THE DESI EM PROJECT: Recent Episodes
Ankur Verma
Founded and created by Dr. Ankur Verma, The DESI EM PROJECT is an endeavour to bring before you discussions on everything emergency medicine, daily EM work, cases, myths, dogmas, concepts, evidence based approaches, conferences, and much more. We would also be focusing on the Indian emergency medicine scenario. EM guests from India and across the globe would be invited to chat with regarding EM in India. This is the 1st Emergency Medicine podcast coming from India. You can DM me on twitter with suggestions and feedbacks - @anksv25
In this conversation, Amy Alkon, an award-winning author and applied behavioral science expert, discusses her journey into medical science and the importance of understanding menopause and perimenopause. She emphasizes the need for women to be informed about their health, particularly regarding hormone levels and the impact of diet and exercise. Alkon also addresses common myths in medical care, particularly those affecting women's health, and provides key takeaways for both women and doctors to improve health outcomes.Amy Alkon is an independent investigative science writer specializing in “applied science”—using scientific evidence to solve real-world problems.
Alkon critically evaluates and synthesizes research across disciplines and then translates it into everyday language, empowering regular people to make scientifically informed decisions for the best of their health and well-being.For 25 years, Alkon wrote an award-winning, science-based nationally syndicated advice column, distributed by Creators. With GOING MENOPOSTAL, Alkon has authored five books—most recently, her “science-help” book Unfuckology: How to Live with Guts and Confidence (St. Martin’s Press, 2018).Alkon is the past President of the Applied Evolutionary Psychology Society, which brings evolutionary science to public policy, education, and medicine.Alkon has given invited talks to academics on applied science at scientific conferences and to large groups at universities, as well as to general audiences. She has given two TED talks, and the Los Angeles City Attorney’s Office hires Alkon, a State of California-certified mediator, to do behavioral science-based dispute resolution talks and training videos.Alkon has been profiled in The New York Times, TIME, The Washington Post, The Independent/UK, and Macleans. Alkon has appeared on numerous national TV and radio shows, including Good Morning America, Today, NPR, CNN, Nightline, Anderson Cooper, Coast to Coast, and Canada’s The Agenda with Steve Paikin, along with podcasts by Adam Carolla, Joe Rogan, Michael Shermer, Robert Wright, and Scott Barry Kaufman.
GRAB HER BOOK "GOING MENOPOSTAL" FROM AMAZON!
Bindesh Vimla shares his transformative journey from struggling with chronic health issues and weight gain to discovering the benefits of a carnivore diet. He discusses his experiences with various diets, mental health challenges, and the significant improvements he has seen in his physical and mental well-being since adopting a meat-based diet. Bindesh emphasizes the importance of understanding dietary impacts on health and the psychological aspects of eating, while also reflecting on the cultural and spiritual implications of food choices.
Follow him on his Instagram - @bindeshvimala
In this episode, Dr. Abs shares his journey from being a dentist to becoming a leading expert in nutrition and cell metabolism. He discusses the scientific basis for the carnivore diet, its health benefits, and its impact on athletic performance. The discussion also delves into cosmetic treatments, the role of diet in aging, and the controversies surrounding GLP-1 drugs for weight loss. Dr. Abs emphasizes the importance of understanding nutrition and challenges cultural beliefs that hinder dietary advancements, particularly in India. We definitely could have spoken about a lot more non stop!
Follow him on his socials -
IG - @doctor.abs
YouTube - https://www.youtube.com/@Dr_Abs
Website - drabs.clinic
In this conversation, Ankur Verma and Craig Emmerich delve into the complexities of chronic diseases, emphasizing the importance of understanding root causes such as insulin resistance and inflammation. They discuss the role of diet, particularly the benefits of ketones for brain health and mental clarity, and how dietary changes can lead to significant health improvements. The conversation also touches on the impact of nutrition on mental health, the relationship between inflammation and heart disease, and the necessity of nutrient-dense foods for overall well-being.Follow Craig on his IG - @craig_emmerich
X -@emmerich_craig
Website - https://mariamindbodyhealth.com/
In this conversation, Dr. Steven Lin discusses his journey from dentistry to understanding the critical role of nutrition in oral health. He emphasizes the importance of vitamins, minerals, and the oral microbiome in preventing dental diseases. Dr. Lin also explores the impact of diet on craniofacial development, the controversies surrounding fluoride, and the significance of breathing and tongue posture for overall health. He advocates for a diet rich in animal nutrients and shares insights from his book, 'The Dental Diet' - Available on Amazon.
Follow him on his Instagram - @drstevenlin
Check out his website for more info - Dr. Steven Lin | Health with Functional Dentistry
In this energetic conversation, Lainy shares her unique journey as a long-time carnivore, discussing her dietary habits, experiences with fasting, and the impact of sugar on health. She reflects on childhood nutrition, her pregnancies, and the importance of exercise and mobility as she navigates menopause. Lainy emphasizes the need for awareness around food choices, particularly for children, and encourages a positive approach to dietary changes. Her insights provide a refreshing perspective on health and nutrition, highlighting the importance of personal experience and instinct in making dietary decisions.
In this episode, Amy shares her transformative journey from chronic kidney disease to recovery through the carnivore diet and fasting. She discusses the challenges she faced, including a life-threatening septic shock, and how she learned to advocate for her health. Amy emphasizes the importance of community support, the role of diet in healing, and the need for self-advocacy in the healthcare system. Her story serves as an inspiration for those dealing with chronic illness and addiction.
Get in touch with Amy on her socials for coaching -
IG - @_carnivore_amy
Facebook - Carnivore Amy
In this conversation, Augustine Colebrook shares her journey as a midwife and functional medicine specialist, discussing her experiences in India and the challenges faced in maternity care. She delves into her personal health struggles, discovering the carnivore diet, and how it transformed her health. Augustine emphasizes the importance of nutrition, particularly for pregnant women, and advocates for a high-fat, high-protein diet to support maternal and fetal health. The discussion also touches on the impact of dietary choices on chronic illnesses and the need for a shift in understanding nutrition.
Follow her on her IG - @carnivoremidwife
In this enlightening episode, Dr. Sean OMara and Dr. Ana Rosa join host Dr. Ankur Verma to discuss the critical issue of visceral fat, often overlooked in medical education and practice. They explore the dangers of visceral fat, its connection to chronic diseases, and the need for better awareness and screening. The conversation emphasizes the importance of lifestyle changes, dietary choices, and the role of the microbiome in managing visceral fat. Personal transformations and case studies highlight the impact of education and advocacy in promoting health and wellness. In this engaging conversation, the speakers discuss the importance of understanding visceral fat and its impact on health. They share personal stories of transformation, emphasizing the body's ability to heal itself when given the right conditions. The discussion also highlights the significance of imaging techniques like MRI and CT scans in assessing health risks, advocating for policy changes to improve access to these services. The speakers stress the need for gratitude and personal advocacy in health, encouraging listeners to take action for themselves and their loved ones. They challenge conventional medical practices, particularly the reliance on statins, and call for a grassroots movement to promote awareness and prevention of diseases linked to visceral fat.
Follow Sean on IG - @drseanomara
and Ana - @anarosagratitude
In this episode, Gayle shares her transformative journey from veganism to a carnivore diet, detailing her struggles with health issues, mental health, and the impact of dietary choices on her life. She discusses her experiences with eczema, hormonal imbalances, and the awakening moments that led her to embrace a meat-based diet, ultimately leading to significant improvements in her health and well-being.
Follow her on her IG - @divine_carnivore
In this episode, Peter Karanfilis, a personal trainer and carnivore coach, shares his transformative journey from struggling with mental health issues to finding healing through the carnivore diet. Peter discusses his background in health and fitness, the challenges he faced during his transition to a meat-based diet, and how he now helps others navigate their own journeys. The conversation delves into the impact of diet on mental health, common challenges faced by those transitioning to carnivore, and the establishment of a coaching program to support others in their health transformations.
To enroll into his carnivore coaching certification program visit - https://www.carnivorecoachinternational.com/courses/carnivore-coach-certification
Check out his IG - @carnivorecoachpeter
Spyros is a professional chef who has been throug the typical mediteranean diet, experimented with some veganism and suffered from psoariasis for as long as he remembers. Till he went carnivore and saw all his symptoms disappear. Watch as he takes us into his journey.
Catch him on his IG - @goatking_official
In this engaging conversation, Dr. Sarah Pugh shares her extensive knowledge on health, nutrition, and the interplay of various biological and environmental factors. She discusses her journey from biochemistry to movement therapy, emphasizing the importance of understanding the physics of nutrition and fitness. The discussion delves into the benefits of grounding, the science behind hydrogen water, the role of red light therapy, and the potential of psychedelics in mental health treatment. Dr. Pugh advocates for a holistic approach to health, integrating various elements such as diet, light exposure, and movement to optimize well-being. She is a powerhouse of knowledge.
Catch her on her socials -
IG - @busy_superhuman
YT - (539) busysuperhuman - Dr Sara Pugh - YouTube
LinkedIn - Sara Pugh
Website -https://sarapughleeds.co.uk/
In this episode, Michael Fine shares his transformative journey from following mainstream nutritional advice to discovering the benefits of a carnivore diet. He discusses his struggles with autoimmune disorders, mental health issues, and the impact of family health history on his choices. Michael emphasizes the importance of questioning conventional wisdom, the role of fat in nutrition, and the significance of community support in health journeys. He also highlights the ancestral mindset in understanding nutrition and the need for education in holistic health.
Follow him on his IG - @ancestrally_healed
In this episode of the, Ahsan shares his transformative health journey, detailing his transition from a standard diet to a low-carb and eventually a carnivore diet. He discusses the pivotal moments that led him to prioritize his health, including advice from family and health professionals. Ahsan emphasizes the importance of understanding visceral fat and its health implications, as well as the role of mindset in achieving health goals.
You can get in touch with Ahsan on his email - ketokhancanada@gmail.com
Check out his fantastic book on - http://awesomelifebook.com
In this episode, Dr. Jocelyn Foran shares her journey from a childhood marked by health challenges to becoming an anesthesiologist and embracing a carnivore diet. She discusses the impact of diet on her health, particularly in reversing her ulcerative colitis, and emphasizes the importance of nutrition in preventing metabolic diseases. Dr. Foran also highlights the challenges within the medical community regarding dietary advice and the need for a shift towards more holistic approaches to health. She advocates for public education on nutrition and shares insights on exercise and family dietary choices.
Catch her on her socials -
IG - @metabolic.medical
X - @sleepyandnumb
Dr Malcolm Kendrick graduated from Aberdeen University and trained as a General Practitioner. He has worked in the NHS for forty years. He has been fascinated by cardiovascular disease since his time as a medical student.
At that time, Scotland had the highest rate of heart disease in the world. He came to realise that ‘cholesterol’ hypothesis was not correct. He has written several papers in this area and three books. The Great Cholesterol Con, A Statin Nation, and The Clot Thickens – which is an attempt to explain what actually does cause heart disease.
He has also written about how data are manipulated in many scientific studies, writing the book Doctoring Data. He has a blog drmalcolmkendrick.org, which is free to read. He loves sports and sorting out the world’s problems in the pub.
Do get his books available on Amazon -
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The Clot Thickens
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The Cholesterol Con
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Doctoring Data
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A Statin Nation
Mary went Keto Carnivore 11 years back and is still going strong. Watch the episode to know more about her story.
She is into coaching and helps people especially with eating disorders.
Follow her on her IG - @ketomary71
Her website is - Reflect, Recharge and Renew
My good friend Jennifer and Carlos take us through their journey into and of Carnivore, coaching, fitness and recovery.
Follow Jenny on her IG to get in touch with any of them for coaching - @ladyofthesteak
Dr. Nadir Ali is a practicing Interventional Cardiologist for over 35 years.
He has several years of experience in the Low Carbohydrate High Fat (LCHF) diet in the treatment of metabolic disease, diabetes, heart disease and to improve the quality of cholesterol. Watch him give a masterclass on cholesterol and statins 101.
Visit his website - Dr Nadir Ali - Interventional Cardiologist in Webster, Texas
Subscribe to his YouTube - https://www.youtube.com/@nadirmirali
Born in New Delhi, Hal Cranmer has been a US Air Force and commercial pilot who now has assisted living homes in the US. He is helping his residents get better, reverse dementia and Alzheimer, get cognitively better on keto - carnivore and lead a more productive life.Some even go back home because they are able to walk again!
Check out his websites - https://aparadiseforparents.com/hal-cranmer/
https://bringmemoryback.com/
His socials -
IG - @HalCranmer
X - @HalCranmer
Watch this interesting talk with Tech entrepreneur and self experimenter Karan Sarin. He has taken social media by storm by experimenting with Indian foods and the effect it has on his CGM glucose readings. He has improved his health with an animal based low carb nutrition lifestyle and shares the results of his experiments for others to learn from.
