Overheard In The Emergency Room

For ten years I treated the bougie as a backup — the break-glass tool, Plan B. Then a 2024 systematic review and meta-analysis in Annals of Emergency Medicine made me reconsider whether it should be my first move on every airway. In this episode of Overheard Journal Club, I break down von Hellmann and colleagues’ pooled analysis of 18 studies and 9,151 patients: the headline 11% relative improveme...

A device can win a randomized trial and still be the wrong tool for your environment. In this episode of Overheard Journal Club, Dr Cois takes apart the 2024 JAMA cluster-randomized trial comparing video and direct laryngoscopy across 8,429 operating-room procedures. Video laryngoscopy cut multiple intubation attempts from 7.6 per cent to 1.7 per cent and reduced device-switch failures roughly fif...

In January 2025, a New York Times headline announced that fluoride exposure is linked to lower IQ in children. Within days, parents were tossing fluoride toothpaste and buying water filters, and a national political fight reignited over community water fluoridation. The paper behind the headline — Taylor et al, JAMA Pediatrics — is the largest and most rigorous meta-analysis of fluoride and childr...

Quick Hits Episode 6. A listener wrote in asking for a framework to read a medical paper — and it could not be timelier. Misinformation has now been ranked the most severe short-term risk facing the world by the World Economic Forum, ahead of armed conflict and cyber attacks. One in four Gen Z respondents turns to TikTok for medical advice, and viral medical content is consistently more likely to...

My pharmacy tried to charge me $90 for a generic nausea medication. Five minutes later, with a coupon I signed up for in the aisle, I paid $9. Same drug. Same store. Same five minutes. If that sounds impossible — or like a trick — this episode is for you. In Quick Hits Episode 5, I walk you through exactly how prescription drug pricing works in America, who is actually setting the price you pay (h...

Welcome to Overheard Journal Club. In this new short-form series, ED physician Dr Adrian Cois takes a single paper that's changed how he practises and breaks it down conversationally — PICO, results, critical appraisal, and the practical "so what do I do with this on my next shift" synthesis. First up: SALT-ED. Self and colleagues, NEJM 2018. A pragmatic crossover trial in 13,347 noncritically ill...

Two vehicles. Same destination. One question: which one will you actually do? If you’ve spent any time on health and fitness social media in the last two years, you’d be forgiven for thinking the only acceptable way to train your VO2 max is to strap on a weighted vest and grind out an hour of Zone 2 cardio every day. That’s what the algorithm is selling. The data tells a very different — and far m...

Welcome to the Season 1 finale of Overheard in the Emergency Room.   There's no single ED case anchoring this episode. There are fourteen of them — every patien every story, every lesson we walked through across the season. And rather than introduce one more case and pretend it summarises a whole year of conversations, Dr Cois pulls everything into a single playbook. Five Tier 1 pillars - in t...

If you work night shifts, swing shifts, or any schedule that doesn't line up with the sun, this Quick Hit is your sleep playbook. Dr Cois — emergency physician and host of Overheard in the Emergency Room — walks through the evidence-based system he uses for himself and shares with his patients. You'll learn why shift work nudges your long-term risk of diabetes, cardiovascular disease, and...

“Dr Cois, I’ve got abdominal pain. What will happen to me when I come to the ED?”  It’s one of the most common questions in my inbox — and one of the top 3 reasons people present to my Emergency Department. In this Quick Hit, I walk you through what actually happens when you come in with stomach pain: the conversation we have, the 4 diagnoses we cannot miss, and the bigger story most patients neve...

Welcome to the very first Quick Hit — a brand new bonus series from Overheard in the Emergency Room where Dr Cois tackles the questions you’ve been sending in. Short. Focused. Practical. Today: “What actually happens when I walk into the Emergency Department with chest pain?” Dr Cois walks you through the full chest pain workup — why we move so fast, what door-to balloon time means, the three body...

The global wellness industry is a 6.8-trillion-dollar business — more than four times the size of global pharma — and it runs on supplements. But how much of it actually has evidence behind it? In Episode 14 of Overheard in the Emergency Room, Dr Adrian Cois — a board-certified Emergency Physician — walks through the published systematic reviews and meta-analyses for the nine most common supplemen...

A 35-year-old patient walked into my Emergency Department with diverticulitis — and told me he was eating 2.2 grams of protein per kilogram of body weight per day because he heard it on a podcast. He had rearranged his entire diet around a number that was never meant for him, and in doing so, had displaced the exact foods that would have protected him from the diagnosis he was sitting in front of...

