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Cannabinoid Hyperemesis Syndrome (CHS) continues to be a major clinical challenge in the emergency department. Patients present with severe abdominal pain, intractable vomiting, and significant fluid and electrolyte derangements. CHS often affects people who have been using cannabis routinely for months to years – it can be difficult for patients to understand that their symptoms are related to cannabis.

Today, emergency pharmacist Haley Burhans joins us to discuss first-line treatments, fluid management, discharge strategies, and how to navigate these tough bedside conversations.

First-Line Therapies: Haldol vs. Droperidol

• Haloperidol (Haldol): Supported by the HAVOC trial (haloperidol vs. placebo), which showed a reduction in symptoms and ED length of stay.
• Droperidol: Highly effective alternative with similar dopaminergic mechanism of action. May carry a lower risk of extrapyramidal symptoms compared to haloperidol.
• Capsaicin Cream: addresses the TRPV1 pathway thought to drive CHS. Patients often dislike it as it causes a burning sensation on the skin and can be inadvertently spread to eyes or face. Can be an option if symptoms persist after trying the above meds and hot showers aren’t feasible.

Backup Options & Anti-Emetics

• Alternative Dopaminergic Agents: Metoclopramide or prochlorperazine can be used.
• Standard Anti-Emetics (e.g., Ondansetron):
  • Serotonergic anti-emetics generally fail to address the underlying CHS pathway.
  • However, a single dose of ondansetron given alongside a butyrophenone (haloperidol/droperidol) is reasonable if you suspect co-existing etiologies.

QTc Prolongation Warning:

Chronic vomiting leads to electrolyte depletion. Combining anti-emetics and haloperidol or droperidol increases the risk of QTc prolongation.

Baseline EKG: Not strictly required for every low-risk patient, but strongly recommended for patients with multiple risk factors (e.g., co-ingestion/use of methadone, history of heart failure, or severe baseline bradycardia).

Fluid Resuscitation & Electrolyte Management

CHS patients can vomit to the point of severe dehydration and profound electrolyte/acid-base derangements.

• Fluid Selection:
  • Normal Saline (NS): A solid choice for initial volume resuscitation when sodium and chloride are severely depleted.
  • Lactated Ringer’s (LR): Ideal as a follow-up or maintenance fluid because it contains a small amount potassium.
• Potassium Repletion: Oral repletion may not be tolerated in the acute setting. Consider IV potassium repletion in the ED, followed by oral home supplementation once nausea is controlled.
• Magnesium: While acute vomiting primarily drives potassium loss, consider IV magnesium if Mg is low or there is concern for QTc prolongation.

Discharge Planning: What to Send Home

• Low-Dose Olanzapine ODT:
  • Send the patient home with 2.5 mg Olanzapine ODT (orally disintegrating tablets).
  • Why it works: It dissolves instantly on the tongue, bypassing the stomach, and provides extended dopaminergic coverage over the multi-day washout period.
• Pharmacokinetics Pearl:
  • Infrequent user THC half-life: ~1.3 hours (cleared in 5–6 hours).
  • Chronic user THC half-life: THC accumulates in adipose tissue. In heavy users, therapeutic levels can persist for up to 2 weeks, driving prolonged receptor dysregulation even after cessation.

Navigating the Bedside Conversation

Explaining to a chronic user that their daily cannabis—the very thing they use to relieve nausea—is causing their illness requires empathy and validation.

1. Explain the Neurological Link: Cannabis acts on receptors throughout the entire body, including the brain’s nausea center and the nervous system of the gut. Chronic, heavy saturation can paradoxically overload these pathways.
2. Validate Their Experience: Acknowledge how counterintuitive it feels: “I know it’s hard to believe that something you’ve used for years to feel better is causing this, but long-term daily use can change how your body processes it.”
3. Set Realistic Expectations: Reiterate that symptoms will not resolve overnight. Even after stopping, it takes time for the pathways to recalibrate.

What do you find most helpful for treating CHS? How do you have these difficult conversaions with your patients? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis

Resources:

Borgundvaag B, Bellolio F, Miles I, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425-455. doi: 10.1111/acem.14911. PMID: 38747203.

Rech MA, Shalaby M, Gage KA, Gottlieb M. Managing Cannabinoid Hyperemesis Syndrome. Ann Emerg Med. 2026 Jun;87(6):717-722. doi: 10.1016/j.annemergmed.2025.12.024. Epub 2026 Feb 3. PMID: 41632059.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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A landmark international trial published in the New England Journal of Medicine evaluated whether fluid type impacts patient outcomes.

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In this episode, we welcome back guest host Dr. Neelou Weeker and ED nurse Leigh Clary to talk about a tough emergency medicine reality that we often avoid discussing: what teamwork looks like when, despite our best efforts, the patient doesn’t survive. We work though a recent, emotionally heavy resuscitation and explore how TeamSTEPPS tools—specifically the structured debrief—serve as a vital safety net for our own mental health, helping us find our footing and reclaim our humanity in a chaotic environment.

The Reality of “Doing Everything Right” and Still Losing

We often connect good teamwork with saving lives, but in the ED, bad outcomes sometimes happen. The true test of a team’s culture is how we handle the aftermath of those tough cases.

1. The Emotional Roller Coaster of the ED

• The “Would-Have, Could-Have, Should-Haves”: When a patient comes in talking and dies in the ED, it carries a heavy psychological weight for everyone and we often replay these cases over and over in our minds.
• Flipping the Switch to Withdrawal of Care: Putting your heart and soul into a long resuscitation, getting pulses back, and then having to pivot and make the decision to withdraw care is an exhausting emotional shift for the whole team.
• The Illusion of the Robot: The ED forces us to “code switch” instantly—moving from declaring a death straight to treating a minor complaint. Without a moment to pause, you start to feel like a robot, which takes a signficant toll on your wellbeing.

2. The Anatomy of a High-Quality Debrief

Debriefing after a tough case should be a priority, not a luxury. A solid debrief balances a clinical review with immediate psychological first aid.

ComponentStandard Protocol & Best PracticesThe Core PurposeFramed around three pillars: Education, Quality Improvement, and Emotional Processing.The ToneStrictly confidential, safe, and non-punitive. It is explicitly stated at the outset that the session is not for assigning blame.The LocationIdeally a quiet, isolated space physically removed from the immediate clinical chaos (a “doc box” or dedicated staff room).The LeadershipFacilitated by designated Debrief Champions. If unavailable, any comfortable team member can step up.The AttendeesOpen to everyone who was involved in or affected by the case, including physicians, nurses, techs, students and scribes.The Power of Prioritization: The emergency department is chronically busy, but a culture of safety means charge nurses actively shuffle staff and adjust coverage to carve out the 10 to 15 minutes required for a team to debrief.

Applying TeamSTEPPS to Team Longevity

1. The Need for a Clinical Respite

Data shows that the most important thing for a clinician after a bad outcome is just a brief break from the clinical area to regroup and compose themselves. Since we physically can’t just leave the ED to get a breath of fresh air, a structured debrief acts as that necessary “bubble” outside of active patient care.

2. Modeling Vulnerability as Leaders

To move away from the expectation that healthcare workers must act as emotionless automatons, leaders must intentionally model healthy processing.

• Visible Humanity: When Attendings and nurse leaders show vulnerability and admit that a case hit them hard, it builds a culture where it’s okay to not be okay.
• Creating “Fence Posts”: We can’t carry the weight of every patient we lose on our backs and still function. Structured debriefs allow us to package the experience into a “fence post” of clinical learning, honoring the patient while protecting the provider’s mental health.

Key Takeaways

• De-Link Teamwork from the Outcome: Perfect teamwork can’t always override catastrophic pathology. Evaluate the team’s performance based on coordination, communication, and execution, not solely on whether the patient survived.
• Establish a Standard Debrief Script: Protect your team by starting every post-event huddle with a reminder that the space is confidential, educational, and completely non-punitive.
• Invest in Your Team: Implementing a formal debrief infrastructure requires minimal resources and builds team morale and resilience. (Pro-tip: bring candy to engage all the senses in a sensory reset!)

Do you use TeamSTEPPS or a similar model in your ED? We’d love to hear what has been successful for your team. Hit us up on social media @empulsepodcast or connect with us on ucdavisem.com

Host:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Guest Host:

Dr. Neelou Tabatabai, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Leigh Clary, RN, BSN, RN, CEN, ADCES, MICN , ED Nurse and TeamSTEPPS Project Lead at UC Davis

Resources:

TeamSTEPPS Player of the Month Program, Presentation by Leigh Clary and Jose Metica

TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety Heidi B. King, MS, CHE, James Battles, PhD, David P. Baker, PhD, Alexander Alonso, PhD, Eduardo Salas, PhD, John Webster, MD, MBA, Lauren Toomey, RN, BSBA, MIS, and Mary Salisbury, RN, MSN.

TeamSTEPPS Pocket Guide – Agency for Healthcare Research and Quality

EM Pulse: TeamSTEPPS, September 17, 2021

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Disclaimer: The opinions expressed on this podcast are those of the hosts or guests and do not necessarily reflect the views of UC Davis Department of Emergency Medicine, UC Davis Health, or their parent organizations.

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In this episode, the we welcome back guest host, Dr. Neelou Weeker, and ED nurse, Leigh Clary, to discuss the critical intersection of language barriers, patient equity, and emergency care. Through two powerful clinical scenarios, the team explores the “gold standards” of medical translation, the challenges of resource-limited community settings, and how TeamSTEPPS tools—specifically closed-loop communication and situational monitoring—can be leveraged to ensure true informed consent and patient safety.

