Academic Life in Emergency Medicine: Recent Episodes
Academic Life in Emergency Medicine
The Emergency Medicine (EM) Match process continues to evolve, with the specialty experiencing significant shifts in recent years. In this 51st installment of the EM Match Advice podcast series, Dr. Sara Krzyzaniak (Stanford EM PD) hosts the annual program director reflection on the Match with Dr. Abra Fant (Northwestern EM PD), who returns for her sixth consecutive year to share insights on the NRMP Match trends and data.
Podcast sound engineer: Dr. Kaitlin Bowers
https://www.aliem.com/em-match-advice-51-em-match-by-numbers/
With interview season complete, it's time to make your rank list. Dr. Sara Krzyzaniak (Stanford) welcomes New York program directors Dr. Elaine Rabin (Mount Sinai Hospital, Elmhurst Program) and Dr. Miriam Kulkarni (St. John's Riverside Hospital) to share what factors should drive your decisions, common pitfalls to avoid, and practical steps you can take right now. Plus: do letters of intent actually matter? The answer might surprise you.
Sound engineer: Dr. Kaitlin Bowers (Campbell University)
Stanford EM Program Director Dr. Sara Krzyzaniak breaks down the five keys to interview success, from strategic planning to post-interview reflection. Learn how to prioritize programs, avoid over-committing, and show up ready to impress on interview day.
https://www.ALiEM.com/em-match-advice-49-5-keys-to-crush-em-residency-interview/
Sound engineer: Dr. Kaitlin Bowers
Dr. Sara Krzyzaniak (Host, Stanford University) speaks with Dr. Tim Fallon (Maine Medical Center) and Dr. Liza Smith (UMass Baystate), both leaders of CORD's Application Process Improvement Committee, about the historic transition from ERAS to ResidencyCAS for emergency medicine residency applications in 2025-2026.
Sound Engineer: Dr. Kaitlin Bowers (Campbell University)
https://www.ALiEM.com/em-match-advice-48-transitioning-from-eras-to-residencycas/
The Emergency Medicine (EM) Match process continues to evolve, with the specialty experiencing significant shifts in recent years. In this 47th installment of the EM Match Advice podcast series, Dr. Sara Krzyzaniak (Stanford EM PD) hosts the annual program director reflection on the Match with Dr. Abra Fant (Northwestern EM PD), who returns for her fourth consecutive year to share insights on the NRMP Match trends and data.
Podcast sound engineer: Dr. Kaitlin Bowers
https://www.ALiEM.com/em-match-advice-47-2025-em-match-by-the-numbers/
As interview season wraps up, medical students across the country are preparing their rank lists for the upcoming Match. EM Match Advice podcast host, Dr. Sara Krzyzaniak (Stanford EM Program Director) recently sat down with Dr. Melissa Parsons (University of Florida College of Medicine - Jacksonville EM Program Director), to discuss the match process from both program and applicant perspectives.
https://www.ALiEM.com/em-match-advice-46-program-directors-share-match-season-insights/
Podcast sound engineer: Dr. Kaitlin Bowers
Dr. Sara Kryzyzaniak (EMMA Podcast Host and Stanford EM Program Director) gives an early heads-up for senior EM medical students who are applying to the 2024-25 residency match. There have been some key updates in the Electronic Residency Application Service (ERAS) rules.
https://www.ALiEM.com/em-match-advice-45-2024-eras-updates/
Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale EM Clerkship Director) who gives thoughtful and thought-provoking insights into the EM sub-intern clerkship. What if you decide to pivot into EM relatively late in your medical school career? What should I be thinking about after the clerkship?
https://www.ALiEM.com/em-match-advice-44-sub-internship-clerskhip/
Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Abra Fant (Northwestern PD) to reflect on the 2024 Match, after last year's shockingly high number (554) of unfilled positions in the match. We discuss our updated table of match metrics and help provide some context, especially as we look to the future.
https://www.ALiEM.com/em-match-advice-43-program-directors-reflect-2024-match/
Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Aaron Kraut (University of Wisconsin PD) in this insightful, rapid-fire, practical episode through the lens of residency program directors.
- What does the ERAS data show so far?
- Have there been any surprises or changes during interview season?
- Has the program signaling option been working?
- What should students think about in the post-interview stage?
Audio engineer: Kellen Vu
EM Match Advice Series: https://www.aliem.com/em-match-advice-series/
Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Alexis Pelletier-Bui (Cooper University Hospital Associate PD) and Dr. Elizabeth Werley (Penn State Hershey PD). Both serve as key representatives on behalf of the EM specialty on the AAMC ERAS Supplemental Application Working Group.
We discuss the changes made, why they were done, and potential sticking points for medical students while completing the application. We also do a deeper dive on "program signaling". What is it, how many programs can EM applicants list, and nuanced decisions to consider.
Audio engineer: Kellen Vu
Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by the Dr. Abra Fant (Northwestern PD) and Dr. Richard Church (University of Massachusetts PD) to debrief each other and you with what went down with the unprecedented results from 2023 EM Match. There were 132 programs with a total of 554 (18.4%) positions that went unfilled. Contrast that to our usual unfilled rates of 0-30 positions in 2015-2021.
We review "The Slide" with all the numbers from the National Resident Matching Program (NRMP) from the past few years. We propose reasons why there were so many unfilled positions in 2023. What does this mean for the upcoming 2024 Match?
Show notes and tables at: https://www.ALiEM.com/em-match-advice-40-program-directors-reflect-2023-match/
Audio engineer: Kellen Vu
Dr. Sara Kryzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by the always-wise Dr. Matt Pirotte (Vanderbilt University PD) to answer questions that YOU, the students, submitted to us regarding interview season. We tackle questions involving the nuances around:
- Preference signaling
- Writing letters or emails of interest
- Meaningfully connecting with busy program directors
Also we answer the perennial question of "Really, how important IS the interview in my overall application?"
Audio engineer: Kellen Vu
Speakers:
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- Arianna Campbell, PA-C (Marshall Medical Center)
- Aimee Moulin, MD FACEP (Professor of Emergency Medicine at University of California Davis, Chief of the Division of Addiction Medicine)
Host: Jason Woods, MD (Assistant Professor of Pediatrics - Emergency Medicine, University of Colorado)
Audio engineer: Kellen Vu (Stanford University)
In this episode of EM Match Advice, our new host, Dr. Sara Krzyzaniak (Stanford University), already has her finger on the pulse on the 2022-23 EM residency application season. Hot off the presses, the Council of EM Residency Directors just released its Standardized Letter of Evaluation (SLOE). We are honored to have CDEM president, Dr. Sharon Bord (Johns Hopkins University) and Dr. Doug Franzen (University of Washington), walk us through the document and the behind-the-scenes thought processes. Co-host: Dr. Michelle Lin (UCSF); sound Engineer: Kellen Vu
https://www.ALiEM.com/em-match-advice-38-our-2-cents-sloe-standardized-letter-of-evaluation
Guest: Edward Jauch MD, MS (Chief of System Research, Mission Health System, Asheville, NC)
Host: Jason Woods MD
References:
- Jauch EC, Cucchiara B, Adeoye O, Meurer W, Brice J, Chan YY, Gentile N, Hazinski MF. Part 11: adult stroke: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S818-28. doi: 10.1161/CIRCULATIONAHA.110.971044. Erratum in: Circulation. 2011 Oct 11;124(15):e404. PMID: 20956227.
- Dall TM, Storm MV, Chakrabarti R, Drogan O, Keran CM, Donofrio PD, Henderson VW, Kaminski HJ, Stevens JC, Vidic TR. Supply and demand analysis of the current and future US neurology workforce. Neurology. 2013 Jul 30;81(5):470-8. doi: 10.1212/WNL.0b013e318294b1cf. Epub 2013 Apr 17. PMID: 23596071; PMCID: PMC3776531.
- Kronick SL, Kurz MC, Lin S, Edelson DP, Berg RA, Billi JE, Cabanas JG, Cone DC, Diercks DB, Foster JJ, Meeks RA, Travers AH, Welsford M. Part 4: Systems of Care and Continuous Quality Improvement: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S397-413. doi: 10.1161/CIR.0000000000000258. PMID: 26472992.
