Always On EM - Mayo Clinic Emergency Medicine - podcast cover

Always On EM - Mayo Clinic Emergency Medicine

Alex Finch; Venk Bellamkondaalwaysonem.podbean.com
Hosts, Alex Finch, MD and Venk Bellamkonda, MD explore topics relevant to the practice, education or research of emergency medicine. Enjoy interviews with people on the front lines, thought leaders from around the world, and the comedy and drama of life when it intersects with emergency care. Follow us on X: @AlwaysOnEM Email: AlwaysOnEM@gmail.com
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Episodes

GRAND ROUNDS - Dr. Neha Raukar - Head's Up! When is that lump more than a bump?

In this final chapter of the 2025 season of Always on EM, Alex and Venk are thrilled to share an amazing Grand Rounds recording from the esteemed educator and clinician, Dr. Neha Raukar. She is renowned for her expertise in many areas - among them, concussion and traumatic brain injury, particularly of athletes. She breaks down imaging guidelines, evaluation of TBI, prognosis, counseling of patients and more in this fantastic talk essential for any emergency healthcare professional to hear! CONT...

Dec 01, 20251 hr 2 minSeason 4Ep. 71

Chapter 47 - Hidden Killer of the Healthy - An "Intimal" Discussion of Spontaneous Coronary Artery Dissection

Dr Sharonne Hayes, Professor of cardiovascular medicine and founding director of Mayo Clinic women’s heart clinic, and Dr. Marysia Tweet, Associate Professor of cardiovascular medicine, and co-leader of the Spontaneous Coronary Artery Dissection Registry and leader in women’s heart health join the show for this amazing November chapter of Always on EM. They are world experts on Spontaneous Coronary Artery Dissection authoring over 60 peer reviewed articles on the topic and in this chapter we exp...

Nov 01, 20251 hr 14 minSeason 4Ep. 70

Chapter 46 - Dont be salty, be phosphorescent! - Sodium, magnesium, and phosphorus in the ED

Dr. Jim Gregoire, consultant nephrologist and master educator, joins the show again to talk about electrolytes this time. He breaks down practicalities in caring for patients with sodium, magnesium, and phosphorus disorders - who is at risk, what history and exam findings to look for, what testing to do and how to correct the problems. Join Alex and Venk as they learn the nuances of care for these conditions that we see every single shift. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @Al...

Sep 01, 20251 hr 20 minSeason 4Ep. 68

Grand Rounds - Dr. John Schupbach - Battling big food, big pharma, and big health

In this chapter, Dr. Schupbach analyzes the business of healthcare and a way he believes can let patients wage war on the mis-alligned incentives. This is a continuation of our Grand Rounds sequence. Come join Alex and Venk on this adventure! TEASER Specifically, childhood obesity is skyrocketing--1 in 5 children are now above the 95th percentile BMI for age and sex. A recent NEJM article showed Liraglutide (a medication that costs approximately $12,000 per year) was effective in children as you...

Aug 01, 202536 minSeason 4Ep. 67

Chapter 45 - Airway to Heaven: A Primer on Mechanical Ventilation for Emergency Providers

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient’s needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but do...

Jul 05, 20251 hr 13 minSeason 4Ep. 66

Grand Rounds - Dr. Taylor Christian - First do no harm: the history and origin of medical racism

This is a capstone presentation from Chief Resident of Mayo Clinic Emergency Medicine, Dr. Taylor Christian. Teaser: Can we fulfill our oath to “do no harm” if we ignore the harm of racial injustice in medicine? Understanding the historical roots and persistent impact of medical racism isn’t just informative; it is a call to action. This presentation is an opportunity to learn, reflect, and act to become better advocates. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @TayMChristian YouTube - @Alwa...

Jun 15, 202553 minSeason 4Ep. 65

Chapter 44 - Withdrawal warriors battle with barbs! Phenobarbital as a treatment for alcohol withdrawal

Is it possible that the cutting edge therapy for alcohol withdrawal care is one of the older tools in our bag? Possibly! In this chapter, one of the rising stars, Dr. Brandy Hernandez, Emergency Pharmacist, discusses the case for phenobarbital for helping patients for with their acute alcohol withdrawal symptoms. Find out when it may be preferable, what we don’t know yet, what the pitfalls are, and more!

