Always On EM - Mayo Clinic Emergency Medicine

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.

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

Dr. Trina Augustin, an assistant professor specializing in anesthesiology and emergency medicine, dives into the complexities of aortic stenosis. She discusses innovative ultrasound techniques for diagnosis and emphasizes the importance of early consultation for optimal patient care. The conversation reveals critical strategies for fluid management and vasopressor use in decompensated patients, as well as insights on managing atrial fibrillation. With a blend of humor and expertise, this discussion showcases the intricacies of cardiac emergencies and enhances understanding of this serious condition.

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!

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

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 - AlwaysonEM@gmail.com

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

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 – 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 – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch LinkedIn - Sarayna McGuire Email - AlwaysOnEM@gmail.com 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):1194-204 McGuire 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):169-177 Speroni 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):218-28 McGuire 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):702-709   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