Best EM podcasts?

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Boatswain2PA

Boatswain2PA

Physician Assistant
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What are your best EM podcasts?

I've been an EM:RAP customer for 12 years, but I find myself fast-forwarding through more and more of their now-weekly casts. The intro's are now generally all social pod-casts, and their focus on woke issues is useless to my practice.

The "how to treat your fasting patient during Ramadan" has me finally throwing in the towel.
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The part where they spoke about nebulizers and IV fluids, glucose , electrolytes not being acceptable for Ramadan was useless...the majority of Ramadan patients are coming for dehydration/weakness/syncope but the only form of fluids acceptable is what? Rectal? EM:RAP is useless at times.
 
valianteffort said:
The part where they spoke about nebulizers and IV fluids, glucose , electrolytes not being acceptable for Ramadan was useless...the majority of Ramadan patients are coming for dehydration/weakness/syncope but the only form of fluids acceptable is what? Rectal? EM:RAP is useless at times.
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Yeah.
I miss the in depth lectures they used to have.
 
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I love all the banter and the Covid reflections and touchy-feely stuff. I guess that's why I'm transitioning to HPM after 15ish years. They have a ton of free podcasts. I'm surprised there aren't more out there for EM. That said, Emcrit is awesome and free.
 
I really like EM Board Bombs. I started paying for their subscription service EM Rapid Bombs. Using it currently for my boards retake prep, but it's all relevant and easy to listen to, I'll probably keep it after I pass
 
CajunMedic said:
I really like EM Board Bombs. I started paying for their subscription service EM Rapid Bombs. Using it currently for my boards retake prep, but it's all relevant and easy to listen to, I'll probably keep it after I pass
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Hadn't heard of these guys, thanks!
 
Pinner Doc said:
That said, Emcrit is awesome and free.
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No longer putting the F in FOAMed, unfortunately. Still some good free content occasionally but the majority is now subscriber-only.

I think Emergency Medicine Cases and the IBCC Podcast series are the two best that are currently free, and I give Scott Weingert credit for hosting the IBCC and keeping a lot of other good stuff online.

I’d love to learn of more at this level of quality out there, especially any putting out new content.

Edit: I actually just looked and it does seem like the RSS podcast feed is still active when I try to access it via the Apple Podcasts app. However, when you try to access the podcast via the website, there is a paywall. Unclear whether or not this is intentional, but I take back what I said about the podcast no longer being available for free.
 
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Boatswain2PA said:
What are your best EM podcasts?

I've been an EM:RAP customer for 12 years, but I find myself fast-forwarding through more and more of their now-weekly casts. The intro's are now generally all social pod-casts, and their focus on woke issues is useless to my practice.

The "how to treat your fasting patient during Ramadan" has me finally throwing in the towel.
Click to expand...

I genuinely thought that "How to treat your fasting patient during Ramadan" was you dropping fire-tier satire because that truly is what EM:RAP (and academic EM) has become.

I threw up in my mouth, a little, when I found out that it wasn't a joke, but actually the current state of content on that worthless platform.
 
valianteffort said:
The part where they spoke about nebulizers and IV fluids, glucose , electrolytes not being acceptable for Ramadan was useless...the majority of Ramadan patients are coming for dehydration/weakness/syncope but the only form of fluids acceptable is what? Rectal? EM:RAP is useless at times.
Click to expand...

For Ramadan, can't these people just wait a few hours until sundown and then eat and drink?
 
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TooMuchResearch said:
Ha, I had no idea. I've fallen out of touch with the new literature and am walking the lonely path of the community physician.
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Well, it's free – and, umm, I guess we might be awful, but I think if we were truly awful they would have fired us many years ago.

I will say we are not always excited about the articles we discuss – Annals seems to have decayed a bit, whereas it once seemed the primary target for EM research. Now I see relevant EM stuff in JAMA Network Open, Annals of Internal Medicine, etc. and even places like Emergency Medicine Australasia end up with more practical content.
 
xaelia said:
Well, it's free – and, umm, I guess we might be awful, but I think if we were truly awful they would have fired us many years ago.

I will say we are not always excited about the articles we discuss – Annals seems to have decayed a bit, whereas it once seemed the primary target for EM research. Now I see relevant EM stuff in JAMA Network Open, Annals of Internal Medicine, etc. and even places like Emergency Medicine Australasia end up with more practical content.
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You don't love rehashing the many papers titled "doctors are racists" and "more women should be academic physicians, even though we didn't bother to survey any women to assess for interest?" Or how about "check out this proprietary deep neural network algorithm with 85% accuracy."
 
deuist said:
You don't love rehashing the many papers titled "doctors are racists" and "more women should be academic physicians, even though we didn't bother to survey any women to assess for interest?" Or how about "check out this proprietary deep neural network algorithm with 85% accuracy."
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Don't forget – "here's something that's entirely outside the scope of emergency medicine, but obviously we should be burdening ourselves with more screening and chronic health management"
 
xaelia said:
Don't forget – "here's something that's entirely outside the scope of emergency medicine, but obviously we should be burdening ourselves with more screening and chronic health management"
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I think this is why I stopped reading the journals 🫠
 
TooMuchResearch said:
I think this is why I stopped reading the journals 🫠
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That and the fact that:
1) Most research can't be replicated (despite having the magical p value of < 0.05)
2) Academia has become a twisted industry in and of itself
3) Many places reward the sheer quantity of papers you publish (even if it's garbage) over the quality of work
4) Institutions are skimming 50% or more of the grant money off the top to do things like break federal civil rights laws
5) And that there's no trust in public health or science in general after it was weaponized to advance a political agenda
 
TooMuchResearch said:
Seriously is there anything new or interesting in emergency medicine I should be doing right now that I'm not doing?

