The Skeptics Guide to Emergency Medicine

Dr. Kay Dingwell, a rural emergency physician specializing in gender-affirming care, discusses the urgent need for specialized healthcare for transgender and gender-diverse patients. She highlights the challenges faced by a non-binary youth seeking emergency care while navigating hormone treatments. The conversation covers clinical guidelines and a systematic review aimed at improving emergency services for this community. Dr. Dingwell advocates for cultural competency among healthcare providers, emphasizing actionable recommendations to enhance inclusivity and sensitivity in emergency settings.

Dr. Caleb Ward, a pediatric emergency medicine expert and professor, dives into the complexities of detecting cervical spine injuries in children. He discusses a case involving a young boy hurt in a fall and the challenges of diagnosing pediatric C-spine injuries. The conversation highlights the impact of unreliable clinical decision rules and the low prevalence of such injuries. Dr. Ward emphasizes the balance between effective imaging and the risk of unnecessary procedures, exploring ongoing research to improve care and safety for young patients.

Dr. Bjug Borgundvaag, Founding Director of the Schwartz/Reisman Emergency Medicine Institute, dives into critical topics in emergency care. He discusses the GRACE-4 guidelines for managing Alcohol Use Disorder and Cannabinoid Hyperemesis Syndrome, emphasizing evidence-based approaches and reducing stigma. The importance of patient voices in developing clinical guidelines is highlighted to enhance care quality. Additionally, he shares insights on managing alcohol withdrawal, advocating for a compassionate and informed approach to treatment.

Dr. Rebecca Szabo, an obstetrician/gynecologist from Melbourne, and Dr. Dennis Ren, a pediatric emergency medicine physician in DC, discuss how 'Ted Lasso' has inspired their medical practices. They explore themes of kindness and resilience that resonate strongly during challenging times like the COVID-19 pandemic. With reflections on empathy, community, and the show’s impact on personal growth, they emphasize the importance of supportive relationships in both healthcare and life. The conversation also touches on hopes for future storytelling, promoting inclusivity and authenticity.

Dr. Brian Lee, a pediatric emergency medicine expert from the Children’s Hospital of Philadelphia, discusses the common yet underestimated challenges of fingertip injuries in children. Addressing myths about nail treatment, he highlights a recent study that questions the need to remove avulsed nails. The conversation dives into patient involvement in research and how it shapes better healthcare outcomes. Dr. Lee advocates for a patient-centered approach, emphasizing the importance of considering family preferences in managing pediatric finger injuries.

Missy Carter, a PA in an ICU and adjunct faculty member in a paramedic program, shares insights on the nuances of intraosseous (IO) access in emergency care. They discuss a real case involving a cardiac arrest and the challenges of maintaining IO access. The conversation highlights the debate between upper and lower extremity IO placements, examining their impact on patient survival. Missy emphasizes the need for high-quality research to better understand these access techniques and their implications on outcomes during critical situations.

Dr. Suchismita Datta, an Assistant Professor and Director of Research in Emergency Medicine, shares insights into innovative pain management techniques for rib fractures. She discusses a compelling case of a patient struggling with pain post-accident, despite standard treatments. Dr. Datta highlights the promising potential of ultrasound-guided erector spinae plane blocks, referencing recent research that showcases their effectiveness. The conversation also touches on the evolving landscape of emergency medicine in India and the importance of equitable trauma research.

Dr. Vasisht Srinivasan, an Emergency Medicine physician and neurointensivist at the University of Washington, dives into the complexities of treating acute ischemic strokes. He discusses a compelling case of a 70-year-old woman and evaluates the shift from alteplase to tenecteplase (TNK) in treatment. The conversation highlights advancements in thrombectomy trials and scrutinizes conflicts of interest in clinical studies. Potential safety concerns and the importance of shared decision-making in stroke treatment underscore the need for ongoing research and adherence to established guidelines.

Dr. Michael Cosimini, a pediatrician and medical editor from Portland, shares insights on the promising new RSV vaccine, Nirsevimab. He explains the case of a young girl with respiratory distress and the significance of effective vaccination in pediatrics. The discussion dives into the historical struggles of developing RSV vaccines and the innovations that have led to recent breakthroughs. Listeners will learn about the implications of vaccine trials and the importance of meticulous evaluation for improving pediatric health outcomes.

Dr. Kirsty Challen, a Consultant in Emergency Medicine at Lancashire Teaching Hospitals, discusses the rising trend of alcohol-related emergency visits among adolescents. The conversation highlights a striking link between initial ED visits for alcohol and increased mortality risks in young patients. They analyze a study revealing demographic differences and the impact of mental health issues. The podcast also dives into the challenges of accurate data measurement and the influence of COVID-19 on youth drinking behaviors, revealing a concerning picture for this vulnerable group.