2 View: Emergency Medicine PAs & NPs

The Center for Medical Education
2 View: Emergency Medicine PAs & NPs

The 2 View is a podcast featuring EM clinicians Martha Roberts NP and Michael Sharma PA. The podcast discusses hot topics in EM and urgent care for advanced practice providers. The podcasts features literature reviews, case studies, controversial topics, and innovative approaches to the emergent and urgent care patient.

  1. 23 HR AGO

    The Regrets Episode… personal regrets in the business, regrets about patients, and breaking up with regrets while moving onto positive moments.

    Welcome to Episode 43 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 43 of “The 2 View” – the regrets episode… personal regrets in the business, regrets about patients, and breaking up with regrets while moving onto positive moments. Segment 1 – Regrets, we’ve all had a few: Personal regrets in the business Kelly NR, Mathews M. The Transition to First Position as Nurse Practitioner. J Nurs Educ. SLACK Journals. Published 2013. Accessed February 11, 2025. https://journals.healio.com/doi/abs/10.3928/0148-4834-20010401-05 Shea ML. Determined persistence: Achieving and sustaining job satisfaction among nurse practitioners. J Am Assoc Nurse Pract. WILEY Online Library. Published March 31, 2014. Accessed February 11, 2025. https://onlinelibrary.wiley.com/doi/abs/10.1002/2327-6924.12119 Segment 2 – Regrets about patients: Case studies, make the call Journal of General Internal Medicine. SpringerLink. SPRINGER NATURE Link. Accessed February 11, 2025. https://link.springer.com/journal/11606 Rohlfing AB, Kelly AE, Flint LA. Make the Call: Engaging Family as a Critical Intervention. J Gen Intern Med. SPRINGER NATURE Link. Published November 14, 2022. Accessed February 11, 2025. https://link.springer.com/article/10.1007/s11606-022-07913-7 Segment 3 – No more regrets: Moving onto positive thinking! Hazan A, Haber, J. Mindful EM: Dealing with Mistakes and Preventing Regrets. Mindful EM. Emergency Medicine News. Lww.com. Published May 2017. Accessed February 11, 2025. https://journals.lww.com/em-news/fulltext/2017/05000/mindful_em__dealing_with_mistakes_and_preventing.17.aspx Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

    1h 12m
  2. 13 FEB

    42 - Pink Cocaine, Holiday Heart Syndrome, Pertussis, Research Updates, and More! | The 2 View