Check out his content on his socials -
IG - @Sweetreactions
YouTube - https://www.youtube.com/@sweetreactions1
Brian from Denmark shares his journey of reversing sciatica of 23 years, gout, tinnitus, sleep apnea etc through the carnivore journey. He has embodied the hunter gatherer mindset and is looking forward to coaching and guiding colleagues in his profession.
Follow him on his IG - @huntergatherermindset
Joff is a registered nurse in Brisbane and transformed his life losing almost 90 pounds through the carnivore lifestyle. Not just that but he reversed multiple health issues and got off numerous medications. He is now giving back to the society through health coaching and working on his Primal Nursing Initiative. He is also the host for the fantastic podcast - Steaks with Mates.
Catch him on his socials -
IG - @healthcoachjoffYoutube - www.youtube.com/@healthcoachjoff
Website - The Busy Carnivore | Health Coach Joff
Nate is a law enforcement officer who went carnivore 1.5 years back. He had to deal with weight gain, mental stress, fatigue, burnout, inflammation, arthritis before he went carnivore.
Follow him on his IG - @the_carnivore_cop_
Sara was a vegan for 10 years till she met Jordy. he joined her on her vegan lifestyle! It didn't suit him. So they both went carnivore and it turned their lives around! Watch this lovely couple share their journey !
Young Jonathan takes us through his journey of disease reversal, mindset change and his carnivore lifestyle. Follow him on his socials -
IG - @norsecarnivore
YouTube - (398) Norse Carnivore - YouTube
Glad to have Eddie back as he shares his story behind his book "Contraindicated" and breaks down its chapters for us. We go on to discuss the nuances of the Randall cycle, CICO and research!
Follow him on his IG - @e.goeke_
And his YouTube - (393) Edward A. Goeke - YouTubeHis book "Contraindicated" is available on Amazon - so order away!
Sarah takes us through her journey of illness, losing her periods, acne, hypothyroidism, hypertension, digestive issues and overcoming all of these and more through carnivore. She worked in the Big Pharma selling drugs and now is nutritionist. She has had a fascinating journey and tells all in this episode.
Get in touch with her for coaching or guidance on her website - www.inthebuffwellness.com
Follow her on IG - @inthebuffwellness
Jeannie suffered from a tornado of illnesses from childhood through adulthood till her 60's. She finally removed sources of oxalates from her diet and added meat and eggs and completely reversed her life. She feels much more fit at 71 than what she was at 30.
Follow her journey on her Instagram - @lowoxgrandma
Stefan K. Hofer was a two time vegan and both time he had massive health issues. He turned his life around by going carnivore and now is a super fit grandfather! Watch him tell his story of recovery and resilience.
Follow him on Instagram and you can get in touch for coaching from him - @deutschkarnivore
Watch Phumi take us through her story from Zimbabwe to UK. From vegan to carnivore. Her health issues to no issues or reversing them. From diabetes to irregular periods to sleep apnea - she reversed all on the carnivore lifestyle in no time. And this after she had already been vegan, keto, SAD, etc.
Follow her on her socials -
IG -@carnivore.cutie8
TikTok - @carnivore.cutie8
YouTube - http://www.youtube.com/@CarnivoreCutie
Jordi met his wife while doing a video shoot. She was vegan and turned him vegan too for health reasons. Until they both started to get sick. Him before her. Then they found the solution in Carnivore and started reversing their ill-health. He even reversed his mom's arthritis and she started hitting the gym and running!
Watch Jordan Donaldson narrate his story.
Follow him on his socials -
IG - jordinary.life
YouTube - https://www.youtube.com/@jordinarylife
Watch this story of Leah as she narrates what she went through when she was vegan/vegetarian, keto and carnivore. An athlete who played tennis to someone to whom life happened and now back on track. 5 years carnivore and loving it. She also narrates stories of her friends one of whom has reversed his multiple sclerosis after giving up on medications and adopting the carnivore lifestyle.
She coaches women on Carnivore and helps them through menopause and premenopause.
Catch her on her IG - @leeiamb
LinkedIn- Leah Borges
If you like the episode and the show please Follow on Spotify and share with your friends.
Watch Selina narrate her fantastic story of overcoming thyroid cancer with the right nutrition, the travails she had to go through with her oncologists, pregnancies and much more. We had such an amazing time and hit it off instantly!
Check out her linktree - https://linktr.ee/selinafoxprimalhealth
Catch her on her IG - @selinafoxprimalhealth
This episode features COO of dLife - Ira Sahay (always a pleasure to have her on)and Dr Parth Samal - a diabetologist who has been certified by dLife in the low carb nutrition lifestyle and now reverses Diabetes and metabolic syndrome for his patients.
If you are a doctor or a health care provider, this is the course for you. Therapeutic Carbohydrate Reduction CR or Low Carb for reversing chronic lifestyle diseases. Contact Ira on her business number- +91 9631570443 for more info. She is a
Certified Metabolic Health Practitioner and Chief Operating Officer - dLife HealthCare Pvt Ltd.
Get to know more about dLife on Indian Low Carb LCHF & Keto Diet Recipes For Diabetes Weightloss & PCOS| dLife.in
Melissa Bee is a visionary leader, event creator, and advocate for holistic living.
With over a decade of experience organising transformative events, Melissa has worked with globally renowned speakers, including Joe Cross (Fat, Sick, and Nearly Dead), Pete Evans, Osher Günsberg, Hal Elrod and Eddie Betts Her expertise spans health, sustainability, personal development, and lifestyle transformations.
She is also the creator of Carnivore Collective Live, a movement that celebrates the carnivore lifestyle and is poised to gain global momentum.Beyond event creation, Melissa is a passionate advocate for empowering individuals to live healthier, more connected lives. Her work emphasises the importance of mindfulness, movement, meditation, nutrition, and self-enquiry, encouraging you to embrace physical, emotional, and spiritual wellness.
Find Melissa on her IG - @melissabee.au
Find out more about Melissa and her events here - www.mpwrdevents.com
Aimee was born in Chicago Heights, Illinois, and moved around a great deal with her family during her early years. As a child, Aimee had numerous medical issues, culminating in a diagnosis of Type 1 diabetes at the age of 16. This condition has driven Aimee to pursue the natural healing arts throughout her life as she seeks a way to heal her condition and help others do the same.She was a vegetarian turned low carb turned raw vegan turned keto and now finally carnivore since 6 years.
Watch her narrate her amazing journey.
Follow her on IG - @aimeefieldsperrin
Website - https://www.aimeefieldsperrin.com/
YouTube- https://www.youtube.com/@aimeeperrin7313
Health/lifestyle consultant, carnivore since 2015 and drummer Phil Escott got chronically ill as a vegetarian, and his body revolted with psoriatic arthritis and other autoimmune conditions in 2010, leaving him unable to move without severe pain, let alone drum or exercise, and he had to throw out all his existing “expertise” and start from scratch. Phil’s eventual combination of a carnivore diet with EMF and artificial light avoidance, cold thermogenesis and a range of other health enhancing practices reversed the “incurable” diseases that he suffered from. His book “Arthritis, The Best Thing That Ever Happened To Me” gained a foreword by Dr. Jack Kruse and has become an Amazon Kindle bestseller and is now available in print. Phil talks from personal experience about contemporary lifestyle and diet choices, disconnects from our ancestral heritage, emotional balancing and the simple but often misunderstood nature of spiritual awakening. He now consults with clients worldwide helping them to reverse their metabolic and autoimmune issues. For up to date info, free e-book, Zoom Q&A calls and more, sign up to his Substack at…
https://philescott.substack.com
All other links including personal consultations, The Big Fat Challenge, online courses, books, podcast, YouTube channel, Facebook groups etc at Phil’s Linktree…
https://linktr.ee/philescott
Sameer grew up watching family members do everything "right"—low-fat diets, cholesterol meds, regular check-ups—yet still suffer heart attacks and strokes. When his own health declined in his 30s, he discovered the real culprits: insulin resistance, chronic inflammation, and oxidative stress. By addressing these, he reversed his risks and now helps others do the same.
Based on Jo'burg he has been helping many people reverse their chronic conditions using an animal based nutrition plan and exercise.
Watch him take us through his journey.
Check out his website and socials -
Healthy Hearts, Happy Humans: Evidence-Based Heart Health Coaching
YT - Sameer Dossani - YouTube
IG - @sam3r
Linkedin - Sameer Dossani
You can also get his e-book - "The Health Dialectic" here - Sameer Dossani - Health Coach
Shashikant lyengar, who has worked in Big Pharma for years before giving it up, now leads the low carb movement in India. He is an integral part of dlife.in, India's only Low carb platform. He has co-hosted the Metabolic Health conference 1.0-3.0 which boasts of a stellar line up of guests. He is back on in this episode where he shares all the research that have been done regarding the prevalence of metabolic syndrome, hypertension, diabetes, micronutrient deficiencies and mental health in healthcare providers. How fit are the doctors that you go to?
Follow him on him socials -
X - @shashiiyengar
IG - @shashikant_iyengar
Learn more about the Low Carb Nutrition and if you want to enroll into their program then check out - www.dlife.in
Apologies for the technical issues in the end.
In this episode I have an intriguing conversation with Dr Darko Velcek. He provides a unique insight into health,nutrition and medicine and compels you to think and learn rather than get indoctrinated. Do watch this episode.
And please Follow THE DESI EM PROJECT if you like the conversations we are having here!
Check out his blogpost - https://darkovelcek.wordpress.com/
Check out his YouTube - https://www.youtube.com/@hilnoretna1
His other socials -
X - @darkovelcek
had a fantastic chat with actor turned stand up turned content creator - The carnivore Scotty Brizzle. he has reversed several auto immune disorders and no longer has pains from osteochondritis dissecans.
Catch him on his socials -
IG - @scottybrizzle
X - @scottybrizzle
FB - Scotty Brizzle
YT - www.youtube.com/@scottybrizzle
Dr. Shawn Baker MD is an orthopedic surgeon, international speaker, world champion and multiple world record holding athlete, and a leading authority on using nutrition therapy to treat chronic diseases. He is also the author of the best selling book - The Carnivore Diet.
He is also the co-founder of Revero.com - Revero is a online medical clinic treating chronic health conditions with personalized medical treatments and precision nutrition. We treat metabolic conditions such as type 2 diabetes, prediabetes, primary hypertension, and obesity as well as autoimmune and inflammatory conditions.
He has been a major influence on my journey into the carnivore lifestyle. Was a major "fanboy" moment for me to have had him on my show!
Find him on his socials -
YouTube - www.youtube.com/@DrShawnBakerPodcastInstagram - @shawnbaker1967
X - @SBakerMD
Lucy takes us on her journey into nursing and carnivore. How she saw chronic diseases in the medical wards and realized they would never get better because of what they eat and did not eat. Why she went carnivore and what benefits were noted by her.
Catch her on her instagram - @thatcarnivorenurse
Brian is mechanical engineer by training. Circumstances and health concerns for his family and himself took him down the rabbit hole of metabolic health, nutrition and fitness. He's a podcaster, film maker and health coach and created the Docuseries - "Food Lies" which is soon to be released. Watch him take us through his journey and discuss more about his film.
You can find him on IG and X - @food.lies
Check out the trailer for his docufilm - https://youtu.be/KTO6ETfUPVc?si=qSaotmHCi7h2TtPW
Visit his website - Food Lies Film | Nutrition Documentary | Sapien DietHis podcasts - Food Lies - YouTubehttps://open.spotify.com/episode/54eVTv7Jyi6mNq90tffyFe?si=d60ab6b4a19645df
Watch Laura's fascinating story and journey from eating disorders and depression to veganism to carnivore and healing. Follow her on her IG - @vegan.turned.carnivore and her YT channel - https://www.youtube.com/@vegan.turned.carnivore
My good friend of 30 years, Ekta Dutt has worked in some of the big pharmaceutical companies. Watch this episode to get some insights into how they want to keep you hooked onto medicines and not want to "cure/reverse" your chronic disease.
Worth a watch!
Watch Clement take us through his journey of carb loaded childhood, and multiple issues resolved through carnivore. His journey and experience into coaching and training people. His perspectives into exercise are very insightful.
Connect with him on his socials -
IG - @coach_qc
Website - https://swiss-personal-training.ch/en/
From cocaine and MDMA addiction to prison time to healing to coaching to carnivore - Ivy Sardi has had quite the journey. This is a fascinating watch for all.
To connect with him for coaching you can catch him on his socials -
IG - @iamivysardi
TikTok - iamivysardi
Facebook - Ivy Sardi
What an intriguing conversation with the authors of the book titled - Why Vegans have a Smaller Brain. Anita, Alison and Dave share their expertise, experiences and research into the right way of eating and why vegans and vegetarians have faster brain atrophies.
