Core EM - Emergency Medicine Podcast

Nicolas Gonzalez, MD, an emergency physician and chief resident, walks through high-output heart failure basics and bedside clues. He explains pathophysiology, causes like AV fistulas and thyrotoxicosis, practical exam and POCUS findings, and pragmatic ED management including when to target access flow. Short, clinical, and focused on what to look for and how to act.

Jonathan Elmer, Associate Professor specializing in emergency, critical care, and neurology research on post-cardiac arrest care. He discusses the critical first minutes after ROSC, high rearrest risk and early shock physiology. Practical priorities include rapid vascular access, bedside push‑dose vasopors, femoral arterial monitoring, broad diagnostics and MAP targets. Family communication and a concise stabilization checklist are highlighted.

A deep dive into recognizing and diagnosing bacterial meningitis in the ED. They walk through a complex patient case, meningeal signs, when to CT before lumbar puncture, and CSF findings. Discussion covers likely pathogens, immediate antibiotic and steroid choices, and post-exposure prophylaxis. Social determinants and prevention also factor into the clinical narrative.

Naz Sarpoulaki, MD, MPH, an emergency physician and senior resident with expertise in acute cardiopulmonary care, walks through a crashing patient with acute pulmonary edema. They define SCAPE and its unique physiology. Quick bedside diagnosis with lung ultrasound, NIPPV strategies, and high‑dose nitroglycerin protocols take center stage. Practical tips on escalation, avoiding common pitfalls, and disposition rounds out the discussion.

Dr. Nichole Bosson, a leading expert in prehospital care, discusses the groundbreaking initiative of delivering blood transfusions before patients reach the hospital. She explains how this shift could save lives in cases of hemorrhagic shock, moving away from traditional fluid resuscitation. Bosson highlights the positive outcomes from pilot programs in regions like San Antonio and LA County, detailing the logistical challenges and ethical considerations involved. The conversation emphasizes collaboration among EMS systems to improve patient survival rates.

Noumi Chowdhury, an emergency medicine resident specializing in pediatric emergency care, joins the conversation to dissect Brief Resolved Unexplained Events (BRUEs). They discuss defining features of BRUEs, such as cyanosis and altered responsiveness, and emphasize the importance of ruling out other causes. The duo explains low- and high-risk criteria for infants and introduces the MISFITS mnemonic for systematic evaluation. With insights into recurrence rates and management strategies, this is a vital listen for those in pediatric care.

Dr. Zayan Firou, an expert in emergency medicine from Rwanda, shares insights from the country's Marburg virus outbreak. He recounts how the initial cluster of cases highlighted the vulnerability of healthcare workers and led to tragic fatalities. Notably, rapid access to experimental therapies and vaccines significantly impacted the outbreak's outcome, reducing the fatality rate. Dr. Firou emphasizes the need for resilient healthcare systems, local production of vaccines, and the importance of equity in emergency care to prepare for future global threats.

Explore the complex diagnosis and management of acute pulmonary embolism, where subtle symptoms can lead to serious outcomes. Learn about the critical risk factors, from recent surgeries to genetic predispositions, and the importance of precise risk stratification. The hosts delve into various presentation signs, treatment protocols, and advanced resuscitation techniques. Discover the role of biomarkers and imaging methods in assessing patient conditions. Plus, get insights into outpatient management and key takeaways for effective care.

Explore the intriguing world of pneumothorax, starting with its diverse risk factors and symptoms. Discover how to differentiate between serious conditions like asthma and pneumothorax. Learn about critical diagnostic tools, particularly the high efficacy of ultrasound in the emergency setting. The discussion also covers management strategies, advocating for simpler techniques like pigtail catheters over traditional chest tubes. This episode is packed with insights for optimal patient care in urgent situations!

Dr. Maria Mulligan-Buckmiller, a rock star chief resident, shares her expertise on angioedema management in the emergency department. She dives into the different types of angioedema, highlighting the crucial distinctions between histamine and bradykinin-mediated responses. The podcast discusses clinical presentations, including upper airway swelling and abdominal symptoms. Mulligan-Buckmiller emphasizes the importance of timely interventions and effective airway management, as well as key treatments like Icatabant and C1 esterase inhibitors to address potential complications.