    Show Notes for Episode 42 of “The 2 View” – Pink cocaine, holiday heart syndrome, pertussis, research updates on Zepbound and Semaglutide, and much more. Segment 1 – Pink cocaine What is Pink Cocaine? Dea.gov. DEA: United States Drug Enforcement Administration. https://www.dea.gov/pink-cocaine What is Pink Cocaine? Poison.org. POISON CONTROL: National Capital Poison Center. https://www.poison.org/articles/pink-cocaine Segment 2 – Holiday heart syndrome Blackburn R, Ajetunmobi O, Mc Grath-Lone L, et al. Hospital admissions for stress-related presentations among school-aged adolescents during term time versus holidays in England: weekly time series and retrospective cross-sectional analysis. BJPsych Open. Cambridge University Press. Cambridge Core. Published November 19, 2021. https://www.cambridge.org/core/journals/bjpsych-open/article/hospital-admissions-for-stressrelated-presentations-among-schoolaged-adolescents-during-term-time-versus-holidays-in-england-weekly-time-series-and-retrospective-crosssectional-analysis/924EE2CD1A8CFAC30E7090674FCEAF72 Carey M, Al-Zaiti S, Kozik T, Pelter M. Holiday Heart Syndrome. ECG Puzzler. Researchgate.net. AJCC: American Journal of Critical Care. American Association of Critical-Care Nurses. https://www.researchgate.net/profile/Mary-Carey/publication/260446497_Holiday_Heart_Syndrome/links/573dda6308ae298602e6d0b1/Holiday-Heart-Syndrome.pdf Ettinger P, Wu C, De La Cruz Jr C, Weisse A, Ahmed S, Regan T. Arrhythmias and the “Holiday Heart”: Alcohol associated cardiac rhythm disorders. Sciencedirect.com. ScienceDirect. American Heart Journal. https://www.sciencedirect.com/science/article/abs/pii/000287037890296X Greenspon AJ, Schaal SF. The “holiday heart”: electrophysiologic studies of alcohol effects in alcoholics. Ann Intern Med. PubMed. NIH: National Library of Medicine: National Center for Biotechnology Information. Published February 1983. https://pubmed.ncbi.nlm.nih.gov/6824246/ Jain A, Yelamanchili V, Brown K, Goel A. Holiday Heart Syndrome. Nih.gov. NIH: National Library of Medicine: National Center for Biotechnology Information. Updated January 16. 2024. https://www.ncbi.nlm.nih.gov/sites/books/NBK537185/ Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. AHA | ASA Journals. Published November 30, 2023. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193 Segment 3 – Pertussis CDC. About Whooping Cough. Whooping Cough (Pertussis). Updated April 2, 2024. https://www.cdc.gov/pertussis/about/index.html Center for Drug Evaluation, Research. FDA Drug Safety Communication: Death resulting from overdose after accidental ingestion of Tessalon (benzonatate) by children under 10 years of age. FDA: U.S. Food and Drug Administration. Published June 28, 2019. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-death-resulting-overdose-after-accidental-ingestion-tessalon Pertussis. Who.int. World Health Organization. https://www.who.int/health-topics/pertussis Simma L, Gesch M. Eyelid Ecchymoses and Subconjunctival Hemorrhage in Pertussis. N Engl J Med. Published December 11, 2024. https://www.nejm.org/doi/full/10.1056/NEJMicm2409052 Something sweet – Research updates: Zepbound and Semaglutide Ernst D. Zepbound Approved for Obstructive Sleep Apnea in Patients With Obesity. Monthly Prescribing Reference. MPR: Medical Professionals Reference. Published December 20, 2024. https://www.empr.com/news/zepbound-approved-for-obstructive-sleep-apnea-in-patients-with-obesity/?utm_source=eloqua&utm_medium=email&utm_campaign=NWLTR_MPR_TOPT_Drug-Database_SS-LAS-LI1-LI2-9654_122924_AL&hmemail=1f%2FJfEV7hN5vJr6vg%2FQRqK0NA6IXtyO3&sha256email=092493d8223fdfa40d9e995176d13e5fc5b5211674db9deb440c025fd462c80c&hmsubid=&nid=1639413404&elqtrack=True Semaglutide shows promise as a potential alcohol use disorder medication. Research Update. Nih.gov. NIH: National Institute on Alcohol Abuse and Alcoholism. Published March 13, 2024. https://www.niaaa.nih.gov/news-events/research-update/semaglutide-shows-promise-potential-alcohol-use-disorder-medication Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share! Looking forward to another year together!

    59 min
  3. 22 JAN

    41 - RCVS and CVT, CPR Care Science, Prehospital Tourniquets, Blood Pressure | The 2 View