Get their book from Amazon. Amazon India link -
https://amzn.in/d/7mh7X1m
Follow their IG account for lots of fun stuff - @whyveganshavesmallerbrains
Olivia has been a in corporate marketing and now into the carnivore lifestyle and metabolic health space. She saw significant health positives once she went Carnivore. She's working in the field of metabolic psychiatry with Ally Houston. Olivia is a core member of the Public Health Collaboration that conducts metabolic health conferences every year in the UK.
Get the tickets for 2025 version here - Public Health Collaboration Annual Conference 2025Follow Olivia on IG - @oliviakhwaja
Her son makes carnivore recipes. Follow on IG - @real_food_kids
Follow the PHC on IG - @phcuk
Follow Metabolic Psy on IG - @metpsy
Watch Claire's journey from a vegan student to a carnivore Phd scientist. She's studied cell biology and her doctorate is in medical sciences. She works in the longevity field and is researching longevity and the applications of AI in the field. She discusses her struggles with being a vegan for 10 years and how her health revolutionized with carnivore. She is also a DJ into psy trance!
Catch her on her IG - @carnivoreclair
Dr Rachel qualified in medicine from the University of Edinburgh in 2003. She has worked within the field of psychiatry since 2004 and is a metabolic psychiatrist, with specialist training in the use of metabolic treatments for mental health. Dr Rachel is also a certified functional medical practitioner and believes passionately that the body needs to be considered as a whole when dealing with any symptoms of ill-health. Dr Rachel can investigate and educate you to deal with any of the following health issues:
Mental health issues including stress, depression, anxiety, psychosis, autism, cognitive impairment, ADHD, chronic fatigue.
In July 2022 Dr Rachel published her first book, Metabolic Madness. The book pieces together available evidence indicating that metabolic disorders are closely linked to mental disorders.
You can check out her IG - @carnivoreshrink
Website - https://rootcausepsych.com/
What a pleasure to have Dr Robert Lufkin on today' show.
Robert Lufkin is a Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools.
A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 400,000 people.
After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.
His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in thirteen languages. His social media posts have over 400,000 followers worldwide.
His social media accounts are -
X - @robertlufkinmd
IG - @robertlufkinmd
Website - https://www.robertlufkinmd.com/
Youtube - @RobertLufkinMD
This episode features Shashikant Iyengar, one of the pioneers of low carb in India. He worked in Big Pharma for years before giving it up and now leads the low carb movement in India. He has co-hosted the Metabolic Health conference which boasts of a stellar line up of guests and the 3rd version will be out next month in February.
Get in touch with him on his socials -
X - @shashiiyengar
IG - @shashikant_iyengar
Metabolic health conference website - https://www.metabolichealthconference.com/
If you want to learn more about the Low carb nutrition and want to learn then check out the website - www.dlife.in
Theo and Nicole are a beautiful couple who have authored the fantastic picture book titled "Our Species Appropriate Diet" and are currently working on their 2nd book which should be released in the next month or two. They are carnivores in France and have seen remarkable results.
Follow them on their journey through their socials -
IG - @theo.nicole.tales
X - @TheoNicoleTales
Order their book from Amazon's across the world (except India).
Simon Lewis was diagnosed with ADHD at a young age of 11. Thankfully his doctors asked him to be tested for food allergies and then his world went into removing gluten and dairy then Paleo followed by keto and carnivore. He works very closely with Dr Anthony Chaffee on Carnivore challenges and helping people start off the carnivore diet and lifestyle.
You can follow him on his Instagram -
@howtocarnivore
Stoked to have Dr Anthony Chaffee back on THE DESI EM PROJECT for the season 3 finale and the 100th episode! We speak about carnivore conversations, medicine, or lack of proper medicine, big pharma and much much more!!
Follow him on his socials -
IG - @anthonychaffeemd
X - @anthony_chaffee
YT - https://www.youtube.com/@anthonychaffeemd
Craig Emmerich graduated in Electrical Engineering who has spent the last 16 plus years researching nutrition and working with thousands of clients along side his wife Maria Emmerich. He is an international best selling author of the “Keto: The Complete Guide” and “The Carnivore Cookbook”. He uses his knowledge of how our bodies work to help clients heal and lose weight leveraging their biology to make it easy. Craig has helped hundreds of thousands of people regain their health and vitality with a strong focus on the science of human nutrition.
Craig has been keto for over 17 years and carnivore for over 6 years to help treat his chronic Lyme disease and CIRS pain.Check out his and Maria's website -
https://ketomaria.com/
mariamindbodyhealth.comKeto-Adapted.com
In conversation with Dave Mac. Dave was born in Scotland and brough up in Australia but now has been living in Japan for years. He has gotten over his rheumatoid arthritis, prediabetes, alcohol dependency, skin issues, anxiety etc through the carnivore lifestyle.
He has a huge following on his YouTube channel which should be checked out -
YT - https://www.youtube.com/@zerocarb
His other socials -
IG - @realdavemac
LinkedIn - Dave Mac
Maili has had an interesting journey into carnivore. She coaches using an animal based lifestyle and optimizing circadian biology.
Her goal as a health & nutrition coach is to help as many people as she can experience true & lasting wellness. She firmly believes we are all capable of healing, and that with the right tools and guidance, optimal health is within reach!
Check out her website if you need help - https://healthcoachmaili.com/#about-me
IG - @healthcoachmais
Colt Milton and Angela Huckaby are IPL Professional Bodybuilders who teach aspiring natural athletes to optimize their HEALTH & AESTHETICS using a PRIMAL WAY OF EATING.
Coach Colt publishes 3x per week on two podcasts where you can learn from athletes like Angela and a regular “ROUND TABLE” of top nutritionists from around the globe!
ANGELA HUCKABY was featured by the INTERNATIONAL PHYSIQUE LEAGUE President Ben Yusef who said this about her after her big victory in Phoenix this last weekend:
- “Angela Huckaby was the EPITOME of the IPL’s new “SHAPE” division at the November 2024 IPL Apex VIII in Phoenix, AZ, USA. At APEX she would dominate the division, earning 1st place and Pro Cards in both Open and Masters 40+ Shape, AND took the Overall SHAPE Master’s title! She would then go on to make her Debuts, earning her first IPL Pro title in the Masters class and placing 2nd in Pro Open.”
Colt’s podcasts:
- Carnivore Coaches Corner
- Co hosted with Richard Smith, GBO Pro natural bodybuilder and the UK’s top nutritionist as seen on TV
- Ranked .#1 in UK Bodybuilding podcasts
-
RICHARD is also Colt’s personal bodybuilding prep coach and they publish every Wednesday on Spotify and all podcast platforms
-
The SuperSetYourLife.Com Podcast
- Workout Motivation
- Faith, Family & Fitness
- 2 publications per week
You can follow them on Instagram:
- @coltmilton
@the.carnivorecutie
Dr Ana Rosa trained in radiology in Brazil and then again in the US when she moved there. She has been through a metabolic journey and lost many loved ones on the way. She deals with her grief and discusses how she does that on a daily basis. She is also one of the rarest of rare radiologists who reports Visceral fats on their patients scans.
Follow her on her Instagram -
@anarosa.medicineaeamor
@anarosagratitude
Its an absolute pleasure to have Monique back on the show. She shares more information on oxalates, how they move around in the body, oxalate dumping and more.
Follow her on -
IG - @lowoxcoach
Jake is an ex-marine, professional body builder, coach, triathlete and a carnivore. He's been through many diets and lifestyles and settled on the carnivore and has been studying nutrition for a while. He wants to make America healthy again and wants to be a voice for freedom.
Check out his Merch at www.thelifelikeus.com
Follow him on -
IG - @lifelikejake
X - @lifelikejake
YT - Sick, Scared and Stupid
Meet Maria Emmerich the keto queen! She reversed her chronic conditions 27 years ago and there has been no looking back. She has coached thousands and thousands of people and got them back on track.
Connect with her on her socials and websites -
Website - www.https://ketomaria.com/.
X - @MariaEmmerich
IG - @MariaEmmerich
Pinterest - @Maria_Emmerich
Allie speaks about her family and her sons having autism. She has put them on the path to recovery through carnivore and discusses how it helps them and how it alleviates their symptoms. More power to Allie!
Follow her on IG - @alliemorgan
Stephanie is a passionate nutrition enthusiast who successfully resolved her own health and mental issues through a targeted, research-based approach to diet. She believes much of conventional nutrition advice is flawed and influenced by corrupt interests. She's convinced that the right diet can cure most diseases and that there is one ideal dietary framework for everyone. Her research focuses on biology, chemistry, anthropology, and the historical evolution of the human diet.
Watch her YouTube channel - https://www.youtube.com/@meaty-bunny
IG - @meaty_bunny
Dr Gary Fettke is a senior orthopaedic surgeon from Tasmania who delved into metabolic health and preventive medicine long before any of the others. He is revered in the LCHF space and continues to advocate for the same even after a 2 year investigation by AHPRA for talking about nutrition. All the charges against him were dismissed but helped in bringing his work and aims into the limelight!
Follow Dr Fettke on IG - @isupportgary
X - @FructoseNo
YT - https://www.youtube.com/@garyfettke3210
Website - www.isupportgary.com
Robert Kiltz, MD, is the Founder and Director of CNY Fertility. He is a Diplomate of the American Board of Obstetrics and Gynecology and fellowship trained and Board Certified in Reproductive Endocrinology and Infertility.
He has been on the carnivore lifestyle for 15 years now and resolved issues like bleeding bowels, psoriasis, arthritis, migraines, ADHD amongst others.
Had a fantastic chat with him and learnt a lot!
Find him here -
IG and X - @doctorkiltz
YT - https://www.youtube.com/@doctorkiltz
Websites - ketoforfertility.co
doctorkiltznutritionalsolutions.com
Spotify - Carnivore Conversations
Dr Lisa Wiedeman is one of the OG's of carnivore since 15 years! She is an optometrist physician and a strong advocate of primal way of living. Watch her journey here.
She has a coaching community called the Carbohydrate sober community.
You can get in touch with her on her IG - @carnivoredoctor
Her YT channel is - http://www.youtube.com/@carnivoredoctor
Check out her community - https://carnivore-doctor-community.mn.co/
Zoe Harcombe is a researcher, author, blogger and public speaker in the field of diet and health. Her particular areas of interest/expertise are public health dietary guidelines (especially dietary fat), nutrition and obesity.
She has a BA and MA from Cambridge University (economics/maths). In 2016, She was awarded a Ph.D. in public health nutrition. Her thesis title was “An examination of the randomised controlled trial and epidemiological evidence for the introduction of dietary fat recommendations in 1977 and 1983: A systematic review and meta-analysis.
Visit her website - https://www.https://www.zoeharcombe.com/
Follow her on X - @zoeharcombe
We have the lovely Linda Salant aka @thecarnitarian back on the show. She takes us through the process of starting someone on carnivore, how to promote healthy eating without judging or getting judged and what to do in festive seasons that are upon us soon!
Get in touch with her on her IG - @the carnitarian
An alumni of IIT,Roorkee, Anup is the pioneer of the LCHF movement in India. On being diagnosed with diabetes in 2011, he refused to take medications and went into researching diabetes and the various treatments. After reversing diabetes with Low Carb he set up the Award winning dLife forum in 2014 which has trained many in the LCHF field and changed the lives of many patients. Anup was also awarded the Icons of India award by the Outlook group.
Watch his story.
You can connect to him through his socials -
X - @dLifein
Website - www.dlife.in
Watch this episode to find out how Ira Sahay, meat eater turned vegetarian turned carnivore reversed her autoimmune condition called membranous nephropathy and other accompanying issues.
She now coaches patients with autoimmune issues to reverse syndromes their doctors cannot reverse on medications through lifestyle and nutrition interventions.
Catch her on X - @theirasahay
IG - @ira_sahay
Charlotte suffered from Asthma, fungal infections, ADHD, weight issues, congested sinuses which have all reversed when she went low carb and animal based.
Watch her share her journey.
You can get in touch through her IG - @charlotteannice
A stimulating conversation with mitochondrial optimization and movement expert Andreas David Christou from Cyprus. He imparts great knowledge into the world of "biohacking" and steps to optimize healthy mitochondria.
You can follow him on his socials and connect through his website -
IG - andreas_david_christou
Website - www.mobility-fitness.com
YT - https://www.youtube.com/@movementspecialistandreas
From being a cop to an undercover agent to an advocate to an EM doctor to a metabolic health expert - Dr Sean O'Mara has been there and done that!
Watch him unravel the mysteries of fat in our body, how it is linked to our metabolic health and sickness and how to get better.
Also new intro music for THE DESI EM PROJECT has been produced by Rohan Soloman. Hope you like it!
Connect with him @ -
https://www.growingbetternotolder.com/
https://drseanomara.com/
IG/X/Linkedin - @drseanomara
Catch Dr Roshani, Mumbai based endocrinologist, Author of "Turning around Diabetes" talk about using lifestyle changes like low carb interventions to reverse diabetes. We speak on myriad issues and had a lot of fun!
