ALT Emergency physicians pride themselves on recognizing and treating life-threatening illness under pressure. Yet substance use disorder—one of the most common, lethal, and treatable conditions in the ED—still often receives fragmented, stigmatized care. As the opioid crisis evolves with increasingly toxic drugs such as nitazenes, opioid-related deaths and ED visits continue to rise. In this episode, Dr. Bjug Borgundvaag, Tish Mizon, and Kari Herbert discuss how stigma affects patient care and how trauma-informed communication, person-first language, compassionate care, peer navigators, and Bridge-style addiction programs can improve outcomes for both patients and clinicians.

ALT This video reviews current evidence around vasopressor use in the setting of trauma presentations in the emergency department. Key takeaways include: 1. There is insufficient evidence to guide the use of vasopressors in early trauma resuscitation despite guideline recommendations for its use. 2. They may be useful in a minority of cases where there is a significant delay to obtaining blood products in the shocky patient and in patients refractory to blood products with a delay to source control who are in shock. 3. Vasopressors should rarely be your first option. Efforts should be directed towards blood volume restoration and hemostasis.

ALT In this episode with guest experts, Dr. Susan Duffy and Dr. Thomas Chun, we tackle the questions that come up at the bedside: How do we rapidly distinguish mild, moderate, and severe agitation in a way that actually changes what we do next? Which patients are most likely to escalate, and how can we intervene early to prevent that? When should we be worried about a medical or toxicologic cause rather than assuming this is “behavioural”? What does effective verbal de-escalation actually look like in a busy ED, and why does it so often fail? When is a “code white” for emergency security measures truly indicated, and how do we avoid turning it into an escalation trigger? How should we be thinking about medications: what to choose, when to give them, and how to avoid over-sedation? And once the patient is finally calm, how do we make sure we aren’t missing the underlying diagnosis? and many more…

ALT In this Part 2 or our 2-part EM Cases podcast series on Cardiac Arrest Update, Dr. Sheldon Cheskes and Dr. Rob Simard take us beyond the algorithms and into the real-world decision-making of cardiac arrest care. We answer questions like: Do vasopressin and steroids improve survival or just ROSC? Should we be giving amiodarone earlier—and is lidocaine just as good? When should we use calcium, bicarbonate, or magnesium, and when should we avoid them? What role does ketamine play in CPR-induced consciousness? How should we choose between supraglottic airways and endotracheal intubation? What are the pitfalls of waveform capnography (ETCO2) to help guide CPR quality, detect ROSC, and inform prognosis? What is the role of PoCUS and TEE during cardiac arrest? When should we terminate resuscitation—and how do ETCO2 and POCUS factor into that decision? Should we widen the criteria to consider thrombolytics and who should go to the cath lab, and should we be ordering whole-body CT? many more

ALT The 2025 AHA ACLS Guidelines reaffirm what saves lives in cardiac arrest: rapid recognition, high-quality CPR, early defibrillation for shockable rhythms, timely vasopressor use, and coordinated post–cardiac arrest care. What the guidelines cannot fully capture is the nuance required when the algorithm becomes sparse. We unpack concepts like compression-adjusted ventilation, the role of arterial lines during arrest, and feedback devices. And perhaps most provocatively, we challenge traditional dogma and the questions: Is the two-minute cycle too rigid? Should we be shocking earlier? Is head up CPR a viable technique? and much more…

ALT In this month's EM Quick Hits Podcast we introduce not one, but two new series! First, "EMC²" - EM Cases Cases (we know, horrible name ;) where Anton or Katie discuss a knowledge building case with a special guest. And second, "Coaching the EM Mind" with Dr. Sara Gray a professional coach for EM providers, where Katie discusses with her the science and best expert advice on how to perform your best in the ED. Plus, a withdrawal syndrome that is new EDs, life-threatening and requires specific treatment - metetomadine withdrawal, EMS handover done right, why community ED docs should not use the PECARN C-spine Rule and Part 2 of Petro's tips on management of traumatic pneumothorax...

ALT In this EM Cases podcast we walk you through what Emergency Physicians need to know to recognize, risk stratify, and manage endometriosis safely and pragmatically. In this podcast we answer question such as: When should endometriosis rise to the top of the differential for pelvic pain? How do we distinguish an endometriosis flare from a dangerous endometriosis complication? from Pelvic Inflammatory Disease? Why hemorrhagic cyst the most common misdiagnosis for endometriosis and how can we tell the difference between hemorrhagic cyst and endometrioma? Which hormonal therapy is safe, reasonable and effective to start in the ED? What are the most common life-threatening complications of endometriosis we should be on the lookout for in the ED? How do we discharge patients with suspected endometriosis safely and reduce repeat visits? and many more…

ALT Convulsive status epilepticus is one of the most morbid neurologic emergencies we manage in the ED, and outcomes depend far more on speed than drug selection. Like ventricular fibrillation, each minute of ongoing convulsions worsens hypoxia, acidosis, cardiovascular instability, and neuronal injury, while making seizures progressively harder to terminate. Modern definitions are intentionally time-compressed to force early, parallel, clock-anchored action. Any patient still convulsing when you reach the bedside should be treated as evolving status epilepticus. In this EM Cases podcast with Dr. Sara Gray, we take a practical, time-based approach to convulsive status epilepticus, focusing on early, adequately dosed benzodiazepines, avoiding common escalation and dosing pitfalls, anticipating post-ictal cardiovascular collapse, and knowing when to escalate to second-line agents, airway control, and anesthetic-dose therapy.

ALT If you’ve been practicing EM for more than a decade, your approach to the febrile young infant has (appropriately) evolved. For years, the default was LP empiric antibiotics admission for almost everyone. That approach prevented missing meningitis, but at the cost of a lot of harm: invasive testing, unnecessary antibiotics, and hospitalization-related complications. The modern approach is a paradigm shift toward risk stratification, biomarkers, and shared decision-making, while still respecting one immutable truth: Missing neonatal bacterial meningitis can be catastrophic. This episode revisits the framework from a prior EM Cases episode and updates it with a landmark RCT that directly informs how far we can safely go—especially in the 0–28 day group, with the father of multiple well-known PECARN rules Dr. Nathan Kuppermann and lead author Dr. Brett Burstein…