    Show Notes for Episode 41 of “The 2 View” – reversible cerebral vasoconstriction syndrome, cerebral venous thrombosis, cardiopulmonary resuscitation and emergency cardiovascular care science, prehospital tourniquets, blood pressure, and more. Segment 1 – Reversible cerebral vasoconstriction syndrome and cerebral venous thrombosis Ropper AH, Klein JP. Cerebral Venous Thrombosis. N Engl J Med. Published June 30, 2021. https://www.nejm.org/doi/full/10.1056/NEJMra2106545 Spadaro A, Scott KR, Koyfman A, Long B. Reversible cerebral vasoconstriction syndrome: A narrative review for emergency clinicians. Am J Emerg Med. ScienceDirect. Published December 2021. https://www.sciencedirect.com/science/article/abs/pii/S0735675721008093 Segment 2 – Cardiopulmonary resuscitation and emergency cardiovascular care science, Prehospital tourniquets, and more Greif R, Bray JE, Djärv T, et al. 2024 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; And First Aid Task Forces. Circulation. AHA | ASA Journals. Published November 14, 2024. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001288?utm_campaign=sciencenews24-25&utm_source=science-news&utm_medium=phd-link&utm_content=phd-11-14-24 Roberts M, Sharma M. The Center for Medical Education. 36 - Marijuana, Sunburns, Pulse Oximetry, Lower UTI’s. 2 View: Emergency Medicine PAs & NPs. Published May 31, 2024. https://2view.fireside.fm/36 Roberts M, Sharma M. The Center for Medical Education. The 2 View: Episode 2. 2 View: Emergency Medicine PAs & NPs. Published February 3, 2021. https://2view.fireside.fm/2 Smith AA, Ochoa JE, Wong S, et al. Prehospital tourniquet use in penetrating extremity trauma: Decreased blood transfusions and limb complications. J Trauma Acute Care Surg. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published January 2019. https://pubmed.ncbi.nlm.nih.gov/30358768/ STB home page. Stop the Bleed. American College of Surgeons. https://www.stopthebleed.org/ Teixeira PGR, Brown CVR, Emigh B, et al. Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. J Am Coll Surg. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published May 2018. https://pubmed.ncbi.nlm.nih.gov/29605726/ Segment 3 – Blood Pressure Bress AP, Anderson TS, Flack JM, et al. The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association. Hypertension. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published August 2024. https://pubmed.ncbi.nlm.nih.gov/38804130/ Liu H, Zhao D, Sabit A. Arm Position and Blood Pressure Readings: The ARMS Crossover Randomized Clinical Trial. Jamanetwork.com. JAMA Network. JAMA Internal Medicine. Published October 7, 2024. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2824754 Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

    56 min
  4. 20/12/2024

    40 - ST-segment Elevation to Occlusion MI, Stercoral Colitis, and KEN MILNE! | The 2 View

    Welcome to Episode 40 – the BIG 4-0!! – of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 40 of “The 2 View” – ST-segment elevation MI to occlusion MI, recurrent uncomplicated UTIs in Women, stercoral colitis in the emergency department, an interview with Dr. Ken Milne, and more. Segment 1 – ST-segment elevation MI to occlusion MI, corneal abrasions, and recurrent uncomplicated UTIs in women Green SM, Tomaszewski C, Valente JH, Lo B, Milne K. Use of Topical Anesthetics in the Management of Patients With Simple Corneal Abrasions: Consensus Guidelines From the American College of Emergency Physicians. Ann Emerg Med. Annals of Emergency Medicine: An International Journal. Published May 2024. https://www.annemergmed.com/article/S0196-0644(24)00004-0/fulltext McLaren J, de Alencar JN, Aslanger EK, Meyers HP, Smith SW. From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction. JACC Adv. JACC Journals. Published November 2024. https://www.jacc.org/doi/10.1016/j.jacadv.2024.101314 Morgenstern J. More medical dogma: The “golden period” for laceration repair. First10EM. Published October 24, 2022. https://first10em.com/more-medical-dogma-the-golden-period-for-laceration-repair/ Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2022) - American urological association. Auanet.org. Published 2019, Reviewed and Validity Confirmed 2022. https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti Segment 2 – Stercoral colitis in the emergency department Bae E, Tran J, Shah K. Stercoral colitis in the emergency department: a review of the literature. Int J Emerg Med. Published January 2 2024. https://intjem.biomedcentral.com/articles/10.1186/s12245-023-00578-x Hoverstadt MDP. International journal of emergency medicine. Wilderness & Environmental Medicine. https://intjem.biomedcentral.com/ International Journal of Emergency Medicine. BioMed Central. https://intjem.biomedcentral.com/ Keim AA, Campbell RL, Mullan AF, et al. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Ann Emerg Med. Annals of Emergency Medicine: An International Journal. Published July 2023. https://www.annemergmed.com/article/S0196-0644(23)00098-7/abstract Segment 3 – Interview with Dr. Ken Milne Milne K. SGEM#457: Inhale – Nebulized or IV Ketamine for Acute Pain? The Skeptics Guide to Emergency Medicine - Meet ’em, greet ’em, treat ’em and street ’em. Published October 19, 2024. https://thesgem.com/2024/10/sgem457-inhale-nebulized-or-iv-ketamine-for-acute-pain/ Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