Get in touch with her through her website or her socials -
IG - @roshanisanghani
Linkedin - Roshani Sanghani
Website - https://reisaanhealth.com/
I have Brett today take us through his journey of Metabolic healing, his past and the metabolic revolution he is an integral part of.
If you want to get in touch with him -
brett@mymetaboliclife.com
262-255-9545
https://mymetaboliclife.com
www.youtube.com/@mymetaboliclife
www.youtube.com/@TheMetabochondriacs
https://MetabolicRevolution.org
Was so stoked to have Prof. Bart Kay on THE DESI EM PROJECT.
Prof. Bart has successfully taught aspects of physiology, anatomy, biochemistry, metabolism/nutrition, and research design/statistics since 2001: both in the UK and in Australasia. He has consulted regarding optimising physical performance to The New Zealand All Blacks, the National Rugby League (NRL) Referees Association, The Royal Australian Defence Force, and The Royal New Zealand Army. Bart has a number of publications in the areas of exercise physiology, biochemistry, metabolism, nutrition, statistics, and physiological performance modelling.
Follow him on his socials -
IG - @bart_kay_nutrition
YouTube channel - https://www.youtube.com/@bart-kay
Patreon - patreon.com/Bart_Kay
Alt YT Channel - youtube.com/@Prof-Kays-Carnivore-Cult
Watch Allie narrate her powerful story of overcoming a multitude of disorders including being diagnosed with bipolar at the age of 8! And how her son goes into autism remission when on carnivore.
Follow her on IG - @allie_morgan._
Listen to Colleen's fascinating story. She bares her life and what she has been through. She is off her medications for MS (as per her own choice) and went fully carnivore and the results show.
Follow her on her IG - @beefbodybuilding
Listen to 20 year young Eddie Goeke take us through his excruciating journey through Ehlers Danlos syndrome and how he is fighting it with Carnivore and his injections. He has managed to write a book though his struggles and done a lot of research into the biochemistry, anatomy, physiology and cellular biology behind nutrition and the species specific diet.
Order his book "Contraindicated" from Amazon - a.co/d/3x4y5GlYoutube - www.youtube.com/@e.goeke_Patreon - patreon.com/EddieGoekeHelp him move closer to his clinic in Florida - gofund.me/dec835e1IG - @e.goeke_
Had such a fun conversation with Rachel from England aka @carnivore.fitness. She has been carnivore for more than 5 years and is a mother of 4 (kid you not!). Listen to her journey and our conversation.
Follow her or get in touch with her on her socials -
IG - @carnivore.fitness; @tallow.glow
It is a pleasure to have Richard aka The keto pro back on the show to discuss more about food and what we should and should not do for our kids. What we should and should not give to them to eat. He takes us through a fantastic presentation. Do not miss this one!
Catch Richard on his socials -
IG - @keto_pro and @richard_smith_nutrition
Visit his website to order to cool products - https://theketopro.com/
Check out his youtube channel - https://www.youtube.com/@keto-pro287
Intriguing conversation with Michael Kummer. We talk all about animal based, fitness, proteins, home school and white castle burgers!
Catch him on his socials -
Blog - https://michaelkummer.com/
Youtube - www.youtube.com/@MichaelKummer
IG - instagram.com/mkummer82
Podcast - primalshiftpodcast.com
Cameron Glover aka @coachcarnivorecam is a fitness coach who has had his ups and downs with different diets till he discovered carnivore. Watch him take us through his journey and converse all things carnivore.
He has fantastic carnivore recipes and you can join his Private online community to start your fitness journey - www.stan.store/coachcarnivorecam
Follow him on his IG/TikTok/Youtube - @coachcarnivorecam
Listen to this amazing conversation I had with the one and only Professor Thomas Seyfried regarding cancer and its pathogenesis (which is not genetic or mutational in origin as per his work). I do suggest all in the medical fraternity including oncologists to listen/watch with an open mind and keep their differences at bay.
Thomas N. Seyfried (born 1946[1]) is an American professor of biology, genetics, and biochemistry at Boston College. He received his PhD from the University of Illinois Urbana-Champaign in 1976. His postdoctoral fellowship studies were in the Department of Neurology at the Yale University School of Medicine where he served as an assistant professor in neurology. He did undergraduate work at the University of New England, formerly St. Francis College, and received a master's degree in genetics from Illinois State University.
His research focuses on mechanisms of chronic diseases such as cancer, epilepsy, neurodegenerative lipid storage diseases, and caloric restriction diets.[2] Thomas N. Seyfried has been published in over 150 peer-reviewed publications.
You can follow him on his IG - @thomasseyfriedbc
All his papers are open access and can be downloaded and read.
Join in as Dr Sandeep and I converse about USG guided nerve blocks and his fantastic RCT published in the EMJ.
He takes us through some basics of nerve blocks and how to identify nerves using the USG machine.
Check out his papers -
https://emj.bmj.com/content/early/2024/07/08/emermed-2023-213799
Follow him on his IG - @drdoom412
In this episode Serena Musick - a 3 year carnivore takes us through her journey of illness, food addictions and parosmia till she found carnivore. We discuss sardine fasts, water fasts and much more!
Follow her on her socials -
IG - @serena.carnivore
Youtube - https://www.youtube.com/@carnivorerevolution
What an amazing conversation with Rick this time round.Rick Miller is a dietitian based in Harley Street, London, UK and the host of The Miller Hour Podcast. Rick’s passion and specialism is in mens’ health and decentralised clinical support, meaning he embraces the use of light, water, magnetism and specific nutrition (such as carnivore) to help his male client reach peak health and reverse metabolic disease. He is lifelong martial artist (Shotokan Karate), legally trained as an expert witness to the UK courts and has worked across many rotations in medical nutrition.
His websites - www.millerhealth.london ; www.rickmillerdietitian.co.uk Follow him on his socials -
Twitter/X @rickmillerrd
Instagram: @rickmillerrd
YouTube: @rickmillerrd
Watch Courtney talk about her health issues, food addiction and how things reversed on carnivore. She gives some tips and tricks into how to start off getting on track with your health. She also has a carnivore cookbook that will release in October 2024. Do pre-order it.
Pre-order her book from - https://courtneyluna.com/
You can follow her on her IG - @itscourtneyluna
Subscribe to her Youtube - https://www.youtube.com/@CourtneyLuna
Listen to Rich aka keto_pro drop absolute knowledge bombs on nutrition and fitness in this episode. Follow him on his IG - @keto_pro
Check out his website if you would like order some exogenous ketones and other products - https://theketopro.com/
Check out his youtube channel - https://www.youtube.com/@keto-pro287
In this short episode, I have brought to you the randomized study that we published on the treatment of hypoglycemia. You can change your practice of treating such patients and use 5-10 gms of sugar rather than the traditionally used 25 gms (6 spoons). If you want me to delve deeper into hypoglycemia ( causes,symptoms, etc.) do let me know in the comments and I shall produce it for you!
You can read the paper here -
https://pubmed.ncbi.nlm.nih.gov/38851077/
Had a very interesting chat with Seema and Suman Modgill from New Zealand. Watch how their life turned for the worse when they went vegan and green smoothie drinking people after watching Game Changers and then reversed everything after watching Paul Saladino. Truly remarkable journey. Their son had severe eczema since he was a toddler and now has his own fitness page on IG. Go follow him there - @fitbysanj
In this episode Jason aka @carnivorejt talks about his journey through carnivore, research, social media, exercises and more.
Check out his website and order carnivore merch - www.theinnercarnivore.com
His podcast - theinnercarnivore
Follow him on his IG - @carnivorejt
Follow him on X - @carnivore_jt
Linda Salant has been a carnivore for 9 years now and going stronger than ever! Watch her narrate her story and our discussions on carnivore and lipedema and other things..
Follow Linda on IG - @thecarnitarian
Subscribe to her Youtube channel - @thecarnitarianlife
Know more about lipedema at - https://lipedemaproject.org/
Enjoy this chat with Anthony Phaesse taking us through the fascinating world of hormones and how it is so important to keep them in sync for a healthy life.
You can follow him on his IG - @leanseven
Learn more about hormones on https://www.hormonedomino.com
If you want to join Anthony's Lean Seven program, click on this following link - https://anksv.krtra.com/t/BtlfcZ5YJjdT
and get $50 off by using the code - 50PROMO
Watch what took Varshitha down the keto/carnivore path and how she turned her health around. Also her experiences with metabolic syndrome patients as a surgeon We had quite an amazing time recording this for you.
Follow her on her IG - dr_varshitha_k
Coach Stephen Thomas specializes in diabetes and obesity and has been coaching thousands of clients over many years leading to reversals in metabolic syndromes and turning their health around. he has been a carnivore for more than 5 years now and at the peak of his health!
Follow him on his IG - @theukcarnivore
Youtube - https://www.youtube.com/@CoachStephen
Website - https://www.theukcarnivore.com/
Sally K Norton did her bachelor's in nutritional science from Cornell University and her Master's in Public Science from University of North Carolina. She is also the author of the best selling book - "TOXIC SUPERFOODS" which delves into the mysterious world of all things OXALATES. Listen to us chat up about oxalate toxicity and dumping and much much more!
You can follow her youtube channel - https://www.youtube.com/@sknorton
Check out her website - https://sallyknorton.com/
Follow her on her IG handles - @sknorton ; @toxicsuperfoods_oxalate_book
Was fun to have Bella aka thesteakandbuttergal come onto the show to take us through her vegan to carnivore journey and talk all things carnivore! She has been a carnivore for 5 years now and absolutely thriving.
Follow her on IG,Youtube,TikTok,Patreon through her handle - @steakandbuttergal
If you want to join the steak and butter gang then click on the link - https://sbg-s-meat-up.mn.coLink to One of my favourite steakandbuttergal youtube videos -
https://youtu.be/VkBfr8aMThw?si=2ey8lxs5AYwnCMX3
In this episode I discuss some of the salient points needed to remember when dealing with the crashing asthmatic patient. As an emergency physician, you got to hold your nerves and go step by step and remember to keep the next step resources ready!
Go through the following sites to know more -
- https://emergencymedicinecases.com/crashing-asthmatic-life-threatening-asthma/
2.https://emcrit.org/pulmcrit/crashing-asthmatic/
3.https://emcrit.org/ibcc/asthma/#nontubed
4.https://rebelem.com/rebelcast-crashing-asthmatic/
- https://emcrit.org/emcrit/severe-asthmatic
Listen to Sarah Zaldivar (Phd) talk about carnivore, dopamine brain, priming and a lot more. What a fun time chatting up with her.
Listen to her songs on spotify -
https://open.spotify.com/track/6RFKB7Y82GEK15Wv47ScyG?si=2e62dc2cf0ba44d4
https://open.spotify.com/track/2dYTNv4RWypRi4zvCp8Uyi?si=3d886a6985dd4dfc
https://open.spotify.com/track/0XcUYMySrHLR8WV3Tettil?si=7cfa065fe8ca4674
Follow her on social media -
IG - @dr.sarah.zaldivar
Website - https://drsarahzaldivar.com/shop/
Listen to Monique Attinger talk about one of the most dreaded antinutrients found in plant foods - Oxalates. What it does to you, how to get rid of them and what the low ox life is all about.
You can visit her website - www.lowoxcoach.com
Follow her on her socials -
X,Instagram,TikTok,Patreon - @lowoxcoach
Dr Anthony Chaffee joins me today to converse all things carnivore and keto. We go through some really important points. You can see the passion he has for the optimal human species specific diet.
Login to his website for the monthly carnivore challenge - https://www.howtocarnivore.com/
You can follow him on his social media -
Instagram - @anthonychaffeemd
X - @anthonychaffeemd
Youtube channel - Plant Free MD - @anthonychaffeemd
In my 50th episode, I talk about how metabolic fitness is important and how it is linked to the majority of patients brought into emergency departments everyday. These can be prevented if only everyone follows the right nutrition. A huge burden on health can be reduced if people reverse their conditions which is not going to take place by popping medicines.
Listen to James aka The Carnivorist as he takes us through his journey from pescetarian to vegan to oxalate toxicities all the way to the Carnivore lifestyle!
Follow him on his
IG - @the_carnivorist
X - @the_carnivorist
or email him on jamesthecarnivorist@gmail.com
Follow his podcast Carnivorist Chats -
https://open.spotify.com/show/5yUt1iK1Q0z12TzJhhmyRV?si=4a6575026f1740b4
Watch and listen to Mahek Lokhandwala who moved onto a carnivore journey after experimenting with other diets and finally got it right. Also pay attention to how her husband found relief from all his ailments thanks to going carnivore. She also produces some amazing goat tallow. Give her a follow.
You can follow Mahek on her IG - @indian_carnivore
Listen to Natalie speak about the damage high oxalate foods did to her and how she went into recovery mode and evolved with animal based diet and cutting off the oxalate bombs to a minimum.
