Wide Complex Tachycardia

In this episode, Sam Ashoo, MD, Dr. Christopher Baugh, MD, MBA, and Dr. Xin Qi, MD, discuss the October 2026 Emergency Medicine Practice article, Antithrombotic-Associated Bleeding: Management in the Emergency Department.1:18 — Guest introductions1:58 — Why the authors chose this topic3:11 — Epidemiology4:27 — Why DOACs over warfarin5:15 — Bleeding trends6:55 — Overlapping antithrombotic regimens 8:09 — Reversibility of agents 9:38 — Bedside priorities11:31 — Bleeding patterns by drug class & three groups13:50 — Antithrombotics & traumatic bleeding risk14:26 — Pre-hospital considerations16:09 — Indications for antithrombotic use & risk of reversing17:54 — Gray-area decisions19:02 — Initial resuscitation20:08 — Blood product ratios 21:24 — PATCH trial 22:04 — TXA evidence23:36 — GI bleed adjuncts24:31 — Critical site bleeds27:20 — Endoscopy timing 30:00 — Reversal agents32:50 — Idarucizumab for dabigatran33:54 — Antiplatelet reversal36:15 — Warfarin reversal38:36 — Protamine for heparin/LMWH39:37 — Fibrinolytic reversal40:14 — Pre-procedural antithrombotic management42:39 — Emerging labs43:50 — Wrap-up & closing promoSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the September 2026 Emergency Medicine Practice article, Emergency Department Diagnosis and Management of Acetaminophen or Salicylate Toxicity1:13 — Welcome and topic introduction3:50 — Key rules: check levels, call Poison Control5:13 — Acetaminophen pathophysiology8:16 — Salicylate pathophysiology10:51 — Coingestions11:11 — Differential diagnosis12:19 — History & pre-hospital care15:28 — Product confusion17:08 — Toxic dose thresholds18:26 — Physical exam & vital signs20:16 — Acetaminophen toxicity stages (1-4)22:35 — Salicylate exam findings23:43 — Lab workup & testing24:45 — Acetaminophen nomogram & levels30:39 — Activated charcoal — when to give it34:11 — NAC therapy — dosing & timing37:22 — Hemodialysis for acetaminophen38:40 — King's College Criteria41:00 — Salicylate treatment44:42 — Potassium management during alkalinization47:28 — Hemodialysis for salicylate48:05 — Intubation50:00 — Pregnancy considerations51:20 — Pediatric considerations52:06 — Emerging: fomepizole as adjunct therapy52:45 — Summary & wrap-upSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. Syeda Maria Muzammil, MD discuss the August 2026 Emergency Medicine Practice article, Emergency Department Management of Postthrombolysis Intracranial Hemorrhage.0:25 – Intro & sponsor message1:18 – Guest introduction: Dr. Maria Muzammil2:24 – Timeframe for post-thrombolysis hemorrhage & ED/ICU boarding considerations4:46 – Thrombolysis eligibility criteria & contraindications5:46 – Incidence rates & symptomatic vs. asymptomatic hemorrhage7:09 – Pathophysiology & risk factors for post-thrombolytic ICH10:18 – Combining IV thrombolysis with endovascular thrombectomy12:33 – Post-treatment monitoring protocols & neurological exam frequency15:02 – Differentiating hemorrhage from other causes of neurological decline18:34 – Initial ED steps20:35 – Heidelberg classification of hemorrhage types21:60 – Follow-up imaging25:27 – Treatment of confirmed hemorrhage30:10 – Platelet transfusion guidance32:39 – Delayed hemorrhage & treatment timing considerations34:21 – Blood pressure management goals post-hemorrhage37:20 – Special populations38:48 – Summary of ED management algorithm40:48 – Closing remarksSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the July 2026 Emergency Medicine Practice article, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Diagnosis and Management in the Emergency Department.0:17 – Intro & sponsor promo1:09 – Episode introduction4:03 – Definitions: SJS vs. TEN vs. "overlap" by body surface area6:12 – Pathophysiology9:52 – Incidence and rarity of the disease10:53 – Differential diagnosis & clinical presentation clues12:08 – Prehospital care & fluid resuscitation considerations13:47 – ED history-taking: medications, infections, rash progression14:47 – Physical exam findings16:46 – Diagnostic studies18:12 – Scoring systems: SCORTEN and ABCD-1020:50 – Treatment goals23:57 – Wound care principles24:43 – Mechanical ventilation risk factors26:02 – Other possible therapies27:50 – Specialty consults & special populations29:06 – Ophthalmologic treatment31:17 – HIV patients and elevated risk31:55 – Emerging therapies & AI-based diagnostic tools32:57 – Five key clinical takeaways34:37 – Closing remarks & sponsor sign-offSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the June 2026 Emergency Medicine Practice article, Diagnosis and Management of Heat Stroke and Other Heat-Related Illness in the Emergency Department0:21 Intro & Promo0:56 Episode Introduction3:14 Spectrum of Heat-Related Illnesses7:37 Differential Diagnosis8:58 Pre-Hospital