    1h 45m
  5. 06/10/2024

    39 - Water Beads, CRHK Pneumonia, STD Treatments, Malingering, and more! | The 2 View

    Welcome to Episode 39 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 38 of “The 2 View” – Water beads, CRHK Pneumonia, STD treatments, malingering, and more. Segment 1 - Water Beads Joynes HJ, Kistamgari S, Casavant MJ, Smith GA. Pediatric water bead-related visits to United States emergency departments. Am J Emerg Med. ScienceDirect. Published October 2024. https://www.sciencedirect.com/science/article/pii/S0735675724003711?via%3Dihub Warning: Popular water beads may cause intestinal blockages in kids. News. UC Davis Health. Children’s Health. Published December 13, 2022. https://health.ucdavis.edu/news/headlines/a-warning-this-sensory-toy-is-life-threatening-if-swallowed/2022/12 Water Beads. United States Consumer Product Safety Commission. Cpsc.gov. https://www.cpsc.gov/Safety-Education/Safety-Education-Centers/Water-Beads-Information-Center Segment 2 - WHO Warns of Carbapenem-Resistant Hypervirulent Klebsiella pneumonia Antimicrobial Resistance, Hypervirulent Klebsiella pneumoniae - Global situation. Who.int. World Health Organization. Disease Outbreak News. Published July 31, 2024. https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON527 Choby JE, Howard-Anderson J, Weiss DS. Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives. J Intern Med. WILEY Online Library. Published November 2, 2019. https://onlinelibrary.wiley.com/doi/10.1111/joim.13007 Segment 3 - STD Treatments Apato A, Cruz SN, Desai D, Slocum GW. Doxycycline adherence for the management of Chlamydia trachomatis infections. Am J Emerg Med. ScienceDirect. Published July 2024. https://www.sciencedirect.com/science/article/abs/pii/S0735675724002250?via%3Dihub The Center for Medical Education. The 2 View: Episode 9. 2 View: Emergency Medicine PAs & NPs. Published September 17, 2021. https://2view.fireside.fm/9 Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. Recommendations and Reports. CDC. Published July 23, 2021. https://www.cdc.gov/mmwr/volumes/70/rr/rr7004a1.htm#chlamydialinfections Segment 4 - Full-dose challenge of moderate, severe, and unknown beta-lactam allergies in the emergency department Anderson AM, Coallier S, Mitchell RE, Dumkow LE, Wolf LM. Full‐dose challenge of moderate, severe, and unknown beta‐lactam allergies in the emergency department. Acad Emerg Med. Wiley Online Library. Published August 2024. https://onlinelibrary.wiley.com/doi/epdf/10.1111/acem.14893 Meghan Jeffres, et al. University of Colorado. Hypersensitivity Type. Beta-lactam allergy tip sheet. Unmc.edu. https://www.unmc.edu/intmed/_documents/id/asp/clinicpath-beta-lactam-cross-reaction-tip-sheet.pdf Milne K. SGEM#452: I’m Still Standing – After The Allergy Challenge. The Skeptics Guide to Emergency Medicine - Meet ’em, greet ’em, treat ’em and street ’em. Published September 14, 2024. https://thesgem.com/2024/09/sgem452-im-still-standing-after-the-allergy-challenge/ Segment 5 - Malingering Alozai UU, McPherson PK. Malingering. In: StatPearls. StatPearls Publishing. NIH. National Library of Medicine. National Center for Biotechnology Information. Last updated June 12, 2023. https://www.ncbi.nlm.nih.gov/books/NBK507837/ Forrest JS. Rapid Review Quiz: Recognizing Malingering. Medscape. Published August 21, 2024. https://reference.medscape.com/viewarticle/1001346?ecd=WNL_rrq_240912_MSCPEDIT_etid6820181&uac=255848DR&impID=6820181 Kadaster AK, Schears MR, Schears RM. Difficult patients: Malingerers, Feigners, Chronic Complainers, and Real Imposters. Emerg Med Clin North Am. Published February 2024. https://www.emed.theclinics.com/article/S0733-8627(23)00067-6/abstract Sherman EMS, Slick DJ, Iverson GL. Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria. Arch Clin Neuropsychol. NIH. National Library of Medicine. National Center for Biotechnology Information. Published September 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452950/ Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share! Don’t miss our upcoming EM Boot Camp this December in Las Vegas: https://courses.ccme.org/course/embootcamp/about

