Academic Life in Emergency Medicine (ALiEM) Podcast

Join us in the fifth installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Led by Dr. Dina Wallin and a team of renowned educators, the featured book is KEEP GOING by Austin Kleon. Come sign up! https://www.aliem.com/leaders-library-keep-going-sign-up-book-club/

ALiEM podcast host, Dr. Dina Wallin, chats with author Dr. Jacqueline Grupp-Phelan about her recent PECARN publication "Prospective Development and Validation of the Computerized Adaptive Screen for Suicidal Youth" In JAMA Psychiatry 2021. Read more: https://ALiEM.com/computerized-adaptive-screen-for-suicidal-youth-cassy-study Edited by Podcast Engineer: Kellen Vu

The 2020-21 residency interview season has required rapid innovation and adaptability for both medical student applicants and residency programs given COVID-19's physical distancing restrictions. Listen to how it started and how it is going thus far with podcast co-hosts Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF). PD Panelists: * Dr. Camiron Pfennig - Prisma Health University of South Carolina Greenville * Dr. Ryan Bodkin - University of Rochester * Dr. Michael Kiemeney - Loma Linda University

A major development in curbing the opioid epidemic is the introduction of the medication buprenorphine to address opioid addiction. Being able to prescribe this medication requires a DEA-X Waiver. Dr. Alister Martin, the Founder of the Get Waivered initiative, has reduced the barriers for clinicians to obtain the necessary training and paperwork. https://getwaivered.com/remote/ Disclosure: ALiEM is a proud collaborator with the Get Waivered Initiative, which is funded by the Foundation for Opioid Response Efforts (FORE) Foundation.

In this episode from the ACEP-EQUAL series, guest Dr. Houman Khosravani discusses the concept of a "protected code stroke", how to operationalize the concepts, and how this system can be applied in your local circumstances. Guests: Houman Khosravani, MD PhD Medical Director, Inpatient Stroke Unit Assistant Professor, Division of Neurology, Department of Medicine, University of Toronto Sunnybrook Health Sciences Center Staff Intensivist, Critical Care Medicine, Southlake Regional Health Center Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal References 1. Rajendram, P., Notario, L., Reid, C., Wira, C. R., Suarez, J. I., Weingart, S. D., & Khosravani, H. (2020). Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care. Neurocritical care, 33(2), 338–346. https://doi.org/10.1007/s12028-020-01057-4 2. Codestroke.net

In this episode from the ACEP-EQUAL series, guest Dr. William Meurer discuss how to protocolize of transferring stroke patients, how to identify and appropriately chose transfer destinations, and how to better align patient needs with the resources of the receiving sites. Guests: William J. Meurer MD MS Associate Professor of Emergency Medicine and Neurology University of Michigan Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal References 1. Saver JL, Goyal M, van der Lugt A, Menon BK, Majoie CB, Dippel DW, Campbell BC, Nogueira RG, Demchuk AM, Tomasello A, Cardona P, Devlin TG, Frei DF, du Mesnil de Rochemont R, Berkhemer OA, Jovin TG, Siddiqui AH, van Zwam WH, Davis SM, Castaño C, Sapkota BL, Fransen PS, Molina C, van Oostenbrugge RJ, Chamorro Á, Lingsma H, Silver FL, Donnan GA, Shuaib A, Brown S, Stouch B, Mitchell PJ, Davalos A, Roos YB, Hill MD; HERMES Collaborators. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016 Sep 27;316(12):1279-88. doi: 10.1001/jama.2016.13647. PMID: 27673305. 2. Campbell BCV, Mitchell PJ, Churilov L, Yassi N, Kleinig TJ, Dowling RJ, Yan B, Bush SJ, Thijs V, Scroop R, Simpson M, Brooks M, Asadi H, Wu TY, Shah DG, Wijeratne T, Zhao H, Alemseged F, Ng F, Bailey P, Rice H, de Villiers L, Dewey HM, Choi PMC, Brown H, Redmond K, Leggett D, Fink JN, Collecutt W, Kraemer T, Krause M, Cordato D, Field D, Ma H, O'Brien B, Clissold B, Miteff F, Clissold A, Cloud GC, Bolitho LE, Bonavia L, Bhattacharya A, Wright A, Mamun A, O'Rourke F, Worthington J, Wong AA, Levi CR, Bladin CF, Sharma G, Desmond PM, Parsons MW, Donnan GA, Davis SM; EXTEND-IA TNK Part 2 investigators. Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial. JAMA. 2020 Apr 7;323(13):1257-1265. doi: 10.1001/jama.2020.1511. PMID: 32078683; PMCID: PMC7139271. 3. Prabhakaran S, O'Neill K, Stein-Spencer L, Walter J, Alberts MJ. Prehospital triage to primary stroke centers and rate of stroke thrombolysis. JAMA Neurol. 2013 Sep 1;70(9):1126-32. doi: 10.1001/jamaneurol.2013.293. PMID: 23817961.

