Evidence-Based Treatment of Common ED Disease Process

Speakers:

Kathryn West, MD, FACEP
Associate Program Director Emergency Medicine Residency
Georgia Emergency Department Services (GEDS)
Northeast Georgia Medical Center

Kartik Shah, MD, FAAEM
Associate Program Director Emergency Medicine Residency

Director of Medical Toxicology
Georgia Emergency Department Services (GEDS)
Northeast Georgia Medical Center

Disclosures: None 

Learning objectives:

1. Appropriately define and recognize hypertensive emergency
2. Discuss how to treat hypertension in the ED and acute care setting
3. Describe how a venous blood gas can guide treatment for hypercapnia

Post Date: 2/20/26

Expiration Date: 2/20/28

Accreditation Statement:

The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians. The Northeast Georgia Medical Center & Health System, Inc. designates this enduring activity for a maximum of 0.50 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. If you have technical difficulties or questions contact CME@nghs.com

Articles referenced in today's podcast:

Writing Committee Members*, Jones DW, Ferdinand KC, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;152(11):e114-e218. doi:10.1161/CIR.0000000000001356

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Asymptomatic Hypertension, Gemme S, Meltzer AC, et al. Clinical Policy: A Critical Issue in the Outpatient Management of Adult Patients Presenting to the Emergency Department With Asymptomatic Elevated Blood Pressure: Approved by the ACEP Board of Directors January 22, 2025. Ann Emerg Med. 2025;86(1):e1-e11. doi:10.1016/j.annemergmed.2024.09.016

Lacy ME, Saa L, Bruss Z, Noronha L. Things We Do for No Reason™: Arterial blood gas testing to screen for hypercarbic respiratory failure. J Hosp Med. 2025;20(9):1002-1004. doi:10.1002/jhm.70039

Miller JB, Calo S, Reed B, Thompson R, Nahab B, Wu E, Chaudhry K, Levy P. Cerebrovascular risks with rapid blood pressure lowering in the absence of hypertensive emergency. Am J Emerg Med. 2019 Jun;37(6):1073-1077. doi: 10.1016/j.ajem.2018.08.052. Epub 2018 Aug 21. PMID: 30172599

Wolf SJ, Lo B, Shih RD, Smith MD, Fesmire FM; American College of Emergency Physicians Clinical Policies Committee. Clinical policy: critical issues in the evaluation and management of adult patients in the emergency department with asymptomatic elevated blood pressure. Ann Emerg Med. 2013 Jul;62(1):59-68. doi: 10.1016/j.annemergmed.2013.05.012. PMID: 23842053

All while not taking themselves too seriously...

Articles discussed in today's podcast:

Fischer U, Koga M, Strbian D, et al. Early versus Later Anticoagulation for Stroke with Atrial Fibrillation. N Engl J Med. 2023;388(26):2411-2421. doi:10.1056/NEJMoa2303048

Johnston SC, Easton JD, Farrant M, et al. Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA. N Engl J Med. 2018;379(3):215-225. doi:10.1056/NEJMoa1800410

All while not taking themselves too seriously...

Articles discussed in today's podcast:

Fretz T, Dasari S, Sakaleros J, et al. One-Year Outcomes of Short-Term Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention With Drug-Eluting Stents: A Meta-Analysis of Randomized Clinical Trials. Catheter Cardiovasc Interv. 2025;106(6):3286-3296. doi:10.1002/ccd.70163

Pagano MB, Stanworth SJ, Dennis J, et al. Red Cell Transfusion in Acute Myocardial Infarction: AABB International Clinical Practice Guidelines. Ann Intern Med. 2025;178(10):1469-1477. doi:10.7326/ANNALS-25-00706

Sullivan AE, Nanna MG, Wang TY, et al. Bridging Antiplatelet Therapy After Percutaneous Coronary Intervention: JACC Review Topic of the Week. J Am Coll Cardiol. 2021;78(15):1550-1563. doi:10.1016/j.jacc.2021.08.013

All while not taking themselves too seriously...

Articles discussed in today's podcast:

Geerts WH, Jay RM, Code KI, et al. A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N Engl J Med. 1996;335(10):701-707. doi:10.1056/NEJM199609053351003

Louis SG, Sato M, Geraci T, et al. Correlation of missed doses of enoxaparin with increased incidence of deep vein thrombosis in trauma and general surgery patients. JAMA Surg. 2014;149(4):365-370. doi:10.1001/jamasurg.2013.3963

Spradling J, Garfinkel S, Edgecomb T, et al. Venous Thromboembolism Rates in Trauma Patients Significantly Increase With Missed Prophylactic Enoxaparin Doses. Am Surg. 2024;90(9):2265-2272. doi:10.1177/00031348241269401

All while not taking themselves too seriously...