The Gold Standard vs. Clinical Reality

Providing equitable care means ensuring every patient, regardless of language or culture, fully understands their medical team. While academic centers are often highly resourced, executing communication seamlessly remains a universal challenge.

1. Translation Tools and Hierarchy

• The Gold Standard: Video- or audio-based professional interpretation tablets allow face-to-face or direct vocal translation.
• The Secondary Backup: In-house dual-handset “blue phones” connect directly to professional phone lines when tablets experience connectivity issues.
• The Tertiary Backup: Multilingual staff members can help act as a bridge. Many institutions feature language fluencies on staff ID badges.
  • Note: Staff members should only be used to establish initial rapport or identify the required dialect, not as official medical interpreters.
• The Danger of Family Interpreters: While family members bring invaluable cultural context and an understanding of the patient’s baseline, studies show they only correctly interpret medical dialogue 19% of the time.
• The Bottom Line: Always utilize the official route first. When technology fails, do your absolute best—never settle for “good enough” when better communication is possible.

2. Academic vs. Community and Rural Settings

• Emergency medicine requires extreme adaptability. In resource-limited community or rural hospitals, finding an interpreter for less commonly spoken languages can take upwards of 30 minutes.
• Physicians must sometimes physically carry translation phones from room to room while managing other patients just to maintain an open line with a rare-dialect interpreter.

Applying TeamSTEPPS to Patient Communication

We routinely use TeamSTEPPS tools to communicate with our fellow clinicians, but we must remember that the patient is the most important member of the healthcare team.

1. Closed-Loop Communication & The Teach-Back Method

To confirm true patient understanding, avoid simple “yes or no” questions, nods, or smiles. Instead, utilize the Teach-Back Method, requiring the patient to repeat the instructions or choices back to you in their own words.

• How to Phrase It (Taking Responsibility):
  • “I want to make sure that I have been clear in what I’ve said to you. To help me feel reassured that I communicated everything correctly, could you tell me what you understand is going on?”
• Clinical Value: This is particularly vital for high-stakes decisions and ED discharge instructions.
• Multimodal Approach: In high-stakes moments, combine professional translation, family context, and teach-back to minimize errors.

2. Situational Monitoring

Resuscitative environments are chaotic, and the primary physician trying to run a cod or secure an airway has immense cognitive load.

• The Team Safety Net: Other team members (nurses, techs, scribes) can help monitor the situation and catch critical communication errors.

Reconciling Clinical Urgency with Informed Consent

How do you balance the immediate need to save a life with the time-consuming process of formal translation?

• The ABC Priority: First and foremost, secure Airway, Breathing, and Circulation. If a patient presents to the ED in extremis and cannot communicate, clinicians must operate under the assumption that the patient wants life-saving measures performed.
• Task Delegation: While the medical team manages the immediate ABCs, immediately task support staff (such as social workers) with finding an official interpreter, locating family members, and gathering background information.
• Next Steps: Once the ABCs are stable, the team has the time and space to pause, establish formal translation, and dive deeper into informed consent for further procedures.

Key Takeaways

• Acknowledge the Bias of Urgency: Time pressure can tempt us to bypass official translation channels. Guard against this by maintaining an equity-first mindset.
• Close the Loop with Patients: Ensure they can paraphrase their care plan or consent choices.
• Protect the Team via Shared Roles: Trust your teammates to monitor the big picture and catch subtle communication gaps during high-stress resuscitations.

Do you use TeamSTEPPS or a similar model in your ED? We’d love to hear what has been successful for your team. Hit us up on social media @empulsepodcast or connect with us on ucdavisem.com

Host:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Guest Host:

Dr. Neelou Tabatabai, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Leigh Clary, RN, BSN, RN, CEN, ADCES, MICN , ED Nurse and TeamSTEPPS Project Lead at UC Davis

Resources:

TeamSTEPPS Player of the Month Program, Presentation by Leigh Clary and Jose Metica

TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety Heidi B. King, MS, CHE, James Battles, PhD, David P. Baker, PhD, Alexander Alonso, PhD, Eduardo Salas, PhD, John Webster, MD, MBA, Lauren Toomey, RN, BSBA, MIS, and Mary Salisbury, RN, MSN.

TeamSTEPPS Pocket Guide – Agency for Healthcare Research and Quality

EM Pulse: TeamSTEPPS, September 17, 2021

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Disclaimer: The opinions expressed on this podcast are those of the hosts or guests and do not necessarily reflect the views of UC Davis Department of Emergency Medicine, UC Davis Health, or their parent organizations.

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It is getting hot in California, which has us thinking about the massive carbon footprint of healthcare. The emergency department is famously resource-heavy, but can we save lives and reduce waste? Dr. David Barnes joins us to explain how going green isn’t just about being a “tree hugger”—it’s about saving money, cutting waste, and making our hospitals resilient against supply chain chaos.

Defining Healthcare Sustainability

• Balancing Safety and Footprint: Sustainability in healthcare means delivering efficient, affordable care that minimizes resource waste while remaining clinically safe and meaningful.
• The Power of Resiliency: A sustainable healthcare system is inherently a resilient one. Reducing reliance on single-use items and utilizing local renewable energy sources (like microgrids) protects hospitals from supply chain disruptions caused by geopolitical conflicts or weather-driven power grid failures.

The Three Scopes of Emissions

• Scope 1 (Direct): Emissions directly produced by hospital operations, such as idling fleet vehicles and leaking anesthetic gases.
• Scope 2 (Indirect): Purchased energy used to power and heat the facilities (e.g., local electricity and steam lines).
• Scope 3 (Supply Chain): The largest bucket, making up 60% to 80% of healthcare emissions. This includes employee commutes, medical waste incineration, manufacturing of disposable devices, and food production.

Clinical Traps: Where We Waste the Most

• Pre-packaged Kits: Studies show 75% to 80% of items inside specialized kits (like central lines) go completely unused and are thrown away.
• Over-Preparation: Opening multiple single-use items (like various ET tube sizes) or donning full trauma PPE for minor injuries creates an immediate, unnecessary trash stream.
• Pharmaceutical Waste: Standard packaging size leads to heavy drug wasting (e.g., using 5 mL from a 100 mL propofol bottle). This regulated medical waste is costly and energy-intensive to incinerate.
• The Glove Epidemic: Glove overuse skyrocketed during COVID-19 and became a habit. Most routine encounters carry no contamination risk, making glove use clinically unnecessary.

Shifting the Culture

• “Take What You Need, Leave What You Don’t”: Avoid opening supplies you may not need or bringing extra gauze or syringes into a room. Due to infection safety protocols, these often end up in the trash.
• Watch Where You Toss: Keep coffee cups and paper out of the red biohazard bins. Regulated medical waste costs six times more to process and must be incinerated, creating massive greenhouse gas emissions.
• Embrace Reprocessing & Reusables: Support partnerships with companies that safely clean and reuse devices historically labeled “single-use” (like EKG leads or waffle mattresses). Swap disposable plastic gowns for reusable cloth gowns that survive 90 washes.
• Model the Behavior: Culture change takes patience and persistence. Instead of finger-wagging or shaming colleagues, visibly adopt sustainable habits to drive grassroots practice changes.

Key Takeaways for the ED Clinician

• Speak up on bad design: Clinicians are on the front lines of waste. Advocate for local sustainability initiatives to grab the attention of hospital executives who handle major purchasing contracts.
• Normalize virtual alternatives: Protect staff well-being and slash commuting emissions by offering Zoom or Teams options for short, solitary administrative meetings.
• Keep it in perspective: Healthcare sustainability is about finding the sweet spot where clinical safety, resource utilization, and environmental impact meet.

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. David Barnes, Professor of Emergency Medicine, Director of ED Sustainability, and Member of the Sustainability Committee at UC Davis Health

Resources:

Practice Greenhealth

Health Care Without Harm

Green ED (Royal College of Emergency Medicine)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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It’s one of the most common—and most frustrating—complaints in the Emergency Department: the patient covered head-to-toe in hives, miserable, itching, and desperate for relief. In this episode of EM Pulse, we welcome back ED Clinical Pharmacist Haley Burhans to tackle the “uncomfortable” topic of urticaria. We move past the myths of one-and-done doses and explore why your standard allergy dosing might be leaving your patients itching for more.

The Power of Second-Generation Antihistamines

Haley explains why second-generation antihistamines (cetirizine, levocetirizine, fexofenadine) should be your first-line ED therapy, rather than the old school standard, diphenhydramine (Benadryl).

• Xyzal vs. Zyrtec: We break down the L-enantiomer (levocetirizine) and whether it actually beats its predecessor in preventing drowsiness.
• The “Double Dose” Pearl: For acute urticaria in the ED, 10mg of cetirizine isn’t enough. Haley recommends starting with 20mg for adults (or doubling the weight-based dose for kids) to see relief within 20–60 minutes.
• The 4x Rule: Guidelines now support up to four times the standard daily dose for refractory cases (usually split BID). We discuss the safety data behind these higher regimens and why they are tolerated so well.

The Steroid Trap and the Rebound Effect

Patients often come in requesting steroids but they are NOT the primary cure for urticaria.

• The Antihistamine Backbone: Steroids treat inflammation, but the antihistamine treats the underlying stimulus. If a patient stops their antihistamines and only takes a steroid burst, they are set up for a miserable rebound.
• Dosing Strategies: If you do use steroids, keep it to a burst or taper of 10 days or less. We discuss the utility of methylprednisolone (Medrol Dosepak) versus a simple prednisone burst/taper or a course of longer-acting dexamethasone.

