EM Pulse Podcast™

In 2024, the American Board of Emergency Medicine (ABEM) qualifying exam first-time pass rate dropped to a historic low of 82% (down from 92.3% in 2019). While structured board preparation is nearly universal across residency programs, pass rates continue to slide—not just in emergency medicine, but across other specialties, as well. Our own Dr. Neelou Weeker joins arDr. Nickolas Srica and Dr. Rya...

Pulmonary embolism (PE) in pediatric patients is high stakes but less frequent diagnosis. Because missing a PE can be devastating, clinicians frequently order diagnostic workups, including labs and imaging. The adult PERC rule identifies adults at very low risk for PE but includes age <50 and adult heart rate cutoffs, making it inapplicable to pediatric patients. And, as we all know, children...

Caring for patients with severe traumatic brain injury (TBI)—especially pediatric patients—is high-stakes and high-stress. In severe TBI, primary brain injury occurs at the moment of impact; our primary goal in the emergency department is preventing secondary brain injury caused by hypoxia, hypoperfusion, elevated intracranial pressure (ICP), seizures, hyperthermia, and dysglycemia. In this episod...

Ultrasound-guided nerve blocks are no longer just a niche skill for fellowship-trained ultrasound specialists—they are a core component of modern multimodal pain management in the ED. Endorsed by ACEP, nerve blocks can offer rapid, targeted pain relief without relying solely on systemic opioids, making everything from rest to imaging and procedural workups significantly more comfortable for patien...

The Outbreak With over 17,000 cases reported across the U.S., a massive Cyclospora outbreak has taken center stage in public health news, marking it as the third-largest foodborne outbreak in modern American history (behind the 1994 Schwan’s ice cream salmonella outbreak and the 1985 Illinois milk outbreak). Infection causes gastrointestinal symptoms, including diarrhea, bloating, nausea and...

Cannabinoid Hyperemesis Syndrome (CHS) continues to be a major clinical challenge in the emergency department. Patients present with severe abdominal pain, intractable vomiting, and significant fluid and electrolyte derangements. CHS often affects people who have been using cannabis routinely for months to years – it can be difficult for patients to understand that their symptoms are related...

A landmark international trial published in the New England Journal of Medicine evaluated whether fluid type impacts patient outcomes.

In this episode, we welcome back guest host Dr. Neelou Weeker and ED nurse Leigh Clary to talk about a tough emergency medicine reality that we often avoid discussing: what teamwork looks like when, despite our best efforts, the patient doesn’t survive. We work though a recent, emotionally heavy resuscitation and explore how TeamSTEPPS tools—specifically the structured debrief—serve as a vital saf...

In this episode, the we welcome back guest host, Dr. Neelou Weeker, and ED nurse, Leigh Clary, to discuss the critical intersection of language barriers, patient equity, and emergency care. Through two powerful clinical scenarios, the team explores the “gold standards” of medical translation, the challenges of resource-limited community settings, and how TeamSTEPPS tools—specifically c...

It is getting hot in California, which has us thinking about the massive carbon footprint of healthcare. The emergency department is famously resource-heavy, but can we save lives and reduce waste? Dr. David Barnes joins us to explain how going green isn’t just about being a “tree hugger”—it’s about saving money, cutting waste, and making our hospitals resilient against supply ch...

It’s one of the most common—and most frustrating—complaints in the Emergency Department: the patient covered head-to-toe in hives, miserable, itching, and desperate for relief. In this episode of EM Pulse , we welcome back ED Clinical Pharmacist Haley Burhans to tackle the “uncomfortable” topic of urticaria. We move past the myths of one-and-done doses and explore why your standard all...

Menopause is not just “hot flashes”—it is a systemic hormonal shift that affects almost every organ system. For the emergency clinician, recognizing the symptoms of perimenopause and menopause is crucial for expanding the differential diagnosis once life-threatening conditions are ruled out. Dr. Pam Dyne joins us for a crash course on evaluating menopausal and perimenopausal patients i...

“Time can only be spent. Think of it as your most valuable currency.” Welcome back to EM Pulse. We are continuing our deep dive with Dr. Resa Lewiss into the world of Micro Skills . If you missed it, go back and listen to Part 1 where we definite micro skills and discuss how they can help you as an early, mid or late career physician. In the second half our interview, we move beyond th...