In this episode from the ACEP-EQUAL series, guest Dr. Bruce Lo reviews several common intracerebral hemorrhage scoring systems, the components, and tips on how to use them in real world practice. Guests: Bruce Lo, MD, MBA, FACEP Chief, Department of Emergency Medicine, Sentara Norfolk General Hospital Professor of Emergency Medicine, Eastern Virginia Medical School Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal References Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001 Apr;32(4):891-7. doi: 10.1161/01.str.32.4.891. PMID: 11283388. Clarke JL, Johnston SC, Farrant M, Bernstein R, Tong D, Hemphill JC 3rd. External validation of the ICH score. Neurocrit Care. 2004;1(1):53-60. doi: 10.1385/NCC:1:1:53. PMID: 16174898. Gregório T, Pipa S, Cavaleiro P, Atanásio G, Albuquerque I, Chaves PC, Azevedo L. Assessment and Comparison of the Four Most Extensively Validated Prognostic Scales for Intracerebral Hemorrhage: Systematic Review with Meta-analysis. Neurocrit Care. 2019 Apr;30(2):449-466. doi: 10.1007/s12028-018-0633-6. PMID: 30426449. Pinho J, Costa AS, Araújo JM, Amorim JM, Ferreira C. Intracerebral hemorrhage outcome: A comprehensive update. J Neurol Sci. 2019 Mar 15;398:54-66. doi: 10.1016/j.jns.2019.01.013. Epub 2019 Jan 14. PMID: 30682522. Øie LR, Madsbu MA, Solheim O, Jakola AS, Giannadakis C, Vorhaug A, Padayachy L, Jensberg H, Dodick D, Salvesen Ø, Gulati S. Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population-based study. Brain Behav. 2018 Oct;8(10):e01113. doi: 10.1002/brb3.1113. Epub 2018 Sep 21. PMID: 30240164; PMCID: PMC6192392. Hemphill JC 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, Fung GL, Goldstein JN, Macdonald RL, Mitchell PH, Scott PA, Selim MH, Woo D; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015 Jul;46(7):2032-60. doi: 10.1161/STR.0000000000000069. Epub 2015 May 28. PMID: 26022637. Houben R, Schreuder FHBM, Bekelaar KJ, Claessens D, van Oostenbrugge RJ, Staals J. Predicting Prognosis of Intracerebral Hemorrhage (ICH): Performance of ICH Score Is Not Improved by Adding Oral Anticoagulant Use. Front Neurol. 2018 Feb 28;9:100. doi: 10.3389/fneur.2018.00100. PMID: 29541054; PMCID: PMC5836590.

Hosted by Dr. Mike Gisondi (Stanford) and Dr. Michelle Lin (UCSF), this episode discusses the uncharted waters of conducting virtual interviews for the EM residency match season in the era of COVID-19. The featured panelists include the following EM program directors: * Dr. David Caro (University of Florida, Jacksonville) * Dr. Erica Shaver (West Virginia University) * Dr. Cedric Lefebvre (Wake Forest University) Podcast engineer: Kellen Vu

In this episode from the ACEP-EQUAL series, guest Dr. Joshua Goldstein discusses ICH after TPA. He reviews what evidence exists, the timing, potential treatment targets, and medications. Guests: Joshua Goldstein MD PhD Professor of Emergency Medicine, Harvard Medical School Director, Center of Neurologic Emergencies, Massachusetts General Hospital Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal References: 1. Yaghi S, Willey JZ, Cucchiara B, et al. Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017;48(12):e343-e361. doi:10.1161/STR.0000000000000152