Beyond the Basics: Benadryl and the MABs

• The Danger of “Dirty” Drugs: Why diphenhydramine has fallen out of favor due to its sodium channel blocking side effects, anticholinergic toxicity, and psychiatric risks.
• The Future of Itch: A look at emerging biologics like omalizumab. While these IgE-blockers shouldn’t be started in the ED, it’s important to know about them to treat patients who are taking them, or who present with rebound urticaria after recently stopping them.

Key Takeaways

• Go Big on Second Generation Antihistamines: Start with a double dose of cetirizine in the ED. It’s safe, effective, and less sedating than first-generation alternatives. Discharge patients on that double dose twice a day.
• Think Long-Term: Urticaria pathways need time to “cool down.” Advise patients to stay on the prescribed meds/doses for 1–2 months, not 1–2 days.
• Steroids are Adjuncts: Use a short burst (<10 days) for severe distress, but never as monotherapy.
• The Taper is Key: Encourage a slow taper of medications to prevent symptom recurrence.
• Managing Expectations: Most urticaria has no identifiable cause (often viral or idiopathic). Reassure the patient that while we may not find the why, we can help manage the itch.

How do you handle the “itch that won’t quit”? Do you have a favorite antihistamine cocktail? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis

Resources:

The international EAACI/ GA²LEN/ EuroGuiDerm/ APAAACI guideline for the definition, classification, diagnosis, and management of urticaria

Emergency Department and Primary Care Clinical Pathway for Evaluation/Treatment of Children with Urticaria or Angioedema (CHOP)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Menopause is not just “hot flashes”—it is a systemic hormonal shift that affects almost every organ system. For the emergency clinician, recognizing the symptoms of perimenopause and menopause is crucial for expanding the differential diagnosis once life-threatening conditions are ruled out. Dr. Pam Dyne joins us for a crash course on evaluating menopausal and perimenopausal patients in the ED.

The “Why”: Why Menopause Matters in the ED

• The Mimic: Menopausal symptoms can mimic emergencies, including cardiac events, neurologic issues, and acute musculoskeletal injuries.
• The “Nothing Bad” Trap: After a negative workup (e.g., for chest pain or abdominal pain), telling a patient “everything is normal” often leaves them without answers. Identifying menopause as a potential etiology provides patient-centered closure and a path to treatment.
• Empowerment: Many medical providers are insufficiently trained when it come to menopause – ED clinicians can help patients advocate for themselves.

Physiology Refresher: When the Ovaries Retire

• The Signal: Prior to menopause, the brain sends FSH/LH to the ovaries, and the ovaries answer with estrogen.
• The Shift: In menopause, the ovaries “retire.” The brain keeps shouting (higher FSH levels), but the ovaries don’t respond.
• Perimenopause: Hormones fluctuate wildly, cycles become irregular, and symptoms are often at their peak due to inconsistency.

Hormone Therapy (MHT): Debunking the Myths

A major barrier to treatment is the “mass hysteria” caused by the 2002 Women’s Health Initiative (WHI) study.

• The Correction: Modern re-analysis shows that for healthy females under 60 and within 10 years of menopause, hormone therapy is extremely safe. (There are some exceptions, including females at high risk for certain cancers)
• The Benefits: It has been shown to reduce all-cause mortality by 30% and has many potential health benefits, including lower the risk of Alzheimer’s, Parkinson’s, and osteoporotic fractures.

The Difficult Pelvic Exam: ED “Hacks”

Examining older female patients can be challenging for myriad reasons, including physical limitations and lack of proper ED pelvic exam gurneys.

1. The Upside-Down Speculum: If you can’t use stirrups, keep the patient flat on the bed. Turn the speculum upside down (handle facing up) so it doesn’t hit the gurney. Tip: Push down on the handle; don’t pull up like a laryngoscope.
2. Lateral Decubitus: Perform the exam with the patient on their side (top leg held up) if they cannot flex their hips.
3. Comfort: Use liberal lubrication and consider topical lidocaine gel.
4. The “Hidden” Problem: Always check for old/forgotten pessaries or fecal impaction in cases of pelvic pain or recurrent UTIs.

Clinical Pearls: Specific Presentations

1. Post-Menopausal Bleeding

• Rule: Cancer until proven otherwise.
• Workup: Speculum exam (confirm source) + Ultrasound (measure endometrial thickness) + Endometrial biopsy (usually outpatient).

2. Genitourinary Syndrome of Menopause (GSM)

• Symptoms: Vaginal dryness, thinning tissue, pH changes, and recurrent UTIs (≥3 culture-proven UTIs in 12 months or ≥2 in 6 months).
• ED Treatment: ED docs can and should prescribe vaginal estrogen cream. It is not absorbed systemically and is highly effective at preventing future UTIs.

3. Pelvic Organ Prolapse

• Types: Cystocele (bladder), Rectocele (rectum), or Uterine prolapse.
• Exam Tip: Symptoms are often gravity-dependent. If you don’t see the bulge while the patient is supine, ask them to bear down.

4. Musculoskeletal (MSK) Syndrome of Menopause

• Presentation: atraumatic joint pain, tendinopathies.
• Cause: Estrogen receptors are located throughout the MSK system; loss of estrogen leads to inflammation and ligamentous changes.

Key Takeaways for the ED Clinician

1. Keep menopause on your differential: Don’t dismiss vague aches, mood changes, or urinary issues in women aged 45–60 as “just stress.”
2. Look at the Problem: If a patient has pelvic pain or bleeding, do the exam. You might find a simple fix, like a forgotten pessary or local atrophy.
3. Connect to Care: If you suspect menopause is the culprit, point them toward menopause.org to find a certified practitioner.

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. Pamela Dyne, Professor of Clinical Emergency Medicine and Chief Physician Wellness Officer at Olive View UCLA Medical Center

Resources:

North Americal Menopause Society (NAMS) – Menopause.org

UTIs and Estrogen: the Overlooked Link, By Ashley Winter, MD; Rachel Rubin, MD; and Howie Mell, MD, MPH. ACEP Now, February 16, 2022

American College of Obstetricians and Gynecologists (ACOG): Menopause

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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“Time can only be spent. Think of it as your most valuable currency.”

Welcome back to EM Pulse. We are continuing our deep dive with Dr. Resa Lewiss into the world of Micro Skills. If you missed it, go back and listen to Part 1 where we definite micro skills and discuss how they can help you as an early, mid or late career physician. In the second half our interview, we move beyond the career stages and into the daily habits that protect our time, our energy, and our sanity.

Protecting Your Time and Energy

The “Failure Friend” and the Board of Directors

Building on the concept from Part 1, Dr. Lewiss emphasizes that your Personal Board of Directors isn’t just for networking—it’s for survival.

• The “No-Judgment” Call: In EM, bad outcomes happen. You need a person you can call to simply be heard without needing a solution. Whether it’s a mistake or just a really rough shift, having a “failure friend” is a vital micro skill for psychological health.

Networking as an Introvert (and for Women)

Networking often feels “creepy” or superficial, but Dr. Lewiss re-frames it as connecting.

• Arrive Rested: For introverts, the best micro skill for networking is showing up with a full battery.
• Deliberate Rest: This is the practice of doing non-work activities (nature, exercise, meals with loved ones) specifically to return to work with more focus.

Meaningful Feedback: Start, Stop, Continue

Tired of vague “Good job!” feedback? Dr. Lewiss shares her own mistakes in giving feedback and offers a better way to receive it:

• The “One Thing” Rule: When someone praises your work, ask: “What is one thing that stood out?”
• The Framework: To get honest feedback from subordinates or peers, ask them: “What is one thing I should start doing, one thing I should stop doing, and one thing I should continue doing?”

Reclaiming the Calendar: Meetings and JOMO

Emergency physicians often suffer from FOMO (Fear Of Missing Out), but Dr. Lewiss argues for JOMO (Joy Of Missing Out).

• Break the “one-hour meeting” mold. Most one-hour meetings can be 30 minutes. Most 30-minute meetings can be 15 minutes. Most 15-minute meetings could be a text or a phone call. Not everything needs a meeting!
• The Power of the Pause: Before saying “yes” to a new committee or project, pause. Ask, “Can you tell me more?” Ask key questions like, what are the goals? What is the timeline? What are the deliverables?

Is Lifestyle Medicine the new frontier?

Dr. Lewiss discusses why many EM physicians are pivoting toward Lifestyle Medicine. By focusing on the “pillars” (sleep, movement, community, and food), physicians can move from treating chronic disease in the ER to preventing it in the community.

We want to hear from you! Which of these micro skills resonated with you? Have you been able to apply these to your daily life and medical practice? Connect with us on social media @empulsepodcast or on our website ucdavisem.com.

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. Resa E. Lewiss, Emergency Medicine and Lifestyle Medicine Physician, Adjunct Professor of Emergency Medicine at the Warren Alpert Medical School of Brown University, TEDMED speaker, educator and mentor.

Resources:

Micro Skills: Small Actions, Big Impact, by Adaira Landry, MD and Resa E. Lewiss, MD

The Visible Voices Podcast, hosted by Dr. Resa Lewiss

Lewiss on Lifestyle Medicine, column on Healio by Dr. Resa Lewiss

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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“If you read this book on a Friday, we promise you will be better at your job on Monday.”

In the high-stakes environment of the Emergency Department, we often focus on the “big saves,” but what if the secret to a thriving career lies in the tiny details? In part one of this special two-part series, we sit down with Dr. Resa Lewiss, an emergency and lifestyle medicine physician, TEDMED speaker, and co-author of the hit book Micro Skills: Small Actions, Big Impact.

