Academic Life in Emergency Medicine

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.  Podcast Sound 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)

https://www.aliem.com/em-match-advice-interview-season-2020-21-how-started-how-going

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 E-QUAL series, guest Dr. Houman Khosravani (Medical Director, Inpatient Stroke Unit Assistant Professor of Neurology, Department of Medicine, University of Toronto Sunnybrook Health Sciences Center; Staff Intensivist, Southlake Regional Health Center) discusses the concept of a "protected code stroke", how to operationalize the concepts, and how this system can be applied in your local circumstances. Host: Jason Woods, MD. Podcast sound engineer: Kellen Vu. www.acep.org/equal

References

Rajendram P, Notario L, Reid C, Wira CR, Suarez JI, Weingart SD, Khosravani H. Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care. Neurocritical Care. 2020; 33(2), 338–346. https://doi.org/10.1007/s12028-020-01057-4

Codestroke.net

In this episode from the ACEP-EQUAL series, guest Dr. William Meurer (Associate Professor of Emergency Medicine and Neurology University of Michigan) 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. Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu. www.acep.org/equal

1. Saver JL, Goyal M, van der Lugt A, et al; 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, et al; 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 (Chief, Department of Emergency Medicine, Sentara Norfolk General Hospital; Professor of Emergency Medicine, Eastern Virginia Medical School) reviews several common intracerebral hemorrhage scoring systems, the components, and tips on how to use them in real world practice.

Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu

www.acep.org/equal

References

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. Hemphill JC 3rd, Greenberg SM, et al; 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.
7. Houben R, Schreuder FHBM, Bekelaar KJ, et al. 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. Featured EM Program Director Panelists: Dr. David Caro (University of Florida, Jacksonville), Dr. Erica Shaver (West Virginia University), Dr. Cedric Lefebvre (Wake Forest University)

Podcast engineer: Kellen Vu

https://www.aliem.com/em-match-advice-virtual-interviews-covid/

In this episode from the ACEP-EQUAL series, guest Dr. Joshua Goldstein (Professor of Emergency Medicine, Harvard Medical School; Director, Center of Neurologic Emergencies, Massachusetts General Hospital) discusses ICH after TPA. He reviews what evidence exists, the timing, potential treatment targets, and medications.

Host: Dr. Jason Woods; Podcast Sound Engineer: 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 (Professor of Emergency Medicine & Neurology; Vice Chair for Research and Academic Affairs; University of Central Florida) 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.

Host: Dr. Jason Woods; Podcast Sound Engineer: 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, Dr. Gail Donofrio (Director, National Institute on Drug Abuse) and Dr. Nora Volkow (Professor and Chair of Emergency Medicine, Yale School of Medicine; Chief of Emergency Services, Yale New Haven Hospital) share their experience with substance use disorder in the time of COVID, as well as some thoughts on needed regulatory change. 

Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu

www.acep.org/equal