    1h 7m
  6. 27/09/2024

    38 - Retinal Artery Occlusion, Femoral Artery, and a guest appearance by Carl Lange, PA | The 2 View

    Welcome to Episode 38 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 38 of “The 2 View” – Retinal Artery Occlusion, Femoral Artery, and a guest appearance by Carl Lange, PA. Segment 1 Yaghoubi G.H., Heidari B. and B. Heidari. Case report: Central retinal artery occlusion in a 28-year-old man after 10 days of smoking cessation. World Health Organization - Regional Office for the Eastern Mediterranean. Accessed September 20, 2024. https://www.emro.who.int/emhj-volume-14-2008/volume-14-issue-5/case-report-central-retinal-artery-occlusion-in-a-28-year-old-man-after-10-days-of-smoking-cessation.html Segment 2 Howden W. Femoral artery. Radiopaedia.org. Revised March 24, 2023. Accessed September 20, 2024. https://radiopaedia.org/articles/femoral-artery?lang=us Ultrasound – Doppler Pseudoaneurysm Evaluation. UT southwestern department of radiology. Utsouthwestern.edu. Revised October 2, 2018. Accessed September 20, 2024. https://www.utsouthwestern.edu/education/medical-school/departments/radiology/protocols/assets/US%20Pseudoaneurysm.pdf Webb S, Madia C. Postcatheterization Femoral Pseudoaneurysms. American College of Cardiology. Published June 4, 2019. Accessed September 20, 2024. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/06/04/10/26/Postcatheterization-Femoral-Pseudoaneurysms Zeman J, Kompella R, Lee J, Kim AS. Case report: Non-thrombotic iliac vein lesion: an unusual cause of unilateral leg swelling in a patient with endometrial carcinoma. Front Cardiovasc Med. PMC PubMed Central. Published online May 2, 2023. Accessed September 20, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185828/ Segment 3 California Board of Registered Nursing. Recruiting Expert Practice Consultants. Rn.ca.gov. Accessed September 20, 2024. https://www.rn.ca.gov/enforcement/expwit.shtml The Academy of Physician Associates in Legal Medicine. APALM. Published March 5, 2024. Updated June 7, 2024. Accessed September 20, 2024. https://www.apalm.net/ Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share! Don’t miss our upcoming EM Boot Camp this December in Las Vegas: https://courses.ccme.org/course/embootcamp/about