You can follow her on her IG - @meat.kaizen
This is an incredible story of Mimi Morgan who fought against all odds and got off multiple medications through her keto and carnivore lifestyle. Must listen!
You can follow her on her IG - mimikmorgan
and X - @mimikmorgan
Check out the list of the Top 10 Indian Medical podcasts her - https://blog.feedspot.com/india_medical_podcasts/
In this episode, I have with me the wonderful Emma from Essex talking about her carnivore lifestyle and how it helped during her premenopausal and post menopausal journey. Listen to her pearls and maybe just maybe something will click for you.
You can get in touch with Emma on her Instagram - @the_inked_pinup
RSI - Resuscitation sequence intubation is still a foreign term in some countries. In this episode I shed some light into the practice of the same in your EDs. Learn up more from the following resources and incorporate it into your airway management techniques.
Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/.https://litfl.com/intubation-hypotension-and-shock/
https://www.acepnow.com/article/timing-resuscitation-sequence-intubation-for-critically-ill-patients/
https://www.emdocs.net/r-e-b-e-l-em-critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/
Talking about one of my favourite topics - Trauma Shocks. Giving out some pearls here specially for the newbies and the ones who have not updated themselves regarding trauma care. Just a few pointers. Don't just believe me. Do your own research too!
I have got Jen Winkler in the house. What a fantastic conversation we had regarding going carnivore and a whole lot of things. Just one of the first few chats we have had! Had to compress the the audio file a bit hence you may hear some static. Apologies for the same!! You can follow her on her Insta - @coachjenwinkler
This finale episode of 2023 is dedicated to my cousin Abhijeet whom we lost at the young age of 30. he gave me insights into how cancer cells feed into sugars. Strengthened my resolve to educate more people regarding diet and nutrition. This is just a snippet into how I reversed my metabolic age. There's a lot more to talk about and I look forward to it in 2024. Happy New Year.
Welcome back to Season 3 of The DESI EM PROJECT! Hope you all have had a fantastic 2023 and here's wishing you a fab 2024. Starting off this season with conversations with fellow carnivore Dr Pallavi Aga. Always interesting to learn from others and their experiences. Lost her for a bit due to network issues but will be back with her for more conversations. You can follow her on her Instagram @pallaviaga
I have got the lovely Mehak Arora to talk to us about the world of psychoanalysis. This is just the beginning. The field is massive and we will be dishing out more episodes. Mental health is important. If you want to get in touch with her for help, you can connect to her on her email address - mehakarora017@gmail.com or DM her on her IG - @me.hak1516
Calling the cardiologist unnecessarily from the ED for every little raised troponin is one of my pet peeves. In this episode, I discuss what troponins are and what are the conditions in which they shoot up. Don't just believe me. Do your own research too. You can go through some of the following literature -
-
https://pubmed.ncbi.nlm.nih.gov/20685679/
-
https://pubmed.ncbi.nlm.nih.gov/15136402/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554225/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860726/
-
https://pubmed.ncbi.nlm.nih.gov/15736582/
-
https://pubmed.ncbi.nlm.nih.gov/12460876/
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https://pubmed.ncbi.nlm.nih.gov/9510880/
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https://pubmed.ncbi.nlm.nih.gov/22105197/
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https://pubmed.ncbi.nlm.nih.gov/26346942/
I have noticed a lot of patients receiving unnecessary oxygen over the years. It's one of my pet peeves. So in this short episode I talk a little about how toxic unnecessary or over oxygenation can be. Go ahead and do your research. You can also go through the following papers -
-
Stub D, Smith K, Bernard S, Nehme Z, Stephenson M, Bray JE, Cameron P, Barger B, Ellims AH, Taylor AJ, Meredith IT, Kaye DM; AVOID Investigators. Air Versus Oxygen in ST-Segment-Elevation Myocardial Infarction. Circulation. 2015 Jun 16;131(24):2143-50
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Vali P, Lakshminrusimha S. The Fetus Can Teach Us: Oxygen and the Pulmonary Vasculature. Children (Basel). 2017 Aug 3;4(8):67. doi: 10.3390/children4080067.
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Mach WJ, Thimmesch AR, Pierce JT, Pierce JD. Consequences of hyperoxia and the toxicity of oxygen in the lung. Nurs Res Pract. 2011;2011:260482.
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Singer M, Young PJ, Laffey JG, Asfar P, Taccone FS, Skrifvars MB, Meyhoff CS, Radermacher P. Dangers of hyperoxia. Crit Care. 2021 Dec 19;25(1):440.
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Hofmann R, James SK, Jernberg T, Lindahl B, Erlinge D, Witt N, Arefalk G, Frick M, Alfredsson J, Nilsson L, Ravn-Fischer A, Omerovic E, Kellerth T, Sparv D, Ekelund U, Linder R, Ekström M, Lauermann J, Haaga U, Pernow J, Östlund O, Herlitz J, Svensson L; DETO2X–SWEDEHEART Investigators. Oxygen Therapy in Suspected Acute Myocardial Infarction. N Engl J Med. 2017 Sep 28;377(13):1240-1249
6.Phillips M, Cataneo RN, Greenberg J, Grodman R, Gunawardena R, Naidu A. Effect of oxygen on breath markers of oxidative stress. Eur Respir J. 2003 Jan;21(1):48-51.
7.The Fetal Circulation. Peter John Murphy. doi 10.1093/bjaceaccp/mki030
8.Rønning OM, Guldvog B. Should stroke victims routinely receive supplemental oxygen? A quasi-randomized controlled trial. Stroke. 1999 Oct;30(10):2033-7.
- Iscoe S, Beasley R, Fisher JA. Supplementary oxygen for nonhypoxemic patients: O2 much of a good thing? Crit Care. 2011;15(3):305. doi: 10.1186/cc10229
3 weeks into my 24 hour intermittent fasting and I feel fantastic. So I thought why not share what I have learnt and researched with all my followers and listeners. You can go through some of the papers here and do your own research before you plan to embark on your journey of Intermittent fasting (if you decide to do so).
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Stockman, M.C.; Thomas, D.; Burke, J.; Apovian, C.M. Intermittent Fasting: Is the Wait Worth the Weight? Curr. Obes. Rep. 2018,7, 172–185
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Swi ˛atkiewicz, I.;Wo´zniak, A.; Taub, P.R. Time-Restricted Eating and Metabolic Syndrome: Current Status and Future Perspectives. ´Nutrients 2021, 13, 221.
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Asher, G.; Sassone-Corsi, P. Time for food: The intimate interplay between nutrition, metabolism, and the circadian clock. Cell 2015, 161, 84–92
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Anton, S.D.; Moehl, K.; Donahoo, W.T.; Marosi, K.; Lee, S.A.; Mainous, A.G.; Leeuwenburgh, C.; Mattson, M.P. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity 2018, 26, 254–268.
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Vasim I, Majeed CN, DeBoer MD. Intermittent Fasting and Metabolic Health. Nutrients. 2022 Jan 31;14(3):631.
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Krishnamoorthy Y, Rajaa S, Murali S, Rehman T, Sahoo J, Kar SS. Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis. PLoS One. 2020 Oct 19;15(10):e0240971
A lot of people have misconceptions regarding cholesterols and their blood work and the need for medications. In this episode I have attempted to bust some myths and point the people towards the right direction. You can go through the research and do your own to come to your own conclusions and choices obviously.
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https://pubmed.ncbi.nlm.nih.gov/27618496/
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https://pubmed.ncbi.nlm.nih.gov/27617709/
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https://pubmed.ncbi.nlm.nih.gov/27292972/
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https://pubmed.ncbi.nlm.nih.gov/34684304/
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https://pubmed.ncbi.nlm.nih.gov/34764414/
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https://pubmed.ncbi.nlm.nih.gov/26339496/
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https://pubmed.ncbi.nlm.nih.gov/27071971/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881926/
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https://meddocsonline.org/annals-of-epidemiology-and-public-health/the-LDL-paradox-higher-LDL-cholesterol-is-associated-with-greater-longevity.pdf
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https://pubmed.ncbi.nlm.nih.gov/23902788/
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https://pubmed.ncbi.nlm.nih.gov/25032333/
Got Cliff again. Conversation about learning from mistakes and cognitive forcing. Hope you all learn something from this episode.
One of my inspirations in Emergency Medicine, Cliff Reid is in the house to have some EM related conversations over beers. He flew down from Sydney to be with us and have an experience and what an experience it has been! Do not miss out on this episode! Many more coming up with him!
In this episode I have tried to simplify some stuff about diabetic ketoacidosis for the residents and the first time consultants. Its a huge topic and just one episode does not do justice to it. But you do not have to follow what I say. Please do your own research too. You can go through the following the references -
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Canadian Diabetes Association Clinical Practice Guidelines Expert Committee; Goguen J, Gilbert J. Hyperglycemic emergencies in adults. Can J Diabetes. 2013 Apr;37 Suppl 1:S72-6. doi: 10.1016/j.jcjd.2013.01.023. Epub 2013 Mar 26. PMID: 24070967.
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Self WH, Evans CS, Jenkins CA, et al. Pragmatic Critical Care Research Group. Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA Netw Open. 2020 Nov 2;3(11):e2024596. doi: 10.1001/jamanetworkopen.2020.24596. PMID: 33196806; PMCID: PMC7670314.
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https://emcrit.org/ibcc/hypokalemia/#top
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https://emcrit.org/ibcc/dka/#definition_&_severity_of_DKA
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Tran TTT, Pease A, Wood AJ, et al. Review of evidence for adult diabetic ketoacidosis management protocols. Front Endocrinol (Lausanne). 2017;8:106. doi:10.3389/fendo.2017.00106
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Fort P, Waters SM, Lifshitz F. Low-dose insulin infusion in the treatment of diabetic ketoacidosis: bolus versus no bolus. J Pediatr 1980;96:36e40.
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Butkiewicz EK, Leibson CL, O’Brien PC, et al. Insulin therapy for diabetic ketoacidosis. Bolus insulin injection versus continuous insulin infusion. Diabetes Care 1995;18:1187e90.
Yes i have been MIA for a month now! Was at Amsterdam to participate at the ICEM 2023 conference. What an experience it was! Loved it! Got to meet my idol Cliff Reid too! That was the icing! but I am back and speaking today about sustainable EDs and how healthcare contributes to climate change. yes it does! Go through some of the papers cited here -
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Walsh O, Harris R, Flower O, Anstey M, McGain F. Everyone’s a winner if we test less: the CODA action plan. Aust Health Rev. 2022 Aug;46(4):460-462. doi: 10.1071/AH22145. PMID: 35772927.
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Linstadt H, Collins A, Slutzman JE, Kimball E, Lemery J, Sorensen C, Winstead-Derlega C, Evans K, Auerbach PS. The Climate-Smart Emergency Department: A Primer. Ann Emerg Med. 2020 Aug;76(2):155-167. doi: 10.1016/j.annemergmed.2019.11.003. Epub 2020 Jan 23. PMID: 31983497.
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McAlister S, Barratt AL, Bell KJ, McGain F. The carbon footprint of pathology testing. Med J Aust. 2020 May;212(8):377-382. doi: 10.5694/mja2.50583. Epub 2020 Apr 18. PMID: 32304240.
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Tennison I, Roschnik S, Ashby B, Boyd R, Hamilton I, Oreszczyn T, Owen A, Romanello M, Ruyssevelt P, Sherman JD, Smith AZP, Steele K, Watts N, Eckelman MJ. Health care's response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health. 2021 Feb;5(2):e84-e92. doi: 10.1016/S2542-5196(20)30271-0. PMID: 33581070; PMCID: PMC7887664.
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Kanem N, Murray CJL, Horton R. The Lancet Commission on 21st-Century Global Health Threats. Lancet. 2023 Jan 7;401(10370):10-11. doi: 10.1016/S0140-6736(22)02576-4. Epub 2022 Dec 15. PMID: 36529147; PMCID: PMC9754642.
In this episode I talk about my experience with carnivore diet, some facts, some myths and some anecdotes.
Ever had trouble convincing other specialties and seniors to do the right thing in your bleeding trauma patient and not give fluids? I am sure everyone has. So I had a light bulb moment and came up with the "Milkshake Paradigm" that you could use on them. I tried it on some and it worked. Well if you think it helps you, remember where you heard it the first!
In this podcast, I've spoken about the complexity of ARDS, risk factors, pathophysiology and treatment strategies. You can check out the references -
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Gragossian A, Siuba MT. Acute Respiratory Distress Syndrome. Emerg Med Clin North Am. 2022 Aug;40(3):459-472. doi: 10.1016/j.emc.2022.05.002. Epub 2022 May 10. PMID: 35953211; PMCID: PMC9085508.
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Meyer NJ, Gattinoni L, Calfee CS. Acute respiratory distress syndrome. Lancet. 2021 Aug 14;398(10300):622-637. doi: 10.1016/S0140-6736(21)00439-6. Epub 2021 Jul 1. PMID: 34217425; PMCID: PMC8248927.