“If you read this book on a Friday, we promise you will be better at your job on Monday.” In the high-stakes environment of the Emergency Department, we often focus on the “big saves,” but what if the secret to a thriving career lies in the tiny details? In part one of this special two-part series, we sit down with Dr. Resa Lewiss , an emergency and lifestyle medicine physi...

This episode of EM Pulse dives into a critical intersection of clinical practice: the overlap between objective evidence-based medicine and the subjective influence of implicit bias. In a special collaboration with Don’t Forget the Bubbles (DFTB) , we are joined by experts from across the globe to discuss a landmark study on how clinical decision rules—specifically the PECARN (Pediatric Emergency...

We’ve all seen it: the patient whose chart is “flagged” with a penicillin allergy, but when you dig into the history, the story doesn’t quite add up. Maybe it was a stomach ache in the 90s, or maybe they’re just carrying a “inherited” allergy from a parent. In this episode of EM Pulse, we sit down with ED Clinical Pharmacist Haley Burhans to discuss why these labels a...

This episode of EM Pulse dives into one of the most stressful scenarios in the ED: the febrile infant in the first month of life. Traditionally, a fever in this age group has meant an automatic “full septic workup,” including the dreaded lumbar puncture (LP). But times are changing. We sit down with experts Dr. Nate Kuppermann and Dr. Brett Burstein to discuss a landmark JAMA study tha...

  Reimagining Care Beyond Hospital Walls Hospitals are a finite resource—but patient needs are not. This episode continues our multi-part series on taking medicine to where patients are—rather than making them come to us . From preventative care to pediatricians meeting families in their own environments, the series has explored how medicine is evolving beyond traditional settings. In this ep...

We’re stepping out of our Medicine on the Go series for a rapid-response episode on something hitting all of us hard right now: **influenza**. A lively debate among our colleagues sparked this conversation—especially around a newer flu antiviral, baloxavir (Xofluza). Who’s using it? When does it make sense? How much does it cost patients? And how does it really compare to the longtime staple oselt...

The next episode of our Medicine on the Go series features Dr. Serena Yang, Professor and Division Chief of General Pediatrics and Vice Chair of Community Engagement at UC Davis Health, as she shares how UC Davis Children’s Hospital’s Pediatric Mobile Clinic is bringing specialty care directly into schools and under-resourced communities across the Sacramento region. Learn how this innovative mobi...

In the second episode of our Medicine on the Go series, we step beyond the ED to explore how UC Davis Health and Sacramento County are partnering to deliver care directly to the community through the Wellness Without Walls (W3) street medicine program. We’re joined by Dr. MK Orsulak, Assistant Professor of Family Medicine at UC Davis. We discuss how a mobile clinic staffed by interdisciplinary tea...

In this first installment of our Medicine on the Go series, we explore how care is moving beyond hospital walls and directly into the community through UC Davis Fire Department’s innovative mobile mental health crisis unit, Health 34. You’ll hear how this no-cost, 24/7 team—staffed by providers with paramedic backgrounds and lay counselor training—meets people where they are to prevent crises, sup...

In this episode of EM Pulse, guest host Dr. Neelou Tabatabai joins Julia in a discussion with ED nurse and TeamSTEPPS advocate, Leigh Clary, to explore how structured communication tools can transform even the most high-stress medical and trauma resuscitations. Through a real-life story of conflict and resolution in the emergency department, Leigh illustrates how TeamSTEPPS strategies—like asserti...

In this episode, we dive into the charged world of Morbidity and Mortality conferences—where good intentions can collide with fear, shame, and silence. We’ve all felt that jolt of adrenaline sitting in the audience—or worse, standing at the podium. Our guest expert, Dr. Jaymin Patel, helps us unpack why the traditional M&M model no longer works and how we can rebuild it into something better:...

What happens when a febrile infant presents at 61 days old? Are they suddenly low risk for invasive bacterial infections? In this episode, we explore the gray zone of managing febrile infants aged 61–90 days with the help of two new clinical prediction rules from PECARN. Joining us are two powerhouses in pediatric emergency medicine: Dr. Nate Kuppermann and Dr. Paul Aronson, who walk us through th...