    1h 23m
  7. 02/09/2024

    37 - Pitfalls in Managing Pain in the ED with Sergey M. Motov, MD, FAAEM

    Welcome to Episode 37 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 37 of “The 2 View” – Pitfalls in Managing Pain in the ED with Sergey M. Motov, MD, FAAEM. Segment 1 Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL. Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996-2013. Am J Public Health. 2016;106(4):686-688. doi:10.2105/AJPH.2016.303061. https://pubmed.ncbi.nlm.nih.gov/26890165/ Bijur PE, Kenny MK, Gallagher EJ. Intravenous morphine at 0.1 mg/kg is not effective for controlling severe acute pain in the majority of patients. Ann Emerg Med. 2005;46(4):362-367. doi:10.1016/j.annemergmed.2005.03.010. https://pubmed.ncbi.nlm.nih.gov/16187470/ Evoy KE, Covvey JR, Peckham AM, Ochs L, Hultgren KE. Reports of gabapentin and pregabalin abuse, misuse, dependence, or overdose: An analysis of the Food And Drug Administration Adverse Events Reporting System (FAERS). Res Social Adm Pharm. 2019;15(8):953-958. doi:10.1016/j.sapharm.2018.06.018. https://pubmed.ncbi.nlm.nih.gov/31303196/ Kim HS, McCarthy DM, Hoppe JA, Mark Courtney D, Lambert BL. Emergency Department Provider Perspectives on Benzodiazepine-Opioid Coprescribing: A Qualitative Study. Acad Emerg Med. 2018;25(1):15-24. doi:10.1111/acem.13273. https://pubmed.ncbi.nlm.nih.gov/28791786/ Li Y, Delcher C, Wei YJ, et al. Risk of Opioid Overdose Associated With Concomitant Use of Opioids and Skeletal Muscle Relaxants: A Population-Based Cohort Study. Clin Pharmacol Ther. 2020;108(1):81-89. doi:10.1002/cpt.1807. https://pubmed.ncbi.nlm.nih.gov/32022906/ Peckham AM, Evoy KE, Covvey JR, Ochs L, Fairman KA, Sclar DA. Predictors of Gabapentin Overuse With or Without Concomitant Opioids in a Commercially Insured U.S. Population. Pharmacotherapy. 2018;38(4):436-443. doi:10.1002/phar.2096. https://pubmed.ncbi.nlm.nih.gov/29484686/ Smith RV, Havens JR, Walsh SL. Gabapentin misuse, abuse and diversion: a systematic review. Addiction. 2016;111(7):1160-1174. doi:10.1111/add.13324. https://pubmed.ncbi.nlm.nih.gov/27265421/ Suvada K, Zimmer A, Soodalter J, Malik JS, Kavalieratos D, Ali MK. Coprescribing of opioids and high-risk medications in the USA: a cross-sectional study with data from national ambulatory and emergency department settings. BMJ Open. 2022;12(6):e057588. Published 2022 Jun 16. doi:10.1136/bmjopen-2021-057588. https://pubmed.ncbi.nlm.nih.gov/35710252/ Segment 2 Caplan M, Friedman BW, Siebert J, et al. Use of clinical phenotypes to characterize emergency department patients administered intravenous opioids for acute pain. Clin Exp Emerg Med. 2023;10(3):327-332. doi:10.15441/ceem.23.018. https://pubmed.ncbi.nlm.nih.gov/37092185/ Connors NJ, Mazer-Amirshahi M, Motov S, Kim HK. Relative addictive potential of opioid analgesic agents. Pain Manag. 2021;11(2):201-215. doi:10.2217/pmt-2020-0048. https://pubmed.ncbi.nlm.nih.gov/33300384/ Fassassi C, Dove D, Davis A, et al. Analgesic efficacy of morphine sulfate immediate release vs. oxycodone/acetaminophen for acute pain in the emergency department. Am J Emerg Med. 2021;46:579-584. doi:10.1016/j.ajem.2020.11.034. https://pubmed.ncbi.nlm.nih.gov/33341323/ Irizarry E, Cho R, Williams A, et al. Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study. J Emerg Med. Published online March 14, 2024. doi:10.1016/j.jemermed.2024.03.018. https://pubmed.ncbi.nlm.nih.gov/38821847/ Sapkota A, Takematsu M, Adewunmi V, Gupta C, Williams AR, Friedman BW. Oxycodone induced euphoria in ED patients with acute musculoskeletal pain. A secondary analysis of data from a randomized trial. Am J Emerg Med. 2022;53:240-244. doi:10.1016/j.ajem.2022.01.016. https://pubmed.ncbi.nlm.nih.gov/35085877/ Wightman R, Perrone J, Portelli I, Nelson L. Likeability and abuse liability of commonly prescribed opioids. J Med Toxicol. 