We dive into why the “workplace playbook” isn’t always handed to us and how breaking down overwhelming professional goals into small, actionable behaviors can transform your trajectory.

What Exactly Are “Micro Skills”?

Dr. Lewiss defines Micro Skills as the small, actionable behaviors and steps that serve as the building blocks for achieving massive goals. Whether it’s tackling an overwhelming project or building a habit you thought was “just for other people,” almost everything can be broken down into these manageable units. For Dr. Lewiss and her co-author, Dr. Adaira Landry, these skills are the “missing playbook” they wish they’d had earlier in their careers.

Early Career: The Micro Skills of Self-Care

For those just entering the workforce—from residents to new attendings—the focus must be on sustainability.

• Become an “Award-Winning Sleeper”: Stop wearing exhaustion as a badge of honor. Dr. Lewiss highlights why sleep is a professional necessity, not a luxury.
• The Personal Board of Directors: Create a “round table” of go-to people—mentors, peers, and sponsors—who can help you navigate professional and personal hurdles.

Mid-Career: Navigating Conflict & Team Dynamics

As physicians gain competence and move into leadership, the challenges become more interpersonal.

• The “Paper Tiger” Colleague: Learn how to identify coworkers who project authority they don’t actually have by trusting your “Spidey sense”, checking organizational charts, asking established leadership.
• Inquiring Carefully: When navigating workplace tension, focus on avoiding gossip and seeking clarity from trusted supervisors.

Late Career: Modeling Culture & Professionalism

Seasoned physicians have the greatest power to shift the culture of a department.

• The Scheduled Send: Protect your team’s “deliberate rest” by scheduling emails to arrive during standard business hours.
• From Bystander to Upstander: Use your seniority to shut down unprofessional behavior with simple scripts like, “I don’t understand the joke, can you explain it to me?”

Coming Up in Part 2…

The conversation continues! In the next episode, we explore the “Power of the Pause,” why Dr. Lewiss advocates for the “Joy of Missing Out” (JOMO), and a simple three-question framework (Start, Stop, Continue) to get the meaningful feedback you actually need to grow.

We want to hear from you! Which of these micro skills resonated with you? Have you been able to apply these to your daily life and medical practice? Connect with us on social media @empulsepodcast or on our website ucdavisem.com.

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. Resa E. Lewiss, Emergency Medicine and Lifestyle Medicine Physician, Adjunct Professor of Emergency Medicine at the Warren Alpert Medical School of Brown University, TEDMED speaker, educator and mentor.

Resources:

Micro Skills: Small Actions, Big Impact, by Adaira Landry, MD and Resa E. Lewiss, MD

The Visible Voices Podcast, hosted by Dr. Resa Lewiss

Lewiss on Lifestyle Medicine, column on Healio by Dr. Resa Lewiss

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This episode of EM Pulse dives into a critical intersection of clinical practice: the overlap between objective evidence-based medicine and the subjective influence of implicit bias.

In a special collaboration with Don’t Forget the Bubbles (DFTB), we are joined by experts from across the globe to discuss a landmark study on how clinical decision rules—specifically the PECARN (Pediatric Emergency Care Applied Research Network) imaging rules—impact disparities in pediatric trauma imaging.

The Variables of Bias

The team explores the concept of equitable care—providing the best possible outcome regardless of factors outside a patient’s control—and why awareness alone often isn’t enough to counteract the biases we all carry.

Standardizing Equity: The Power of the Rule

The core of this discussion centers on a prospective multicenter study titled “Perceived Race and Ethnicity on CT Use in Children with Minor Head or Abdominal Trauma.”

The Question: Do racial and ethnic disparities in CT use still exist in the “PECARN era”?

• The Twist: Why the researchers chose to look at clinician-perceived race rather than self-identification to capture what is actually happening in the provider’s mind during a shift.
• The Finding: The guests discuss the encouraging results regarding how structured clinical rules can act as “equity builders.”

A Global Perspective

Bias isn’t just a local issue. With representation from UC Davis, UCSF, Children’s National, and Athens, Greece, the panel looks at the international landscape of pediatric emergency care. We discuss:

• The barriers to implementing decision tools in different healthcare systems.
• How these rules—originally developed in the U.S.—are being validated and adapted from Australia to Europe.

Our guests share how they envision these findings changing their next shift—not by removing the “humanity” of the process, but by anchoring conversations with families in solid evidence.

Check the Show Notes: We’ve included links to the original study and the companion blog post at Don’t Forget the Bubbles, which features a deep dive into the data. You can also find the PECARN Pediatric Head Injury and Intra-abdominal Injury (IAI) rules on MDCalc to use on your next shift.

We want to hear from you! Connect with us on social media @empulsepodcast or on our website ucdavisem.com.

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children’s National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences

Dr. Nisa Atigapramoj, Pediatric Emergency Medicine Physician at UCSF Benioff Children’s Hospital

Dr. Spyridon Karageorgos, Pediatric Emergency Medicine Physician at Aghia Sophia Children’s’ Hospital in Athens, Greece

Resources:

DontForgetTheBubbles.com: CT Use in Children with Minor Head or Abdominal Trauma

Atigapramoj NS, McCarten-Gibbs K, Ugalde IT, Badawy M, Chaudhari PP, Yen K, Ishimine P, Sage AC, Nielsen D, Uppermann JS, Kravitz-Wirtz ND, Tancredi DJ, Holmes JF, Kuppermann N. Perceived Race and Ethnicity on CT Use in Children With Minor Head or Abdominal Trauma. Pediatrics. 2026 Feb 1;157(2):e2024070582. doi: 10.1542/peds.2024-070582. PMID: 41520991.

PECARN Spotlight: Tools Validated

Excuse Me, Your Bias is Showing

PECARN

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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We’ve all seen it: the patient whose chart is “flagged” with a penicillin allergy, but when you dig into the history, the story doesn’t quite add up. Maybe it was a stomach ache in the 90s, or maybe they’re just carrying a “inherited” allergy from a parent.

In this episode of EM Pulse, we sit down with ED Clinical Pharmacist Haley Burhans to discuss why these labels are more than just a nuisance—they’re a clinical liability—and how a simple tool can empower you to fix them on the fly.

The Hidden Danger of the “Safe” Choice

Choosing a non-beta-lactam antibiotic because of a questionable allergy label feels like the path of least resistance, but the data tells a different story. We explore how “playing it safe” can actually lead to:

• Worse Outcomes: Why second line antibiotics often mean higher treatment failure rates.
• The “Superbug” Factor: The surprising link between penicillin allergy labels and the rise of MRSA and VRE in our communities.
• The C. diff Connection: Why alternative choices might be setting your patient up for a much more difficult recovery.

The Solution: The PEN-FAST Score

How do you move from “I think this might not be a true allergy” to “I am confident this antibiotic is safe”? Haley introduces the PEN-FAST score, a validated scoring tool designed to risk-stratify patients based on a few key historical questions.

• The Mnemonic: We break down the PEN-FAST acronym so you know exactly which three questions to ask to risk-stratify your patient in seconds.
• IgE vs. The Rest: Learn to distinguish between the “true” dangerous hypersensitivity and the delayed reactions that shouldn’t stop you from using the best drug for the job.
• The “Amoxicillin Rash”: We dive into this common pediatric “gotcha.”, why many kids end up with a lifelong allergy label after a routine ear infection, and why it often has nothing to do with the drug itself.

The Bottom Line: Patients with low PEN-FAST scores are considered low risk, making an oral challenge under observation in the ED a reasonable option. Higher scores may require shared decision-making or referral.

Why the ED is the Perfect Place for a “Challenge”

Delabeling isn’t just for the allergist’s office. We argue that the Emergency Department is actually the ideal setting to challenge these allergies.

• The “Oral Challenge”: Learn the practical steps for performing a trial dose in the department.
• Safety First: Why your environment and expertise make you uniquely qualified to handle the “what-ifs” better than anyone else.

Key Takeaways

• Question the Label: The vast majority of reported penicillin allergies are inaccurate due to patients outgrowing the allergy or misinterpreting common side effects as allergic reactions.
• History is Everything: Dig deeper than just “rash.” Ask about the timing relative to the dose, specific appearance (hives vs. flat rash), and what treatment was required (epinephrine vs. antihistamines).
• Use PEN-FAST: Utilize this tool to objectify the risk.
• Document Tolerance: Even if you don’t fully delete the allergy label, if you successfully treat the patient with another beta-lactam (like ceftriaxone), document that tolerance clearly to aid future clinicians.
• Cephalosporins are likely safe: Later-generation cephalosporins generally have very low cross-reactivity and are usually safe options even in truly allergic patients

How do you handle documented penicillin allergies? Do you use the PEN-FAST tool? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis

Resources:

PEN-FAST Score on MDCalc

Penicillin Allergy Evaluation Should Be Performed Proactively in Patients with a Penicillin Allergy Label – A Position Statement of the American Academy of Allergy, Asthma & Immunology

Staicu ML, Vyles D, Shenoy ES, Stone CA, Banks T, Alvarez KS, Blumenthal KG. Penicillin Allergy Delabeling: A Multidisciplinary Opportunity. J Allergy Clin Immunol Pract. 2020 Oct;8(9):2858-2868.e16. doi: 10.1016/j.jaip.2020.04.059. PMID: 33039010; PMCID: PMC8019188.

Yang C, Graham JK, Vyles D, Leonard J, Agbim C, Mistry RD. Parental perspective on penicillin allergy delabeling in a pediatric emergency department. Ann Allergy Asthma Immunol. 2023 Jul;131(1):82-88. doi: 10.1016/j.anai.2023.03.023. Epub 2023 Mar 27. PMID: 36990206.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This episode of EM Pulse dives into one of the most stressful scenarios in the ED: the febrile infant in the first month of life. Traditionally, a fever in this age group has meant an automatic “full septic workup,” including the dreaded lumbar puncture (LP).