- Adeoye O, Nyström KV, Yavagal DR, Luciano J, Nogueira RG, Zorowitz RD, Khalessi AA, Bushnell C, Barsan WG, Panagos P, Alberts MJ, Tiner AC, Schwamm LH, Jauch EC. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update. Stroke. 2019 Jul;50(7):e187-e210. doi: 10.1161/STR.0000000000000173. Epub 2019 May 20. Erratum in: Stroke. 2020 Apr;51(4):e70. PMID: 31104615.
This episode is a rapid fire review of litigation issues surrounding the provision of (or lack of provision of) tPA for stroke.
Guests: Latha Ganti, MD, MS, MBA Professor of Emergency Medicine & Neurology ,University of Central Florida College of Medicine
Joshua N. Goldstein MD, PhD Professor of Emergency Medicine, Harvard Medical School
Host: Jason Woods MD
References:
- Chernyshev OY, Martin-Schild S, Albright KC, Barreto A, Misra V, Acosta I, Grotta JC, Savitz SI. Safety of tPA in stroke mimics and neuroimaging-negative cerebral ischemia. Neurology. 2010 Apr 27;74(17):1340-5. doi: 10.1212/WNL.0b013e3181dad5a6. Epub 2010 Mar 24. PMID: 20335564; PMCID: PMC2875935.
- Gebel JM, Sila CA, Sloan MA, Granger CB, Mahaffey KW, Weisenberger J, Green CL, White HD, Gore JM, Weaver WD, Califf RM, Topol EJ. Thrombolysis-related intracranial hemorrhage: a radiographic analysis of 244 cases from the GUSTO-1 trial with clinical correlation. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. Stroke. 1998 Mar;29(3):563-9. doi: 10.1161/01.str.29.3.563. PMID: 9506593.
- Kass J et al. CONTINUUM (MINNEAP MINN) 2020;26(2, CEREBROvascular disease): 499-505
Guest: Adam Oostema, MD MS FACEP (Associate Professor of EM, Michigan State University College of Human Medicine)
Host: Jason Woods MD
Select References:
- National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995 Dec 14;333(24):1581-7. doi: 10.1056/NEJM199512143332401. PMID: 7477192.
- Saver JL, Gornbein J, Starkman S. Graphic reanalysis of the two NINDS-tPA trials confirms substantial treatment benefit. Stroke. 2010 Oct;41(10):2381-90. doi: 10.1161/STROKEAHA.110.583807. Epub 2010 Sep 9. PMID: 20829518; PMCID: PMC2949055.
- Kwiatkowski TG et al. Effects of tissue plasminogen activator for acute ischemic stroke at one year. National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. N Engl J Med. 1999 Jun 10;340(23):1781-7. doi: 10.1056/NEJM199906103402302. PMID: 10362821.
- Ingall TJ et al. Findings from the reanalysis of the NINDS tissue plasminogen activator for acute ischemic stroke treatment trial. Stroke. 2004 Oct;35(10):2418-24. doi: 10.1161/01.STR.0000140891.70547.56. Epub 2004 Sep 2. PMID: 15345796.
- Emberson J et al. Stroke Thrombolysis Trialists' Collaborative Group. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014 Nov 29;384(9958):1929-35. doi: 10.1016/S0140-6736(14)60584-5. Epub 2014 Aug 5. PMID: 25106063; PMCID: PMC4441266.
- Hacke W et al. ECASS Investigators. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008 Sep 25;359(13):1317-29. doi: 10.1056/NEJMoa0804656. PMID: 18815396.
- Alper BS et al. Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances. BMJ Evid Based Med. 2020 Oct;25(5):168-171. doi: 10.1136/bmjebm-2020-111386. Epub 2020 May 19. PMID: 32430395; PMCID: PMC7548536.
- Powers WJ et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Oct 30. Erratum in: Stroke. 2019 Dec;50(12):e440-e441. PMID: 31662037.
In this episode of EM Match Advice, our panel tackles the hot topic of making your rank list for residency match, which includes the shocking news of so many SOAP positions this year (over 200!) as well as the upcoming preference signaling being employed in the 2022-23 Match season. In this podcast, Dr. Mike Gisondi and Dr. Michelle Lin host an all-star panel of 3 program directors, Dr. Sara Krzyzaniak (Stanford University), Dr. Abra Fant (Northwestern University), and Dr. Bonnie Kaplan (Denver Health). Sound Engineer: Kellen Vu
Go to the EM Match Advice blog posts on ALiEM.
Join us in the sixth installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Led by Dr. Dina Wallin and a team of renowned educators, the featured book is New Rules of Work: The Muse Playbook for Navigating the Modern Workplace by Alexandra Cavoulacos and Kathryn Minshew. Come sign up! https://www.aliem.com/leaders-library-new-rules-of-work-sign-up-book-club/
In this episode from ACEP E-QUAL, we feature Dr. Jeanmarie Perrone (@JMPerroneMD), Professor of Emergency Medicine and the Director of the Center for Addiction Medicine and Policy at the University of Pennsylvania.
Host: Jason Woods, MD Sound Engineer: Kellen Vu
In this episode from ACEP E-QUAL, Dr. Bill Soares is an Associate Professor of EM and Director of Harm Reduction Services in the Deptartment of Emergency Medicine at Bay State Medical Center. He also serves as a Fellow at the Institute of Health Care Delivery and Population Science at the University of Massachusetts Chan School of Medicine.
Host: Jason Woods, MD Sound Engineer: Kellen Vu
In this episode of EM Match Advice, our panel tackles the hot topic of making your rank list for residency match, which includes "love letters" to programs and second look visits. In this podcast, Dr. Mike Gisondi and Dr. Michelle Lin host an esteemed panel of 3 program directors, Dr. Emily Fisher (University of Oklahoma), Dr. William Paolo (SUNY Upstate), and Dr. Michael Van Meter (University of Texas Health Science Center at Houston).
In this episode from ACEP E-QUAL, Dr. Elizabeth Samuels discusses a social emergency medicine approach to opioid use disorder.
- Guest: Elizabeth A. Samuels, MD MPH MHS, Brown Emergency Medicine
- Host: Jason Woods MD
Select references:
- Weiner SG, Baker O, Bernson D, Schuur JD. One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. Ann Emerg Med. 2020 Jan;75(1):13-17. doi: 10.1016/j.annemergmed.2019.04.020. Epub 2019 Jun 20. PMID: 31229387; PMCID: PMC6920606.
- Wakeman SE, Larochelle MR, Ameli O, et al. Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622
- Larochelle MR, Bernson D, Land T, Stopka TJ, Wang N, Xuan Z, Bagley SM, Liebschutz JM, Walley AY. Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort Study. Ann Intern Med. 2018 Aug 7;169(3):137-145. doi: 10.7326/M17-3107. Epub 2018 Jun 19. PMID: 29913516; PMCID: PMC6387681.
- Kilaru AS, Xiong A, Lowenstein M, et al. Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients. JAMA Netw Open. 2020;3(5):e205852. Published 2020 May 1. doi:10.1001/jamanetworkopen.2020.5852
- D'Onofrio G, O'Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015 Apr 28;313(16):1636-44. doi: 10.1001/jama.2015.3474. PMID: 25919527; PMCID: PMC4527523.
- Hawk KF, D’Onofrio G, Chawarski MC, et al. Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine. JAMA Netw Open. 2020;3(5):e204561. doi:10.1001/jamanetworkopen.2020.4561
In this episode of EM Match Advice, our panel takes on the tough issues of 2021. Specifically we discuss the American College of Emergency Physicians (ACEP) Workforce Study that projects fewer jobs for emergency physicians and the hot-off-the-press ERAS data showing a drop in the number of EM residency applicants, compared to 2 years ago. Did one cause the other?
In this podcast, Dr. Mike Gisondi and Dr. Michelle Lin host an esteemed panel of 3 program directors, Dr. Cassandra Bradby (East Carolina University), Dr. Adam Kellogg (Baystate Health), and Dr. Craig Krausz (Saint Louis University).
This session for the INFODEMIC Conference features speakers, Dr. Seema Yasmin and Dr. Yvonne Maldonado. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speaker, Dr. Heidi Larson. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Drs. Agnes Binagwaho, Aida Habtezion, and Gloria Giraldo, and moderated by Dr. Seema Yasmin. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Dr. Italo Brown. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Danielle Pacia, Lisa Menning, and Tom Bollyky, and moderated by William Haseltine. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Dr. Anne Merritt, Aaron Berman, and Brian Clarke, and moderated by Dr. Renee DiResta. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speaker, Dr. Vin Gupta. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Jessica Malaty Rivera and Dr. Sanjay Juneja, and moderated by Dr. Cedric "James" Rutland. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Mayor Adrian Perkins and Rev. Dr. Gabriel Salguero, and moderated by Dr. Matthew Strehlow. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
This session for the INFODEMIC Conference features speakers, Drs. Travis Rieder, Nancy Berlinger, and Arthur Caplan. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions.
The conclusion session for the INFODEMIC Conference features speaker, Dr. Seema Yasmin. INFODEMIC is a Stanford conference on social media and COVID-19 misinformation in 2021, has released open access podcasts of their discussions
We survived the 2021 Emergency Medicine residency match season in the pandemic era! Listen to the sage advice and reflections of program directors Dr. Jacob Ufberg (Temple), Dr. Amita Sudhir (University of Virgina), and Dr. William Caputo (Staten Island Medical Center). Hosts: Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF/ALiEM).
Read more: https://www.aliem.com/em-match-advice-program-directors-reflect-2021-match/
Listen about the concepts of gaming and gamification in volume 1 of Education Theory Made Practical (chapter 10) with host Dr. Daniel Harper. E-book chapter written by Dr. Will Sanderson and Dr. Samantha L. Wood.
Listen about the theory of dual-process reasoning in volume 1 of Education Theory Made Practical (chapter 9) with host Dr. Daniel Harper. E-book chapter written by Dr. Antonia Quinn, Dr. Daniel Robinson, and Dr. Adam Tobias.
Listen about the theory of Bloom's Taxonomy in volume 1 of Education Theory Made Practical (chapter 8) with host Dr. Daniel Harper. E-book chapter written by Dr. Aaron Brown, Dr. Nicolas Pineda, and Dr. Christopher Sampson.
Listen about the theory of self-directed learning in volume 1 of Education Theory Made Practical (chapter 7) with host Dr. Daniel Harper. E-book chapter written by Dr. Jenna Fredette, Dr. Cathy Grossman, and Dr. Joe Walter.
Listen about the theory called reflective practice in volume 1 of Education Theory Made Practical (chapter 6) with host Dr. Daniel Harper. E-book chapter written by Dr. Jordan Spector, Dr. Sara Krzyzaniak, and Dr. Lauren Wendell.
Listen about the theory of social constructivism in volume 1 of Education Theory Made Practical (chapter 5) with host Dr. Daniel Harper. E-book chapter written by Dr. Eric Cioè Peña, Dr. Abra Fant, and Dr. Anne Messman.
Listen about the principles of emotional intelligence in volume 1 of Education Theory Made Practical (chapter 4) with host Dr. Daniel Harper. E-book chapter written by Dr. Lauren Conlon, Dr. Kory London, and Dr. Michael Pasirstein.
Listen about the concept of communities of practice in volume 1 of Education Theory Made Practical (chapter 1) with host Dr. Daniel Harper. E-book chapter written by Dr. Andrew King, Dr. Michael Abraham, and Dr. Kevin Scott.
Listen about the theory of naturalistic decision making in volume 1 of Education Theory Made Practical (chapter 2) with host Dr. Daniel Harper. E-book chapter written by Dr. Clare Desmond, Dr. Josh Kornegay, and Dr. Jillian Mongelluzzo.
Listen about the theory called modal model of memory in volume 1 of Education Theory Made Practical (chapter 1) with host Dr. Daniel Harper. E-book chapter written by Dr. Sylvia Alden, Dr. Rachel Dahms, and Dr. Emily Rose.
Join us in the fifth installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Led by Dr. Dina Wallin and a team of renowned educators, the featured book is KEEP GOING: 10 WAYS TO STAY CREATIVE IN GOOD TIMES AND BAD by Austin Kleon. Come sign up! https://www.aliem.com/leaders-library-keep-going-sign-up-book-club/
ALiEM podcast host, Dr. Dina Wallin, chats with author Dr. Jacqueline Grupp-Phelan about her recent PECARN publication "Prospective Development and Validation of the Computerized Adaptive Screen for Suicidal Youth" in JAMA Psychiatry 2021. Read more: https://ALiEM.com/computerized-adaptive-screen-for-suicidal-youth-cassy-study. Podcast Sound Engineer: Kellen Vu
The 2020-21 residency interview season has required rapid innovation and adaptability for both medical student applicants and residency programs given COVID-19's physical distancing restrictions. Listen to how it started and how it is going thus far with podcast co-hosts Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF).
PD Panelists: Dr. Camiron Pfennig (Prisma Health University of South Carolina Greenville), Dr. Ryan Bodkin (University of Rochester), Dr. Michael Kiemeney (Loma Linda University)
https://www.aliem.com/em-match-advice-interview-season-2020-21-how-started-how-going
A major development in curbing the opioid epidemic is the introduction of the medication buprenorphine to address opioid addiction. Being able to prescribe this medication requires a DEA-X Waiver. Dr. Alister Martin, the Founder of the Get Waivered initiative, has reduced the barriers for clinicians to obtain the necessary training and paperwork. https://getwaivered.com/remote/
Disclosure: ALiEM is a proud collaborator with the Get Waivered Initiative, which is funded by the Foundation for Opioid Response Efforts (FORE) Foundation.
In this episode from the ACEP E-QUAL series, guest Dr. Houman Khosravani (Medical Director, Inpatient Stroke Unit Assistant Professor of Neurology, Department of Medicine, University of Toronto Sunnybrook Health Sciences Center; Staff Intensivist, Southlake Regional Health Center) discusses the concept of a "protected code stroke", how to operationalize the concepts, and how this system can be applied in your local circumstances. Host: Jason Woods, MD. Podcast sound engineer: Kellen Vu. www.acep.org/equal
References
Rajendram P, Notario L, Reid C, Wira CR, Suarez JI, Weingart SD, Khosravani H. Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care. Neurocritical Care. 2020; 33(2), 338–346. https://doi.org/10.1007/s12028-020-01057-4
Codestroke.net
In this episode from the ACEP-EQUAL series, guest Dr. William Meurer (Associate Professor of Emergency Medicine and Neurology University of Michigan) discuss how to protocolize of transferring stroke patients, how to identify and appropriately chose transfer destinations, and how to better align patient needs with the resources of the receiving sites. Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu. www.acep.org/equal
- Saver JL, Goyal M, van der Lugt A, et al; HERMES Collaborators. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016 Sep 27;316(12):1279-88. doi: 10.1001/jama.2016.13647. PMID: 27673305.
- Campbell BCV, Mitchell PJ, Churilov L, et al; EXTEND-IA TNK Part 2 investigators. Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial. JAMA. 2020 Apr 7;323(13):1257-1265. doi: 10.1001/jama.2020.1511. PMID: 32078683; PMCID: PMC7139271.
- Prabhakaran S, O'Neill K, Stein-Spencer L, Walter J, Alberts MJ. Prehospital triage to primary stroke centers and rate of stroke thrombolysis. JAMA Neurol. 2013 Sep 1;70(9):1126-32. doi: 10.1001/jamaneurol.2013.293. PMID: 23817961.
In this episode from the ACEP-EQUAL series, guest Dr. Bruce Lo (Chief, Department of Emergency Medicine, Sentara Norfolk General Hospital; Professor of Emergency Medicine, Eastern Virginia Medical School) reviews several common intracerebral hemorrhage scoring systems, the components, and tips on how to use them in real world practice.
Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
References
- Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001 Apr;32(4):891-7. doi: 10.1161/01.str.32.4.891. PMID: 11283388.
