Emerge in EM

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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.

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Immigration enforcement doesn’t just shape borders—it shapes health outcomes.
In this episode of Emerge in EM, Dr. Mohamed Hagahmed is joined by Dr. Italo Brown for a candid, clinician-to-clinician conversation about how immigration enforcement affects patient care, trust, and public health.
Originally recorded as a live Instagram discussion, this conversation was brought to the podcast because the issues raised were too important to disappear after a moment on social media. From emergency departments to outpatient clinics, fear of immigration enforcement is changing how and when patients seek care—often leading to delayed presentations, worse outcomes, and preventable harm.
Together, Dr. Hagahmed and Dr. Brown unpack:
How fear of enforcement becomes a barrier to care
What clinicians are seeing at the bedside when patients delay treatment
Why immigration enforcement is a public health issue—not just a policy debate
How trust, or lack of it, directly impacts health outcomes
Practical steps healthcare workers and institutions can take to protect patients
This episode challenges the idea that healthcare is neutral in the face of fear and structural harm. It reframes immigration enforcement as a patient safety issue and calls on clinicians, health systems, and public health professionals to acknowledge their role in protecting access to care.
As the first episode of 2026, this conversation sets the tone for the year ahead—centering equity, courage, and accountability in emergency medicine and beyond.
Care without fear should never be controversial.

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In this episode of 'EMERGE in EM,' Dr. Mohamed Hagahmed and ICU doctor Dr. Obi Anozie discuss the critical neurological emergency of benzodiazepine-refractory status epilepticus (BRSE). They explore the pathology behind why BRSE occurs, the necessary aggressive treatment strategies, and second-line agent options including levetiracetam, valproic acid, fosphenytoin, propofol, and ketamine. They emphasize the importance of correct dosing, timely escalation of treatment, and thorough patient examination. The conversation also covers the need for a comprehensive approach to non-convulsive status epilepticus and the practical aspects of pre-hospital and ED management, including the use of paralytic agents like rocuronium over succinylcholine.
Paper reference: Pelletier J, Merriman W, Koyfman A, Long B. Benzodiazepine-refractory status epilepticus: A narrative review. Am J Emerg Med. 2025;81:228-235. doi:10.1016/j.ajem.2025.01.046.

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In this episode of EMERGE, I sit down with Dr. Ricky Tripp to dive deep into the challenges and best practices of managing trauma in pregnancy. As your host, I guide the conversation through the latest evidence and NAEMSP guidance, real-life stories, and practical pearls that every clinician should know when faced with these high-risk, low-frequency events.
We discuss the unique physiology of pregnancy, how to spot and manage shock, and the critical nuances of trauma assessment in pregnant patients. Dr. Tripp shares her expertise from the field, her work with AKOMA United, and her perspective as an emergency physician and EMS medical director.
I also highlight the importance of community, communication, and understanding the psychosocial factors that impact patient care. Whether you work in the field or in the hospital, this episode will help you feel more prepared and confident when caring for pregnant trauma patients. Join me for expert insights, actionable tips, and a reminder of the power of teamwork and compassion in emergency medicine.

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In this episode of EMERGE, I sit down with my friend and colleague, Dr. Tony Pizon, Chief of Medical Toxicology at UPMC, to dive into a topic that’s been showing up more and more in our emergency departments: 7-Hydroxymitragynine (7-OH).
I wanted to understand what 7-OH is, how it’s connected to Kratom, and why it’s suddenly making headlines. Tony and I break down the science, discuss the clinical effects, and talk about why products like vapes and gummies containing 7-OH are so concerning—especially when they’re packaged to look like candy and marketed as “natural.”
We share real cases, practical management tips (including when and how to use naloxone), and highlight the risks for kids and the importance of public health reporting. My goal with this conversation is to give you the latest insights, actionable advice, and a better understanding of how to recognize and manage this emerging toxicology threat.
Whether you’re a fellow healthcare professional or just want to stay informed about what’s happening in emergency medicine, I hope you find this episode as eye-opening and useful as I did.