Articles discussed in today's podcast:

Pallin, D. Inhaled Isopropyl Alcohol Superior to Oral Ondansetron as an Antiemetic. NEJM Journal Watch. 2018;:NA46286. doi:10.1056/nejm-jw.NA46286

Beran A, Mohamed MFH, Vargas A, et al. Early Diagnostic Paracentesis Improves Outcomes of Hospitalized Patients With Cirrhosis and Ascites: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2024;119(11):2259-2266. doi:10.14309/ajg.0000000000002906

Tan D, Wang B, Cao P, et al. High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: a randomized controlled non-inferiority trial. Crit Care. 2024;28(1):250. Published 2024 Jul 18. doi:10.1186/s13054-024-05040-9

The panel features doctors:

*Sung Lee, Medical Director of Neurointerventional Surgery

* Tarek Dakakbi, Director of Acute Care Neurology and Neurocritical Care Director

* Jon Kerrick, Neurologist NGPG, Neurology and Physician Service Line Director, NGPG Specialty Services *Larry Dudas Hospitalist, NGPG Service Line Director, and Medical director of NGMC Patient Safety and Quality *Stephen Morgan, outgoing Chief of Medicine and Credentials Chair

Speakers have no financial disclosures to disclose.

Speakers:

Stephen Morgan, MD

Larry Dudas, MD

Allison Ruch, MD

Merin Varghese, MD

Hisham Qutob, MD

Objectives:

Biomarkers- Follow their Lead!

Fluids- Who? What? When?

Antibiotic -Stewardship vs Empiric Coverage

Perfusion- What is the REAL Goal?

Accreditation Statement:

The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

The Northeast Georgia Medical Center & Health System, Inc. designates this enduring activity for a maximum of .75 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Here’s a link is to a great table from a landmark paper comparing POCUS, the stethoscope, cxr with CT imaging as the gold standard.  (I couldn’t find the article Dr. Nolan Soni mentioned)

https://imgur.com/a/o5NADd4

Article link here

https://pubmed.ncbi.nlm.nih.gov/14695718/

Lastly here is a link to a few of the memes that came from that “landmark” CNN piece Dr Marsh smoothly referenced. 

https://imgur.com/a/gDJEq39

Objectives:
1. Understand BH prior to COVID-19
2. Describe the BH impact of COVID-19
3. Describe changes to BH service delivery in response to COVID-19 (both nationally and internally at NGHS)

Disclosures:
 - There is no commercial support for this activity
 - The speakers have disclosed that there are no relevant personal or financial relationships

Accreditation and Designation:
The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

The Northeast Georgia Medical Center & Health System, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Click here to complete the survey for CME credit. 

Links

• Click here to complete the survey for CME credit.

Links

• Click here to complete the survey for CME credit.

2. Discuss SGLT2 inhibitors use for systolic congestive heart failure. 

3. Discuss A1c goals related to clinical condition and goals for a particular patient.

Disclosures:
- There is no commercial support for this activity
- The speakers have disclosed that there are no relevant personal or financial relationships

Accreditation and Designation:
The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

The Northeast Georgia Medical Center & Health System, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Dr. Egolum’s lecture - (it’s apparently 45 pages and not 12)

https://docs.google.com/presentation/d/1MvjVZQwQn8CHh8yEf1H0P9neJ7l8YAgpod0REEw8XqY/edit

• Alix Schnibben PharmD, BCACP, Clinical Pharmacist Specialist-Abulatory Care
• Barry G. Barns, Jr. PharmD, BCIDP, Northeast Georgia Medical, Clinical Pharmacist Specialist, Infectious Diseases/Antimicrobial Stewardship

Enduring CME will expire on 8/14/2022.

The presentation is originating from Northeast Georgia Medical Center Gainesville.

Objectives:
1. Discuss difficulties surrounding COVID-19 pharmacotherapy recommendations
2. Review clinical literature about treatment of COVID-19
3. Summarize Inpatient and Ambulatory Treatment approach

Disclosures:
- There is no commercial support for this activity
- The speakers have disclosed that there are no relevant personal or financial relationships

Accreditation and Designation:
The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

The Northeast Georgia Medical Center & Health System, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Links

• Click here to complete the survey for CME credit.

• Meredith Pickett DO, HMDC, NGPG Palliative and Supportive Care Ambulatory/Inpatient

Enduring CME will expire on 7/23/2022.

The presentation is originating from Northeast Georgia Medical Center Gainesville.

Objectives:
In this session, we will:
• Explore six stages of human emotional response to disaster.
• Review the role of clear communication—with patients, families and colleagues—throughout each stage of a crisis.
• Discuss restructuring self-care during a season of tragedy.

Disclosures:
- There is no commercial support for this activity
- The speakers have disclosed that there are no relevant personal or financial relationships

Accreditation and Designation:
The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

The Northeast Georgia Medical Center & Health System, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Links

• Click here to complete the survey for CME credit.

• Devin Vicknair MS, PhD, LPC, Behavioral Health Faculty, Family Medicine GME
• Holly Stewart BSW, MSOL, Director of GME Resident Wellness

Enduring CME will expire on 6/3/2022.

The presentation is originating from Northeast Georgia Medical Center Gainesville.

Objectives:
Participants will learn about:
• Ongoing drivers of clinician distress and burnout
• COVID-specific drivers of stress and burnout
• Techniques for managing and mitigating stress, grief, compassion fatigue and work/life integration
• Support resources offered through NGHS

Disclosures:
- There is no commercial support for this activity
- The speakers have disclosed that there are no relevant personal or financial relationships

Accreditation and Designation:
The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

The Northeast Georgia Medical Center & Health System, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Links

• Click here to complete the survey for CME credit.