- Clarke JL, Johnston SC, Farrant M, Bernstein R, Tong D, Hemphill JC 3rd. External validation of the ICH score. Neurocrit Care. 2004;1(1):53-60. doi: 10.1385/NCC:1:1:53. PMID: 16174898.
- Gregório T, Pipa S, Cavaleiro P, Atanásio G, Albuquerque I, Chaves PC, Azevedo L. Assessment and Comparison of the Four Most Extensively Validated Prognostic Scales for Intracerebral Hemorrhage: Systematic Review with Meta-analysis. Neurocrit Care. 2019 Apr;30(2):449-466. doi: 10.1007/s12028-018-0633-6. PMID: 30426449.
- Pinho J, Costa AS, Araújo JM, Amorim JM, Ferreira C. Intracerebral hemorrhage outcome: A comprehensive update. J Neurol Sci. 2019 Mar 15;398:54-66. doi: 10.1016/j.jns.2019.01.013. Epub 2019 Jan 14. PMID: 30682522.
- Øie LR, Madsbu MA, Solheim O, Jakola AS, Giannadakis C, Vorhaug A, Padayachy L, Jensberg H, Dodick D, Salvesen Ø, Gulati S. Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population-based study. Brain Behav. 2018 Oct;8(10):e01113. doi: 10.1002/brb3.1113. Epub 2018 Sep 21. PMID: 30240164; PMCID: PMC6192392.
- Hemphill JC 3rd, Greenberg SM, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015 Jul;46(7):2032-60. doi: 10.1161/STR.0000000000000069. Epub 2015 May 28. PMID: 26022637.
- Houben R, Schreuder FHBM, Bekelaar KJ, et al. Predicting Prognosis of Intracerebral Hemorrhage (ICH): Performance of ICH Score Is Not Improved by Adding Oral Anticoagulant Use. Front Neurol. 2018 Feb 28;9:100. doi: 10.3389/fneur.2018.00100. PMID: 29541054; PMCID: PMC5836590.
Hosted by Dr. Mike Gisondi (Stanford) and Dr. Michelle Lin (UCSF), this episode discusses the uncharted waters of conducting virtual interviews for the EM residency match season in the era of COVID-19. Featured EM Program Director Panelists: Dr. David Caro (University of Florida, Jacksonville), Dr. Erica Shaver (West Virginia University), Dr. Cedric Lefebvre (Wake Forest University)
Podcast engineer: Kellen Vu
https://www.aliem.com/em-match-advice-virtual-interviews-covid/
In this episode from the ACEP-EQUAL series, guest Dr. Joshua Goldstein (Professor of Emergency Medicine, Harvard Medical School; Director, Center of Neurologic Emergencies, Massachusetts General Hospital) discusses ICH after TPA. He reviews what evidence exists, the timing, potential treatment targets, and medications.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
References:
- Yaghi S, Willey JZ, Cucchiara B, et al. Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017;48(12):e343-e361. doi:10.1161/STR.0000000000000152
In this episode from the ACEP-EQUAL series, guest Dr. Lantha Ganti (Professor of Emergency Medicine & Neurology; Vice Chair for Research and Academic Affairs; University of Central Florida) reviews how to evaluate and treat blood pressure in the setting of ICH. She reviews the major existing data, BP targets, and medications to use.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
References:
-
Butcher KS, Jeerakathil T, Hill M, et al. The Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial. Stroke. 2013;44(3):620-626. doi:10.1161/STROKEAHA.111.000188
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Butcher KS, Baird T, MacGregor L, Desmond P, Tress B, Davis S. Perihematomal edema in primary intracerebral hemorrhage is plasma derived. Stroke. 2004;35(8):1879-1885. doi:10.1161/01.STR.0000131807.54742.1a
-
https://www.mdcalc.com/modified-rankin-scale-neurologic-disability
In this episode, Dr. Gail Donofrio (Director, National Institute on Drug Abuse) and Dr. Nora Volkow (Professor and Chair of Emergency Medicine, Yale School of Medicine; Chief of Emergency Services, Yale New Haven Hospital) share their experience with substance use disorder in the time of COVID, as well as some thoughts on needed regulatory change.
Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Hosted by Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF), an expert panel of directors of Administration fellowships discuss the nuts and bolts of the who, what, why, and how of applying to this fellowship.
Panelists: Martin Reznek, MD MBA (University of Massachusetts), Jennifer Wiler, MD MBA (University of Colorado), Robert Tanouye, MD MBA (Cornell University)
Podcast audio engineer: Kellen Vu
https://www.aliem.com/em-match-advice-administration-fellowship/
Join us in the fourth installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Led by Dr. Dina Wallin and a team of renowned educators, the featured book is THE POWER OF MOMENTS by Chip and Dan Heath. Come sign up! https://www.aliem.com/the-leaders-library-power-of-moments/
A panel of experts talks about the experience with opioid use disorder (OUD) in the time of COVID and specifically efforts to maintain access to MAT during COVID. Note that the original recording contained contributions from Dr. Karen Scott (President, Foundation for Opioid Response Efforts) and Dr. Alister Martin (Emergency Medical Specialist, Founder Get Waivered) but were cut for the podcast due to time constraints.
Guests: Gail D’Onofrio, MD, MS (Professor and Chair, Department of Emergency Medicine, Yale School of Medicine Chief of Emergency Services, Yale New Haven Hospital), Emily Kauffman, DO, MPH (Assistant Clinical Professor Ohio State University Wexner Medical Center), Sandra Schneider, MD, FACEP (Associate Executive Director, Clinical Affairs Past President American College of Emergency Physicians), Karen Scott, MD, MPD(President, Foundation for Opioid Response Efforts (FORE), Alister Martin MD, MPP (Emergency Medical Specialist, Founder, Get Waivered)
Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Additional Resources: * www.forefdn.org * www.getwaivered.com/remote * https://www.drugabuse.gov/ed-buprenorphine * https://medicine.yale.edu/edbup/
References 1. Volkow ND. Collision of the COVID-19 and Addiction Epidemics. Ann Intern Med. 2020;173(1):61-62. doi:10.7326/M20-1212 2. Hedegaard H, Minino A and Warner M. Drug Overdose Deaths in the United States, 1999-2018. NCHS Data Brief, number 356. Hyattsville, MD: National Center for Health Statistics 2020. 3. Hall OT, Hall OE, Kolodny A, Teater J, McGrath RP. Assessment of Excess Mortality Associated With Drug Overdose in Ohio From 2009 to 2018. JAMA Netw Open. 2020;3(4):e202183. Published 2020 Apr 1. doi:10.1001/jamanetworkopen.2020.2183 4. Hall OT, Hall OE, McGrath RP, Haile ZT. Years of Life Lost due to Opioid Overdose in Ohio: Temporal and Geographic Patterns of Excess Mortality. J Addict Med. 2020;14(2):156-162. doi:10.1097/ADM.0000000000000554
In this episode from the ACEP-EQUAL series, guests Dr. Aimee Moulin and Dr. Hannah Snyder discuss how to transition a patients treatment for opiate use disorder from the ED to the outpatient environment. They discuss how to use local resources, legal ramifications, waivers, and why they think a formal system to accomplish this is achievable.
Guests: Aimee Moulin, MD (Associate Professor, UC Davis; Behavioral Health Director for Emergency Department; Dual appointments in EM and psychiatry), Hannah Snyder MD (Assistant Professor of Family Community Medicine, UCSF; Primary Care Addiction Medicine Specialist)
Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
In this episode from the ACEP-EQUAL series, guests Ariana Samson and Dr. Andrew Herring share their experiences with the use of PAs and APRNs to drive the treatment of opiate use disorder in the ED.
Guests: Ariana Samson PA-C (ED APP Lead for US Acute Care Solutions, Marshall Medical Center); Andrew Herring, MD (Associate Director of Research, Highland Hospital, Alameda Health System Medical Director, Substance Use Disorder Treatment Program; Assistant Clinical Professor, UCSF)
Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
This is part 2 of a 2 part discussion with Dr. Andrew Herring on the use of Buprenorphine after an opiate overdose, primarily in the ED.