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National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network; Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006 Jun 15;354(24):2564-75. doi: 10.1056/NEJMoa062200. Epub 2006 May 21. PMID: 16714767.
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Yadav H, Thompson BT, Gajic O. Fifty Years of Research in ARDS. Is Acute Respiratory Distress Syndrome a Preventable Disease? Am J Respir Crit Care Med. 2017 Mar 15;195(6):725-736. doi: 10.1164/rccm.201609-1767CI. PMID: 28040987.
Apologies for being MIA for a month now. Been busy! But am back and in this episode talk about calcium channel blocker toxicity. The physiology behind it, a little pharmacology and then the treatment. Busting some myths and reinforcing the need for proactive emergency medicine evidence based treatment. You can check out these papers and do more research for yourselves too -
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Wightman RSHRA. Cardiologic Principles II: Hemodynamics. In: Nelson LS, Howland MA, Lewin NA, et al, editors. Goldfrank’s toxicologic emergencies. 11th Edition. New York City, NY: McGraw Hill; 2019. p. 260–7
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Levine M, Brent. Beta-Receptor Antagonists. In: Brent J, Burkhart K, Daragan P, et al, editors. Critical care toxicology. New York City, NY: Mosby; 2017. p. 771–86.
Wallukat G. The beta-adrenergic receptors. Herz 2002;27(7):683–90.
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Ranniger C, Roche C. Are one or two dangerous? Calcium channel blocker exposure in toddlers. J Emerg Med 2007;33(2):145–54
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Gummin DD, Mowry JB, Beuhler MC, et al. 2019 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 37th Annual Report. Clin Toxicol 2020;58(12):1360–541.
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Holger JS, Engebretsen KM, Obetz CL, et al. A comparison of vasopressin and glucagon in beta-blocker induced toxicity. Clin Toxicol 2006;44(1):45–51
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Jang DH, Donovan S, Nelson LS, et al. Efficacy of methylene blue in an experimental model of calcium channel blocker-induced shock. Ann EmergMed 2015;65(4):410–5.
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Laes JR, Williams DM, Cole JB. Improvement in hemodynamics after methylene blue administration in drug-induced vasodilatory shock: a case report. J Med Toxicol 2015;11(4):460–3.
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Wang GS, Levitan R, Wiegand TJ, et al. Extracorporeal membrane oxygenation (ECMO) for severe toxicological exposures: review of the toxicologyinvestigators consortium (ToxIC). J Med Toxicol 2016;12(1):95–9
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Hayes BD, Gosselin S, Calello DP, et al. Systematic review of clinical adverse events reported after acute intravenous lipid emulsion administration. ClinToxicol 2016;54(5):365–404
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American College of Medical Toxicology. ACMT position statement: guidance for the use of intravenous lipid emulsion. J Med Toxicol 2017;13(1):124–5.
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Kerns W 2nd. Management of beta-adrenergic blocker and calcium channel antagonist toxicity. Emerg Med Clin North Am. 2007 May;25(2):309-31; abstract viii. doi: 10.1016/j.emc.2007.02.001. PMID: 17482022.
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Cole JB, Arens AM. Cardiotoxic Medication Poisoning. Emerg Med Clin North Am. 2022 May;40(2):395-416. doi: 10.1016/j.emc.2022.01.014. Epub 2022 Apr 5. PMID: 35461630.
In this episode I talk about my fitness journey and the research I have done. I totally promote an animal based diet and talk about awareness regarding food and nutrition. I also take on a bit of the processed food industry that is hurting us in many ways and ask everyone to steer away from them. I also discuss some bioavailability of nutrients in food items. Some of the papers are mentioned below but you can do your own research too. Your health is in your hands.
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Swanson D, Block R, Mousa SA. Omega-3 fatty acids EPA and DHA: health benefits throughout life. Adv Nutr. 2012 Jan;3(1):1-7. doi: 10.3945/an.111.000893. Epub 2012 Jan 5. PMID: 22332096; PMCID: PMC3262608.
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Smith NW, Fletcher AJ, Hill JP, McNabb WC. Modeling the Contribution of Meat to Global Nutrient Availability. Front Nutr. 2022 Feb 2;9:766796. doi: 10.3389/fnut.2022.766796. PMID: 35187029; PMCID: PMC8849209.
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Pereira PM, Vicente AF. Meat nutritional composition and nutritive role in the human diet. Meat Sci. 2013 Mar;93(3):586-92. doi: 10.1016/j.meatsci.2012.09.018. Epub 2012 Oct 31. PMID: 23273468.
4.Melse-Boonstra A. Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits. Front Nutr. 2020 Jul 24;7:101. doi: 10.3389/fnut.2020.00101. PMID: 32793622; PMCID: PMC7393990.
- Lee JE, McLerran DF, Rolland B, Chen Y, Grant EJ, Vedanthan R, Inoue M, Tsugane S, Gao YT, Tsuji I, Kakizaki M, Ahsan H, Ahn YO, Pan WH, Ozasa K, Yoo KY, Sasazuki S, Yang G, Watanabe T, Sugawara Y, Parvez F, Kim DH, Chuang SY, Ohishi W, Park SK, Feng Z, Thornquist M, Boffetta P, Zheng W, Kang D, Potter J, Sinha R. Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies. Am J Clin Nutr. 2013 Oct;98(4):1032-41. doi: 10.3945/ajcn.113.062638. Epub 2013 Jul 31. PMID: 23902788; PMCID: PMC3778858.
This is a short and sweet episode on managing anaphylactic airways. Key points to remember, drugs that can be used and some pearls. But do your own research and do not just take my word for it! Happy airways!
In this episode I explore the small yet deadly world of Anaphylaxis. Remember the most common cause of death in anaphylaxis is the wrong dose at the wrong time of epinephrine! Feel free to go through the following references -
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McHugh K, Repanshek Z. Anaphylaxis: Emergency Department Treatment. Emerg Med Clin North Am. 2022 Feb;40(1):19-32. doi: 10.1016/j.emc.2021.08.004. Epub 2021 Oct 29. PMID: 34782088.
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Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report–second National
Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med 2006;47(4):373–80. -
Manivannan V, Hess EP, Bellamkonda VR, et al. A multifaceted intervention for patients with anaphylaxis increases epinephrine use in adult emergency department. J Allergy Clin Immunol Pract 2014;2(3):294–9.e1.
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Alqurashi W, Ellis AK. Do corticosteroids prevent biphasic anaphylaxis? J Allergy Clin Immunol Pract 2017;5(5):1194–205.
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Thomas M, Crawford I. Best evidence topic report. Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. Emerg Med J 2005;22(4):
272–3 -
Ahmad I, El-Boghdadly K, Bhagrath R, et al. Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults. Anaesthesia 2020;75(4):509–28.
In the first episode of this season I talk about using high dose Nitroglycerine and Bipap for the sympathetic crashing acute pulmonary edema (SCAPE) patients in you ED. Don't take my word for it. Go through the following references and make your own protocol for your department. We have had fantastic results!
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Paone S, Clarkson L, Sin B, Punnapuzha S. Recognition of Sympathetic Crashing Acute Pulmonary Edema (SCAPE) and use of high-dose nitroglycerin infusion. Am J Emerg Med. 2018 Aug;36(8):1526.e5-1526.e7. doi: 10.1016/j.ajem.2018.05.013. Epub 2018 May 10. PMID: 29776826.
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Mathew R, Kumar A, Sahu A, Wali S, Aggarwal P. High-Dose Nitroglycerin Bolus for Sympathetic Crashing Acute Pulmonary Edema: A Prospective Observational Pilot Study. J Emerg Med. 2021 Sep;61(3):271-277. doi: 10.1016/j.jemermed.2021.05.011. Epub 2021 Jun 30. PMID: 34215472.
3.Hsieh YT, Lee TY, Kao JS, Hsu HL, Chong CF. Treating acute hypertensive cardiogenic pulmonary edema with high-dose nitroglycerin. Turk J Emerg Med. 2018 Feb 2;18(1):34-36. doi: 10.1016/j.tjem.2018.01.004. PMID: 29942881; PMCID: PMC6009803.
- Levy P, Compton S, Welch R, Delgado G, Jennett A, Penugonda N, Dunne R, Zalenski R. Treatment of severe decompensated heart failure with high-dose intravenous nitroglycerin: a feasibility and outcome analysis. Ann Emerg Med. 2007 Aug;50(2):144-52. doi: 10.1016/j.annemergmed.2007.02.022. Epub 2007 May 23. PMID: 17509731.
5.Houseman BS, Martinelli AN, Oliver WD, Devabhakthuni S, Mattu A. High-dose nitroglycerin infusion description of safety and efficacy in sympathetic crashing acute pulmonary edema: The HI-DOSE SCAPE study. Am J Emerg Med. 2023 Jan;63:74-78. doi: 10.1016/j.ajem.2022.10.018. Epub 2022 Oct 18. PMID: 36327753.
In this season finale episode I am joined with my residents Drs Nainika and Ashutosh talking about central lines and chest tubes from emergency medicine trainees' perspective. We talk about the indications, contraindications and complications and the basic steps of performing the 2 most common procedures performed in the ED. This is not an exhaustive list but an insight into the world of central line and chest tube insertions in the ED.
In this episode after a month, I talk about an offbeat topic - The what, how and where of issuing a media bulletin. Those who want to know more about it can go check out the following links -
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Telg, Ricky, and Lisa Lundy. 2021. “News Writing for Television and Radio: WC193/AEC531, Rev. 6/2021”. EDIS 2021 (3). https://doi.org/10.32473/edis-wc193-2021.
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Telg, Ricky, and Lisa Lundy. 2021. “News Writing for Print: WC191/AEC529, Rev. 6/2021”. EDIS 2021 (3). https://doi.org/10.32473/edis-wc191-2021.
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https://www.ap.org/about/news-values-and-principles/telling-the-story/
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https://jacklimpert.com/2016/04/flash-bulletin-when-ten-bells-or-five-bells-really-meant-something/
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https://edis.ifas.ufl.edu/publication/WC191
In this episode, I am joined by Dr Sanjay who has been a stalwart of emergency medicine for about 25-30 years in India. We discuss how to make emergency medicine teams and what are the qualities one needs to have to be a good team and how to move onto becoming a great emergency medicine team. Hope you enjoy listening in.
In this episode I speak a little about my favourite topic. You got that right - Airways. In this short episode I share some airway pearls that I have picked up in my experience and learnt from many different difficult airway courses , workshops and conferences. Remember, first pass success is the international standard for safe airway management. If you want to discuss something you can DM me on my twitter @anksv25
In this episode, I speak about a little bit about my experience in CODA 22 in Melbourne followed by airway techniques that can be used in the daily practice of an emergency physician. You can go through the following papers -
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Mosier JM, Joshi R, Hypes C, Pacheco G, Valenzuela T, Sakles JC. The Physiologically Difficult Airway. West J Emerg Med. 2015 Dec;16(7):1109-17. doi: 10.5811/westjem.2015.8.27467. Epub 2015 Dec 8. PMID: 26759664; PMCID: PMC4703154.
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Perbet S, De Jong A, Delmas J, Futier E, Pereira B, Jaber S, Constantin JM. Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study. Crit Care. 2015 Jun 18;19(1):257. doi: 10.1186/s13054-015-0975-9. PMID: 26084896; PMCID: PMC4495680.
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Mort TC. The incidence and risk factors for cardiac arrest during emergency tracheal intubation: a justification for incorporating the ASA Guidelines in the remote location. J Clin Anesth. 2004 Nov;16(7):508-16. doi: 10.1016/j.jclinane.2004.01.007. PMID: 15590254.
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Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar;59(3):165-75.e1. doi: 10.1016/j.annemergmed.2011.10.002. Epub 2011 Nov 3. PMID: 22050948.
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Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559.
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Schwenk ES, Viscusi ER, Buvanendran A, Hurley RW, Wasan AD, Narouze S, Bhatia A, Davis FN, Hooten WM, Cohen SP. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med. 2018 Jul;43(5):456-466. doi: 10.1097/AAP.0000000000000806. PMID: 29870457; PMCID: PMC6023582.
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Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med. 2011 May;57(5):449-61. doi: 10.1016/j.annemergmed.2010.11.030. Epub 2011 Jan 21. PMID: 21256625.
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Sehdev RS, Symmons DA, Kindl K. Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emerg Med Australas. 2006 Feb;18(1):37-44. doi: 10.1111/j.1742-6723.2006.00802.x. PMID: 16454773.
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Zeiler FA, Teitelbaum J, West M, Gillman LM. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014 Aug;21(1):163-73. doi: 10.1007/s12028-013-9950-y. PMID: 24515638.
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Tsan et al. Comparison of Macintosh Laryngoscopy in Bed-up-Head-Elevated Position With GlideScope Laryngoscopy: A Randomized, Controlled, Noninferiority Trial. Anesth Analg. PMID: 31348051.