Mostly I try to do law #13.
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Probably should not be using rocuronium for the vast majority of your intubations, as it significantly increases the risk of awake paralysis.

But yeah, I take your point. I don't think we need to read the literature every month to provide excellent care. EM doesn't move that quickly.
 
xaelia said:
Don't forget – "here's something that's entirely outside the scope of emergency medicine, but obviously we should be burdening ourselves with more screening and chronic health management"
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I would like to believe that it all went to hell after I published the meta-analysis on contrast nephropathy.

I still listen to the podcast, though, because I am certainly not going to read all of those articles that you and I just mentioned.
 
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TooMuchResearch said:
Seriously is there anything new or interesting in emergency medicine I should be doing right now that I'm not doing?
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YEARS criteria for pulmonary embolism
HEART score for discharging low risk chest pain
Ottawa Aggressive Protocol for new onset atrial fibrillation
 
WilcoWorld said:
Probably should not be using rocuronium for the vast majority of your intubations, as it significantly increases the risk of awake paralysis.

But yeah, I take your point. I don't think we need to read the literature every month to provide excellent care. EM doesn't move that quickly.
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I think you shouldn't do it unless you're using good doses of ketamine followed by opioids and sedation but we already knew this when I started using ketamine and rocuronium during an etomidate and succinylcholine shortage most of a decade ago.

Has something else changed about it?
 
deuist said:
YEARS criteria for pulmonary embolism
HEART score for discharging low risk chest pain
Ottawa Aggressive Protocol for new onset atrial fibrillation
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This was all during my residency training too. I live in a mostly post HEART world in which 98% of my patients with two stable 5th generation trops want to go home and already have a cardiologist.
 
TooMuchResearch said:
I think you shouldn't do it unless you're using good doses of ketamine followed by opioids and sedation but we already knew this when I started using ketamine and rocuronium during an etomidate and succinylcholine shortage most of a decade ago.

Has something else changed about it?
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I think what's changed/changing is our awareness and appreciation of awake paralysis, nothing about the drugs.

Funny for this to come up in a discussion about EM podcasts, as I suspect the increased use of rocuronium had a lot to do with EM Rap saying "roc rocks and sux sucks".
 
WilcoWorld said:
I think what's changed/changing is our awareness and appreciation of awake paralysis, nothing about the drugs.

Funny for this to come up in a discussion about EM podcasts, as I suspect the increased use of rocuronium had a lot to do with EM Rap saying "roc rocks and sux sucks".
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Generous helping of ketamine with a reasonable helping of rocuronium followed by generous helpings of opioids and propofol.
 
TooMuchResearch said:
Generous helping of ketamine with a reasonable helping of rocuronium followed by generous helpings of opioids and propofol.
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There's nothing wrong with using rocuronium – but, just as a lot of folks have "pre-intubation checklists", using rocuronium means its just as important to have a "post-intubation checklist" in order to facilitate uninterrupted ongoing sedation in the short-term.
 
WilcoWorld said:
I wonder what the correlation coefficient is between not reading medical literature and making criticisms of medical science without providing evidence for those criticisms.
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I also wonder. It’s a good point. I will say though that it wasn’t until I went medical school that I started to not infrequently question the benefit of medicine. Before that I was in awe and saw it as infallible. Ahh, what a premed I was. I next started reading Cochrane reviews and then started to question the benefit of a lot of research. Eventually with patient care I started using my gut more, or perhaps that’s just gestalt and wisdom from experience. Either way, I understand a little better the skepticism at times of our profession. It is important to distinguish blind, uninformed criticism from knowledgeable critique, as certainly a lot has probably come from the former. I wholeheartedly admit too that evaluating evidence and science is a difficult field on its own.
 
TooMuchResearch said:
Seriously is there anything new or interesting in emergency medicine I should be doing right now that I'm not doing?

Mostly I try to do law #13.
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One-time dose of prophylactic rocephin reduces VAP in intubated stroke/TBI patients by 40%.

PROPHY-VAP trial.
 
Jabbed said:
One-time dose of prophylactic rocephin reduces VAP in intubated stroke/TBI patients by 40%.

PROPHY-VAP trial.
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Interesting. Looks like it's "within 12 hours," so maybe why I haven't heard about it in our clinical practice. Published early 2024 and in a journal that I wouldn't have read. Possibly covered in the three years of emrap I fell behind on. We haven't had intubated patients sticking around for more than an hour or two in a couple of years.
 
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