Jun 01, 202549 minSeason 4Ep. 64

Grand Rounds - Dr Fiterman Molinari - Cardiac Arrest: when Standard Care is Not Enough

In this grand rounds, Dr. Daniel Fiterman Molinari challenges the status quo of cardiac arrest care with thought provoking takes on the literature. Take a listen to his Capstone presentation and find yourself pondering whether you agree or disagree, and whether you need to go revisit the literature yourself. You may find your own heart skips a beat in this great episode.

May 14, 202552 minSeason 4Ep. 63

Chapter 43 - Code Brown: When the runs run the room! - Management of Acute Diarrheal Emergencies

Diarrhea is one of the more common concerns in emergency medicine worldwide and in the United States, yet we often do not spend enough time understanding the breadth of causes and considerations for this syndrome. Do you know which patients benefit from Zinc? Would you like to review HUS? Can you mixup Oral Rehydration Solution if you needed to? We cover all of this and more in this “code brown” of a chapter! So come, get dirty with Alex and Venk in this truly crappy chapter of Always on EM! CON...

May 01, 20251 hrSeason 4Ep. 62

Grand Rounds - Dr. Lauren Chernick - Designing Digital Interventions to Improve Adolescent Sexual Health

The rapid evolution of digital health is transforming emergency care, but how do we design and implement technologies that truly meet patient needs? This session will explore the landscape of digital health tools and unpack how user-centered design ensures their effectiveness. Using a phased approach to development, Dr. Lauren Chernick from Columbia emergency medicine will discuss key strategies for integrating technology into engaging mobile health interventions. She will also share insights fr...

Apr 14, 202548 minSeason 4Ep. 61

Chapter 42 - Yes, I can help - Feeling empowered to help with in-flight emergencies

Alex and Venk discuss the fundamental differences of caring for people during an in-flight emergency: what changes with oxygen and pressure, what is available to you, what are the expectations, and more. Both have been teaching about this scenario to others and have been present for several such encounters. They bring their expertise and the available literature to establish this level-setting chapter of the Always on EM Podcast. By the end of this, hopefully, you'll have zero hesitation standin...

Apr 01, 202546 minSeason 4Ep. 60

Grand Rounds - Dr. Alexander Ginsburg - Integrating Palliative Care in the ED: Streamlined Solutions to Minimize Provider Burden

In this Grand Rounds chapter, Dr. Alex Ginsburg, board certified in both emergency medicine and palliative care, and physician leader practicing in both specialties at Mayo Clinic in Rochester, Minnesota discusses a pragmatic way to incorporate palliative care into a busy and complicated emergency medicine practice. Beginning with why this is important and highlighting the challenges and barriers to making this happen, Dr. Ginsburg then proceeds to talk through approaches that are patient-centri...

Mar 14, 202555 minSeason 4Ep. 59

Chapter 41 - Conversations toward cohesive practice - Optimizing the emergency physician and APP interface

The variety of practice models in the United States emergency healthcare system is numerous and most of them involve both physicians as well as advanced practice providers (physician assistants and nurse practitioners). Yet, the preparation for how to supervise an APP from a physician perspective, or what to expect from a physician colleague from the APP perspective is not standardized. In this chapter, we sit down with Dr. Eric Boie who is the current medical director for the APP practice at Ma...

Mar 01, 20251 hr 18 minSeason 4Ep. 58

Grand Rounds - Dr. Brit Long - Choose your own adventure - High risk diseases in the emergency department

Legendary emergency medicine educator, Dr. Brit Long, gave grand rounds in Rochester in a highly interactive experience covering high risk, yet low frequency conditions that we need to watch for on shift. He uses an engaging style filled with cases to drill home key points related to these conditions. Enjoy this Valentine's Day chapter of Always on EM-Grand Rounds for a fun and engaging reminder of what our specialty is all about! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @Long_Brit YouTube - ...

Feb 14, 202556 minSeason 4Ep. 57

Chapter 40 - The Full Bird and Fumar de Cystica - an EM guide to the gallbladder

Dr. Henry Schiller, Professor of Surgery, Liutenant Colonel in the US Army Reserve, and Mayo Clinic Teaching Hall of Fame inductee rejoins the show to talk about gallbladders. We review the distinction between the evaluation and management of cholelithiasis, choledocolithiasis, the role of different imaging modalities, and much more in this awesome chapter of the show - dont miss this! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Ve...