But times are changing. We sit down with experts Dr. Nate Kuppermann and Dr. Brett Burstein to discuss a landmark JAMA study that suggests we might finally be able to safely skip the LP in many of our tiniest patients.

The Study: A Game Changer for Neonates

Our discussion centers on a massive international pooled study evaluating the PECARN Febrile Infant Rule specifically in infants aged 0–28 days. While previous guidelines were conservative due to a lack of data for this specific age bracket, this study provides the evidence we’ve been waiting for.

• The Cohort: A large pool of infants across multiple countries.
• The Findings: The PECARN rule demonstrated an exceptionally high negative predictive value for invasive bacterial infections.
• The Big Win: The rule missed zero cases of bacterial meningitis.

Defining the Danger: SBI vs. IBI

The experts break down why we are shifting our terminology and our clinical focus.

Serious Bacterial Infection (SBI)

Historically, this was a “catch-all” term including Urinary Tract Infections (UTIs), bacteremia, and meningitis. However, UTIs are generally more common, easily identified via urinalysis, and typically less life-threatening than the other two.

Invasive Bacterial Infection (IBI)

This term refers specifically to bacteremia and bacterial meningitis. These are the “high-stakes” infections the PECARN rule is designed to rule out. Dr. Kuppermann notes that we should ideally view bacteremia and meningitis as distinct entities, as the clinical implications of a missed meningitis case are far more severe.

The HSV Elephant in the Room

One of the primary reasons clinicians hesitate to skip an LP in a neonate is the fear of missing Herpes Simplex Virus (HSV) infection.

• Low Baseline Risk: While the overall risk of HSV in a febrile infant is low, the risk of “isolated” HSV (meningitis without other signs or symptoms) is even rarer.
• Screening Tools: Most infants with HSV appear clinically ill. Clinicians can also use ALT (liver function) testing as a secondary screen – transaminase elevation is a common marker for systemic HSV.
• Clinical Judgment: If the baby is well-appearing, has no maternal history of HSV, no vesicles, and no seizures, the risk of missing HSV by skipping the LP is exceptionally low.

Practical Application: Shared Decision-Making

This isn’t just about the numbers—it’s about the parents.

“Families don’t mind their babies being admitted… They do not want the lumbar puncture. It is the single most anxiety-provoking aspect of care.” — Dr. Brett Burstein

The PECARN “Low-Risk” Criteria:

(Remember, this rule applies only to infants who are not ill-appearing.)

1. Urinalysis: Negative
2. Absolute Neutrophil Count (ANC): ≤ 4,000/mm³
3. Procalcitonin (PCT): ≤ 0.5 ng/mL

The Bottom Line: If an infant is well-appearing and meets these criteria, physicians can have a nuanced conversation with parents about the risks and benefits of forgoing the LP, while still admitting the child for observation (often without empiric antibiotics) while cultures brew.

Key Takeaways

• The “Well-Appearing” Filter: If an infant looks ill, the rule does not apply. These patients require a full workup, including an LP, regardless of lab results.
• Meticulous Physical Exam: Assess for a strong suck, normal muscle tone, brisk capillary refill, and any rashes or vesicles.
• History is Key: Always ask about maternal GBS/HSV status, pregnancy or birth complications, prematurity, sick contacts, and any changes in feeding, stooling or activity.
• Procalcitonin: PCT is the superior inflammatory marker for this rule. If your facility only offers traditional markers like CRP, the PECARN negative predictive value cannot be strictly applied. In the words of Dr. Kuppermann: “If you don’t have it, for God’s sakes, just get it!
• ALT to Screen for HSV: While not part of the official PECARN rule, our experts suggest that significantly elevated liver enzymes should raise suspicion for systemic HSV.
• Observe, Don’t Discharge: Being “low risk” does not mean the infant goes home. All infants ≤ 28 days still require admission for 24-hour observation and blood/urine cultures.

We want to hear from you! Does this change how you approach febrile neonates in the ED? How do you handle shared decision-making with parents? Connect with us on social media @empulsepodcast or on our website ucdavisem.com.

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children’s National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences

Dr. Brett Burstein, Clinician-Scientist and Pediatric Emergency Medicine Physician at Montreal Children’s Hospital, McGill University

Resources:

Burstein B, Waterfield T, Umana E, Xie J, Kuppermann N. Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. 2026 Feb 3;335(5):425-433. doi: 10.1001/jama.2025.21454. PMID: 41359314; PMCID: PMC12687207

“Hot” Off the Press: Infant Fever Rule

Do I really need to LP a febrile infant with a UTI?

PECARN Infant Fever Update: 61-90 Days

Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, Saunders M, Ruddy RM, Roosevelt G, Rogers AJ, Powell EC, Nigrovic LE, Muenzer J, Linakis JG, Grisanti K, Jaffe DM, Hoyle JD Jr, Greenberg R, Gattu R, Cruz AT, Crain EF, Cohen DM, Brayer A, Borgialli D, Bonsu B, Browne L, Blumberg S, Bennett JE, Atabaki SM, Anders J, Alpern ER, Miller B, Casper TC, Dean JM, Ramilo O, Mahajan P; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342-351. doi: 10.1001/jamapediatrics.2018.5501. PMID: 30776077; PMCID: PMC6450281.

Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O’Leary ST, Okechukwu K, Woods CR Jr; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 2021 Aug;148(2):e2021052228. doi: 10.1542/peds.2021-052228. Epub 2021 Jul 19. Erratum in: Pediatrics. 2021 Nov;148(5):e2021054063. doi: 10.1542/peds.2021-054063. PMID: 34281996.

****Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Reimagining Care Beyond Hospital Walls

Hospitals are a finite resource—but patient needs are not. This episode continues our multi-part series on taking medicine to where patients are—rather than making them come to us. From preventative care to pediatricians meeting families in their own environments, the series has explored how medicine is evolving beyond traditional settings. In this episode, we explore one of the most compelling—and long-overdue—ideas yet: care at home.

What Is Home-Based Medical Care?

Joined by Dr. Kelly Owen, Professor of Emergency Medicine at UC Davis and Medical Director for Express Care and Dispatch Health, the conversation dives into what home-based care really looks like—from urgent care at home to ED-to-home follow-ups and post-hospital discharge support designed to prevent readmissions.

A Patient-Centered Solution That Works

Through a powerful real-world case, the team illustrates how mobile medical units can deliver wraparound care—medications, follow-up appointments, and clinical evaluation—right in a patient’s living room, avoiding unnecessary hospital stays while improving outcomes and patient satisfaction.

Why This Model Matters Now

With emergency departments stretched thin, home-based care offers ways to:

• Reduce avoidable ED visits and hospitalizations
• Improve continuity of care after discharge
• Support vulnerable, homebound, or transportation-limited patients
• Deliver care that insurance covers and patients prefer

The model is compelling: high patient satisfaction, low ED escalation rates, and health care dollars saved—all while keeping patients at the center.

The Future of “Medicine on the Go”

As technology and remote monitoring continue to evolve, this episode makes the case that home-based care isn’t a niche experiment—it’s a scalable, sustainable future for emergency and outpatient medicine.

Tune in to hear how taking medicine to where patients are is transforming care—for the better.

Was this series helpful for you? What other topics would you like to see us cover? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Dr. Kelly Owen, Professor of Emergency and Medical Director of Express Care and Dispatch Health at UC Davis

Resources:

‘The next frontier of emergency medicine’: House calls following emergency room

by Liam Connolly, April 30, 2024.

UC Davis Health embarks on innovative care at home journey

by Liam Connolly, July 18, 2023.

AMA’s Return on Health: Telehealth framework for practices.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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We’re stepping out of our Medicine on the Go series for a rapid-response episode on something hitting all of us hard right now: influenza. A lively debate among our colleagues sparked this conversation—especially around a newer flu antiviral, baloxavir (Xofluza). Who’s using it? When does it make sense? How much does it cost patients? And how does it really compare to the longtime staple oseltamivir (Tamiflu)? The questions came fast, the opinions were strong, and we knew it was time to dig in. With flu season in full swing, this episode is all about practical decision-making at the bedside.

Back to Basics: How Flu Antivirals Work

To help break it all down, we welcome back our trusted ED pharmacist, Haley Burhans. We begin with a quick review of how influenza antivirals have evolved.

, approved in 1999, was the first widely used antiviral and works by blocking the neuraminidase enzyme. Over time, concerns about resistance led to the development of newer options. That brings us to baloxavir (Xofluza), approved in 2018. Xofluza works differently by stopping viral replication earlier in the virus life cycle. While both medications aim to shorten illness and reduce complications, they differ in how they work, how they are dosed, and which patients benefit most.

Who Should Get What—and When?

Next, we focus on real-world ED decision-making. Who should receive Tamiflu, and who is a good candidate for Xofluza? We review use in children, pregnant patients, hospitalized patients with severe or worsening illness, immunocompromised patients, and those at higher risk due to conditions like asthma, lung disease, diabetes, heart disease, obesity, or older age. Timing is critical. Both medications work best when started within 48 hours of symptom onset. However, oseltamivir is still recommended even after that window for patients who are hospitalized or severely ill. We also discuss when antivirals can be used for post-exposure prpphylaxis.

What Does the Evidence Say?

