The Skeptics Guide to Emergency Medicine

Dr. Anireddy Reddy, a pediatric intensive care attending physician at Children’s Hospital of Philadelphia, dives into the intricacies of oxygen therapy for critically ill children. The discussion highlights a case of a 3-year-old girl with severe respiratory distress, emphasizing careful assessment instead of knee-jerk reactions to low oxygen levels. Dr. Reddy examines a recent clinical trial on conservative versus liberal oxygenation strategies, revealing critical insights about patient outcomes and health disparities in oxygen monitoring.

Dr. Rob Leeper, an intensivist and trauma surgeon at Western University, discusses the innovative use of REBOA for hemorrhage control in trauma cases. He analyzes a gripping clinical scenario involving a severely injured patient and emphasizes the complexities of implementing this technique. The dialogue dives into the recent UK-REBOA trial outcomes, highlighting concerns about efficacy, patient data analysis, and biases. Furthermore, Leeper sheds light on the impact of financial conflicts on study results and mortality rates, urging careful evaluation in trauma care strategies.

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.