Feb 01, 20251 hr 16 minSeason 4Ep. 56

Grand Rounds - Dr. Lekshmi Kumar - Response to Recovery; Elevating trauma care with prehospital blood transfusions

Dr. Lekshmi Kumar, Associate Professor of Emergency Medicine at Emory University / Grady Hospital system in Atlanta, Georgia and the EMS director or the city of Atlanta presents grand rounds to kick off the 2025 calendar year! She talks about their collaborative work to create a prehospital blood transfusion program to uplift the trauma care in their region. Tune in to learn about the method for handling the change, the specifics for implementation and to learn the difference that this is making...

Jan 15, 20251 hr 11 minSeason 4Ep. 55

Chapter 39 - Unbreak My Heart - Decompensation in a Person with Aortic Stenosis

Dr. Trina Augustin, assistant professor of both anesthesiology and perioperative medicine as well as emergency medicine takes us on a deep dive into the care of persons with aortic stenosis. In this chapter, Alex and Venk learn about how to use ultrasound to diagnose AS, the keys to resuscitation, the pathophysiology of this condition, as well as the value of consultative services and the potential interventions that they may unlock for these patients. Kickoff season 4 with this in depth reminde...

Jan 01, 20251 hr 35 minSeason 4Ep. 54

Grand Rounds - Dr. Adiba Matin - Climate Change and Emergency Medicine

In this final episode of the third season of the Always on EM podcast, we share a grand rounds recording of Dr. Adiba Matin, former resident at Mayo Clinic giving her senior capstone presentation on climate change and emergency medicine. In this visionary presentation, she projects physiologic consequences of the climate change on human health, as well as discusses adaptations for clinical practices, highlights how environmental change might impact social determinants of health, and touches on w...

Dec 14, 202444 minSeason 3Ep. 53

Chapter 38 - Appendicitis strikes back: Next level diagnosis, myths, and management Appendicitis in the ED

Dr. David Turay, trauma consultant physician at Mayo Clinic, sits down with Alex and Venk to talk about appendicitis! Have you wondered about ultrasound vs CT imaging? antibiotics only vs operative care? what labs to order? we will go over it in this chapter of Always on EM! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS 2013 British Journal of Surgery ...

Dec 01, 20241 hr 2 minSeason 3Ep. 52

Chapter 37.5 - Nonaccidental trauma in children, part two.

Dr. Mark Mannenbach, emeritus pediatric emergency physician, former chairperson of pediatric emergency medicine at Mayo Clinic and career long advocate for children comes back on the show to talk through nonaccidental trauma in children in a two part series. In this second part, we talk through mimics of abuse, second victim syndrome related to caring for children of abuse, some aspects of neglect, and more. CONTACTS x- @AlwaysonEM; @VenkBellamkonda YouTube - @AlwaysonEM; @VenkBellamkonda Instag...

Nov 14, 20241 hrSeason 3Ep. 51

Chapter 37 - Nonaccidental trauma in children, part one.

Dr. Mark Mannenbach, emeritus pediatric emergency physician, former chairperson of pediatric emergency medicine at Mayo Clinic and career long advocate for children comes back on the show to talk through nonaccidental trauma in children in a two part series. In this first part, we talk through the approach to sharing the concern that you have with the family, keys to the physical examination, the role of additional testing such as serum, urine, and radiograph. CONTACTS x- @AlwaysonEM; @VenkBella...

Nov 01, 20241 hr 21 minSeason 3Ep. 50

Chapter 36 - The Butterfly Effect - Principles of Supply Chain Management

Dr. Pritish Tosh, consultant physician in Infectious Diseases, and Supply Chain Management specialist for Mayo Clinic talks through the relationship between our clinical delivery of care and the strength of our supply chain practices. Our recent experiences with facemasks in the pandemic, the daily threats to medication access, and the events of recent longshoreman strike as well as Hurricane Helene damage to saline production locations has shown us how valuable it is to understand our supply ch...

Oct 14, 202449 minSeason 3Ep. 49

Chapter 35 - Diffusing the fuse - Violence in the emergency department

Dr. Sarayna McGuire is an emergency physician who has been investigating workplace violence in the ED and in the prehospital setting. She and Dr. Casey Clements, who is the chief safety officer for Rochester Mayo Clinic campus talk with Venk and Alex about the violence in the emergency department. The scope of the problem is staggering, the impact ripples broadly into the community, and we all have the opportunity to intervene and change the trajectory of how life unfolds – learn the what, the w...