We then take a closer look at the data behind antiviral treatment. Both Tamiflu and Xofluza shorten the time to symptom improvement. Observational studies suggest oseltamivir may reduce hospital length of stay and in-hospital death in adults and shorten hospital stays in children. Trial data also suggest baloxavir may be more effective against influenza B. We compare dosing strategies—five days of twice-daily Tamiflu versus a single-dose Xofluza—and review side effects and pediatric considerations.

Real-World Barriers: Access and Cost

Finally, we tackle the practical issues clinicians face every day. Tamiflu is widely available and familiar to most providers. Xofluza, on the other hand, often requires prior authorization and may be harder for patients to obtain. We discuss insurance barriers, out-of-pocket costs, manufacturer coupons, and situations where Xofluza may or may not be a realistic option.

Take-Home Message

This episode is a practical, evidence-based conversation designed to help emergency clinicians make confident decisions during flu season. Whether you’re treating a high-risk patient, considering a single-dose option for uncomplicated flu, or simply trying to stay current, this discussion delivers clear, useful guidance you can use on your next shift!

What’s your go to flu treatment? What other medications would you like to learn more about? Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis

Resources:

CDC: Influenza Antiviral Medications: Summary for Clinicians

AAP: Recommendations for Prevention and Control of Influenza in Children, 2025–2026: Policy Statement

ACEP Influenza Resources and Updates

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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The next episode of our Medicine on the Go series features Dr. Serena Yang, Professor and Division Chief of General Pediatrics and Vice Chair of Community Engagement at UC Davis Health, as she shares how UC Davis Children’s Hospital’s Pediatric Mobile Clinic is bringing specialty care directly into schools and under-resourced communities across the Sacramento region. Learn how this innovative mobile model addresses urgent needs in child development, mental health, and asthma, removes barriers to care, and builds trust through strong school and community partnerships—offering an inspiring blueprint for delivering equitable pediatric care beyond the clinic walls.

Does your health system have a mobile outreach clinic? Would you consider starting one? We’d love to hear from you! Share with us on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. Serena Yang, Clinical Professor and Division Chief of General Pediatrics, and Vice Chair of Community Engagement at UC Davis

Resources:

UC Davis Pediatric Mobile Clinic Program

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In the second episode of our Medicine on the Go series, we step beyond the ED to explore how UC Davis Health and Sacramento County are partnering to deliver care directly to the community through the Wellness Without Walls (W3) street medicine program.

We’re joined by Dr. MK Orsulak, Assistant Professor of Family Medicine at UC Davis. We discuss how a mobile clinic staffed by interdisciplinary teams brings primary care, wound care, mental health services, HIV/STI testing, vaccinations, and substance use treatment to people experiencing homelessness—meeting patients where they are and reducing preventable ED visits.

This episode offers a powerful look at how innovative, cross-system collaboration can extend emergency care beyond hospital walls and improve access to the right care at the right time.

Do you have a program similar to W3 in your area?

We’d love to hear about it! Share with us on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. MK Orsulak, Assistant Professor of Family and Community Medicine at UC Davis

Resources:

Sacramento County Department of Health Services: Wellness Without Walls (W3)

Street medicine team improves lives of unhoused patients, by Edwin Garcia, Feb 27 2024

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this first installment of our Medicine on the Go series, we explore how care is moving beyond hospital walls and directly into the community through UC Davis Fire Department’s innovative mobile mental health crisis unit, Health 34. You’ll hear how this no-cost, 24/7 team—staffed by providers with paramedic backgrounds and lay counselor training—meets people where they are to prevent crises, support mental health needs, and connect patients to the right resources before problems escalate. Health 34 Provider, Blythe Clark, joins us to share the origins of the program, how it works, who it serves, and what other communities can learn from this model. We’ll explore how prehospital services can act as a powerful preventative tool and how collaborations like this could reshape the future of care far beyond campus.Do you have a program similar to Health 34 in your area? We’d love to hear how it’s working and what you’ve learned. Share with us on social media @empulsepodcast or connect with us on ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Professor of Emergency Medicine at UC DavisGuest:Blythe Clark, Health 34 Provider, UC Davis Fire DepartmentResources:Health 34***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode of EM Pulse, guest host Dr. Neelou Tabatabai joins Julia in a discussion with ED nurse and TeamSTEPPS advocate, Leigh Clary, to explore how structured communication tools can transform even the most high-stress medical and trauma resuscitations. Through a real-life story of conflict and resolution in the emergency department, Leigh illustrates how TeamSTEPPS strategies—like assertive communication, the Two-Challenge Rule, and CUS words—empower teams to speak up, de-escalate tension, and protect patient safety. Together, they unpack how calm, composed dialogue preserves respect, strengthens teamwork, and ensures every voice is heard when it matters most.

Do you use TeamSTEPPS or a similar model in your ED? We’d love to hear what has been successful for your team. Hit us up on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Guest Host:

Dr. Neelou Tabatabai, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Leigh Clary, RN, BSN, RN, CEN, ADCES, MICN , ED Nurse and TeamSTEPPS Project Lead at UC Davis

Resources:

TeamSTEPPS Player of the Month Program, Presentation by Leigh Clary and Jose Metica

TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety Heidi B. King, MS, CHE, James Battles, PhD, David P. Baker, PhD, Alexander Alonso, PhD, Eduardo Salas, PhD, John Webster, MD, MBA, Lauren Toomey, RN, BSBA, MIS, and Mary Salisbury, RN, MSN.

TeamSTEPPS Pocket Guide – Agency for Healthcare Research and Quality

EM Pulse: TeamSTEPPS, September 17, 2021

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode, we dive into the charged world of Morbidity and Mortality conferences—where good intentions can collide with fear, shame, and silence. We’ve all felt that jolt of adrenaline sitting in the audience—or worse, standing at the podium. Our guest expert, Dr. Jaymin Patel, helps us unpack why the traditional M&M model no longer works and how we can rebuild it into something better: a space that turns mistakes into meaningful learning, supports both patient and provider healing, and helps us face our ghosts without fear.How do you think we can improve M&M? Share your ideas with us on social media @empulsepodcast or connect with us on ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Professor of Emergency Medicine at UC DavisGuest:Dr. Jaymin Patel, Assistant Professor of Emergency Medicine and Assistant Residency Program Director at UC DavisResources:ALiEM: The M&M Shame Game; Case by Dr. Tamara McColl  Nussenbaum B, Chole RA. Rethinking Morbidity and Mortality Conference. Otolaryngol Clin North Am. 2019 Feb;52(1):47-53. doi: 10.1016/j.otc.2018.08.007. Epub 2018 Oct 5. PMID: 30297182.Wittels K, Aaronson E, Dwyer R, Nadel E, Gallahue F, Fee C, Tubbs R, Schuur J; EM M&M Culture of Safety Research Team. Emergency Medicine Morbidity and Mortality Conference and Culture of Safety: The Resident Perspective. AEM Educ Train. 2017 May 4;1(3):191-199. doi: 10.1002/aet2.10033. PMID: 30051034; PMCID: PMC6001737.***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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What happens when a febrile infant presents at 61 days old? Are they suddenly low risk for invasive bacterial infections? In this episode, we explore the gray zone of managing febrile infants aged 61–90 days with the help of two new clinical prediction rules from PECARN. Joining us are two powerhouses in pediatric emergency medicine: Dr. Nate Kuppermann and Dr. Paul Aronson, who walk us through their recent study published in Pediatrics. We discuss why prior research has traditionally stopped at 60 days, what the new data shows about risk in this slightly older age group, and how these rules might help guide clinical decision-making. This study fills a long-standing gap—but should we start using the rules now? Tune in for a nuanced discussion on sensitivity, missed cases, practical application, and the future of risk stratification in young infants with fever.

What is your practice in terms of work-up of 2-3 month old febrile infants? Will this change what you do? Hit us up social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children’s National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences

Dr. Paul Aronson, Professor of Pediatrics (Emergency Medicine); Deputy Director, Pediatric Residency Program at Yale University School of Medicine

Resources:

“Hot” Off the Press: Infant Fever Rule

Do I really need to LP a febrile infant with a UTI?

Aronson PL, Mahajan P, Meeks HD, Nielsen B, Olsen CS, Casper TC, Grundmeier RW, Kuppermann N; PECARN Registry Working Group. Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections. Pediatrics. 2025 Sep 1;156(3):e2025071666. doi: 10.1542/peds.2025-071666. PMID: 40854562; PMCID: PMC12432541.

Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, Saunders M, Ruddy RM, Roosevelt G, Rogers AJ, Powell EC, Nigrovic LE, Muenzer J, Linakis JG, Grisanti K, Jaffe DM, Hoyle JD Jr, Greenberg R, Gattu R, Cruz AT, Crain EF, Cohen DM, Brayer A, Borgialli D, Bonsu B, Browne L, Blumberg S, Bennett JE, Atabaki SM, Anders J, Alpern ER, Miller B, Casper TC, Dean JM, Ramilo O, Mahajan P; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342-351. doi: 10.1001/jamapediatrics.2018.5501. PMID: 30776077; PMCID: PMC6450281.

Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O’Leary ST, Okechukwu K, Woods CR Jr; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 2021 Aug;148(2):e2021052228. doi: 10.1542/peds.2021-052228. Epub 2021 Jul 19. Erratum in: Pediatrics. 2021 Nov;148(5):e2021054063. doi: 10.1542/peds.2021-054063. PMID: 34281996.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Dive into the second half of our envenomation series! Dr. Jonathan Ford, a UC Davis Medical Toxicologist and Professor of Emergency Medicine, returns to the podcast to tackle scorpions and spiders. We’re going beyond the basics to discuss the “why” and “how” of these bites and stings. Learn about the neurotoxic effects of bark scorpion venom and the life-threatening airway risks. Explore the mechanism behind black widow bites that leads to intense pain and spasms, and the crucial role of antivenom in severe cases. Plus, we’re setting the record straight on a common myth—the brown recluse—and the proper supportive care for its nasty bite. Join us to discover the latest evidence-based approaches that could change how you manage your next bite or sting.

