Emerge in EM

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In this episode of EMERGE in EM, Dr. Mohamed Hagahmed sits down with cardiology fellow Dr. Njeri Kuria to discuss Spontaneous Coronary Artery Dissection (SCAD)—an often underrecognized cause of acute myocardial infarction that predominantly affects young and otherwise healthy women.
Through a real clinical case, they explore how SCAD presents, why it's frequently mistaken for more common conditions, how it's diagnosed, and what makes its management fundamentally different from traditional heart attacks. They also discuss pregnancy-associated SCAD, recurrence, long-term follow-up, and the critical role of recognizing cognitive biases when evaluating chest pain.
Whether you're an emergency clinician, cardiologist, paramedic, nurse, medical student, or simply interested in understanding heart health, this episode offers practical insights that could change the way you think about chest pain—and perhaps even save a life.
In this episode, you'll learn:
Why SCAD is one of the leading causes of heart attacks in women under 50
How to recognize high-risk patients in the emergency setting
Why PCI isn't always the best treatment
The role of fibromuscular dysplasia and pregnancy
Long-term management, recurrence, and patient counseling
Key clinical pearls for healthcare professionals
🎧 Tune in for an engaging conversation that challenges common assumptions about heart disease and highlights the importance of listening to patients, recognizing bias, and delivering thoughtful, evidence-based care.
Resources
📖 New England Journal of Medicine Review: Spontaneous Coronary Artery Dissection
https://www.nejm.org/doi/full/10.1056/NEJMra2001524
If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.
📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:
Instagram: @HagahmedMD
YouTube: @HagahmedMD
Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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Welcome to Public Health Briefs — a new series from EMERGE in EM where we break down the public health stories shaping our world through the lens of emergency medicine, critical care, and frontline science.
In this episode, we tackle the growing public concern surrounding hantavirus after recent viral headlines and online speculation sparked fear across social media. Joined by infectious disease specialist Dr. Yassin, I take a deep dive into what hantavirus actually is, how it spreads, why certain strains raise concern for person-to-person transmission, and what clinicians and the public truly need to know.
We discuss rodent exposure, incubation periods, cardio-pulmonary syndrome, ECMO considerations, diagnostic challenges, public health response, quarantine recommendations, and the dangers of misinformation during emerging infectious disease events.
This conversation is not about panic — it’s about perspective, preparedness, and evidence-based medicine.
Because in public health, the goal is always the same: awareness over fear, science over speculation, and protecting communities through accurate information.
Thank you for listening to Public Health Briefs on EMERGE in EM.
If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.
📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:
Instagram: @HagahmedMD
YouTube: @HagahmedMD
Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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What happens after the pulse comes back?
In this episode, we dive into one of the most practical — and controversial — questions in post-cardiac arrest care: Which vasopressor should clinicians reach for first after ROSC? Epinephrine or norepinephrine?
Joining me is Dr. Nathalie Van Der Rijst, pulmonary and critical care physician from Philadelphia, for an energetic and evidence-driven debate exploring the physiology, pharmacology, real-world logistics, and limitations of current research surrounding post-cardiac arrest hypotension.
Together, we tackle:
Why post-ROSC hypotension remains so deadly
The physiologic argument for epinephrine vs. norepinephrine
Myocardial stunning, vasoplegia, and recurrent arrest
What observational studies and limited randomized data actually show
Why prehospital realities matter when choosing vasopressors
The challenges EMS agencies face with pumps, medications, and resources
How ICU and emergency medicine perspectives sometimes differ — and where they align
Along the way, expect spirited Pittsburgh vs. Philadelphia banter, ICU vs. ER jabs, practical resuscitation pearls, and an honest discussion about the gap between ideal medicine and real-world medicine.
Whether you work in EMS, emergency medicine, critical care, anesthesia, or hospital medicine, this conversation will challenge the way you think about post-cardiac arrest shock and the critical minutes after ROSC.
As always, thank you for listening, sharing feedback, and helping grow this community focused on resuscitation, emergency medicine, critical care, and public health.
If you enjoy the episode, please share it with a colleague and send along topics you’d like covered in future episodes.
If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.
📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:
Instagram: @HagahmedMD
YouTube: @HagahmedMD
Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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As an emergency physician and someone who loves EMS, I’ve always believed that we should understand the history of the systems we work in. But the truth is, many clinicians today don’t realize how modern paramedicine actually began.
Before paramedics existed, an ambulance call in many cities meant a police wagon. There were no trained providers in the back, no oxygen, no medications—just a ride to the hospital.
That changed in Pittsburgh in the late 1960s with the creation of the Freedom House Ambulance Service.
In this episode, I had the incredible honor of sitting down with Chief John Moon, one of the original Freedom House paramedics. Alongside pioneers like Dr. Peter Safar and Dr. Nancy Caroline, these men helped build the very foundation of modern EMS—bringing advanced medical care directly to patients long before it became standard practice.
But this story is about more than the birth of paramedicine.
It’s about a group of young Black men from Pittsburgh’s Hill District who were given an opportunity to serve their community—and in doing so changed emergency medicine forever.
Chief Moon shares powerful stories about the early days of Freedom House, the groundbreaking training they received, the lives they saved, and the challenges they faced along the way.
For me, this conversation is also deeply personal. The story of Freedom House is one of the reasons I came to Pittsburgh and pursued EMS and emergency medicine here.
If you are a paramedic, EMT, nurse, physician, or anyone who works in emergency care, this is a piece of history that belongs to all of us.
I’m truly honored to share Chief Moon’s story with you.
If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.
📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:
Instagram: @HagahmedMD
YouTube: @HagahmedMD
Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.

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What happens when life-saving care collides with deeply held faith?
As Ramadan begins this month, millions of patients around the world will be fasting—and many of them will still come to the emergency department sick, unstable, and in need of urgent care. In this episode of EMERGE, we dive into the real-world challenges of caring for the fasting patient, from hypotension and sepsis to IV fluids, medications, and shared decision-making in high-acuity settings.
Joined by Dr. Laila Abubshait, we unpack common myths, high-stakes cases, and practical strategies for clinicians navigating faith, culture, and emergency medicine—without compromising resuscitation or trust. This conversation builds on our ALiEM article “Caring for the Fasting Patient” and translates it into bedside wisdom every resuscitationist and clinician can use.
This isn’t just about Ramadan. It’s about seeing the whole patient, asking better questions, and recognizing that sometimes the most powerful intervention in the ED is curiosity, humility, and listening first.
👉 Read the companion article: https://www.aliem.com/caring-for-the-fasting-pt/

🎙️ We want to hear from you—share your experiences, questions, and reflections as we continue this essential conversation.
If you enjoyed this episode, please follow, subscribe, and leave a review—it helps us reach more listeners.
📱 Connect with me for more educational content, clinical pearls, podcast clips, and behind-the-scenes updates:
Instagram: @HagahmedMD
YouTube: @HagahmedMD
Thank you for being part of the EMERGE in EM community. Until next time, stay curious, keep learning, and continue to EMERGE.