Guest: Andrew Herring MD (Associate Director of Research, Highland Hospital, Alameda Health System; Medical Director, Substance Use Disorder Treatment Program; Assistant Clinical Professor, UCSF)
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
References:
- Weiner, Scott, et al. One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. Annals of Emergency Medicine. April 2, 2019. doi.org/10.1016/j.annemergmed.2019.04.020
- Walsh SL, Preston KL, Stitzer ML, Cone EJ, Bigelow GE. Clinical pharmacology of buprenorphine: ceiling effects at high doses. Clin Pharmacol Ther. 1994;55(5):569-580. doi.org/10.1038/clpt.1994.71
- Dahan A, Yassen A, Romberg R, et al. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006;96(5):627-632. doi.org/10.1093/bja/ael051
- Ciraulo DA, Hitzemann RJ, Somoza E, et al. Pharmacokinetics and pharmacodynamics of multiple sublingual buprenorphine tablets in dose-escalation trials. J Clin Pharmacol. 2006;46(2):179-192. doi.org/10.1177/0091270005284192
- Ang-Lee K, Oreskovich MR, Saxon AJ, et al. Single dose of 24 milligrams of buprenorphine for heroin detoxification: an open-label study of five inpatients. J Psychoactive Drugs. 2006;38(4):505-512. doi.org/10.1080/02791072.2006.10400589
- Wang D, Sun X, Sadee W. Different effects of opioid antagonists on mu-, delta-, and kappa-opioid receptors with and without agonist pretreatment. J Pharmacol Exp Ther. 2007;321(2):544-552. doi.org/10.1124/jpet.106.118810
- Boysen K, Hertel S, Chraemmer-Jørgensen B, Risbo A, Poulsen NJ. Buprenorphine antagonism of ventilatory depression following fentanyl anaesthesia. Acta Anaesthesiol Scand. 1988;32(6):490-492. doi.org/10.1111/j.1399-6576.1988.tb02772.x
- Zamani N, Buckley NA, Hassanian-Moghaddam H. Buprenorphine to reverse respiratory depression from methadone overdose in opioid-dependent patients: a prospective randomized trial. Crit Care. 2020;24(1):44. Published 2020 Feb 7. doi.org/10.1186/s13054-020-2740-y
- Phillips RH, Salzman M, Haroz R, Rafeq R, Mazzarelli AJ, Pelletier-Bui A. Elective Naloxone-Induced Opioid Withdrawal for Rapid Initiation of Medication-Assisted Treatment of Opioid Use Disorder. Ann Emerg Med. 2019;74(3):430-432. doi.org/10.1016/j.annemergmed.2019.01.006
- Tompkins DA, Bigelow GE, Harrison JA, Johnson RE, Fudala PJ, Strain EC. Concurrent validation of the Clinical Opiate Withdrawal Scale (COWS) and single-item indices against the Clinical Institute Narcotic Assessment (CINA) opioid withdrawal instrument. Drug Alcohol Depend. 2009;105(1-2):154-159. doi.org/10.1016/j.drugalcdep.2009.07.001
- Carroll GG, Wasserman DD, Shah AA, et al. Buprenorphine Field Initiation of ReScue Treatment by Emergency Medical Services (Bupe FIRST EMS): A Case Series [published online ahead of print, 2020 May 4]. Prehosp Emerg Care. 2020;1-5. 10.1080/10903127.2020.1747579
This is part 1 of a 2 part discussion with Dr. Andrew Herring on the use of Buprenorphine after an opiate overdose, primarily in the ED.
Guest: Andrew Herring MD (Associate Director of Research, Highland Hospital, Alameda Health System; Medical Director, Substance Use Disorder Treatment Program; Assistant Clinical Professor, UCSF)
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
References:
- Weiner, Scott, et al. One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. Annals of Emergency Medicine. April 2, 2019. https://doi.org/10.1016/j.annemergmed.2019.04.020
- Walsh SL, Preston KL, Stitzer ML, Cone EJ, Bigelow GE. Clinical pharmacology of buprenorphine: ceiling effects at high doses. Clin Pharmacol Ther. 1994;55(5):569-580. https://doi.org/10.1038/clpt.1994.71
- Dahan A, Yassen A, Romberg R, et al. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006;96(5):627-632. https://doi.org/10.1093/bja/ael051
- Ciraulo DA, Hitzemann RJ, Somoza E, et al. Pharmacokinetics and pharmacodynamics of multiple sublingual buprenorphine tablets in dose-escalation trials. J Clin Pharmacol. 2006;46(2):179-192. https://doi.org/10.1177/0091270005284192
- Ang-Lee K, Oreskovich MR, Saxon AJ, et al. Single dose of 24 milligrams of buprenorphine for heroin detoxification: an open-label study of five inpatients. J Psychoactive Drugs. 2006;38(4):505-512. https://doi.org/10.1080/02791072.2006.10400589
- Wang D, Sun X, Sadee W. Different effects of opioid antagonists on mu-, delta-, and kappa-opioid receptors with and without agonist pretreatment. J Pharmacol Exp Ther. 2007;321(2):544-552. https://doi.org/10.1124/jpet.106.118810
- Boysen K, Hertel S, Chraemmer-Jørgensen B, Risbo A, Poulsen NJ. Buprenorphine antagonism of ventilatory depression following fentanyl anaesthesia. Acta Anaesthesiol Scand. 1988;32(6):490-492. https://doi.org/10.1111/j.1399-6576.1988.tb02772.x
- Zamani N, Buckley NA, Hassanian-Moghaddam H. Buprenorphine to reverse respiratory depression from methadone overdose in opioid-dependent patients: a prospective randomized trial. Crit Care. 2020;24(1):44. Published 2020 Feb 7. https://doi.org/10.1186/s13054-020-2740-y
- Phillips RH, Salzman M, Haroz R, Rafeq R, Mazzarelli AJ, Pelletier-Bui A. Elective Naloxone-Induced Opioid Withdrawal for Rapid Initiation of Medication-Assisted Treatment of Opioid Use Disorder. Ann Emerg Med. 2019;74(3):430-432. https://doi.org/10.1016/j.annemergmed.2019.01.006
- Tompkins DA, Bigelow GE, Harrison JA, Johnson RE, Fudala PJ, Strain EC. Concurrent validation of the Clinical Opiate Withdrawal Scale (COWS) and single-item indices against the Clinical Institute Narcotic Assessment (CINA) opioid withdrawal instrument. Drug Alcohol Depend. 2009;105(1-2):154-159. https://doi.org/10.1016/j.drugalcdep.2009.07.001
- Carroll GG, Wasserman DD, Shah AA, et al. Buprenorphine Field Initiation of ReScue Treatment by Emergency Medical Services (Bupe FIRST EMS): A Case Series [published online ahead of print, 2020 May 4]. Prehosp Emerg Care. 2020;1-5. 10.1080/10903127.2020.1747579
In this Wellness Think Tank series, Dr. Katie Rebillot (LA County-USC) hosts a 2-part series on resident wellness particularly in the COVID era, featuring EM residents Dr. Jacqueline Furbacher (The Ohio State University), Dr. Sydney Beck (Harbor-UCLA), and Dr. Surriya Ahmad (SUNY Downstate/Kings County). This second installment focuses on strategies and resources in navigating resident life during stressful COVID19 times.
In this Wellness Think Tank series, Dr. Katie Rebillot (LA County-USC) hosts a 2-part series on resident wellness particularly in the COVID era, featuring EM residents Dr. Jacqueline Furbacher (The Ohio State University), Dr. Sanida Lukovic (Jacobi-Montefiore), Dr. Sydney Beck (Harbor-UCLA).
In this episode from the ACEP-EQUAL series, Dr. Adam Oostema discusses the diagnosis of hemorrhagic stroke in the ED, the current state of the evidence, and some common pitfalls that can lead to diagnosis error.
Guest: Dr. Adam Oostema (Associate Professor of Emergency Medicine, Director of Neurological Emergency Medicine Research, Michigan State University College of Human Medicine)
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
In this episode from the ACEP-EQUAL series, Dr. Joshua Goldstein discusses anticoagulant reversal in the setting of hemorrhagic stroke. He reviews common anticoagulants, their specific and non-specific reversal agents, and reviews the literature base.