Have you had a patient with a serious or challenging envenomation? How did you manage it? Share your story with us social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. Jonathan Ford, Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources:

Quan D. North American poisonous bites and stings. Crit Care Clin. 2012 Oct;28(4):633-59. doi: 10.1016/j.ccc.2012.07.010. PMID: 22998994.

Levine M, Friedman N. Terrestrial envenomations in pediatric patients: identification and management in the emergency department. Pediatr Emerg Med Pract. 2021 Sep;18(9):1-24. Epub 2021 Sep 2. PMID: 34403224..

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Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Summer hikes and backyard play mean we’re bound to see a few snakebites in the ED—and getting the first steps right makes all the difference. In the first half of this 2 part series, Medical Toxicologist Dr. Jonathan Ford joins us to walk through the key steps in caring for patients with snake envenomations. We’ll walk through what to do (and not to do) in terms of pre-hospital care, how to triage and assess patients when they arrive in the ED, and how to decide which patients need antivenom. Dr. Ford reviews dosing strategies, monitoring, and key considerations for children, elderly, and pregnant patients. And we discuss practical guidance on supportive care, from pain control to wound management. By the end of this episode, you’ll be ready to provide effective, evidence-based care for your next snakebite patient.

Have you had a patient with a serious or challenging envenomation? How did you manage it? Share your story with us social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. Jonathan Ford, Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources:

Seifert SA, Armitage JO, Sanchez EE. Snake Envenomation. N Engl J Med. 2022 Jan 6;386(1):68-78. doi: 10.1056/NEJMra2105228. PMID: 34986287; PMCID: PMC9854269.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In the second half of this two part episode, Dr. David Leon unpacks some of the most hotly debated topics in resuscitation—fluids, blood products, ECMO, and post-arrest care. He breaks down the pros and cons of crystalloids (yes, even the “pasta water” debate), explains why lactated Ringer’s is often preferred over normal saline, and dips into the use of albumin and colloids. Dr. Leon also discusses the promise and challenges of extracorporeal life support (ECLS), the evolving role of targeted temperature management (TTM), and even peeks into what advances the future might hold. It’s a thoughtful, forward-looking conversation every resuscitationist should hear.

What do you think of Dr. Leon’s tips? Are you using these tools in your practice? We’d love to hear from you. Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis

Resources:

American Heart Association (AHA) Algorithms

Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC; American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024 Jan 30;149(5):e254-e273. doi: 10.1161/CIR.0000000000001194. Epub 2023 Dec 18. PMID: 38108133.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this high-yield two part episode, we dive into the evolving world of resuscitation with Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis. From the shift in priorities from ABC (Airway-Breathing-Circulation) to CAB (Circulation first) to the practical use of peripheral vasopressors and rapid infusion catheters, this episode breaks down how frontline ED care is adapting to sicker patients, longer ICU boarding times, and limited resources. Tune in for insights on advanced access strategies, pre-hospital blood products, and why old tools, like whole blood and vasopressin, are making a powerful comeback.

What do you think of Dr. Leon’s tips? Are you using these tools in your practice? We’d love to hear from you. Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest:

Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis

Resources:

American Heart Association (AHA) Algorithms

Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC; American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024 Jan 30;149(5):e254-e273. doi: 10.1161/CIR.0000000000001194. Epub 2023 Dec 18. PMID: 38108133.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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We’re back with another episode of Push Dose Pearls with ED Clinical Pharacist, Haley Burhans! In this episode, we break down the essentials of managing agitation in the ED—starting with why you should avoid diphenhydramine in the elderly and benzodiazepines in the 3 D’s: drunk, delirium, and dementia. We discuss how to quickly assess the cause, choose the right medication, and decide between IM and IV routes. And Haley offers some key safety tips and considerations for special populations, including kids and the elderly.

Was this episode helpful? What other medications would you like to learn more about? Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis

Resources:

ACEP’s New Clinical Policy on Severe Agitation. By Molly E.W. Thiessen, MD, FACEP | on February 12, 2024

Pediatric Education and Advocacy Kit (PEAK): Agitation

Hoffmann JA, Pergjika A, Konicek CE, Reynolds SL. Pharmacologic Management of Acute Agitation in Youth in the Emergency Department. Pediatr Emerg Care. 2021 Aug 1;37(8):417-422. doi: 10.1097/PEC.0000000000002510. PMID: 34397677; PMCID: PMC8383287.

Gerson R, Malas N, Feuer V, Silver GH, Prasad R, Mroczkowski MM. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. West J Emerg Med. 2019 Mar;20(2):409-418. doi: 10.5811/westjem.2019.1.41344. Epub 2019 Feb 19. Erratum in: West J Emerg Med. 2019 May;20(3):537. doi: 10.5811/westjem.2019.4.43550. Erratum in: West J Emerg Med. 2019 Jul;20(4):688-689. doi: 10.5811/westjem.2019.4.44160. PMID: 30881565; PMCID: PMC6404720..

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode, we welcome back Dr. John Rose as cohost for a conversation with Dr. Gary Tamkin—Emergency Physician and Vice President of Provider Development at US Acute Care Solutions. Together, they explore what it really takes to find happiness and fulfillment in the high-stakes world of emergency medicine. From the trap of the arrival fallacy to the pressure of always chasing the next milestone, Dr. Tamkin shares personal insights and practical strategies tailored to the unique challenges EM clinicians face. You’ll come away with two actionable tools to help build more meaning, balance, and joy—both on shift and off.

What are your tips for avoiding burnout and finding balance? Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Medical Director at UC Davis

Guest:

Dr. Gary Tamkin, Emergency Physician and Vice President of Provider Development and US Acute Care Solutions

Resources:

Podcast: 10% Happier with Dan Harris

Podcast: Hidden Brain with Shankar Vedantam

Transitions by William Bridges, PhD with Susan Bridges

The Happiness Advantage by Shawn Achor

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Hypoglycemia can be subtle—or dangerously obvious—and knowing when and how to treat it is critical. In her first episode as our new Push Dose Pearls expert, Emergency Medicine Clinical Pharmacist, Haley Burhans, joins us to break it down. We discuss glucose thresholds by age, when to draw critical labs, and how to choose the right treatment—whether it’s oral glucose, IV dextrose, or IM or intranasal glucagon. From neonates to older adults, Haley delivers practical, evidence-based pearls to help you manage low blood sugar safely and effectively in the ED.

Was this episode helpful? What other medications would you like to learn more about? Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis

Resources:

Gandhi K. Approach to hypoglycemia in infants and children. Transl Pediatr. 2017 Oct;6(4):408-420. doi: 10.21037/tp.2017.10.05. PMID: 29184821; PMCID: PMC5682370.

Rickels MR, Ruedy KJ, Foster NC, Piché CA, Dulude H, Sherr JL, Tamborlane WV, Bethin KE, DiMeglio LA, Wadwa RP, Ahmann AJ, Haller MJ, Nathan BM, Marcovina SM, Rampakakis E, Meng L, Beck RW; T1D Exchange Intranasal Glucagon Investigators. Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study. Diabetes Care. 2016 Feb;39(2):264-70. doi: 10.2337/dc15-1498. Epub 2015 Dec 17. PMID: 26681725; PMCID: PMC4722945..

MD Calc GIR (Glucose Infusion Rate) Calculator

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Summer travel is in full swing and, for physicians, that means more than just packing swimsuits and sunscreen. In this episode of EM Pulse, we sit down with wilderness medicine expert, Dr. Mary Bing, to unpack the real-world essentials of travel medical kits. From duct tape and whistles to epinephrine and steroids, you’ll learn what to bring, how to tailor your supplies based on destination and group, and why your role as a physician—formal or not—comes with extra responsibilities. Whether you’re headed to the Alps or the backyard, this episode is your go-to guide for staying medically prepared on the move. Don’t just travel light—travel smart.

What’s in your first aid kit? Hit us op on on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Dr. Mary Bing, Professor of Emergency Medicine and Assistant EM Residency Program Director at UC Davis

Resources:

Surviving a Wilderness Emergency by Peter Kummerfeldt

ACEP: First Aid Kit

U.S. Customs and Border Protection: Traveling with medication

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this follow-up to our artificial intelligence in EM series, we’re diving into how AI can enhance your professional life outside of clinical shifts. Joined by Dr. Jaymin Patel—Assistant Residency Program Director and tech-savvy educator—we explore three practical AI tools that can streamline teaching, content creation, communication, and even how you consume literature on your commute. From ChatGPT to DALL·E to NotebookLM, we break down what each tool does, how to use it effectively, what pitfalls to avoid, and how even non-educators can leverage them. Tune in to learn how to use AI intentionally, efficiently, and ethically in your day-to-day professional life.