Short sweet and concise information on strokes for the general public. This episode aims at reducing the knowledge gap and improving the awareness regarding strokes in the community.
In this episode I have spoken about the young adult epidemic that I have been talking about for months now linking it with metabolic syndromes. To check your metabolic health, you can get the following tests done - "Fasting Hba1C, homocysteine, insulin, sugars, lipid profile, GGTP, SGOT, Uric acid". Please do your own research too. Everything I have spoken about in this episode is based on the research I have done in the past year, my knowledge as a doctor, my experiences and learnings from Dr Robert Lustig.
What an academic feast organized by the SEMI-WB on the weekend of 16-17th July 2022 for the academic residents of emergency medicine. I start of the episode by talking about the EZECON. Also the 24th Annual Conference of SEMI is happening in Kerala from 23-27th November. Do register for it. In this episode I give an insight towards dealing with acid base disorders using the modified stewart's approach. Following are the references you can go through to understand more and change your practice -
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https://emcrit.org/wp-content/uploads/acid_base_sheet_2-2011.pdf
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Story DA. Stewart Acid-Base: A Simplified Bedside Approach. Anesth Analg. 2016 Aug;123(2):511-5. doi: 10.1213/ANE.0000000000001261. PMID: 27140683.
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Jones NL. A quantitative physicochemical approach to acid-base physiology. Clin Biochem. 1990 Jun;23(3):189-95. doi: 10.1016/0009-9120(90)90588-l. PMID: 2115411.
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Mallat J, Michel D, Salaun P, Thevenin D, Tronchon L. Defining metabolic acidosis in patients with septic shock using Stewart approach. Am J Emerg Med. 2012 Mar;30(3):391-8. doi: 10.1016/j.ajem.2010.11.039. Epub 2011 Jan 28. PMID: 21277142.
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Morgan TJ. The Stewart approach--one clinician's perspective. Clin Biochem Rev. 2009 May;30(2):41-54. PMID: 19565024; PMCID: PMC2702213.
6.Kaplan LJ, Kellum JA. Initial pH, base deficit, lactate, anion gap, strong ion difference, and strong ion gap predict outcome from major vascular injury. Crit Care Med. 2004 May;32(5):1120-4. doi: 10.1097/01.ccm.0000125517.28517.74. PMID: 15190960.
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Malatesha G, Singh NK, Bharija A, Rehani B, Goel A. Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment. Emerg Med J. 2007 Aug;24(8):569-71. doi: 10.1136/emj.2007.046979. PMID: 17652681; PMCID: PMC2660085.
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Kelly AM, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. Emerg Med J. 2001 Sep;18(5):340-2. doi: 10.1136/emj.18.5.340. PMID: 11559602; PMCID: PMC1725689.
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Byrne AL, Bennett M, Chatterji R, Symons R, Pace NL, Thomas PS. Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta-analysis. Respirology. 2014 Feb;19(2):168-175. doi: 10.1111/resp.12225. Epub 2014 Jan 3. PMID: 24383789.
A very Happy Doctors' Day to you all! In this episode I discuss some salient points regarding the physiologically difficult airway. There are many physicians I know who are still not aware regarding this concept that can kill patients as soon as we try and save them. Also - EZECON is being organised in Kolkata from 16-17th July,22 and it is going to be an academic feast for the residents. So do register for it.
The references for reading up more on the physiologically difficult airways are as follows -
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Mosier JM, Joshi R, Hypes C, Pacheco G, Valenzuela T, Sakles JC. The Physiologically Difficult Airway. West J Emerg Med. 2015 Dec;16(7):1109-17. doi: 10.5811/westjem.2015.8.27467. Epub 2015 Dec 8. PMID: 26759664; PMCID: PMC4703154.
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Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559.
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https://www.acepnow.com/article/crash-a-mnemonic-for-the-physiological-difficult-airway/
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Myatra SN, Divatia JV, Brewster DJ. The physiologically difficult airway: an emerging concept. Curr Opin Anaesthesiol. 2022 Apr 1;35(2):115-121. doi: 10.1097/ACO.0000000000001102. PMID: 35165233.
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Cai SR, Sandhu MRS, Gruenbaum SE, Rosenblatt WH, Gruenbaum BF. Airway Management in an Anatomically and Physiologically Difficult Airway. Cureus. 2020 Sep 24;12(9):e10638. doi: 10.7759/cureus.10638. PMID: 33123451; PMCID: PMC7584327.
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Kornas RL, Owyang CG, Sakles JC, Foley LJ, Mosier JM; Society for Airway Management’s Special Projects Committee. Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesth Analg. 2021 Feb 1;132(2):395-405. doi: 10.1213/ANE.0000000000005233. PMID: 33060492.
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Mosier, Jarrod M. “Physiologically Difficult Airway in Critically Ill Patients: Winning the Race between Haemoglobin Desaturation and Tracheal Intubation.” British Journal of Anaesthesia 125, no. 1 (July 2020): e1–4. https://doi.org/10.1016/j.bja.2019.12.001.
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Scott Weingart, MD FCCM. EMCrit 325 – The Hypoxemic Difficult Airway and Preox Discussion with Jarrod Mosier. EMCrit Blog. Published on June 5, 2022. Accessed on June 30th 2022. Available at [https://emcrit.org/emcrit/hypoxemic-difficult-airway/ ].
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Salim Rezaie, "An Emergency Difficult Airway Predictor Would be From HEAVEN", REBEL EM blog, January 31, 2018. Available at: https://rebelem.com/emergency-difficult-airway-predictor-heaven/.
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Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/.
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Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.
So the International Conference on Emergency Medicine 2022 is on in Melbourne. There is quite a bit of representation from India at the biggest EM conference! In today's episode, I talk about how India emergency physicians are contributing to the academic fest in Melbourne. Enjoy!
In this episode I bid farewell to my passing out residents and discuss some trauma myths like Manual in line stabilization and the use of steroids in acute spinal cord injuries. You all can go through the following articles to learn more -
- Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Ann Emerg Med. 2007 Dec;50(6):653-65. doi: 10.1016/j.annemergmed.2007.05.006. Epub 2007 Aug 3. PMID: 17681642.
2.Manoach S, Paladino L. Manual in-line stabilization for acute airway management of suspected cervical spine injury: historical review and current questions. Ann Emerg Med. 2007 Sep;50(3):236-45. doi: 10.1016/j.annemergmed.2007.01.009. Epub 2007 Mar 6. PMID: 17337093.
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Thiboutot F, Nicole PC, Trépanier CA, Turgeon AF, Lessard MR. Effect of manual in-line stabilization of the cervical spine in adults on the rate of difficult orotracheal intubation by direct laryngoscopy: a randomized controlled trial. Can J Anaesth. 2009 Jun;56(6):412-8. doi: 10.1007/s12630-009-9089-7. Epub 2009 Apr 24. PMID: 19396507.
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Kapp JP. Endotracheal intubation in patients with fractures of the cervical spine [technical note]. J Neurosurg. 1975;42:731-732.
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Hachen HJ. Idealized care of the acutely injured spinal cord in Switzerland. J Trauma. 1977;17:931-936
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Bohlman HH. Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am. 1979;61:1119-1142.
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Podolsky S, Baraff LJ, Simon RR, et al. Efficacy of cervical spine immobilization methods. J Trauma. 1983;23:461-465.
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Hugenholtz H, Cass DE, Dvorak MF, Fewer DH, Fox RJ, Izukawa DM, Lexchin J, Tuli S, Bharatwal N, Short C. High-dose methylprednisolone for acute closed spinal cord injury--only a treatment option. Can J Neurol Sci. 2002 Aug;29(3):227-35. doi: 10.1017/s0317167100001992. PMID: 12195611.
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Suberviola B, González-Castro A, Llorca J, Ortiz-Melón F, Miñambres E. Early complications of high-dose methylprednisolone in acute spinal cord injury patients. Injury. 2008 Jul;39(7):748-52. doi: 10.1016/j.injury.2007.12.005. Epub 2008 Jun 9. PMID: 18541241.
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Bracken MB, Shepard MJ, Collins WF, Holford TR, Young W, Baskin DS, Eisenberg HM, Flamm E, Leo-Summers L, Maroon J, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med. 1990 May 17;322(20):1405-11. doi: 10.1056/NEJM199005173222001. PMID: 2278545.
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Bracken MB, Collins WF, Freeman DF, Shepard MJ, Wagner FW, Silten RM, Hellenbrand KG, Ransohoff J, Hunt WE, Perot PL Jr, et al. Efficacy of methylprednisolone in acute spinal cord injury. JAMA. 1984 Jan 6;251(1):45-52. PMID: 6361287.
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Evaniew N, Noonan VK, Fallah N, Kwon BK, Rivers CS, Ahn H, Bailey CS, Christie SD, Fourney DR, Hurlbert RJ, Linassi AG, Fehlings MG, Dvorak MF; RHSCIR Network. Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Propensity Score-Matched Cohort Study from a Canadian Multi-Center Spinal Cord Injury Registry. J Neurotrauma. 2015 Nov 1;32(21):1674-83. doi: 10.1089/neu.2015.3963. Epub 2015 Jul 17. PMID: 26065706; PMCID: PMC4638202.
In this episode of myths in emergency medicine, I talk about Oxygen in STEMI patients, Epinephrine in digital anaesthesia, C- line for CVP monitoring and MILS in trauma patients. You can go through some of the following papers and decide what you want to do with your EM practice -
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Stub D, Smith K, Bernard S, Nehme Z, Stephenson M, Bray JE, Cameron P, Barger B, Ellims AH, Taylor AJ, Meredith IT, Kaye DM; AVOID Investigators. Air Versus Oxygen in ST-Segment-Elevation Myocardial Infarction. Circulation. 2015 Jun 16;131(24):2143-50. doi: 10.1161/CIRCULATIONAHA.114.014494. Epub 2015 May 22. PMID: 26002889.
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Hofmann R, Befekadu Abebe T, Herlitz J, James SK, Erlinge D, Yndigegn T, Alfredsson J, Kellerth T, Ravn-Fischer A, Völz S, Lauermann J, Jernberg T, Lindahl B, Langenskiöld S. Routine Oxygen Therapy Does Not Improve Health-Related Quality of Life in Patients With Acute Myocardial Infarction-Insights From the Randomized DETO2X-AMI Trial. Front Cardiovasc Med. 2021 Mar 15;8:638829. doi: 10.3389/fcvm.2021.638829. PMID: 33791349; PMCID: PMC8006541.
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Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol. 2004 Nov;51(5):755-9. doi: 10.1016/j.jaad.2004.05.028. PMID: 15523354.
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Mohan, P P. “Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Epinephrine in digital nerve block.” Emergency medicine journal : EMJ vol. 24,11 (2007): 789-90. doi:10.1136/emj.2007.053793
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Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008 Jul;134(1):172-8. doi: 10.1378/chest.07-2331. PMID: 18628220.
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Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Ann Emerg Med. 2007 Dec;50(6):653-65. doi: 10.1016/j.annemergmed.2007.05.006. Epub 2007 Aug 3. PMID: 17681642.
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Santoni BG, Hindman BJ, Puttlitz CM, Weeks JB, Johnson N, Maktabi MA, Todd MM. Manual in-line stabilization increases pressures applied by the laryngoscope blade during direct laryngoscopy and orotracheal intubation. Anesthesiology. 2009 Jan;110(1):24-31. doi: 10.1097/ALN.0b013e318190b556. PMID: 19104166.
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Manoach S, Paladino L. Manual in-line stabilization for acute airway management of suspected cervical spine injury: historical review and current questions. Ann Emerg Med. 2007 Sep;50(3):236-45. doi: 10.1016/j.annemergmed.2007.01.009. Epub 2007 Mar 6. PMID: 17337093.
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Wiles MD. Manual in-line stabilisation during tracheal intubation: effective protection or harmful dogma? Anaesthesia. 2021 Jun;76(6):850-853. doi: 10.1111/anae.15472. PMID: 33939842.
In today's episode, I've discussed some myths that are still prevalent in emergency medicine practices across the world. They are still taught even if some clinicians do not practice it. do you own research. Don't take my word for it. Change your practice accordingly. You can go through some of the following references -
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SELLICK BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet (London, England). 1961; 2(7199):404-6. PMID:13749923
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Birenbaum A, Hajage D, Roche S, et al. Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial. JAMA surgery. 2018; PMID:30347104
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Allman KG. The effect of cricoid pressure application on airway patency. Journal of clinical anesthesia. 1995; 7(3):197-9. PMID:7669308
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Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Annals of emergency medicine. 2007; 50(6):653-65. PMID:17681642
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Neilipovitz DT, Crosby ET. No evidence for decreased incidence of aspiration after rapid sequence induction. Canadian journal of anaesthesia = Journal canadien d’anesthesie. 2007; 54(9):748-64. PMID:17766743
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Palmer JH, Ball DR. The effect of cricoid pressure on the cricoid cartilage and vocal cords: an endoscopic study in anaesthetised patients. Anaesthesia. 2000; 55(3):263-8. PMID:10671846
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Byrne AL, Bennett M, Chatterji R, Symons R, Pace NL, Thomas PS. Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta-analysis. Respirology. 2014 Jan 3. PMID: 24383789.
