Vexus in the ED

In this episode, Elizabeth and Dr Ronald Tan interview Associate Professor Lois Lee from Boston Children’s Hospital and Harvard Medical School about Pediatric Injury Prevention. Tune in to learn why it matters to frontline Emergency Physicians, and what you can do about it!Timestamps01:07 How did you first become interested in Injury Prevention? 02:09 Why does Injury Prevention matter to frontline Emergency Physicians? 05:45 Pediatric Clinics of North America Issue: Preventing Unintentional Injuries among Children and Youth06:39 Haddon Matrix and 7 ‘E’s of Injury Prevention 11:14 Policy and advocacy: Keeping injury prevention on the agenda15:17 Precision Prevention16:43 What would you tell a resident interested in finding out more about Injury Prevention? 18.17: What are some important types of data sources for injury prevention? 20: 38 How do you translate your research into actionable interventions for injury prevention that will lead to decreased injuries and deaths to children?24:05  TETRIS project: AI applied to the PECARN registryReferences: https://www.t4cip.org/child-passenger-safety https://www.pediatric.theclinics.com/issue/S0031-3955(25)X0006-7 CreditsMusic: Life-line by Colorful Sound via Pixabay/ SGH Podcast StudioAny comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

Ever wondered about VEXUS and its clinical utility in the Emergency Department? In this episode, Jocelyn interviews Dr Lokesh about VEXUS and when it may be helpful in our clinical practice. Tune in to find out more! CreditsMusic: Life-line by Colorful Sound via Pixabay/Best Day by Octosound via Pixabay SGH Podcast StudioSEMSAll recordings should not be taken by users/ audience as medical advice. Everyone is encouraged to see their physicians for proper medical consultation. Any comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Jocelyn and Elizabeth interview Dr Tang Dilin on the intriguing topic of Toxic Alcohols. Timestamps00:40 Brief overview 01:20 Methanol, Ethylene Glycol, Isopropyl Alcohol - Comparing and contrasting 04:20 Approach to undifferentiated high osmolar gap or high anion gap 08:04 Osmolar gap, hockey stick diagram 12:18 Treatment of toxic alcohol including Fomepizole 21:13 Role of Haemodialysis23:49 Cofactors24:44 Considerations for intubation25:20 Isopropyl Alcohol 27:17 Key takeawaysReferenceshttps://emergencymedicinecases.com/toxic-alcohols/https://litfl.com/toxic-alcohol-ingestion/ https://litfl.com/osmolar-gap/ CreditsMusic: Life-line by Colorful Sound via Pixabay SGH Podcast StudioAny comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Dr Joanna Chan and Dr Matthew Low interview Dr Kei Ouchi, Associate Professor at Harvard Medical School, on the topic of Palliative Emergency Medicine. His work focuses on improving care for adults with palliative care needs through high quality serious illness communications in the ED setting. Tune in to find out more! Timestamps00:56 What first drew you to the topic of bringing palliative care to the ED? 04:49 Could you explain why it is important for an ED doctor to be able to handle these situations well? 06:26 What does a goals of care discussion in the emergency department sound like in your practice?08:59 How can you direct the conversation to help patients and families understand the gravity of their present crisis?13:21 Tips on high-yield questions that help to bring out the wishes of a patient in a new crisis situation that can help the doctor to make a sound recommendation?15:41 Navigating situations where patients have deferred serious illness decision-making to their family members20:48 How much time do you budget for your communication when it is your first time meeting the family?22:55 In terms of communication, what are the common blind spots that you would like to highlight?    25:19 What ED innovation of the future is likely to have the most impact on ED Palliative Care delivery; What highlights have you seen from your time here with us, and how could we feasibly and meaningfully advance from here? Referenceshttps://pmc.ncbi.nlm.nih.gov/articles/PMC8219473/ https://connects.catalyst.harvard.edu/Profiles/display/Person/125411 CreditsMusic: Life-line by Colorful Sound via Pixabay/SGH Podcast StudioAny comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Dr Eunizar Omar interviews Dr Colin Ong and Dr Juliana Poh on the  topic of Geri EM! They discuss CFS, safe discharge measures, falls, frailty and gait assessments and more! Tune in to find out more. Timestamps01:03 Tell us about GeriEm in your department?04:50 Clinical Frailty Scale (CFS): Why it is important, evidence supporting it, and applicability. 06:03 Falls: What are the issues with the term “mechanical fall”, and what questions should we be asking to uncover the truth behind the fall?07:51 Minimum falls history; SPLATT mnemonic (Symptoms, Previous falls, Location, Activity, Time of fall, Trauma/ post fall complications)09:36 Reversible causes of falls to look out forMAPHD (Medications, visual Acuity, Postural Hypotension, 4 Ds - Delirium, Dementia, Depression, Vitamin D) 10:47 Gait assessment: Timed up and go test, Gait Speed Test13:56 Safe alternatives to admissions17:17 PolypharmacyHigh risk meds mnemonic: ABCS (anticholinergics, benzodiazepines and sedating drugs, cardiovascular medications). 22:33 Safe discharge measures 24:36 Advice for those who would like to learn more about the GeriEM scene26:13 Practical takeawaysReferences1. Sri-on J, Tirrell GP, Lipsitz LA, Liu SW. Is there such a thing as a mechanical fall? Am J Emerg Med. 2016 Mar;34(3):582-5. doi: 10.1016/j.ajem.2015.12.009. Epub 2015 Dec 12. PMID: 26795891; PMCID: PMC6785031.2. American College of Surgeons Geriatric Trauma Management: Best Practice Guidelines Nov 20233. https://www.facs.org/media/ubyj2ubl/best-practices-guidelines-geriatric-trauma.pdf4. GeriatricsCareOnline.org5. https://gedcollaborative.com/ CreditsMusic: Life-line by Colorful Sound via Pixabay SGH Podcast StudioAny comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Matthew and Elizabeth interview Dr Sohil Pothiawala and Dr Nijanth M Raj about hyperacute stroke in the Emergency Department. Ever wondered what was the evidence behind the time cut-offs for thrombolysis, tried to recall all the relative and absolute contraindications for thrombolysis, or wondered what was the optimal blood pressure for your patient and which anti-hypertensive to choose? Tune in to find out more! Timestamps02:52 NINDS trial04:20 ECASS III trial 04:59 RTPA absolute (ABCDES mnemonic) and relative contraindications, pearls and pitfalls 08:44 BP targets and preferred antihypertensives for BP control 10:03 Permissive Hypertension 12:22 Alteplase vs Tenecteplase (AcT trial, TIMELESS trial, ETERNAL-LVO trial) 16.27 Thrombectomy (EXTEND IA trial, MR CLEAN trial, SWIFT PRIME trial, DAWN & DEFUSE-3 trials)18.08 LVO (Large Vessel Occlusion) 20:25 Basilar strokes/ Posterior Circulation Strokes24:33 Combining Thrombolysis and EVT 27:05 WAKE-UP trial28:52 More on the DAWN & DEFUSE-3 trials30:39 What works for shortening door to intervention times? 32.40 What’s on the horizon? CreditsMusic: Life-line by Colorful Sound via Pixabay/ SGH Podcast StudioReferencesClinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Acute Ischemic Stroke. Ann Emerg Med. 2023 Aug;82(2):e17-e64. doi: 10.1016/j.annemergmed.2023.03.007.American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Thrombolytics; Lo BM et al. Clinical Policy: Use of Thrombolytics for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med. 2024 Dec;84(6):e57-e86. doi: 10.1016/j.annemergmed.2024.07.023. PMID: 39578010.Note: This episode was recorded in 2025.Any comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Jocelyn and Dr Lokesh interview Dr Francis Lee about the exciting topic of Lung Ultrasound in the ED! Tune in to learn about when to do lung ultrasound, tips for how to improve your lung ultrasound skills, and what’s potentially in the future for lung ultrasound. Timestamps: 3:00 Lung US basics 8.31 Conditions and scenarios where Lung US is useful12:14 BLUE protocol 19:11 Tips for EPs hoping to improve in Lung US skills21:13 Future Directions for Lung US in ED  CreditsMusic: Life-line by Colorful Sound via Pixabay SGH Podcast StudioReferencesLichtenstein DA. Lung ultrasound in the critically ill. Ann Intensive Care. 2014 Jan 9;4(1):1. doi: 10.1186/2110-5820-4-1. PMID: 24401163; PMCID: PMC3895677.Any comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Matthew and Elizabeth interview Dr Mok Shao Feng about Feedback in Education and Entrustable Professional Activities (EPAs). Tune in to learn more about what EPAs are, what they mean to the frontline clinician, and how to apply principles of good feedback to do workplace based assessments well. Shownotes can be found at: https://tinyurl.com/EPAshownotes Timestamps01:01 What is an EPA03:42 How do you use the data from EPA based assessments? 08:14 Models of Feedback10:33 Following up on the Action Plan 12:38 Grading the EPA for Straightforward cases14:11 Take home pointsCreditsMusic: Life-line by Colorful Sound via Pixabay SGH Podcast StudioAny comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Jocelyn and Elizabeth interview Dr Nicolas Lim (@POCUSclub) about his unique journey through both Emergency Medicine and Intensive Care training. Tune in to hear about his motivations, inspirations, challenges, and experiences! Credits: Music -  Life-line by Colorful Sound via Pixabay/ Best Day by OctoSound via Pixabay SEMSDr Nicolas’s Recording Studio Note: This episode was recorded in Dec 2024 All recordings should not be taken by users/ audience as medical advice. Everyone is encouraged to see their physicians for proper medical consultation.Any comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/ 