2012;8(4):335-340. doi:10.1007/s13181-012-0263-x. https://pubmed.ncbi.nlm.nih.gov/22992943/ Segment 3 Anshus AJ, Oswald J. Erector spinae plane block: a new option for managing acute axial low back pain in the emergency department. Pain Manag. 2021;11(6):631-637. doi:10.2217/pmt-2021-0004. https://pubmed.ncbi.nlm.nih.gov/34102865/ Chauhan G, Burke H, Srinivasan SK, Upadhyay A. Ultrasound-Guided Erector Spinae Block for Refractory Abdominal Pain Due to Acute on Chronic Pancreatitis. Cureus. 2022;14(11):e31817. Published 2022 Nov 23. doi:10.7759/cureus.31817. https://pubmed.ncbi.nlm.nih.gov/36579238/ Dove D, Fassassi C, Davis A, et al. Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial. Ann Emerg Med. 2021;78(6):779-787. doi:10.1016/j.annemergmed.2021.04.031. https://pubmed.ncbi.nlm.nih.gov/34226073/ Elkoundi A, Eloukkal Z, Bensghir M, Belyamani L, Lalaoui SJ. Erector Spinae Plane Block for Hyperalgesic Acute Pancreatitis. Pain Med. 2019;20(5):1055-1056. doi:10.1093/pm/pny232. https://pubmed.ncbi.nlm.nih.gov/30476275/ Finneran Iv JJ, Gabriel RA, Swisher MW, Berndtson AE, Godat LN, Costantini TW, Ilfeld BM. Ultrasound-guided percutaneous intercostal nerve cryoneurolysis for analgesia following traumatic rib fracture -a case series. Korean J Anesthesiol. 2020 Oct;73(5):455-459. doi: 10.4097/kja.19395. Epub 2019 Nov 5. PMID: 31684715; PMCID: PMC7533180. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533180/ Finneran JJ, Swisher MW, Gabriel RA, et al. Ultrasound-Guided Lateral Femoral Cutaneous Nerve Cryoneurolysis for Analgesia in Patients With Burns. J Burn Care Res. 2020;41(1):224-227. doi:10.1093/jbcr/irz192. https://pubmed.ncbi.nlm.nih.gov/31714578/ Gabriel RA, Finneran JJ, Asokan D, Trescot AM, Sandhu NS, Ilfeld BM. Ultrasound-Guided Percutaneous Cryoneurolysis for Acute Pain Management: A Case Report. A A Case Rep. 2017;9(5):129-132. doi:10.1213/XAA.0000000000000546. https://pubmed.ncbi.nlm.nih.gov/28509777/ Herring AA, Stone MB, Nagdev AD. Ultrasound-guided abdominal wall nerve blocks in the ED. Am J Emerg Med. 2012;30(5):759-764. doi:10.1016/j.ajem.2011.03.008. https://pubmed.ncbi.nlm.nih.gov/21570238/ Kampan S, Thong-On K, Sri-On J. A non-inferiority randomized controlled trial comparing nebulized ketamine to intravenous morphine for older adults in the emergency department with acute musculoskeletal pain. Age Ageing. 2024;53(1):afad255. doi:10.1093/ageing/afad255. https://pubmed.ncbi.nlm.nih.gov/38251742/ Mahmoud S, Miraflor E, Martin D, Mantuani D, Luftig J, Nagdev AD. Ultrasound-guided transverse abdominis plane block for ED appendicitis pain control. Am J Emerg Med. 2019;37(4):740-743. doi:10.1016/j.ajem.2019.01.024. https://pubmed.ncbi.nlm.nih.gov/30718116/ McCahill RJ, Nagle C, Clarke P. Use of Virtual Reality for minor procedures in the Emergency Department: A scoping review. Australas Emerg Care. 2021;24(3):174-178. doi:10.1016/j.auec.2020.06.006. https://pubmed.ncbi.nlm.nih.gov/32718907/ Nguyen T, Mai M, Choudhary A, et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Ann Emerg Med. Published online May 2, 2024. doi:10.1016/j.annemergmed.2024.03.024. https://pubmed.ncbi.nlm.nih.gov/38703175/ Sikka N, Shu L, Ritchie B, Amdur RL, Pourmand A. Virtual Reality-Assisted Pain, Anxiety, and Anger Management in the Emergency Department. Telemed J E Health. 2019;25(12):1207-1215. doi:10.1089/tmj.2018.0273. https://pubmed.ncbi.nlm.nih.gov/30785860/ Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