Guests: Dr. Joshua Goldstein (Professor of Emergency Medicine, Director of Center for Neurologic Emergencies, Massachusetts General Hospital and Harvard Medical School)
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
A panel of emergency medicine residency directors reflect on the data and trends from the 2020 EM Match year and use it as a springboard to discuss significant changes coming for the 2021 application season. COVID-19, physical distancing guidelines, and COPA-EM society consensus recommendations are discussed. PD panelists include: Dr. Sean Fox (Carolinas Medical Center), Dr. Amy Stubbs (University of Missouri-Kansas City), Dr. Butch Humbert (Indiana University).
Podcast sound engineer: Kellen Vu
Hosted by Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF)
https://www.aliem.com/em-match-advice-program-directors-reflect-2020-residency-match/
Join us in the third installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Led by Dr. Dina Wallin and a team of renowned educators, the featured book is an illustrated text by Jon Gordon and Damon West, called THE COFFEE BEAN. https://www.aliem.com/leaders-library-coffee-bean/
Join us in this Q&A session with Dr. Doo Ryeon Chung, MD PhD, Director of Infection Prevention and Control at Samsung Medical Center in Seoul, South Korea. He will be sharing key lessons and strategies for preventing COVID-19 transmission within hospitals, including PPE standards, workflows, infrastructure, and workforce management.
Host: Ron C. Li, MD (Stanford) Guest: Doo Ryeon Chung, MD, PhD Podcast Engineer: Kellen Vu (Stanford)
What is going to change and what is not for residency application season in the unprecedented COVID-19 era? What are the nuanced considerations that are affecting medical students, medical schools, residency programs, and hospitals? An expert panel of EM program directors discuss their mindsets and initial advice in the ever-evolving landscape of medical education and training. Hosted by Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF) with PD panelists Dr. Charles Khoury (University of Alabama Birmingham, Dr. Melissa Platt (University of Louisville), Dr. Paul DeKoning (Dartmouth-Hitchcock Medical Center).
Podcast sound engineer: Kellen Vu
https://www.aliem.com/em-match-advice-covid-19-residency-application-season/
Hosted by Dr. Michael Gisondi and Dr. Michelle Lin, an expert panel of directors of EM medical education fellowships discuss the nuts and bolts of the who, what, why, and how of applying to this fellowship. Panelists: Dr. Danielle Hart (Hennepin County), Dr. Dmitri Papanagnou (Thomas Jefferson), Dr. Jeffrey Riddell (LAC-USC)
Podcast sound engineer: Kellen Vu
https://www.aliem.com/em-fellowship-match-advice-medical-education-fellowship/
A deep dive into the Standardized Letter of Evaluation (SLOE) for emergency medicine residency applicants with hosts, Dr. Michael Gisondi and Dr. Michelle Lin. Panelists include Dr. Abra Fant (Northwestern), Dr. David Gordon (Duke), Dr. Michael Takacs (University of Iowa).
Podcast sound engineer: Kellen Vu
https://www.aliem.com/em-match-advice-deep-dive-sloe/
Emergency physicians Dr. Vytas Karalius (Northwestern), Dr. Deirdre Goode (University of Chicago), and Dr. Katie Rebillot (Harbor-UCLA and WTT's Chief Operating Officer) discuss imposter syndrome, the 5 different types, how they plague many emergency medicine residents, its contribution to burnout, and how to address it. Have you experienced imposter syndrome (also known as an "imposter experience")?
Wellness Think Tank (WTT): https://www.aliem.com/wellness-think-tank/
In this episode from the ACEP-EQUAL series, Dr. Steven Godwin and Dr. Richard Shih review the recently published ACEP clinical policy regarding the treatment of headaches in the emergency department.
Guests: Dr. Steven Godwin (Professor and Chair of Emergency Medicine, University of Florida), Dr. Richard Shih (Professor of Integrated Medical Science and Program, Charles E Schmidt College of Medicine at Florida Atlantic University)
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
References:
- Perry JJ et al. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA. 2013 Sep 25;310(12):1248-55. doi: 10.1001/jama.2013.278018 Carpenter CR et al. Spontaneous Subarachnoid Hemorrhage. A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Exam, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds. Acad Emerg Med. 2016 Sep;23(9):963-1003. doi: 10.1111/acem.12984. Epub 2016 Sep 6.
- Perry JJ. Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4277 Dubosh NM et al. Sensitivity of Early Brain Computed Tomography to Exclude Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.Stroke. 2016 Mar;47(3):750-5. doi: 10.1161/STROKEAHA.115.011386.
- Carstairs SD. Computed tomographic angiography for the evaluation of aneruysmal subarachnoid hemorrhage. Acad Emerg Med. 2006 May;13(5):486-92. Epub 2006 Mar 21.
- El Khaldi M. et al. Detection of cerebral aneurysms in nontraumatic subarachnoid haemorrhage: role of multislice CT angiography in 130 consecutive patients. La radiologia medica. 200 Feb;112(1):123–137.
- Menke J et al. Diagnosing cerebral aneurysms by computed tomographic angiography: meta-analysis. Ann Neurol. 2011 Apr;69(4):646-54. doi: 10.1002/ana.22270.
- Friedman BW et al. Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine. Neurology. 2017 Nov 14; 89(20): 2075–2082. doi: 10.1212/WNL.0000000000004642
Hosted by Dr. Michael Gisondi and Dr. Michelle Lin, an expert panel of residency program directors discuss finding the right-fit residency program for you using modern dating terms. Which programs should you swipe right or left on? Panelists: Dr. Arlene Chung (Maimonides), Dr. David Snow (Loyola), Dr. Robin Naples (Thomas Jefferson)
https://www.aliem.com/em-match-advice-swipe-right/
Dr. Adam Rodos discusses the CMS measure SEP-1 as well as the EQUAL sepsis initiative. The talk focuses on the effect of these measures on patient care and strategies for sepsis care improvement.
Guest: Adam Rodos MD (Assistant Professor, Dept of Emergency Medicine and Medicine, University of Illinois College of Medicine)
Host: Dr. Jason Woods
www.acep.org/equal
References: * Barbash IJ, Davis B, Kahn JM. National Performance on the Medicare SEP-1 Sepsis Quality Measure. Critical Care Medicine. 2019. 47(8):1026–1032. doi: 10.1097/CCM.0000000000003613 Kahn JM, et al. Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis. JAMA. 2019. 322(3):240-250. doi: 10.1001/jama.2019.9021. * Venkatesh AK et al. Preliminary Performance on the New CMS Sepsis-1 National Quality Measure: Early Insights From the Emergency Quality Network (E- QUAL). Annals of Emergency Medicine. 2018;71(1):10-15.e1. doi: 10.1016/j.annemergmed.2017.06.032
In this episode from the ACEP-EQUAL series, Dr. Alexis LaPietra reviews greater trochanteric pain syndrome and its treatment, as well as gives an overview of one piece of osteopathic manipulative therapy called muscle energy.
Guest: Alexis LaPietra, DO (Chair, ACEP Pain/Addiction Section System Chief, Pain/Addiction St. Josephs Health, Paterson NJ)
Host: Dr. Jason Woods
www.acep.org/equal
In this episode from the ACEP-EQUAL series, Dr. Katherine Vlasica reviews the technique, indications, contraindications, and benefits of the use of occipital nerve blocks and low paraspinous injections in the treatment of headache in the ED.
Guest: Katherine Vlasica DO (Director of EM Pain Management, St Joseph’s Health in Paterson NJ; Clinical Assistant Professor of Medicine, New York Medical Center)
Host: Dr. Jason Woods
www.acep.org/equal
Link for video of nerve blocks:
- https://cha.com/clinician-training-materials/
- https://www.youtube.com/user/lmellick/videos
Join us in the second installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Hosted by Dr. Dina Wallin, the featured book is Kim Scott's RADICAL CANDOR.
https://www.aliem.com/leaders-library-radical-candor/
In this episode from the ACEP-EQUAL series, Dr. Jay Schuur, Dr. Chris Moore, and Dr. Courtney Moreno discuss the development of and recommendations from the new publication from the ACEP EQUAL group, "Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus."
Article: https://www.ncbi.nlm.nih.gov/pubmed/31402153
DOSE project (Dose Optimization for Stone Evaluation): https://medicine.yale.edu/emergencymed/dose/
Radiology Safety Information: https://www.radiologyinfo.org/en/info.cfm?pg=safety-xray
Host: Dr. Jason Woods
www.acep.org/equal
In this episode from the ACEP-EQUAL series, Dr. Jay Schuur, Dr. Deb Diercks, and Dr. Kaushal Shah discuss the development and primary recommendation from the ACEP Clinical Policy for Thoracic Aortic Dissection.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Hosted by Dr. Michael Gisondi and Dr. Michelle Lin, an expert panel of residency program directors reflect on the 2019 Match year based on the NRMP data. Was it more or less competitive? What was new and what is their advice for the 2020 Match? View the data table for 2011-2019 on the ALiEM.com site. PD panelists: Dr. Sorabh Khandelwal (The Ohio State University), Dr. Fiona Gallahue (University of Washington), Dr. Brad Bunney (University of Illinois at Chicago)
https://www.aliem.com/em-match-advice-program-directors-2019-residency-match/
In this episode from the ACEP-EQUAL series, Dr. Stephen Wolf (Professor and Vice Chair at the Department of EM, Denver Health Medical Center; Chair of the ACEP clinical policies committee, subcommittee chair for this policy) talks about the development and primary recommendation from the ACEP Clinical Policy: Suspected Acute Venous Thromboembolic Disease
Host: Dr. Jason Woods
www.acep.org/equal
In this episode, Dr. Craig Hostein and Dr. Thomas Vaughan discuss their success in reducing avoidable imaging for low back pain in the ED.
Host: Dr. Jason Woods
www.acep.org/equal
Dr. Frank Peacock and Dr. Michael Kontos review the 2015 guidelines, published in the Journal of the American College of Cardiology regarding appropriate use of cardiovascular imaging.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
PDF of slide deck: https://www.acep.org/globalassets/sites/acep/media/equal-documents/webinar_chestpainw3_policy_cvimaging.pdf
References
- Rybicki FJ, Udelson JE, Peacock F et al. 2015 ACR/ACC/AHA/AATS/ACEP/ASNC/NASCI/ SAEM/SCCT/SCMR/SCPC/SNMMI/STR/STS Appropriate Utilization of Cardiovascular Imaging in Emergency Department Patients With Chest Pain. JACC. Feb 2016. 67;7. DOI: 10.1016/j.jacc.2015.09.011
- Singer AJ, Than MP, Smith S et al. “Missed myocardial infarctions in ED patients prospectively categorized as low risk by established risk scores”. Am J Emerg Med. 2017 May;35(5):704-709. DOI: 10.1016/j.ajem.2017.01.003.
- Poldevaart JM, Reitsma JB, Backus BE. “Effect of Using the HEART Score in Patients with Chest PAin in the Emergency Department: A Stepped-Wedge, Cluster Randomized Trial.” Ann Intern Med. 2017 May 16;166(10):689-697. doi: 10.7326/M16-1600
- Than MP, Aldous SJ, Troughton RW et al. “Detectable High-Sensitivity Cardiac Troponin within the Population Reference Interval Conveys High 5-Year Cardiovascular Risk: An Observational Study.” Clin Chem. 2018 Jul;64(7):1044-1053. DOI: 10.1373/clinchem.2017.285700
Dr. Simon Mahler, Dr. Deborah Diercks, and Dr. Christopher Baugh discuss how to implement the use of high sensitivity troponin in your clinical setting on this featured ACEP E-QUAL podcast.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Dr. Peacock and Dr. Christensen discuss the nuances of the high sensitivity troponin lab test on this featured ACEP E-QUAL podcast.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Host Dr. Jason Woods discusses the new PECARN Infant Fever Prediction Rule with lead author Dr. Nate Kuppermann. They review how this rule is different than its predecessors, understanding recursive partitioning, and how/when to use this rule in clinical practice. Article: Kuppermann et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Peds. Feb 2019.
The Leader's Library book club series kicks off featuring Brene Brown's DARE TO LEAD. Hosted by Dr. Dina Wallin, this podcast provides a teaser on why this book is critical for leaders in healthcare and academia. Learn more at: https://www.aliem.com/the-leaders-library-dare-to-lead/
Guest host, Dr. Michelle Lin chats with Dr. Jill Baren (University of Pennsylvania) on the whys, hows, and behind-the-scenes stories about conducting research under the Exception From Informed Consent (EFIC) regulation. Spoiler alert: It is not for the timid or impatient.
An EM Match Advice episode on promoting diversity and inclusion during residency training, hosted by Drs. Michael Gisondi and Michelle Lin. Featuring Dr. Joel Moll (Virginia Commonwealth), Dr. Tyson Pillow (Baylor), and Dr. Bonnie Kaplan (Denver Health).
https://www.aliem.com/em-match-advice-diversity-inclusion/
Facilitated by Dr. Matt Melamed, this podcast features powerful insights from Lt. Col. David Grossman, the author of On Combat, as he relates stories in the military as it applies to emergency physicians. Strategic sleep hygiene, deep breathing, and food/water are discussed as they relate to stress management and staying in a constant "condition yellow" of alertness.
Facilitated by Dr. Matt Melamed and Dr. Nicole Battaglioli, this podcast discusses the 2019 Western Journal of Emergency Medicine's article on The Happiness Practice curriculum for EM residents. This curriculum was modeled after several successful wellness initiatives at the corporate level. Authors Dr. Danielle Hart and Dr. Glenn Paetow from Hennepin join us to discuss their study findings, the broader challenges in studying wellness, and some promising systems-level changes at their institution.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324712/
ALiEM Wellness Think Tank: https://www.aliem.com/wellness-think-tank/
Co-hosted by Drs. Mary and Nate Haas, this episode of the SAEM's Research Learning Series features Dr. Daren Beam (Indiana University) on how to write a winning abstract for a scientific meeting or conference. Take notes and apply his practical pearls of do's and don'ts, while also hearing some funny, behind-the-scenes stories about his time as a research coordinator for the PERC rule.
Co-hosted by Drs. Mary and Nate Haas, this installment of SAEM's Research Learning Series features Dr. Zachary Meisel (University of Pennsylvania) on how to turn your interest into research. Get inspired by his career path from prehospital research to narratives in evidence-based medicine.
Dr. Christian Tomaszewski and Dr. Michael Ross reviews the 2018 ACEP Clinical Policy on Critical Issues in the Evaluation and Management of Emergency Department Patients with Suspected Non–ST-Elevation Acute Coronary Syndromes (NSTEMI). Read the entire policy here: https://www.acep.org/patient-care/clinical-policies/nonst-elevation-acute-coronary-syndromes/
Dr. Tomaszewski was the lead for writing this clinical policy and is a Professor of Emergency Medicine at UC San Diego. Mr. Ross is a Professor of Emergency Medicine at Emory. He is the Medical Director of Observation Medicine for the Department of Emergency Medicine and the Chest Pain Center Director for Emory University.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Dr. Erik Hess, Dr. W. Franklin Peacock, and Dr. Simon Mahler discuss complex issues involving chest pain protocols in "ruling-out" low risk chest pain patients. They tackle the issues of:
- Troponin-Only Pathway: The Era of High Sensitivity Troponins (Hess)
- Importance of Incorporating Accelerated Diagnostic Protocols (Peacock)
- How to Get Buy-In and Implement ADPs in the Emergency Department (Mahler)
Dr. Hess is the Vice Chair in the Department of Emergency Medicine at the University of Alabama. Dr. Peacock is the Vice Chair in the Department of Emergency Medicine at Baylor University. Dr. Mahler if the Director of Clinical Research in the Department of Emergency Medicine at Wake Forest University.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Dr. Kristin Newby and Dr. Michael Kontos discuss the pros and cons of various stress testing modalities and imaging for patients presenting with suspected acute coronary syndrome. There are nuanced decisions to be made based on the disease probability, patient characteristics, test characteristics, test availability, and cost.