In this episode, Jocelyn and Elizabeth interview Dr Nicolas Lim (@POCUSclub) about Ultrasound in Shock! Tune in to find out more about how to utilize POCUS in patients in shock in the ED, as well as how to integrate your findings into clinical decision making! Timestamps01:47 Ultrasound in the ED and how it has evolved over the years04:29 RUSH protocol 06:45 Volume Responsiveness & Volume Tolerance09:45 Integration of findings into clinical decision making12:44 Tips for EPs hoping to improve on our POCUS skillsCreditsMusic: Life-line by Colorful Sound via Pixabay/ Best Day by OctoSound via Pixabay SEMSDr Nicolas’s Recording Studio Note: This episode was recorded in Dec 2024 ReferencesKenny JS, Prager R, Rola P, Haycock K, Basmaji J, Hernández G. Unifying Fluid Responsiveness and Tolerance With Physiology: A Dynamic Interpretation of the Diamond-Forrester Classification. Crit Care Explor. 2023 Dec 12;5(12):e1022. doi: 10.1097/CCE.0000000000001022. PMID: 38094087; PMCID: PMC10718393.https://www.youtube.com/@pocusclub5411 All recordings should not be taken by users/ audience as medical advice. Everyone is encouraged to see their physicians for proper medical consultation. Any comments or feedback? Suggestions for future episodes? Send us a message!https://semspodcast.buzzsprout.com/