Month: June 2026

Day in the Life of… an EM Chair

by

What does it actually take to become the chair of an academic emergency medicine department? In this episode, Dr. Edleda James, PGY3 and future simulation fellow interviews Dr. Jeffrey Caterino, Professor of Emergency and Internal Medicine and Chair of Emergency Medicine at The Ohio State University. He shares his career journey to become department chair, the realities of leading a large academic department, and the leadership skills that aren’t taught during residency. They discusses mentorship, developing financial and administrative expertise, intentionally building leadership skills, and practical advice for trainees and junior faculty interested in future leadership roles.

Guest: Jeffrey Caterino, MD, MPH; Host: Edleda James, MD; Editor: Kim Bambach, MD; Audio Editor: Nick Roesel

🔑 Key Learning Points

  • Leadership is rarely a straight path. Career interests often develop after becoming faculty and gaining insight into how departments function.
  • Mentorship remains essential at every career stage, including for department chairs. Peer mentorship can be just as valuable as traditional mentor-mentee relationships. Seek advice broadly.
  • Leadership is a learnable skillset that requires intentional development, including:
    • Running effective meetings
    • Hiring and personnel management
    • Delivering difficult feedback
    • Motivating teams
    • Financial literacy
    • Organizational leadership
  • Experiential learning is invaluabl. Serve on committees, observe leaders, and gain exposure to departmental operations before stepping into leadership roles.
  • Leadership courses offered through institutions and professional organizations can provide practical skills and invaluable insights from experienced leaders, such as leadership courses from SAEM.
  • An MBA or administrative fellowship can be helpful, particularly for hospital leadership, but they are not prerequisites for becoming a department chair. The key is acquiring the necessary business and leadership skills by any effective pathway.
  • If you’re considering a leadership role:
    • Talk with multiple people currently doing the job.
    • Learn what skills they actually use.
    • Intentionally build those competencies before you need them.
  • Final leadership advice: pursue opportunities with “magnitude and direction“. Be intentional about the experiences and skills you choose so they align with your long-term goals.

📚 Further Resources

  1. Administration Fellowship at The Ohio State University
  2. SAEM Chair Development Program
  3. SAEM Emerging Leader Development Program
  4. EM Resident- What You Need to Know About EM Administration Fellowships

Podcast: Play in new window | Download

Drowning: Rescue, Resuscitation, and Prevention

by

Drowning deaths have increased in recent years, making it more important than ever for emergency physicians manage effectively. In this episode, Corey Williams, MD, reviews current drowning terminology, the pathophysiology that drives treatment decisions, and practical pearls for resuscitation, observation, and disposition. We also discuss common misconceptions and key prevention strategies to share with patients and families (and your own!).

Guest: Corey Williams, MD; Host: Kim Bambach, MD; Audio editor: Nick Roesel

🔑 Key Learning Points:

  1. Use the modern drowning terminology:
    • Fatal or non-fatal drowning (with or without morbidity). Avoid outdated terms such as near drowning, dry drowning, and secondary drowning.
  2. Demographics:
    • Young children, adolescent males, and patients with alcohol use, seizure disorders, or developmental disabilities are at highest risk for drowning.
  3. Pathophysiology:
    • Drowning is primarily a hypoxic injury. In cardiac arrest, provide ventilations in addition to chest compressions. Compression-only CPR is not sufficient.
  4. Hypothermia:
    • Consider hypothermia when a patient has a drowning event, even in warmer months. Active rewarming remains a critical part of management.
  5. Trauma:
    • Consider cervical spine injury only when the mechanism or examination raises concern (e.g., diving injuries, unwitnessed events, neurologic deficits).
  6. Mythbusting:
    • Fresh water versus salt water does not change management. Clinically significant electrolyte abnormalities from aspiration are unlikely.
    • A normal initial chest X-ray does not rule out delayed pulmonary injury. Patients with non-fatal drowning who remain asymptomatic should generally be observed for at least 4 hours before discharge.
    • Routine prophylactic antibiotics and steroids are not recommended after drowning unless there is concern for heavily contaminated water exposure.
  7. Prevention matters:
    • Early swim lessons, four-sided pool fencing, close supervision, and CPR training for caregivers remain the most effective ways to reduce drowning-related morbidity and mortality.

📚 Further Reading:

  1. Davis CA, Schmidt AC, Bierens JJLM, et al. Wilderness Medical Society clinical practice guidelines for the treatment and prevention of drowning: 2024 update. Wilderness Environ Med. 2024;35(1):101-120. doi:10.1016/j.wem.2023.12.004.
  2. Dezfulian C, McCallin TE, Bierens J, Dunne CL, Idris AH, Kiragu A, Mahgoub M, Shenoi RP, Szpilman D, Terry M, Tijssen JA, Tobin JM, Topjian AA; on behalf of the American Heart Association and the American Academy of Pediatrics. 2024 American Heart Association and American Academy of Pediatrics focused update on special circumstances: resuscitation following drowning: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024;150(23):e473-e501. doi:10.1161/CIR.0000000000001274.
  3. Szpilman D, Bierens JJLM, Handley AJ, Orlowski JP. Drowning. N Engl J Med. 2012;366(22):2102-2110. doi:10.1056/NEJMra1013317.
  4. American Academy of Pediatrics. Prevention of drowning. Pediatrics. 2021.

Podcast: Play in new window | Download