Management11:54 Exertional Heat Stroke13:50 Non-Exertional Heat Stroke15:40 ED Evaluation21:54 ED Treatment27:15 Managing Complications29:33 Special Populations30:58 Disposition & J-ERATO Score33:12 Risk Management Pearls36:56 Wrap-Up & PromoSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the May 2026 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Serious and High-Risk Infections in the Febrile Returning Traveler.0:16 — Podcast Introduction1:08 — Episode Introduction7:30 — Malaria13:55 — Dengue17:33 — Enteric Fever (Typhoid/Paratyphoid)20:53 — Leptospirosis22:43 — Clinical Presentations26:33 — Diagnostic Testing33:17 — Treatment38:59 — Special Populations & Risk Pitfalls43:05 — Closing Pearls & OutroSubscribers, take the CME test here. Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. T.R. Eckler, MD discuss the April 2026 Emergency Medicine Practice article, Wide Complex Tachycardia in the Emergency Department: An Updated Approach to Diagnosis and Management.Introduction – 0:11Article Overview – 2:02Top 5 Bedside Steps – 7:54Sodium Channel Blockade – 9:26Hyperkalemia – 11:53SVT with Aberrancy – 12:47WPW & Accessory Pathway – 13:34AFib with Accessory Pathway – 14:09Monomorphic VT – 19:01Polymorphic VT / Torsades – 20:08Bidirectional VT – 21:29Pacemaker-Mediated Tachycardia – 22:30Pre-Hospital Considerations – 24:52Stable vs. Unstable Assessment – 27:58Diagnostic Studies – 29:42Treatment – 38:00Risk Management Pitfalls – 44:49Wrap-Up – 49:44Subscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD interviews Jack Teitel on the topic of AI in medicine. Introduction & Welcome — 0:17Jack's Background in Healthcare AI — 0:58Brief History of AI — 3:57The "Perfect Storm" That Created Modern AI — 5:48From General to Specialized: Fine-Tuning AI for Medicine — 7:04LLM Confidence & the Sycophancy Problem — 13:01The Benchmark Problem — 14:25Building Your Own Personal AI Benchmark — 17:44Can You "Turn Off" AI Sycophancy? — 20:00RAG Systems & How Specialty AI Tools Work — 22:09Choosing the Right AI Tool for Clinical Use — 26:18Why 95% of AI Pilots Fail in Deployment— 28:10How to Ask AI Questions Well (Prompt Quality) — 31:25Knowledge Base Currency & Sam's Drug Withdrawal Test — 35:06Closing & Contact Info — 37:12For more about Jack Teitel - Title-AI.com Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and Dr. Dana Klavansky, MD discuss the March 2026 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Severe Traumatic Brain InjuryIntroduction & Welcome (0:15)Guest Introduction (0:55)Epidemiology of Severe TBI (2:37)Pathophysiology: Primary vs. Secondary TBI (4:24)Types of Hemorrhage and Hematomas (5:25)Classification (7:31)Mild vs. Moderate vs. Severe TBIImpact Loading vs. Inertial LoadingDifferential Diagnosis (9:22)Prehospital Care (9:42)Emergency Department History (13:33)Diagnostics (15:13)CT Scan and the A-B-B-B-C ApproachRepeat CT TimingBedside Ultrasound for Optic Nerve Sheath DiameterPupillometryBiomarkersTreatment (24:52)Airway ManagementVentilation and CO2 TargetsHyperosmolar Therapy: Hypertonic Saline and MannitolCerebral Perfusion PressureBlood Pressure GoalsTemperature ManagementCoagulopathy ManagementSeizure Prophylaxis and EEG MonitoringTiered ICP Management (35:29)Surgical Indications (38:40)Prognosis (40:33)Special Topics (41:30)Sports Injuries and CTETranexamic Acid (CRASH-3 Trial)Wrap-Up (43:46)Subscribers, take the CME test here. Emergency Medicine Residents, get your free subscription by writing [email protected]

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the February 2026 Emergency Medicine Practice article, Emergency Department Diagnosis and Management of Acute Coronary Occlusion00:00 - Introduction & Welcome01:21 - Episode Overview: Acute Coronary Occlusion02:06 - Why This Topic Matters: Statistics & New Guidelines03:35 - Nomenclature: ACO vs STEMI/NSTEMI06:15 - Differential Diagnosis for STEMI07:41 - Pre-Hospital Care & EMS Role11:37 - Patient History & Presenting Symptoms12:28 - Physical Examination Findings14:54 - EKG: The Most Important Test17:00 - STEMI Definition & Criteria20:32 - STEMI Equivalents: Scarbosa Criteria22:40 - Smith Modified Scarbosa Criteria24:10 - Hyperacute T Waves25:30 - Posterior STEMI28:40 - De Winter Sign29:38 - Non-STEMI EKG Findings31:30 - AVR ST Elevation32:47 - Wellens Syndrome33:54 - Reciprocal ST Segment Changes36:15 - Inferior MI Patterns37:54 - Laboratory Testing39:51 - Imaging: Chest X-Ray & Echocardiography42:25 - Supplemental Oxygen: What the Evidence Shows44:50 - Analgesia & Pain Management46:35 - Pharmacotherapy: Aspirin & Antiplatelet Agents49:18 - Reperfusion Therapies & Thrombolytics53:05 - Cardiac Arrest in STEMI Patients53:55 - Closing Remarks & CME InformationSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing [email protected]