The Skeptics Guide to Emergency Medicine

Dr. Brendan Freeman, an emergency medicine physician and medical education fellow, joins the discussion on pain management with ketamine. They unpack a recent clinical trial comparing nebulized to intravenous ketamine for acute pain, revealing that both methods effectively reduce pain scores. The complexities of pain measurement are examined, highlighting the subjective nature of pain perception. Freeman emphasizes personalized care and shared decision-making for optimal treatment outcomes, making this a must-listen for medical professionals.

Dr. Andrew Tagg, an emergency physician passionate about education, dives into pediatric emergency care. He highlights the importance of effective communication with young patients and their families to improve experiences in emergency settings. The conversation also covers the findings from a national survey, revealing gaps in children's understanding of their conditions despite overall satisfaction. Tagg emphasizes inclusive practices, pain management, and community engagement as vital components for enhancing care outcomes for children in medical environments.

Dr. Lauren Westafer, an expert in emergency medicine and co-founder of FOAMcast, and Dr. James Paxton, lead author of a pivotal COVID-related study, discuss groundbreaking advancements in prehospital stroke detection. They explore the challenges of identifying large vessel occlusion strokes and introduce the Harmony 5000 cranial accelerometry device, showcasing its enhanced sensitivity. The conversation also delves into biases in stroke research funding, the evolution of stroke detection technologies, and their implications for improving patient outcomes.

Dr. Casey Parker, a rural generalist and ultrasound expert from Australia, dives into the challenges of diagnosing acute aortic syndromes in emergency settings. He discusses the critical role of D-dimer testing and its high sensitivity, exploring how it can help rule out serious conditions while navigating limited resources in rural clinics. The conversation also highlights the need for more research on D-dimer's effectiveness, emphasizing the importance of context in decision-making and advocating for better training and educational resources for healthcare professionals.

Dr. Chris Root, an experienced emergency medicine physician and former NYC paramedic, delves into the controversial use of naloxone in out-of-hospital cardiac arrests. They discuss a compelling case of a young man possibly linked to opioid use, exploring the impacts of naloxone on survival and recovery. The conversation also critiques the methodologies used in studies evaluating naloxone's efficacy, emphasizing the need for robust evidence. Additionally, they reflect on the emotional ramifications for families involved in such emergencies.

Dr. Kirsty Challen, a Consultant in Emergency Medicine, joins to tackle the complexities of managing penicillin allergies in the emergency department. She discusses the alarming prevalence of inaccurately reported allergies and their impact on treatment choices. The conversation highlights a recent study on the safety of beta-lactam allergy challenges, revealing that many patients labeled as allergic may not be. Challen emphasizes the importance of accurate assessments and collaborative practices in improving patient outcomes while mitigating antibiotic resistance.

Join Dr. Mel Herbert, a renowned emergency medicine physician and educator, as he discusses his transformative book, "The Extraordinary Power of Being Average." Mel reveals how embracing his perceived average status has fueled his success. The conversation touches on the relatable challenges of childhood learning struggles and the life-changing impact of mentorship. They explore the Tall Poppy Syndrome, comparing cultural attitudes toward success in Australia versus the U.S. It’s a heartfelt dialogue about resilience, mental health, and the beauty of shared experiences.

Dr. Sean Baldwin, an Emergency Physician from Sydney with a keen focus on digital health, discusses the complexities of managing rib fractures in older patients. He highlights a case of a 67-year-old man and the challenges these injuries present. The conversation delves into the innovative use of serratus anterior plane blocks for pain relief, revealing research findings that suggest reduced opioid use while maintaining health outcomes. They also touch on the need for further studies to validate the efficacy and safety of this promising technique.

Dr. Francisco Campillo Palma and Dr. Carmen María Cano are two expert emergency medicine doctors from Spain, deeply involved in organizing the IncrEMentuM 2025 conference. They discuss the excitement building for this event, scheduled for March 2025, and its role in establishing a specialty in Spanish emergency medicine. Their conversation includes innovative educational approaches and the importance of skepticism in the field. They also highlight engaging pre-conference workshops and the value of vibrant networking opportunities, enticing listeners to join.

Dr. Vasisht Srinivasan, an Emergency Medicine physician and neurointensivist at the University of Washington, discusses a critical case of a patient with a suspected intracerebral hemorrhage. He delves into the management of hemorrhagic strokes, highlighting the role of reversing Factor Xa inhibitors like Andexanet. The conversation touches on the efficacy and ethical implications of recent clinical trials, revealing concerns about potential conflicts of interest and thrombotic events. Ultimately, it emphasizes the balance between emerging treatments and patient outcomes.