Interviewing and beginning your career in medicine comes with challenges! Dr. Sarah Bunting, MD is a PGY-1 emergency medicine resident at Maine Medical Center. Listen in to hear her advice on transitioning from medical school to residency, virtual interviewing, and what to look for in a residency!

The 21st Century CURES act has mandated that starting on April 5th, 2021 patient notes (with a few very narrow exceptions) must be easily available to patients via their patient portal. How did this come about, and what does it mean for us?

In this Vodcast episode. Dr. Andrew Fried, ultrasound Jedi, give us a masterclass on placing ultrasound guided IVs.

This year we are very fortunate to have Dr. Amal Mattu, EKG Jedi, as teaching faculty for our 39th Maine Medical Center/Maine ACEP Winter Symposium. In this lecture, he helps us differentiate septal STEMIs from other potentially life threatening mimics.

Ludwig’s Angina is an uncommon but dangerous floor of the mouth infection. It is important to recognize and manage it appropriately. For this reason we present images and video of a case of Ludwig’s Angina… and sprinkle in nuggets of wisdom regarding source, presentation, complications, and management.

In this post and podcast we review mRNA vaccines and the Pfizer phase 3 study to help frontline providers answer some important questions- What is an mRNA vaccine? How does this differ from the traditional vaccines? Is it safe? Efficacious? We take a closer look at the recent NEJM article to help us come to a final answer on the most important question- Should I feel comfortable getting this vaccine?

Intubation in the emergency department (ED) can be a stressful endeavor. We are often presented with patients who have complex anatomy and tenuous physiology. Because of this, it can be hard to look past the critical step of securing the airway. Rapid sequence intubation (RSI) and positive pressure ventilation can dismantle patients’ physiology and contribute to an almost 4% rate of post intubation cardiac arrest (PICA). Is there anything we can do to predict or prevent this? In this podcast, Sam Wood gives us an overview of the literature to help us answer these questions.

The management of diabetic ketoacidosis (DKA) in children is full of difficult questions- how much insulin should I give? Who is at risk for cerebral edema? What treatments, if any, increase the risk for this dreaded complication? Which fluid is ideal? How much of this fluid should I give? We sat down with ED physician and endocrine aficionado Dr. George Willis to answer these questions.

They have something DOWN THERE... No surprises, it's herpes. But making the diagnosis is the just first of many issues and questions- how do you treat it? Will it come back? How do I stop from spreading it to other partners? Is there something I can do to decrease my number of outbreaks? All great questions we should be ready to answer. In this vodcast Dr. Leger reviews this disease and these important questions.

The diagnosis of Wernicke's encephalopathy is an elusive beast. The classic triad of altered mental status, ataxia, and ophthalmoplegia is, of course, anything but classic in terms of presentation. To make matters worse, the most at-risk population, the chronic alcohol misuser, often have these signs and symptoms for alternative reasons. In this podcast we discuss diagnosing Wernicke's in the alcoholic.

Boarding is a problem across most Emergency Departments in the United States, and likely the world. This adversely affects patients and staff. In this post we review the data on the detriments of boarding in the ED, how it impacts patients, and some ideas on how to fix it.

Uterine bleeding is a common presentation to the Emergency Department and rarely these patients are SICK. When they come in sick, it's not the time to be googling the ACOG recs on managing uterine bleeding. Here we review the proper management of the pregnant, post-partum, and non-pregnant patient with uterine bleeding.

The personal protective equipment (PPE) for COVID-19 has been the center of attention in the medical world and laypress, in part because of the short supply and in part because of the importance of healthcare personnel safety. In this vodcast we review the different levels of PPE and what you need to know to safely protect yourself.

Tranexamic acid (TXA) is a synthetic lysine derivative that binds with the lysine site on plasminogen, inhibits fibrinolysis and stabilizes clot. While it has been around since the 1960’s, its popularity for major trauma has gained a lot of steam in recent years. This has also led creative emergency providers to find novel uses for it at the bedside. In this podcast, Dr. Tim Fallon discusses some of the more novel bedside uses for TXA including epistaxis, hemoptysis, post tonsillectomy bleeding, and dental trauma.

Syncope is an incredibly common presentation to the Emergency Department with a broad differential diagnosis from the benign (vasovagal) to the lethal (arrhythmia). Because of this, the care and disposition of these patients can be challenging. In this podcast we sat down with Dr. Mike Burla to talk through the potential of a new decision aid- the Canadian Syncope Risk Score.

FOAM [free open access medical education] is growing at an amazing rate (we are actually using FOAM now to talk about FOAM). This resource, like most powerful tools, has its pro and cons. To review FOAM and its use in Graduate Medical Education, we sat down with Matt Delaney.

Keeping the blood pressure targets straight for different intracranial processes can be a daunting task. In this blog and associated podcast we review the specific intracranial pathologies, their associated blood pressure targets, and reference the supporting literature.

Running a good resuscitation for a cardiac arrest patient is hard, especially when staffing or resources are low. Here we look at the data on how to run a code well when resources are limited.

In this podcast episode we sit down with ED toxicologist Ryan Marino to talk about the phenomenon known in the media as "Fentanyl Hysteria"- a trend of fear-mongering, exaggerated reporting, and misinformation. 

In this post we look at some under-represented topics in Emergency Medicine- gender roles, biases, and Mansplaining.

The world of emergency neuroimaging is evolving and increasingly influencing time-sensitive treatment decisions. A basic understanding of the imaging studies and sequences you may be asked to obtain in the ED may help you better manage your patients. In this post, Dr. Matthew Siket reviews the major four neuroimaging modalities (CT, CTA, Perfusion, and MRI).

It’s one of those diseases that really tightens the sphincter and we need to talk about it - a foreign body in a kid’s upper airway and how to deal with it. In this blog and podcast we review the complexity of the oral foreign body (FB) in kids and why this disease process is so tough to handle.

We talk a fair bit in MedEd (that's medical education for cool people) about how to best teach medicine, but rarely ask those who these conversations and thoughts most effect... the residents. 

So we sat down with two of our graduating chief residents to ask them their parting thoughts on GME. 

Metacognition is a person’s ability to understand their thought patterns and how they come to their conclusions. It is a critically important skill for health care providers as it has the ability to both hinder and help their medical decision making. In this podcast episode, Dr. Samantha Wood describes the dual process theory of thinking as well as seven metacognition hacks that you can use on your next shift.

When you're intubating your patient, twiddling your thumbs and waiting for your induction and paralytic to work, do you ever ask yourself "hmm, should I be bagging this patient?" In this podcast episode we talk about that very question and the new data from the PREVENT trial.

In this blog post we talk ear infections, or Acute Otitis Media (AOM)- a common disease commonly diagnosed... and probably commonly done wrong. We'll talk definitions of disease, common alternative diagnoses, and treatment plans by age. I assure you- you'll learn something new.

Prompt, safe, and effective pain management is a core competency of the emergency provider. Unfortunately, traditional strategies for administering analgesics for acute pain have shown poor success rates. In this podcast episode, Dr. Matthew Delaney shares a few evidence based pain management pearls you can use on your next shift.

In this blog post and podcast we take a look at the PARAMEDIC-2 trial and discuss the implications this study has on the use of epinephrine in out of hospital cardiac arrest.

How we deal with the Opioid Epidemic in the Emergency Department has been a topic of hot debate. We sat down with addiction medicine specialist Dr. Ken Starr to discuss buprenorphine use in the Emergency Department.