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Kelly AM, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. Emerg Med J. 2001 Sep;18(5):340-2. PMID 11559602
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Middleton P, Kelly AM, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J. 2006 Aug;23(8):622-4. PMID16858095
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Klein LR, Cole JB. Ketamine: Focusing on the Facts and Forgetting the Fiction. Ann Emerg Med. 2021 Jul;78(1):132-139. doi: 10.1016/j.annemergmed.2021.03.039. PMID: 34167728.
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Godoy DA, Badenes R, Pelosi P, Robba C. Ketamine in acute phase of severe traumatic brain injury "an old drug for new uses?". Crit Care. 2021 Jan 6;25(1):19. doi: 10.1186/s13054-020-03452-x. PMID: 33407737; PMCID: PMC7788834.
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Schofer JM. Premedication during rapid sequence intubation: a necessity or waste of valuable time? Cal J Emerg Med. 2006 Dec;7(4):75-9. PMID: 20505811; PMCID: PMC2872531.
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Robinson N, Clancy M. In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature. Emerg Med J 200;8:453-7.
In today's episode, I invite Drs Sanjay and Shivani back to the show to discuss the 6 steps to manage hyponatremia in your ED in a little bit more detail. This will be a learning curve for the young (and the old) emergency physicians. Later on, I would have them back to discuss real life cases that have been managed in our department using the 6 cases. Enjoy! For any questions you can DM us on our twitter handles - @anksv25 (Ankur), @drshivanisarda (Shivani) and @drbobby71sanjay (Sanjay)
In this episode, I have discussed a little bit about some advances in trauma resuscitation, some goals and how ATLS should be the basic trauma skill an emergency physician should have. I did not mean to break any hearts, but yes trauma resus goes beyond ATLS. Do not believe what I say blindly, do your research. You can go through the following mind blowing papers and up your trauma game and prepare your own trauma protocols for your emergency departments.
The papers you can go through (not in any order of preference). And these are not exhaustive -
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Harris T, Davenport R, Mak M, Brohi K. The Evolving Science of Trauma Resuscitation. Emerg Med Clin North Am. 2018 Feb;36(1):85-106. doi: 10.1016/j.emc.2017.08.009. PMID: 29132583.
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Leibner E, Andreae M, Galvagno SM, Scalea T. Damage control resuscitation. Clin Exp Emerg Med. 2020;7(1):5-13. doi:10.15441/ceem.19.089
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Carrick MM, Leonard J, Slone DS, Mains CW, Bar-Or D. Hypotensive Resuscitation among Trauma Patients. Biomed Res Int. 2016;2016:8901938. doi: 10.1155/2016/8901938. Epub 2016 Aug 9. PMID: 27595109; PMCID: PMC4993927.
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https://www.jsomonline.org/References/PDF/Damage_Control_Resuscitation_03_Feb_2017_ID18.pdf
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Petrosoniak A, Hicks C. Resuscitation Resequenced: A Rational Approach to Patients with Trauma in Shock. Emerg Med Clin North Am. 2018 Feb;36(1):41-60. doi: 10.1016/j.emc.2017.08.005. PMID: 29132581.
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Mutschler, M., Nienaber, U., Münzberg, M., Wölfl, C., Schoechl, H., Paffrath, T., Bouillon, B., Maegele, M., & TraumaRegister DGU (2013). The Shock Index revisited - a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU. Critical care (London, England), 17(4), R172. https://doi.org/10.1186/cc12851
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Brohi K, Singh J, Heron M, Coats T. Acute traumatic coagulopathy. J Trauma. 2003 Jun;54(6):1127-30. doi: 10.1097/01.TA.0000069184.82147.06. PMID: 12813333.
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Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015 Feb 3;313(5):471-82. doi: 10.1001/jama.2015.12. PMID: 25647203; PMCID: PMC4374744.
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Spahn DR, Bouillon B, Cerny V, Duranteau J, Filipescu D, Hunt BJ, Komadina R, Maegele M, Nardi G, Riddez L, Samama CM, Vincent JL, Rossaint R. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care. 2019 Mar 27;23(1):98. doi: 10.1186/s13054-019-2347-3. PMID: 30917843; PMCID: PMC6436241.
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Spinella PC, Holcomb JB. Resuscitation and transfusion principles for traumatic hemorrhagic shock. Blood Rev. 2009 Nov;23(6):231-40. doi: 10.1016/j.blre.2009.07.003. Epub 2009 Aug 19. PMID: 19695750; PMCID: PMC3159517.
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Wiles MD. ATLS: Archaic Trauma Life Support? Anaesthesia. 2015 Aug;70(8):893-7. doi: 10.1111/anae.13166. PMID: 26152249.
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Mutschler M, Nienaber U, Brockamp T, Wafaisade A, Wyen H, Peiniger S, Paffrath T, Bouillon B, Maegele M; TraumaRegister DGU. A critical reappraisal of the ATLS classification of hypovolaemic shock: does it really reflect clinical reality? Resuscitation. 2013 Mar;84(3):309-13. doi: 10.1016/j.resuscitation.2012.07.012. Epub 2012 Jul 24. PMID: 22835498.
In today's episode I am joined by Dr Abbas and we discuss the young adult epidemic - emergency conditions that young adults suffer from and lose their lives to. We discuss as to why this may be happening and what can be done. Again - these are our opinions and experiences. We apologise if we hurt some sentiments in this one!
In this episode, I talk about incorporating checklists in our daily emergency medicine practice. Why is it important? How does it help and how do you use them? I would be discussing these in this episode with some anecdotes sprayed in. You can go through the following resources if you need help in using an airway checklist in your department or can hit me up on twitter (@anksv25) or Instagram @anksv. Hope you enjoy listening.
Here are the resources -
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Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J, Goeschel C. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006 Dec 28;355(26):2725-32. doi: 10.1056/NEJMoa061115. Erratum in: N Engl J Med. 2007 Jun 21;356(25):2660. PMID: 17192537.
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Smith KA, High K, Collins SP, Self WH. A preprocedural checklist improves the safety of emergency department intubation of trauma patients. Acad Emerg Med. 2015 Aug;22(8):989-92. doi: 10.1111/acem.12717. Epub 2015 Jul 20. PMID: 26194607.
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Kerrey BT, Mittiga MR, Rinderknecht AS, Varadarajan KR, Dyas JR, Geis GL, Luria JW, Frey ME, Jablonski TE, Iyer SB. Reducing the incidence of oxyhaemoglobin desaturation during rapid sequence intubation in a paediatric emergency department. BMJ Qual Saf. 2015 Nov;24(11):709-17. doi: 10.1136/bmjqs-2014-003713. Epub 2015 Jul 16. PMID: 26183713.
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Jaber S, Jung B, Corne P, Sebbane M, Muller L, Chanques G, Verzilli D, Jonquet O, Eledjam JJ, Lefrant JY. An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Intensive Care Med. 2010 Feb;36(2):248-55. doi: 10.1007/s00134-009-1717-8. Epub 2009 Nov 17. PMID: 19921148.
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https://emcrit.org/wp-content/uploads/2013/02/emcrit-airway-checklist-2013-02-05.pdf
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https://das.uk.com/guidelines/icu_guidelines2017
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https://intensiveblog.com/alfred-icu-intubation-checklist/
The famous Greek astrologer Aristotle once quoted – “A whole is that which has a beginning, middle and end.” Emergency Medicine is altogether a different type of “whole”.
In this Episode, I attempt to give a sneak peek into what is Emergency Medicine.
Drs Sanjay, Shivani and Anubhooti join us today to discuss Hyponatremia - an easy approach and how to manage it according to the pathophysiology. It's an interesting take as hyponatremia remains as one of the most common presentations to an ED but yet under/over treated. The 6 step approach that Dr Shivani describes is as follows -
First - correctly diagnose hyponatremia (Na <130)
Second - classification based on time of onset of symptoms, serum osmolality levels and volume status of the patient - Acute/chronic, hyper/hypoosmolar, hypo/eu/hyper-volemic
Third - identify the cause
Fourth - co -relate it with the pathophysiology.
Fifth - calculate the actual sodium deficit and rate of correction.
Sixth - correct management
You can ask Drs Sanjay and Shivani more regarding hyponatremia - Their twitter handles are - @drbobby71sanjay and @drshivanisarda
This episode I have tried to educate the masses regarding when to visit an emergency department, what happens in the emergency department and open their eyes to the verbal and physical assault that takes place in the ED. This is just a basic. There would be more episodes dedicated to the work we do and regarding violence in detail in the future. Some of the references used and the ones that people can read are mentioned below -
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https://www.hopkinsacg.org/a-plan-of-action-to-reduce-avoidable-ed-visits/
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Davey K, Ravishankar V, Mehta N, et al. A qualitative study of workplace violence among healthcare providers in emergency departments in India. Int J Emerg Med. 2020;13(1):33. Published 2020 Jun 17. doi:10.1186/s12245-020-00290-0
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Lavoie FW, Carter GL, Danzl DF, Berg RL. Emergency department violence in United States teaching hospitals. Ann Emerg Med. 1988;17:1227–1233. doi: 10.1016/S0196-0644(88)80076-3
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World Health Organization. Workplace violence in the health sector: state of the art. Available from: http://www.who.int/violence_injury_prevention/violence/workplace/en/.
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Joshi SC, et al. Doctor becomes a patient: a qualitative study of health care work place violence related perception among junior doctors working in a teaching hospital in India. Int J Community Med Public Health. 2018;5(5):1775–1786. doi: 10.18203/2394-6040.ijcmph20181381
In this episode, we talk about ketamine and how we have been using it in our department. Our experiences, some anecdotes, some evidence. We are not endorsing that you HAVE to use ketamine, but enlightening you that it can be used and the dogmas regarding it being unsafe are exactly those - DOGMAS. Following are the papers that you may read as references. They will guide you more about ketamine. Hope you enjoy the episode!. Have a Happy New Year!
Reading material -
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Domino EF, Chodoff P, Corssen G. Pharmacologic effects of CI-581, A new dissociative anesthetic, in man. Clin Pharmacol Ther. 1965 May-Jun;6:279-91. doi: 10.1002/cpt196563279. PMID: 14296024.
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Godwin SA, Burton JH, Gerardo CJ, Hatten BW, Mace SE, Silvers SM, Fesmire FM; American College of Emergency Physicians. Clinical policy: procedural sedation and analgesia in the emergency department. Ann Emerg Med. 2014 Feb;63(2):247-58.e18. doi: 10.1016/j.annemergmed.2013.10.015. Erratum in: Ann Emerg Med. 2017 Nov;70(5):758. PMID: 24438649.
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Kiureghian E, Kowalski JM. Intravenous ketamine to facilitate noninvasive ventilation in a patient with a severe asthma exacerbation. Am J Emerg Med. 2015 Nov;33(11):1720.e1-2. doi: 10.1016/j.ajem.2015.03.066. Epub 2015 Apr 7. PMID: 25895715.
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Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med. 2011 May;57(5):449-61. doi: 10.1016/j.annemergmed.2010.11.030. Epub 2011 Jan 21. PMID: 21256625.
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Godoy DA, Badenes R, Pelosi P, Robba C. Ketamine in acute phase of severe traumatic brain injury "an old drug for new uses?". Crit Care. 2021 Jan 6;25(1):19. doi: 10.1186/s13054-020-03452-x. PMID: 33407737; PMCID: PMC7788834.
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Cohen L, Athaide V, Wickham ME, Doyle-Waters MM, Rose NG, Hohl CM. The effect of ketamine on intracranial and cerebral perfusion pressure and health outcomes: a systematic review. Ann Emerg Med. 2015 Jan;65(1):43-51.e2. doi: 10.1016/j.annemergmed.2014.06.018. Epub 2014 Jul 23. PMID: 25064742.
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Verma A, Snehy A, Vishen A, Sheikh WR, Haldar M, Jaiswal S. Ketamine Use allows Noninvasive Ventilation in Distressed Patients with Acute Decompensated Heart Failure. Indian J Crit Care Med. 2019 Apr;23(4):191-192. doi: 10.5005/jp-journals-10071-23153. PMID: 31130793; PMCID: PMC6521817.
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Shaprio HM, Wyte SR, Harris AB. Ketamine anaesthesia in patients with intracranial pathology. Br J Anaesth. 1972 Nov;44(11):1200-4. doi: 10.1093/bja/44.11.1200. PMID: 4647115.
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Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559.
In this episode we discuss how our team of emergency medicine specialists entered into the world of emergency medicine. It is a light hearted episode filled with anecdotes and fun. Hope it (along with future episodes) also inspires future doctors and current doctors to take up emergency medicine as a specialty.