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

Chapter 31 - Legal landmines and lifeboats: Understanding legal risk in emergency medicine

Alex and Venk talk through the medicolegal aspects of practicing emergency medicine with emergency physician and attorney, Dr. Rachel Lindor. She is previous chair of research for Mayo Clinic Emergency Medicine in Scottsdale Arizona and holds both MD & JD degrees. She outlines how the most commonly litigated conditions (MI, orthopedics etc) still only accounts for about 1/5 of medicolegal cases in the United States and the importance of certain key behaviors in our practice to maintaining le...

Jun 01, 20241 hr 6 minSeason 3Ep. 40

Grand Rounds - Dr. John Wilson - Updates in Tuberculosis "The gift that keeps on giving"

Dr. John Wilson, consultant in the division of infectious diseases at Mayo Clinic, and professor of medicine, director of Tuberculosis consultations at Mayo Clinic presents updates in Tuberculosis for Mayo Clinic Emergency Medicine Grand Rounds back in February. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com...

May 14, 202454 minSeason 3Ep. 39

Chapter 30 - Two minutes to midnight: Critical overview of hemoptysis

Dr. Dagny Anderson, a specialist in the division of pulmonary and critical care medicine at Mayo Clinic, joins Alex and Venk to talk about both life threatening hemoptysis and non-lifethreatening hemoptysis. In this chapter we review what we need to be doing in the emergency department, while also shedding light on what our teammates in other specialties can offer the patients downstream. Join for this colorful journey of how to manage the situation when no one likes what is coming out of the pa...

May 01, 20241 hr 10 minEp. 38

Grand Rounds - Dr. Michael Wilson - What your psychiatrist isn't telling you about suicide prevention in the ED

Whether or not emergency physicians believe that patients with thoughts of self-harm belong in the ED, they are coming to your ED anyway. According to the Centers for Disease Control, ED visit rates for nonfatal self-harm increased 42% among persons 10 years or older, and visits for suicidal ideation, self-directed violence, or both increased 25.5% from 2017-2018. That’s an increase of more than 1% per month pre-COVID. This solutions-oriented talk will discuss some of the science behind suicide ...

Apr 14, 20241 hr 13 minSeason 3Ep. 37

Chapter 29 - How to save a life - A primer on ECPR and ED ECMO

Dr. Suraj Yalamuri, Mayo Clinic Anesthesiology Critical Care and Cardiovascular Medicine Consultant, joins Alex and Finch to talk about the fundamentals of ECMO and ECPR. This is a great way to get caught up on this emerging science so that you'll be ready to provide the best resuscitative care for your patients when your system is ready too.

Apr 01, 20241 hr 20 minSeason 3Ep. 36

Grand Rounds - Dr. Rebecca Leff - Fit for Purpose: Emergency Medicine Physicians and Humanitarian Response in Complex Emergencies

Dr. Leff shares, in her senior resident capstone presentation, a primer on humanitarian efforts, what are basic principles of aid, how to identify the key health needs of populations affected by crises and how EM clinicians can respond to those needs with the greatest impact. She will discuss how to engage responsibly and to anticipate how humanitarianism will develop and adapt in the future to improve responsiveness.

Mar 14, 20241 hr 6 minSeason 3Ep. 35

Chapter 28 - Cant stop the bleeding - Mastering epistaxis

Dr. Mike Olson, former EM PA and now ENT attending sits down to talk about epistaxis with Alex and Venk. We go through a pragmatic approach to epistaxis, discuss some nuance cases including telangiectasia, hypertension, and anticoagulation. interventions are key, what patients are most likely to suffer a bad outcome and more. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REF...

Mar 01, 20241 hr 24 minSeason 3Ep. 34

Chapter 27.5 - Unbundling the bundle - Part two of sepsis

Dr. Casey Clements spent two hours breaking down the history and influences in sepsis care over the past three decades and going through the best practices in today's emergency medicine. This is the second part of the two part series. Do you know how Sepsis is defined currently? What is the difference between SEP - 1 and surviving sepsis campaign? What is the role of steroids or vitamin C? Can you resuscitate these patients with albumin? These and so many more questions will be answered in this ...

Feb 14, 20241 hr 8 minSeason 3Ep. 33

Chapter 27 - Machiavelli's Hectic Fever - Part one of sepsis

Dr. Casey Clements spent two hours breaking down the history and influences in sepsis care over the past three decades and going through the best practices in today's emergency medicine. Do you know how Sepsis is defined currently? What is the difference between SEP - 1 and surviving sepsis campaign? What is the role of steroids or vitamin C? Can you resuscitate these patients with albumin? These and so many more questions will be answered in this two part series. So join Venk like vancomycin, a...

Feb 01, 20241 hr 8 minSeason 3Ep. 32

Grand Rounds - Dr. Dougie Moss - Chart-onomics

In this chapter, Dr. Dougie Moss, final year EM resident presents his Capstone presentation on best charting practices to match reimbursement to the care we deliver. Take a listen to better understand the new billing expectations of our documentation. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com...