    1h 7m
  8. 01/06/2024

    36 - Marijuana, Sunburns, Pulse Oximetry, Lower UTI's

    Welcome to Episode 36 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 36 of “The 2 View” – Marijuana as a schedule III drug, treating sunburns and other skin problems, pulse oximetry and racial bias, and diagnosing lower UTIs. Marijuana as a schedule III drug Burton KW. The DEA Plans to Reschedule Marijuana: What Happens Next? Medscape: Emergency Medicine. Published May 2, 2024. Accessed May 10, 2024. https://www.medscape.com/viewarticle/dea-plans-reschedule-marijuana-what-happens-next-2024a10008ka?ecd=wnl_edit_tpal_etid6489685&uac=106964SV&impID=6489685 Dea.gov. DEA: United States Drug Enforcement Administration. Accessed May 10, 2024. https://www.dea.gov/drug-information/drug-scheduling Treating sunburns and other skin problems 12 Summer Skin Problems You Can Prevent. Aad.org. American Academy of Dermatology Association. Accessed May 10, 2024. https://www.aad.org/public/everyday-care/skin-care-secrets/routine/prevent-summer-skin-problems Benedetti J. Sunburn. Merck Manual Professional Edition. Reviewed/Revised Oct 2023. Accessed May 10, 2024. https://www.merckmanuals.com/professional/dermatologic-disorders/reactions-to-sunlight/sunburn Faurschou A, Wulf HC. Topical corticosteroids in the treatment of acute sunburn: A randomized, double-blind clinical trial. Arch Dermatol. PubMed. NIH: National Library of Medicine: National Center for Biotechnology Information. Published May 2008. Accessed May 10, 2024. https://pubmed.ncbi.nlm.nih.gov/18490588/ How to Treat Sunburn. Aad.org. American Academy of Dermatology Association. Accessed May 10, 2024. https://www.aad.org/public/everyday-care/injured-skin/burns/treat-sunburn Skowrońska W, Bazylko A. The Potential of Medicinal Plants and Natural Products in the Treatment of Burns and Sunburn—A Review. Pharmaceutics. PMC: PubMed Central. NIH: National Library of Medicine: National Center for Biotechnology Information. Published February 2023. Accessed May 10, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958865/ Pulse oximetry and racial bias Gudelunas MK, Lipnick M, Hendrickson C, et al. Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. PubMed. NIH: National Library of Medicine: National Center for Biotechnology Information. Published March 1, 2024. Accessed May 10, 2024. https://pubmed.ncbi.nlm.nih.gov/38109495/ Valbuena VSM, Seelye S, Sjoding MW, et al. Racial bias and reproducibility in pulse oximetry among medical and surgical inpatients in general care in the Veterans Health Administration 2013-19: multicenter, retrospective cohort study. BMJ. Published July 6, 2022. Accessed May 10, 2024. https://www.bmj.com/content/378/bmj-2021-069775.long Diagnosing Lower UTIs Aydemir B, Overton D. Diagnosing Lower Urinary Tract Infections. ACEP Now: The Official Voice of Emergency Medicine. Published May 10, 2024. Accessed May 10, 2024. https://www.acepnow.com/article/diagnosing-lower-urinary-tract-infections/ Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

    1h 19m

About

The 2 View is a podcast featuring EM clinicians Martha Roberts NP and Michael Sharma PA. The podcast discusses hot topics in EM and urgent care for advanced practice providers. The podcasts features literature reviews, case studies, controversial topics, and innovative approaches to the emergent and urgent care patient.

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