shellfish allergy history and contrast? What is the role of steroids in anaphylaxis management? These are just some of the questions that we answer in this discussion.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
WANT TO WORK AT MAYO?
EM Physicians: https://jobs.mayoclinic.org/emergencymedicine
EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs
Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine
EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice
All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs
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Dr. Ken Milne presents his talk entitled, âOld Fashioned Doctors,â to Mayo Clinic Emergency Medicine as our keynote speaker for our annual research day. In this talk, he goes through 10 ideas that were proposed in an article by Dr. Herbert Fred as potential ways that old-fashioned doctors may practice medicine more effectively or more palatably than younger counterparts. In this talk, he challenges those ten ideas while offering insights and reflections founded from his experiences before that can help guide or shape the way people can practice tomorrow. This is all done through the use of story and humor as he does in all of his other public speaking opportunities.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda; @KenMilne4234
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
TikTok - @Dr_Venk
Email - [email protected]
REFERENCES & LINKS
Skeptics guide to emergency medicine: https://thesgem.com/ Ken Milneâs Youtube video of his presentation: https://youtu.be/f18FmFci-BI?si=jqJ-53HMLTI-uwLyHerbert L Fred M.D. (1998) Old-Fashioned Doctors, Hospital Practice, 33:12, 15-15, DOI: 10.1080/21548331.1998.11443787WANT TO WORK AT MAYO?
EM Physicians: https://jobs.mayoclinic.org/emergencymedicine
EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs
Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine
EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice
All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs
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Dr. Lacey Shiue, emergency ultrasound faculty, sits down with Alex and Venk to talk through ultrasound guided nerve blocks and plane blocks. We talk through key differences in commonly used medications, how to manage toxicity from those medications as well as a detailed discussion of several different specific blocks including: Erector Spinae Plane Block, Fascia Iliaca Compartment Block, Supraclavicular Block, Interscalene Block among others. In addition, she discusses the keys to advancing an emergency regional anesthesia program.
CONTACTS
X - @AlwaysOnEM; @VenkBellamkonda
YouTube - @AlwaysOnEM; @VenkBellamkonda
Instagram â @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch
Email - [email protected]
RESOURCES FOR PRACTICE:
MDCALC for anesthetic dose calculation: https://www.mdcalc.com/calc/10205/local-anesthetic-dosing-calculator Safe Local app for anesthetic dose calculation: https://apps.apple.com/us/app/safelocal/id1440999841 New York School of Regional Anesthesia: https://www.nysora.com/filter-topics/ Highland County Emergency Medicine Website: https://highlandultrasound.com/ ASRA - American Society of Regional Anesthesia - Checklist for treatment of LAST: https://www.asra.com/news-publications/asra-updates/blog-landing/guidelines/2020/11/01/checklist-for-treatment-of-local-anesthetic-systemic-toxicityREFERENCES:
American College of Emergency Physicians Policy Statements: Ultrasound-Guided Nerve Blocks, published April 2021. Document accessed June 20, 2024 via: https://www.acep.org/patient-care/policy-statements/ultrasound-guided-nerve-blocksAmerican College of Emergency Physicians Policy Statements: Guideline for ultrasound transducer cleaning and disinfection, approved April 2021. Document accessed June 20, 2024 via: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.acep.org/siteassets/new-pdfs/policy-statements/guideline-for-ultrasound-transducer-cleaning-and-disinfection.pdf Disinfection of Ultrasound Transducers Used for Percutaneous Procedures: Intersocietal Position Statement. J Ultrasound Med. 2020; online before print. https://doi.org/10.1002/jum.15653 Ramesh S, Ayyan SM, Rath DP,Sadanandan DM. Efficacy and safety of ultrasound-guidederector spinae plane block compared to sham procedure inadult patients with rib fractures presenting to the emergencydepartment: A randomized controlled trial. Acad Emerg Med.2024;31:316-325. doi:10.1111/acem.14820New York School of Regional Anesthesia: Ultrasound-guided fascia iliaca nerve block. Accessed June 21, 2024 via: https://www.nysora.com/techniques/lower-extremity/ultrasound-guided-fascia-iliaca-block/ Downs T, Jacquet J, Disch J, Kolodychuk N, Talmage L, Krizo J, Simon EL, Meehan A, Stenberg R. Large Scale implementation of fascia iliaca compartment blocks in an emergency department. West J Emerg Med. 2023 May 3;24(3):384-389Makkar JK, Singh NP, Bhatia N, Samra T, Singh PM. Fascia iliaca block for hip fractures in the emergency department: meta-analysis with trial sequential analysis. Am J Emerg Med. 2021 Dec:50:654-660Rukerd MRZ, Erfaniparsa L, Movahedi M, et al. Ultrasound-guided femoral nerve block versus fascia iliaca compartment block for femoral fractures in emergency department: a randomized controlled trial. Acute Med Surg. 2024 Mar 6;11(1):e936Beaudoin FL, Haran JP, Liebmann O. A comparison of ultrasound-guided three-in one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial. Acad Emerg Med. 2013 Jun;20(6):584-91Reavley P, Montgomery AA, Smith JE, Binks S, Edwards J, Elder G, Benger J. Randomised trial of the fascia iliaca block versus the 3-in-1 block for femoral neck fractures in the emergency department. Emerg Med J. 2015;32:685-689Schulte SS, Fernandez I, Van Tienderen R, Reich MS, Adler A, Nguyen MP. Impact of the fascia iliaca block on pain, opioid consumption, and ambulation for patients with hip fractures: a prospective, randomized study. J Orthop Trauma. 2020 Oct;34(10):533-538WANT TO WORK AT MAYO?
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