Jan 14, 202448 minSeason 3Ep. 31

Chapter 26 -Sick young person with spots - Meningococcemia in the ED

Alex and Venk talk through a previous case where they care for a young person with meningococcemia on a night shift. We review the disease, what to watch for, how to treat it, and go over some of the residue after being part of a case like this. We also review some of the considerations regarding ECMO for severe sepsis. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCE...

Jan 01, 20241 hr 2 minSeason 3Ep. 30

Grand Rounds - Dr. Aaron Klassen - Out of hospital cardiac arrest - Challenges and Changes

It is no surprise that outcomes are poor for patients who already meet one definition for 'death' even before the point of their first medical contact. But for nearly half of certain patients with out-of-hospital cardiac arrest, good neurologic outcomes can be achieved. And while patients with in-hospital cardiac arrest are also very likely to suffer a poor outcome, there is some reason to believe that some out-of-hospital cardiac arrest patients might have a better chance of survival. During th...

Dec 14, 20231 hrSeason 2Ep. 29

Chapter 25 - The one where Alex finally gets to ask about REBOA - Hematomas

This chapter we talk with Dr. Henry Schiller, trauma surgeon and professor of surgery at Mayo Clinic, about a variety of hematomas including Morel Lavellee lesions, retroperitoneal hematomas, rectus sheath and more! Alex even gets to ask a question about REBOA that he has been hoping to do for a long time. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS ...

Dec 01, 20231 hr 18 minSeason 2Ep. 28

Grand Rounds - Dr. Heather Murray - Diagnostic error in the ED - Lets talk about it

In this episode, Dr. Heather Murray, from Queen's University Department of Emergency Medicine presents the landscape of diagnostic errors in emergency medicine from the perspective of why they might occur, what can be done when they happen, and how we might minimize them in the future. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES ARHQ report and responses: Decemb...

Nov 14, 202359 minSeason 2Ep. 27

Chapter 24 - In the heat of the moment - Neonatal fever

Neonatal fever can raise the temperature of the entire clinical pod along with the baby, but it doesnt have to. Join as Dr. Meghan Cain, chair of the division of pediatric and adolescent emergency medicine at Mayo Clinic, talks through the nuances of evaluating fever concerns in neonates of different ages and risk profiles and empowers you to be cool as a cucumber in these situations. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Ven...

Nov 01, 202357 minSeason 2Ep. 26

Grand Rounds - Dr. Arya Mohabbat - Central Sensitization: a syndrome of multiple difficult-to-explain chronic debilitating symptoms

So many people come to emergency departments with unexplained recurrent pains, fatigues, gastrointestinal symptoms and more - when there seems like no way we can help them, Dr. Mohabbat offers us some insight into what might be happening and how we can help be a positive experience in these patient's and family's lives. Listen to this grand rounds on Central Sensitization and be a better doctor for this large segment of the population. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @Always...

Oct 14, 20231 hr 1 minSeason 2Ep. 25

Chapter 23 - A mother’s love -Peripartum Cardiomyopathy

Dr. Katie Young, co-director of the cardioobstetrics clinic here at Mayo Clinic sits down to talk about peripartum cardiomyopathy. This is something we will likely consider many times in our careers for patients with shortness of breath in and around late pregnancy. Find out what interventions are key, what patients are most likely to suffer a bad outcome and more. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @...

Oct 01, 20231 hr 25 minSeason 2Ep. 24

Grand Rounds - Dr. Alex Niven - Difficult airway management, an intensivist’s perspective

In this chapter, Dr. Alex Niven, renowned critical care physician and educator, provides a mirror for us to see our current state of emergency airway management - for its opportunities for improvement, innovations and best practices. This evidence fueled presentation is a must-listen for any emergency healthcare physician or provider. CONTACTS Youtube - https://www.youtube.com/@AlwaysonEM X - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnE...

Sep 14, 20231 hr 1 minSeason 2Ep. 23

Chapter 22 -Did she just say hemosuccus pancreaticus? - Gastrointestinal bleeding in the emergency department

Dr. Nayantara Coelho-Prabhu, Mayo Clinic gastroenterologist specializing in the care of patients with gastrointestinal bleeding and endoscopy, talks through many aspects of acute GI bleeding. She helps to clarify the prioritization of medications, when to incorporate imaging, broadens our differentials for upper and lower GI bleeding, gives mindblowing advice on stool guiac testing and SO much more in this over-stuffed (or should we say constipated) chapter of Always on EM. There is also a speci...

Sep 01, 20231 hr 43 minSeason 2Ep. 22

Grand Rounds - Dr. Shannon McNamara - Safety 1 to Safety 2 - A paradigm shift to improve performance in a complex world

Is healthcare more like an airplane, a flock of birds, or a mayonnaise? Why does it matter? In this talk, Dr. McNamara, emergency physician and patient safety champion, explores the question through the story of how she found herself at the intersection of complexity theory, safety science, and emergency medicine. She will discuss multiple perspectives on safety science, including specific strategies for clinicians to apply in their daily practice to survive amidst the complexity. CONTACTS X (fo...