In this episode from the ACEP-EQUAL series, guest Dr. Lantha Ganti reviews how to evaluate and treat blood pressure in the setting of ICH. She reviews the major existing data, BP targets, and medications to use. Guests: Latha Ganti, MD, MS, MBA, FACEP, FAHA Professor of Emergency Medicine & Neurology Vice Chair for Research and Academic Affairs University of Central Florida College of Medicine Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal References: 1. Butcher KS, Jeerakathil T, Hill M, et al. The Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure Trial. Stroke. 2013;44(3):620-626. doi:10.1161/STROKEAHA.111.000188 2. Butcher KS, Baird T, MacGregor L, Desmond P, Tress B, Davis S. Perihematomal edema in primary intracerebral hemorrhage is plasma derived. Stroke. 2004;35(8):1879-1885. doi:10.1161/01.STR.0000131807.54742.1a 3. https://www.mdcalc.com/modified-rankin-scale-neurologic-disability

In this episode, Drs. Gail Donofrio and Nora Volkow share their experience with SUD in the time of COVID, as well as some thoughts on needed regulatory change. Guests: Nora Volkow, MD Director, National Institute on Drug Abuse (NIDA) Gail D’Onofrio, MD, MS Professor and Chair, Department of Emergency Medicine, Yale School of Medicine Chief of Emergency Services, Yale New Haven Hospital Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal

Hosted by Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF), an expert panel of directors of Administration fellowships discuss the nuts and bolts of the who, what, why, and how of applying to this fellowship. Panelists: * Martin Reznek, MD MBA (University of Massachusetts) * Jennifer Wiler, MD MBA (University of Colorado) * Robert Tanouye, MD MBA (Cornell University)

Join us in the fourth installment of ALiEM's The Leader's Library, which is a professional development book club for health professionals. Led by Dr. Dina Wallin and a team of renowned educators, the featured book is THE POWER OF MOMENTS by Chip and Dan Heath. Come sign up! https://www.aliem.com/the-leaders-library-power-of-moments/

In this episode, a panel of experts talks about the experience with OUD in the time of COVID and specifically efforts to maintain access to MAT during COVID. Note that the original recording contained contributions from Dr. Karen Scott (President, Foundation for Opioid Response Efforts) and Dr. Alister Martin (Emergency Medical Specialist, Founder Get Waivered) but were cut for the podcast due to time constraints. Guests: Gail D’Onofrio, MD, MS Professor and Chair, Department of Emergency Medicine, Yale School of Medicine Chief of Emergency Services, Yale New Haven Hospital Emily Kauffman, DO, MPH Assistant Clinical Professor Ohio State University Wexner Medical Center Sandra Schneider, MD, FACEP Associate Executive Director, Clinical Affairs Past President American College of Emergency Physicians Karen Scott, MD, MPD Present, Foundation for Opioid Response Efforts (FORE) Alister Martin MD, MPP Emergency Medical Specialist, Founder, Get Waivered Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal Additional Resources: www.forefdn.org www.getwaivered.com/remote https://www.drugabuse.gov/ed-buprenorphine https://medicine.yale.edu/edbup/ References 1. Volkow ND. Collision of the COVID-19 and Addiction Epidemics. Ann Intern Med. 2020;173(1):61-62. doi:10.7326/M20-1212 2. Hedegaard H, Minino A and Warner M. Drug Overdose Deaths in the United States, 1999-2018. NCHS Data Brief, number 356. Hyattsville, MD: National Center for Health Statistics 2020. 3. Hall OT, Hall OE, Kolodny A, Teater J, McGrath RP. Assessment of Excess Mortality Associated With Drug Overdose in Ohio From 2009 to 2018. JAMA Netw Open. 2020;3(4):e202183. Published 2020 Apr 1. doi:10.1001/jamanetworkopen.2020.2183 4. Hall OT, Hall OE, McGrath RP, Haile ZT. Years of Life Lost due to Opioid Overdose in Ohio: Temporal and Geographic Patterns of Excess Mortality. J Addict Med. 2020;14(2):156-162. doi:10.1097/ADM.0000000000000554

In this episode from the ACEP-EQUAL series, guests Dr. Aimee Moulin and Dr. Hannah Snyder discuss how to transition a patients treatment for opiate use disorder from the ED to the outpatient environment. They discuss how to use local resources, legal ramifications, waivers, and why they think a formal system to accomplish this is achievable. Guests: Aimee Moulin MD, Associate Professor, UC Davis Behavioral Health Director for Emergency Department Dual appointments in emergency medicine and psychiatry Hannah Snyder MD Assistant Professor, Family Community Medicine, UCSF Primary Care Addiction Medicine Specialist Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal