The Skeptics Guide to Emergency Medicine

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.

Dr. Neil Dasgupta, an emergency medicine physician and program director from Long Island, discusses alarming trends of violence in emergency departments. He explores the concept of behavioral flags in electronic health records, revealing patient perceptions and concerns about bias. The conversation highlights communication challenges in addressing these flags and the importance of transparency to combat racial disparities in care. Dasgupta emphasizes the need for effective communication strategies that consider diverse patient backgrounds and improve healthcare equity.

Dr. Justin Morgenstern, an emergency physician and the mastermind behind www.First10EM.com, dives deep into the complexities of sepsis prediction. He questions the efficacy of traditional screening tools like qSOFA and MEWS, advocating for the critical role of clinical judgment. The conversation highlights notable findings from a study involving over 2,500 patients that challenges the need for immediate antibiotics. Morgenstern emphasizes the importance of reevaluating current practices to better enhance patient outcomes in emergency settings.

Dr. Aine Yore, an experienced emergency physician and healthcare policy advocate, discusses the critical topic of preoxygenation in airway management for ill patients. She dives into the PREOXI trial, comparing non-invasive ventilation methods like CPAP against traditional strategies, revealing insights into hypoxemia rates. The conversation highlights the complexities of intubation strategies, challenges in measuring clinical outcomes, and the promise of non-invasive ventilation to enhance safety during emergencies. Family communication amidst urgent care is also emphasized.

Dr. Christina Lindgren, a Pediatric Emergency Medicine Attending at Children’s National Hospital, delves into the nuanced diagnosis of pneumonia in febrile infants. She highlights the rarity of radiographic pneumonia and the critical role of shared decision-making with families. Discussion on viral testing reveals challenges in identifying bacterial infections amidst viral overlaps. Innovative diagnostic methods like ultrasound are explored, alongside the complexities of differentiating pneumonia from bronchiolitis, making the episode a rich source of insights for healthcare professionals.

Dr. Lauren Westafer discusses conflict in emergency medicine, focusing on a case of discharged patient without antibiotics causing conflict with their primary care provider. Topics include workplace rudeness, professional bias, clinician conflicts, effective communication strategies, interdisciplinary collaboration, and managing conflicts at individual, team, and institutional levels.

Dr. Fernada Bellolio, a Mayo Clinic speaker, joins Dr. Herbert L. Fred, an author known for his insights on traditional medicine, in a lively discussion. They explore the humorous and often critical perceptions of 'old-fashioned' doctors through a Monty Python skit. The conversation dives into the pitfalls of 'eminence-based medicine' versus evidence-based practices. They also reflect on generational divides in medical care, advocating for personalized treatment and emphasizing timeless principles of patient-centered care.