Aug 14, 202359 minSeason 2Ep. 16

Chapter 21 - Chickity Check Yo’ Self Before Yo’ Wreck Yo Self! Tick borne infections

Drs. Alex Finch and Venk Bellamkonda talk through tick related infectious diseases including Lyme Disease, Rocky Mountain Spotted Fever, Ehrlichiosis, Babesiosis and more! Tick related illnesses are prevalent this time of year, so take a moment to brush up on how to manage them. CONTACTS Twitter - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Society guidelines: United States CDC Tickborne diseases of th...

Aug 01, 20231 hr 2 minSeason 2Ep. 15

Grand Rounds - Dr. Kharmene Sunga - Can You Hear Me Now? How To Speak Like An Emergency Physician

Dr. Kharmene Sunga, Mayo Clinic emergency medicine consultant physician, specializing in simulation, diversity equity and inclusion, and education shares a guide for how to communicate (both through listening and speaking) most effectively when it counts. TEASER There's no place like the Emergency Department. Patients are in pain, scared, and anxious. Staff are distracted, fatigued, frustrated - and sometimes, well, also scared and anxious. How can Emergency Physicians speak to rise above the fr...

Jul 14, 202358 minSeason 2Ep. 14

Chapter 20 - Relaxin to the maxin - Intrathecal baclofen pumps in the ED

Ms Lisa Beck, assistant professor of nursing and a clinical nurse specialist in the department of physical medicine and rehabilitation, shares her experiences over a career in caring for persons with intrathecal baclofen pumps for managing spinal cord injury related spasticity. Baclofen related complications such as withdrawal and overdose can both be fatal and pump specific complications as well require timely expertise from the emergency care team – but not often discussed in emergency medicin...

Jul 01, 20231 hr 8 minSeason 2Ep. 13

Grand Rounds - Dr. Laura Walker & Dr. Katharina Kohler - Network Science Applied to Healthcare

This is really two separate episodes put together - Dr. Walker delivered grand rounds on network science applications to emergency medicine and it was inspiring. Though because it was such a visual talk, Alex and I had a conversation with her and Dr. Kohler to better understand the topic and present it in a more easily digestable state for you. Both experiences are presented here for your interest.

Jun 14, 20231 hr 32 minSeason 2Ep. 12

Chapter 19 - Sugar, we’re goin down swinging! - Pediatric diabetic ketoacidosis

Dr. Mark Mannenbach, emeritus pediatric emergency medicine faculty of Mayo Clinic and former chairperson of the division of pediatric emergency medicine sits down with Alex and Venk to talk about pediatric diabetic ketoacidosis. We review tips and tricks from a lifetime of caring for sick kids, discuss our Mayo Clinic practice guideline, cerebral edema diagnosis and management, compare the care of pediatric DKA with that of adult DKA and more - Check out this ultra-sweet chapter! CONTACTS Twitte...

Jun 01, 20231 hr 24 minSeason 2Ep. 11

Chapter 18 - a Joint Venture - A guided tour of Rheumatoid Arthritis

Rheumatoid arthritis is a challenging disease with variable presentations and complex medications that can make providing emergency care challenging. Dr. John Davis, Vice Chair of Division of Rheumatology at Mayo Clinic sits down with us to help us move easier through RA for our patients. CONTACTS Twitter - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Kaeley et al. The importance of ultrasound in identi...

May 01, 20231 hr 35 minSeason 2Ep. 9

Grand Rounds - Dr. Alyson McGregor - How sex and gender based research impacts the delivery of emergency care

Dr. Alyson McGregor is an emergency physician and champion for health equity with regards to sex and gender. She gave an important and incredible talk to our department about the importance of recognizing the differences between sexes and genders and how that can and should impact our clinical care and research. CONTACTS Twitter - @AlwaysOnEM; @VenkBellamkonda; @McGregorMD Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com Dr. McGregor’s website: www.alysonmcgr...

Apr 14, 202357 minSeason 2Ep. 8

Chapter 17 - LactatED: A stat consult on optimizing lactation in the ED

Possibly the first ever podcast dedicated to optimizing the experience of lactating persons in the ED, Alex and Venk sit down with Dr. Sarah Dodd, assistant professor of anesthesiology at Mayo Clinic and passionate champion for optimizing the care of lactating persons throughout healthcare. Lengthy ED visits have the potential to begin a cascade that hastens the end of milk production, and is a significant source of stress for lactating persons and families. We have an opportunity to do better. ...

Apr 01, 20231 hr 4 minSeason 2Ep. 7

Grand Rounds - Dr. Laura Burke - Emergency Physicians as leaders of high-value healthcare

Dr. Laura Burke is a health sciences researcher and assistant professor of emergency medicine at Harvard Medical School. She gave a reaffirming grand rounds talk to us, packed full of evidence to support the concept that emergency medicine and emergency physicians provide an incredible quality of service and value to the healthcare system overall. Listen in! Articles she references throughout are listed below in chronological order. CONTACTS Twitter - @AlwaysOnEM; @VenkBellamkonda; @LauraBurke20...

Mar 14, 202350 minSeason 2Ep. 6
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