Oct 01, 20241 hr 14 minSeason 3Ep. 48

Grand Rounds - Dr. Samit Shah - Seeing the invisible: Angina and Nonobstructive Coronary Arteries (ANOCA)

Ischemic heart disease is a leading cause of morbidity and mortality. While atherosclerotic coronary artery disease (CAD) is the focus of most outpatient and inpatient evaluations for cardiovascular symptoms, up to two thirds of patients suffer from myocardial ischemia with non-obstructive coronary arteries (INOCA). Patients with INOCA have unique symptoms and are more likely to have functional limitation and repeat presentations for cardiovascular evaluation. While there has been increasing rec...

Sep 14, 20241 hr 7 minSeason 3Ep. 47

Chapter 34 - Gyne Logic on Gynecologic Emergencies - Discussion about PID, Torsion, Ectopic and more

Dr. Adela Cope breaks down pelvic inflammatory disease, tubo-ovarian abscess, ovarian torsion, ectopic pregnancy and more in this densely packed chapter of Always on EM. Tune in as Alex and Venk also try to figure out which one has the correct mental model of PID and who will ask the first stupid question. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com LEARN MORE ABOUT RESIDE...

Sep 01, 20241 hr 30 minSeason 3Ep. 46

Grand Rounds - Dr. Rich Griffey - Subcutaneous Insulin in Diabetic Ketoacidosis (SQUID Protocol)

This past winter, Dr. Rich Griffey, healthcare quality leader from Washington University School of Medicine and Emergency Medicine, came to present grand rounds on a new way to care for patients with mild to moderate DKA, which they call the SQuID protocol. This talk serves to inspire us to look even at some of our well established conditions and see what we could do differently, as well as appreciate the value that healthcare quality improvement integrated with research methods and implementati...

Aug 14, 202454 minSeason 3Ep. 45

Chapter 33 - it’s not all iodine and shellfish - A fresh take on contrast related anaphylaxis

Dr. Ronna Campbell, professor of emergency medicine, and passionate anaphylaxis researcher schools Alex and Venk on several issues related to contrast-related anaphylaxis. She helps clarify an approach to managing ED situations where a contrasted CT is desired yet the patient has documented anaphylaxis to iodine, or how to treat a patient who returns with unexpected reaction after receiving contrasted imaging. Can you be allergic to Iodine? What is the relationship between shellfish allergy hist...

Aug 01, 202450 minSeason 3Ep. 44

Grand Rounds - Dr. Ken Milne - Old Fashioned Doctors

Dr. Ken Milne presents his talk entitled, “Old Fashioned Doctors,” to Mayo Clinic Emergency Medicine as our keynote speaker for our annual research day. In this talk, he goes through 10 ideas that were proposed in an article by Dr. Herbert Fred as potential ways that old-fashioned doctors may practice medicine more effectively or more palatably than younger counterparts. In this talk, he challenges those ten ideas while offering insights and reflections founded from his experiences before that c...

Jul 14, 202453 minSeason 2Ep. 43

Chapter 32 - You’re invited to our block party! - Emergency department Ultrasound guided regional anesthesia

Dr. Lacey Shiue, emergency ultrasound faculty, sits down with Alex and Venk to talk through ultrasound guided nerve blocks and plane blocks. We talk through key differences in commonly used medications, how to manage toxicity from those medications as well as a detailed discussion of several different specific blocks including: Erector Spinae Plane Block, Fascia Iliaca Compartment Block, Supraclavicular Block, Interscalene Block among others. In addition, she discusses the keys to advancing an e...

Jul 01, 20241 hr 6 minSeason 3Ep. 42

Grand Rounds - Dr. Matthew Hamilton - The History of Homosexuality and Medicine

In this final chapter of the academic year 2023-2024, we celebrate our graduating EM class of residents by spotlighting a senior capstone presentation by Dr. Matthew Hamilton covering the intersection of homosexuality and medicine. In this presentation, he aims for the learner to be able to recognize pivotal movements in LGBTQ+ history and civil rights; describe structural mechanisms that excluded gay people from medicine for over 150 years; and to be able to recognize and mitigate ongoing threa...

Jun 15, 202445 minSeason 3Ep. 41
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