Always On EM - Mayo Clinic Emergency Medicine

This is a capstone presentation from Chief Resident of Mayo Clinic Emergency Medicine, Dr. Taylor Christian.   Teaser: Can we fulfill our oath to “do no harm” if we ignore the harm of racial injustice in medicine? Understanding the historical roots and persistent impact of medical racism isn’t just informative; it is a call to action. This presentation is an opportunity to learn, reflect, and act to become better advocates.   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @TayMChristian YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @drtaylormonet Email - AlwaysOnEM@gmail.com   REFERENCES & LINKS Meisel ZF, Shofer FS, Dolan AR, Goldberg E, Cannuscio CC, Rhodes KV, Perrone J, Hess EP, Rogers M, Bellamkonda V, Bell J, Zyla M, Becker L, McCollum S, Schapira M. Comparing Three Ways to Help Patients with Acute Pain Learn about Opioid Risks — The Life STORRIED Study [Internet]. Washington (DC): Patient-Centered Outcomes Research Institute (PCORI); 2021 Oct. PMID: 39383261. Engel-Rebitzer E, Dolan AR, Aronowitz SV, Shofer FS, Nguemeni Tiako MJ, Schapira MM, Perrone J, Hess EP, Rhodes KV, Bellamkonda VR, Cannuscio CC, Goldberg E, Bell J, Rodgers MA, Zyla M, Becker LB, McCollum S, Meisel ZF. Patient Preference and Risk Assessment in Opioid Prescribing Disparities: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2021 Jul 1;4(7):e2118801. doi: 10.1001/jamanetworkopen.2021.18801. PMID: 34323984; PMCID: PMC8322998. Racic M, Roche-Miranda MI, Fatahi G. Twelve tips for implementing and teaching anti-racism curriculum in medical education. Med Teach. 2023 Aug;45(8):816-821. doi: 10.1080/0142159X.2023.2206534. Epub 2023 May 3. PMID: 37134226. Sahai A, Corley AMS, Lipps L, Lawton R, DeBlasio D, Klein M. A Locally-Focused Structural Racism Curriculum for Pediatric Primary Care Residents. Acad Pediatr. 2023 Nov-Dec;23(8):1510-1512. doi: 10.1016/j.acap.2023.06.012. Epub 2023 Jun 9. PMID: 37302703. Carrera D, Tejeda C, Kakani P, Napolitano J. Addressing Racism in Medical Education: A Longitudinal Antiracism Discussion Curriculum for Medical Students. Med Sci Educ. 2023 Apr 28;33(3):639-643. doi: 10.1007/s40670-023-01788-x. PMID: 37501797; PMCID: PMC10368613. Seegmiller Renner AM, Gross JR, Laughlin-Tommaso SK. Paving a Path to Inclusion, Diversity, Anti-Racism, and Equity: A Curriculum Roadmap. Mayo Clin Proc. 2023 Dec;98(12):1755-1762. doi: 10.1016/j.mayocp.2023.08.026. PMID: 38043992.

Brandy Hernandez, an Emergency Medicine pharmacist and PGY2 resident at Mayo Clinic, dives into the innovative use of phenobarbital for treating alcohol withdrawal. She discusses its benefits over traditional benzodiazepines and explores the mechanisms that make it effective. The conversation highlights the importance of personalized treatment plans, risks involved, and the intricacies of managing severe cases like Delirium Tremens. Brandy also shares insights into the evolving guidelines and the challenges healthcare providers face in this critical area of medicine.

In this grand rounds, Dr. Daniel Fiterman Molinari challenges the status quo of cardiac arrest care with thought provoking takes on the literature. Take a listen to his Capstone presentation and find yourself pondering whether you agree or disagree, and whether you need to go revisit the literature yourself. You may find your own heart skips a beat in this great episode.

Dive into the messy world of acute diarrhea management in emergency medicine! Learn about the critical role of hydration strategies, including the WHO’s Oral Rehydration Solution. Discover when zinc supplementation may benefit patients, and gain insights into differentiating viral from bacterial causes. The hosts discuss the significance of Complete Blood Count results, the risks of infections like E. coli, and share real case studies for a practical understanding. Join for an engaging exploration of a vital yet often overlooked issue in urgent care!

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 ED—highlighting 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 – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com  

Discover expert insights into handling in-flight medical emergencies, from the effects of altitude on oxygen and pressure to the available resources. Hear real-life experiences and legal and ethical dilemmas faced by medical professionals mid-air. Learn about critical interventions for respiratory distress, seizures, and allergic reactions, emphasizing calmness and creative problem-solving. By the end, feel empowered and ready to assist confidently in any airborne medical situation!

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 – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com

Join Jeff Wood, a Physician Assistant and Assistant Professor at Mayo Clinic, as he dives into the evolving landscape of collaboration in emergency medicine. He shares insights on the importance of mentorship and clear communication between emergency physicians and advanced practice providers (APPs). Discover strategies for supporting APP autonomy and enhancing patient care, as well as how to navigate conflicts and build strong professional relationships in high-pressure environments. It's all about teamwork and optimizing emergency healthcare for better outcomes!

Dr. Brit Long, an engaging Emergency Medicine physician and Lieutenant Colonel in the US Air Force, delivers an interactive talk on high-risk, low-frequency conditions in the emergency department. He discusses complex cases like spinal epidural abscess and cervical artery dissection, stressing timely interventions. The episode dives into managing ectopic pregnancies and revealing insights on toxic shock syndrome, all while sharing personal anecdotes and emphasizing the role of education and collaboration in military medicine.

Dr. Henry Schiller, a Mayo Clinic Professor of Surgery and Army Reserve Lieutenant Colonel, shares his expertise on gallbladder health. He discusses the formation of gallstones and the significance of timely diagnosis. The conversation delves into differentiating gallstones from cholecystitis, highlighting critical imaging techniques like ultrasound and CT scans. Insights into interpreting liver function tests and the complexity of acalculous cholecystitis are explored, along with engaging personal anecdotes from his medical journey.