I was running through Forest Park in Portland when the thought hit me. No headphones. Wind in the trees. A creek below the trail. And then, out of nowhere: my two boys might never get to hear this if we let climate change go unchecked. I remember thinking: I’m just an Emergency Room doctor. What can I do about this?   It turns out — quite a lot. And in this episode, Dr Cois — Emergency Physician a...

He walked into Bay Four holding eight pages of printed lab results. He was 43, fit, did CrossFit five times a week, and had spent real money on a direct-to-consumer “longevity subscription” panel. His LDL was 170 mg/dL — meaningfully high. When I raised it, he told me it didn’t matter. His LDL fractionation showed mostly large, fluffy particles. Those are the harmless kind. Right?  Wrong. And in t...

She came in on the bus. An 84-year-old woman, independent antwenty years, wa her health for d diligent abouts sitting in my waiting room for four and a half hours with a blood pressure of 222 over 104. Her insurer had dropped her long-standing doctor. The next available appointmentwith a covered provider was five months away. She was on $60 a day. She couldn't afford to pay out of pocket. So h...

The gut microbiome is one of the most talked-about — and most misunderstood — topics in modern health. In this episode, Dr. Cois cuts through the noise with a clear, evidence-based breakdown of what your gut microbiome actually does, how to support it, and why some popular dietary trends may be doing more harm than good. We start in the Emergency Department, where a 33-year-old woman with Crohn&#3...

In this episode of *Overheard in the Emergency Room*, Dr. Adrian Cois breaks down one of the most misunderstood medical conditions in modern healthcare: obesity. Starting with a real case from the Emergency Department, we explore why obesity is not a failure of willpower but a chronic, biologically regulated disease. Drawing from major clinical guidelines and landmark studies, this episode walksth...

In this episode, Dr. Cois examines the science behind LDL cholesterol and heart disease. Through a real Emergency Room case, we explore how plaque forms, what ApoB means, why “lower for longer” matters, and how randomized trials have shaped modern prevention. We also tackle common myths about saturated fat and statins — and explain how to spot misinformation online. This is a data-driven, calm, ev...

In this episode of Overheard in the Emergency Room, we break down metabolic syndrome and type 2 diabetes using a clear, evidence-based two-tier framework. We cover: • What metabolic health actually means• Why diabetes is so common in Australia and the U.S.• The real pathophysiology of insulin resistance• What the best meta-analyses show about diet and lifestyle• Medications like metformin, SGLT2 i...

A 75‑second guided box breathing reset you can use anytime your body feels stuck in fight‑or‑flight . Inhale 3 • Hold 3 • Exhale 3 • Hold 3 (repeat). Disclaimer: Educational content only; not medical advice. If you have severe symptoms (e.g., chest pain with exertion, fainting, severe shortness of breath, new neurologic symptoms, or thoughts of self-harm), seek urgent medical care or call your loc...

In this episode, Dr Cois breaks down the biology of stress: how your eyes and amygdala can flip the body into fight-or-flight, why panic feels so physical, and what chronic ‘on-edge’ does to sleep, mood, blood pressure, and the gut. Through two ER cases—a first-time panic attack and an 8-year-old with stress-triggered abdominal pain—you’lllearn practical tools to tap the brakes: box breathing, dow...

I flipped from night shifts to days for my kids’ soccer and school events and felt “fine”… until my wearable gave me a literal skull recovery score. That screenshot did what no lecture ever did: it made sleep feel urgent. In this episode, we cover Sleep Basics — what sleep is (NREM/REM cycles), how it’s regulated (sleep pressure + circadian rhythm), and how melatonin, cortisol, light exposure, mea...

G’day team! Episode 3 is all about exercise: what to do, how much to do, and why it matters for living with "less bad days and more good decades". We build around the Two-Tiered Longevity Blueprint: • Tier 1 (foundations): weekly cardio targets, 2 days of strength, and everyday movement (NEAT/steps). • Tier 2 (upgrades): VO₂max work, smarter programming, power/balance as you age, and how...

In Episode 2 of Overheard in the Emergency Room, Dr. Cois breaks down diet as the first Tier 1 pillar in a two-tier blueprint for longevity. Using real ED cases—including incidental fatty liver and severe hypertension—he explains what major dietary guidelines consistently agree on, why nutrition science often gets misunderstood online, and what the biggest cohort studies reveal about long-term hea...