Always On EM - Mayo Clinic Emergency Medicine

Grand Rounds - Dr. Brian Patterson - Predictive analytics to prevent falls after ED visits

SPEAKER: Brian Patterson, MD, University of Wisconsin

He discusses the experience at UW conceiving, designing, and implementing a program, which incorporates a machine-learning algorithm for real-time calculation of fall risk for all older adults who visit the ED. The talk will include the rationale for using automation to improve public health referrals from the ED, techniques used to create the intervention, and issues surrounding the design and governance of similar interventions.

 

TWITTER @BPatterson; @AlwaysOnEM; @VenkBellamkonda

INSTAGRAM @AlwaysOnEM

EMAIL AlwaysOnEM@Gmail.com

Chapter 11 - What’s cooler than being cool? Ice Cold! - Hypothermic Cardiac Arrest

Dr. Doug Brown is an emergency physician and expert in wilderness medicine and mountain rescue with a special career focus on hypothermic cardiac arrest. He has been instrumental in building the rescue and resuscitation practices in Vancouver region of Canada and has published his work in the New England Journal of Medicine. Dr. Brown talks with Alex and Venk about a bunch of very COOL topics!

 

Contacts:

TWITTER - @AlwaysOnEM; @VenkBellamkonda

INSTAGRAM – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

EMAIL - AlwaysOnEM@gmail.com

 

References:

1. Brown DJ, Brugger H, Boyd J, Paal P. Accidental Hypothermia. N Engl J Med. 2012 Nov 15, 367(20):1930-8

2. Paal P, Brown DJ, Brugger H, Boyd J. In hypothermic major trauma patients the appropriate hospital for damage control and rewarming may be life saving. Injury. 2013 Nov;44(11):1665

3. Wanscher M, et al. Outcome of accidental hypothermia with or without circulatory arrest experience from the Danish Praesto Fjord boating accident. Resuscitation. 2012 Sep;83(9):1078-84

Grand Rounds - Dr. Sara Crager - Reframing Shock

SPEAKER: Sara Crager, MD, UCLA Emergency Medicine

When it comes to shock, we have developed a blood pressure addiction. Our propensity for a laser-like focus on blood pressure frequently hobbles our ability to promptly diagnose and optimally manage shock patients. This lecture aims to facilitate a more naunced approach to shock through an expanded mental model of shock pathophysiology combined with an iterative hypothesis testing strategy for clinical problem solving

 

TWITTER @SaraCrager; @AlwaysOnEM; @VenkBellamkonda

INSTAGRAM @AlwaysOnEM

EMAIL AlwaysOnEM@Gmail.com

Chapter 10 - Deserts and Reservoirs - A Map of the EM Workforce

There has been discussion nationally about the potential for a mismatch in the needs of the United States and the emergency physician workforce. Alex and Venk talk with Dr. Christopher Bennett, from Stanford Emergency Medicine about what he has learned and how he perceives the situation moving forward after spending a significant amount of time researching the EM workforce.

 

TWITTER: @AlwaysOnEM; @VenkBellamkonda; @CLeeBennett

INSTAGRAM: @Always On EM; @Venk_like_vancomycin; @ASFinch

GMAIL: AlwaysOnEM@gmail.com

 

References:

1. Bennett CL, et al. National Study of the Emergency Physician Workforce, 2020. Annals of Emerg Med. Dec 2020

2. Marco CA, et al. The Emergency Medicine Physician Workforce: Projections for 2030. Annals of Emerg Med. Dec 2021

 

Chapter 9 - Monkeys, Chickens, and Dustin Hoffman - Monkeypox

Dr. Pritish Tosh, Infectious Disease attending at Mayo Clinic, joins Alex and Venk on the podcast to talk about Monkeypox, especially how it compares and contrasts to Smallpox and Chickenpox. Stick around to the end where an addendum is added to discuss the July 2022 New England Journal of Medicine case series on Monkeypox.

Contacts:

@AlwaysOnEM - TWITTER

AlwaysOnEM@gmail.com

@VenkBellamkonda - TWITTER

References:

1. Thornhill JP, et al. Monkeypox Virus Infection in Humans across 16 countries - April-June 2022. N Engl J Med. 2022 Jul 21. doi: 10.1056/NEJMoa2207323. Online ahead of print.

2. WHO Director-General's statement at the press conference following IHR Emergency Committee regarding the multi-country outbreak of monkeypox - 23 July 2022; read July 24, 2022; weblink: https://www.who.int/director-general/speeches/detail/who-director-general-s-statement-on-the-press-conference-following-IHR-emergency-committee-regarding-the-multi--country-outbreak-of-monkeypox--23-july-2022  

3. Second meeting of the International Health Regulations (2005)(IHR) Emergency Committee regarding the multi-country outbreak of monkeypox - 23 July 2022; read July 24, 2022; weblink: https://www.who.int/news/item/23-07-2022-second-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-outbreak-of-monkeypox 

 

 

Chapter 8 - A loss of power - Myasthenia Gravis and Guillain-Barre Syndromes

Dr. Lyell Jones, award winning neurologist educator, joins us on the podcast to talk about Myasthenia Gravis, Guillain-Barre Syndrome and neuromuscular weakness.

Chapter 7 - Too Wide, Too Fast - Ventricular Tachycardia (Vtach)

Alex and Venk talk with Dr. Nandan Anavekar, cardiac intensivist, about wide complex tachycardias - antitachycardia pacing, balloon pumps, dual sequential cardioversion, vasopressors, beta blockers and more!

 

SHOW: @AlwaysOnEM | @VenkBellamkonda | EMBlog.mayo.edu | AlwaysOnEM@gmail.com

GUEST: @NandanAnavekar | @MayoCVFellows | @MayoClinicCV

 

Chapter 6 - Simulation is the sincerest form of flattery - Medical Simulation

The Always On crew is joined by Dr. Jessica Schoen who is a world expert in medical simulation who shares perspectives on simulation fellowship as well how to uplift community emergency medicine practice through simulation. 

Chapter 5 - Newer Medicine for Older Adults - Geriatric Emergency Medicine

Dr. Lauren Southerland, president of ACEP and former president of SAEM geriatric EM sections and Associate Professor of Emergency Medicine at Ohio State University, joins the show and truly inspires us to think differently about how we approach the care of older patients. She talks us through four models for providing geriatric emergency care, what does an ideal setup for older patients look like, what should we be doing to train future geriatrics-capable emergency physicians and much more! Please listen and check out the companion piece in the Mayo Clinic EM Blog. 

Tweet Dr. Southerland @LSGeriatricEM

Tweet Dr. Bellamkonda @VenkBellamkonda

Tweet Always on EM Podcast @AlwaysonEM

Chapter 4 - Pump it up! - Left Ventricular Assist Device (LVAD)

Left ventricular assist devices (LVADs) can feel incredibly complex and these patients can inspire fear or trepidation in many healthcare providers. In this episode, we talk through the basics of LVADs from taking vital signs, to managing alarms, and evaluating common issues all with the experience and insights of our wonderful guest, Sarah Schettle, PA-C in Cardiovascular Surgery at Mayo Clinic. She is an incredible educator and breaks this topic down into really digestable and applicable pieces.

 

Check out a summary on the Mayo Clinic EM Blog