Dr. Newby is a Professor of Medicine in the Division of Cardiology at Duke University. Dr. Kontos is an Associate Professor in the Departments of Internal Medicine, Cardiology, Radiology, and Emergency Medicine at Virginia Commonwealth University.
Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu
www.acep.org/equal
Dr. Reuben Strayer and Dr. Eric Ketcham discuss the management of patients with opioid withdrawal and initiation of buprenorphine in the Emergency Department for opioid use disorder patients. Dr. Strayer is the Associate Medical Director at the Department of EM at Maimonides Medical Center and author of EMUpdates.com. Dr. Ketcham is the Medical Director for the New Mexico Treatment Services program and is an emergency physician at the San Juan Regional Medical Center in New Mexico.
Hosted by Dr. Michelle Lin
www.acep.org/equal
Dr. Maureen Boyle and Dr. Edward Bernstein discuss the public health crisis of opioid overdoses, overdose prevention, and home naloxone distribution from systems and operational perspectives. Dr. Boyle is the Chief Scientific Officer for the Addiction Policy Forum and was previously the Chief of Science Policy at NIDA. Dr. Bernstein is a Professor of Emergency Medicine and Vice Chair for Academic Affairs at Boston Medical Center and the Medical Director for the Faster Paths to Treatment Program.
Hosted by Dr. Michelle Lin
www.acep.org/equal
Dr. Andrew Herring, the Medical Director for the Substance Use Disorder Treatment Program at Highland Hospital and Principal Investigator for the California ED Bridge Emergency Buprenorphine Program, discusses the art and science in managing pain for patients with opioid use disorders. Hosted by Dr. Michelle Lin.
www.acep.org/equal
Dr. Alexis LaPietra, the creator of the ALternatives To Opioids (ALTO) program, provides insights into the nuts and bolts of starting an ALTO program at one's local institution. Dr. LaPietra is the Medical Director of the EM Pain Management program at St. Joseph’s and created the Pain Management and Addition Medicine Section for the American College of Emergency Physicians. Hosted by Dr. Michelle Lin.
www.acep.org/equal
Co-hosted by Drs. Mary and Nate Haas, this installment of SAEM's Research Learning Series features Dr. Rob Ehrman (Wayne State) on why grant proposals get rejected and how to deal with them.
Co-hosted by Drs. Mary and Nate Haas, this installment of SAEM's Research Learning Series features Dr. Mike Puskarich (University of Minnesota) on writing high-quality specific aims in your grant proposal. He shares the key do's and don'ts that make or break a grant writeup.
Co-hosted by Drs. Mary and Nate Haas, this installment of SAEM's Research Learning Series features Dr. James Paxton on common IRB pitfalls based on his experience as the Chairman of Wayne State University's Institutional Review Board.
Ultrasound fellowship directors discuss recent updates to the EM Clinical Ultrasound Fellowship match process, which now involves the National Resident Match Program (NRMP). Panelists: Dr. Jeremy Boyd (VanderbiltUniversity) Dr. Matt Fields (Kaiser Permanente San Diego) Dr. Arthur Au (Thomas Jefferson University) Co-hosts: Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF-SFGH)
https://www.aliem.com/em-fellowship-match-advice-ultrasound-fellowship/
In this PECARN series, Dr. Jason Woods, discusses the sensitivity and specificity of the urinalysis for febrile infants ≤60 days old with the first authors of the 2018 Pediatrics article, Dr. Leah Tzimenatos. Tzimenatos L, Mahajan P, Dayan PS, et al; Pediatric Emergency Care Applied Research Network (PECARN). Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger. Pediatrics. 2018 Feb;141(2). https://www.ncbi.nlm.nih.gov/pubmed/29339564
Hosted by Dr. Michael Gisondi and Dr. Michelle Lin, an expert panel of fellowship program directors in global health discuss the nuts and bolts of applying to a global health fellowship in EM. Panelists: Dr. Kristiana Kaufman (Wayne State University), Dr. Rebecca Walker (Stanford University), Dr. Hani Mowafi (Yale University)
https://www.aliem.com/fellowship-match-advice-global-health/
Hosted by Dr. Derek Monette (ALiEM Deputy Editor in Chief), this podcast discusses the hot-off-the-press New England Journal of Medicine publication on diabetic ketoacidosis (DKA), fluid resuscitation, and cerebral edema. Authors Dr. Nathan Kuppermann and Dr. Nicole Glaser explain the importance of their groundbreaking RCT and challenge the theoretical association between IV fluids and the development of cerebral edema during pediatric DKA treatment. Kuppermann N, Ghetti S, Schunk JE, et al; PECARN DKA FLUID Study Group. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018 Jun 14;378(24):2275-2287. https://www.ncbi.nlm.nih.gov/pubmed/29897851
Hosted by Dr. Michael Gisondi and Dr. Michelle Lin, an expert panel of residency program directors reflect on the 2018 Match year. Was it more or less competitive? What was new and what is their advice for the 2019 Match? Panelists: Dr. Elise Lovell (Advocate Christ), Dr. Leslie Oyama (UCSD), Dr. Jeremy Branzetti (NYU-Bellevue)
https://www.aliem.com/em-match-advice-program-directors-reflect-2018-match/
Facilitated by Dr. Matt Melamed and joined by EM residents Dr. Laila Nasser and Dr. Jon Smart Gende, this podcast covers a broad range of topics with wellness expert and Facebook's EM Docs founder Dr. K Kay Moody. She discusses how EM Docs started, how the opioid epidemic affects the wellness of emergency physicians, pivots in her career which align with her mission to improve physician wellness, and taking a leap of faith by building the Glacier Rock Wellness Ranch in Washington.
Facilitated by Dr. Annahieta "AK" Kalantari and joined by EM residents Dr. Alecia Gende and Dr. Adrienne Taren, this podcast covers a broad range of topics with wellness expert Dr. Shahina Braganza from the Gold Coast in Australia. She discusses the concepts behind Emotional Contagion, her published "oneED" program, and the challenges of adopting wellness initiatives in the ED.
Let's normalize the conversation and talk postpartum mood disorders! These can include postpartum anxiety, depression, and even psychosis. These are more common than you think. When are the timeframes, who is at risk, and how can you as a provider help?
Host: Dr. Nicole Battaglioli Wellness Strategist: Dr. Annahieta "AK" Kalantari Expert: ALLISON LOFTUS, MD LPC (Professional Counselor at Flourishing Counseling Center)
Key resource: Postpartum Support International (http://www.postpartum.net/)
Wellness Think Tank: https://www.aliem.com/wellness-think-tank/
Concepts and pearls in applying performance psychology practices to high-acuity and high-risk cases in the Emergency Department featuring performance psychologist DR. JASON BROOKS, our Wellness Think Tank strategist. Being a medically skilled practitioner does not necessarily mean that we know how to deal with natural human factors and emotional triggers. Left unaddressed, these can fester and lead to physician burnout.
Topics covered include:
• Emotionally and mentally preparing for unpredictable shifts and/or high stakes, low-frequency procedures • Attention-shifting to the next case immediately after a highly emotional case to be sure you are fully present and not distracted • Self-reflecting on each stressful/difficult case • Opening a debriefing conversation immediately after each high-stress case • Focusing on lessons learned from both negative AND positive experiences
Host: Dr. Matt Melamed WTT Members: Dr. Kuljit Kaur (Jefferson-Northeast), Dr. Laila Nasser (McMaster) Website: https://www.aliem.com/wellness-think-tank/
In this corner, former editor of EM:RAP, coproducer of EM Essentials, creator/editor in chief of ERcast, and… the coolest dude you’ve ever known! Dr. Rob Orman! (Applause, Cheering, Etc.) In the opposing corner boring, old, and tired… Your current pre/post shift routine and some of your beliefs about your first year as an attending! Welcome to a sold-out podcast that only VIP’s like you with the link have access to! You’re welcome! Listen as Rob “The Doc” Orman strikes like lightning against what you thought you knew! He masterfully dissects some of the most difficult mental obstacles to your first year as an attending! Believe the hype! Let’s get ready to rumbleeeeeee!
Hangout host: Dr. Liang Liu Podcast editor: Dr. Aron Slear