Are you using AI in your professional life? What’s your favorite tool? Share your experience with us on social media @empulsepodcast or connect with us on ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis

Guests:

Dr. Jaymin Patel, Assistant Professor of Emergency Medicine and Assistant EM Residency Program Director at UC Davis

Resources:

Nivritti Gajanan Patil, Nga Lok Kou, Daniel T. Baptista-Hon, Olivia Monteiro. Artificial Intelligence in Medical Education: A Practical Guide for Educators. MedComm – Future MedicineVolume 4, Issue 2 e70018. First published: 02 April 2025 https://doi.org/10.1002/mef2.70018

ChatGPT

DALL•E

NotebookLM

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode of EM Pulse, Dr. Daniel Hernandez, an emergency medicine and addiction specialist at UC Davis, joins the team to spotlight methadone—one of the original and still powerful tools for treating opioid use disorder (OUD). While newer medications like buprenorphine often steal the spotlight, methadone remains a critical option, especially in the era of fentanyl. Tune in for a practical conversation on when and how to initiate methadone in the ED, navigating regulatory barriers, arranging follow-up at opioid treatment programs, and managing pain in patients already on methadone. Whether you’re new to methadone or looking to sharpen your approach, this episode offers real-world insights and actionable pearls Have you started methadone from the ED? Share your experience with us on social media @empulsepodcast or connect with us on ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Professor of Emergency Medicine at UC DavisGuests:Dr. Daniel Hernandez, Assistant Professor of Emergency Medicine and Assistant Director of the Addiction Medicine Fellowship at UC DavisResources:CA BridgeACEP/CA Bridge - Methadone Hospital Quick StartLiberate Methadone: An Introduction for the Emergency Medicine PhysicianBy Terence M. Hughes, MD; Joan Chen, MD; and Utsha G. Khatri, MD, MSHP | on April 14, 2025***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This is the next episode of our Push Dose Pearls miniseries with ED Clinical Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. In this epsidoe, we unpack the complexities of anticoagulation reversal in the emergency department - It’s not just about vitamin K anymore! Tune in as we explore the key reversal agents, when and why to use them, how fast they work, and the risks that come with turning off anticoagulation. From bleeding emergencies to stroke prevention, this quick dive offers practical pearls for navigating the coagulation cascade in real time.Have you had a bad GI bleed or intracranial hemorrhage in a patient on thinners?. Share your story with us on social media or at ucdavisem.com.Hosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Professor of Emergency Medicine at UC DavisGuests:Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and former Assistant Professor at UC DavisResources:Baugh CW, Levine M, Cornutt D, et al. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel. Ann Emerg Med. 2020 Oct;76(4):470-485. doi: 10.1016/j.annemergmed.2019.09.001. Epub 2019 Nov 13. PMID: 31732375; PMCID: PMC7393606.ACEP Point of Care Tools: Anticoagulation Reversal.****Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Big news for emergency medicine residencies! The ACGME is proposing several major changes to EM program requirements. To comply with these new requirements, programs would need to be 4 years long. This is a hotly debated topic at the moment as most EM residencies in the U.S. currently are 3 year programs. So what are the proposed changes? How would they affect the curriculum and training for future EM physicians? To answer these questions, we sit down with UC Davis EM Program Director and medical education specialist, Dr. Aaron Danielson. What do you think of these proposed changes? We’d love to hear from you. We’re on social media @empulsepodcast or connect with us on ucdavisem.comHost:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisGuest:Dr. Aaron Danielson, Associate Professor of Emergency Medicine and Emergency Medicine Residency Program Director at UC DavisResources:Share your comments with the ACGMEACEP: ACGME Releases Proposed Changes to EM Program RequirementsUC Davis Emergency Medicine Residency Program***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.Disclaimer

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In the fourth and final episode of our advocacy mini series with guest host, Dr. Anna Yap, we dive into a powerful story of advocacy led by a mother-daughter duo. Pediatric nurse practitioner Robyn Lao and her 9-year-old daughter, Addie, who has severe food allergies, turned their personal challenges into a statewide movement by co-authoring California Senate Bill 68—the Allergen Disclosure for Dining Experiences (ADDE) Act. Together, they share their journey from navigating daily food allergy struggles to pushing for legislative change, proving that anyone, at any age, can make a difference. Tune in to hear how their determination is shaping a safer future for millions.Have you been involved in health care related legislation? Share your story with us on social media @empulsepodcast or at ucdavisem.comHost:Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest Host:Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC DavisGuest:Robyn Lao, D.N.P., C.P.N.P.-A.C., Pediatric Surgery Nurse Practitioner at UC Davis Addie Lao, 9-year-old Food Allergy AdvocateResources:Addie’s website: Addie Tells AllAddie’s Video and YouTube ChannelCalifornia SB 68: The Allergen Disclosure for Dining Experiences (ADDE) ActACEP: Tools for Effective State Advocacy****Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.Disclaimer

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In the third episode of our advocacy mini series with Dr. Anna Yap, we explore the evolving challenges faced by transgender patients and medical professionals in today’s political climate. We’re joined by Charlie Adams, a fourth-year medical student and dedicated advocate, who shares his powerful journey fighting for transgender rights and health equity. Together, we discuss the importance of gender-affirming care, the real-world impact of restrictive laws, and how we can improve emergency department care for transgender patients. Tune in for an insightful conversation on advocacy, inclusivity, and the role we all play in creating a more supportive healthcare system.How have your patients and your practice environment been affected by legal and political changes in transgender rights? Share your story with us on social media @empulsepodcast or at ucdavisem.comHost:Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest Host:Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC DavisGuest:Charlie Adams, Medical Student, Future Emergency Physician, and Transgender Health Advocate Resources:Charlie Adams’ Instagram: @transproudmedACEP: Caring for Transgender and Gender Diverse Patients in the Emergency DepartmentClarifying Misconceptions About Youth Gender-Affirming Care. By Center for Health Journalism Fellow, Sophie Putka. May 22, 2024Trans adults on edge as legislatures broaden focus beyond children. Washington Post, February 15, 2024Gender-affirming care is life-saving, research says. Why is it so controversial? by David Oliver, USA Today, Nov 1, 2023***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.Disclaimer

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In the second episode of our advocacy mini series with Dr. Anna Yap, we dive into the critical intersection of emergency medicine and immigration health. As emergency physicians, we frequently care for undocumented patients, asylum seekers, and refugees—individuals who face significant barriers to medical care, including fear, cost concerns, and language obstacles. Dr. Ellen Shank, a UC Davis health policy fellow and expert in migrant healthcare, joins us to explore the legal and ethical responsibilities of emergency providers, including how to navigate interactions with immigration enforcement, protect patient rights, and provide trauma-informed care. We’ll discuss practical ways physicians can advocate for these vulnerable populations, from facilitating asylum medical exams to supporting protective hospital policies. Tune in for an essential discussion on how emergency physicians can go beyond medical treatment to become informed advocates for their patients in an evolving immigration landscape.Has ICE come to your ED? Share your story with us on social media @empulsepodcast or at ucdavisem.comHost:Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest Host:Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC DavisGuest:Dr. Ellen Shank, Emergency Physician and Health Policy Fellow at UC Davis. Resources:ACEP: Navigating Immigration Enforcement in the Emergency DepartmentRed Cards/Tarjetas Rojas (download and print in multiple languages)Q&A on Immigration Enforcement for Hospitals (Greater New York Hospital Association)“Know Your Rights” video for patients in several languages (Immigration Institute of the Bay Area)***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.Disclaimer

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When corporate interests threaten patient care, who speaks up for doctors and their patients? This episode kicks off a special EM Pulse mini-series with guest host, Dr. Anna Yap, in which we explore the power of advocacy in medicine. In our first episode, Dr. Michelle Wiener shares how she and her colleagues took on a private equity-backed staffing group, formed a union, and fought for safer working conditions—proving that real change starts from within. Whether you’re new to advocacy or already involved, this series will inspire you to take action.Have you or you colleagues considered collective bargaining to address concerns in your ED?  We’d love to hear from you on social media @empulsepodcast or at ucdavisem.comHost:Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest Host:Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC DavisGuest:Dr. Michelle Wiener, Emergency Physician and Clinical Faculty at Henry Ford Health in Detroit, MI. mrsdrwiener@gmail.comResources:ACEP: UnionizationUnionization. An Information Paper This information paper was created by members of the ACEP Medical-Legal Committee June 2024 AMA Advocacy Resource Center*Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.Disclaimer

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In this final installment of our three-part series on artificial intelligence in emergency medicine, we explore the rapid expansion of AI and its implications for clinical practice. In previous episodes, we explored how AI is revolutionizing tasks like diagnosis, treatment planning, and patient monitoring. In this final chapter, guest expert, Dr. Brian Patterson, joins us to discuss how to safely integrate AI into clinical practice. We recap insights from previous episodes, including AI’s transformative potential and real-world applications, while diving into the challenges and regulatory efforts shaping this exploding field. Whether you’re an AI skeptic or an early adopter, this episode unpacks what you need to know about integrating AI safely and effectively into emergency medicine.How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Brian Patterson, Associate Professor Emergency Medicine and Physician Administrative Director of Clinical AI at the University of Wisconsin. Resources:Liao F, Adelaine S, Afshar M, Patterson BW. Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes. Front Digit Health. 2022 Aug 24;4:931439. doi: 10.3389/fdgth.2022.931439. PMID: 36093386; PMCID: PMC9448877.Mello MM, Guha N. Understanding Liability Risk from Using Health Care Artificial Intelligence Tools. N Engl J Med. 2024 Jan 18;390(3):271-278. doi: 10.1056/NEJMhle2308901. PMID: 38231630.OpenEvidence.com***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In the second episode our three part series, we dive deeper into the practical impact of artificial intelligence on emergency medicine with expert, Dr. Gabriel Wardi. Building on our previous discussion about AI’s role in healthcare, we explore clinical decision support systems (CDS)—how they aim to improve diagnostic accuracy but can sometimes miss the mark. Dr. Wardi shares insights from his own experience implementing AI-driven CDS, highlighting both its successes and challenges, including bias, reliability, and the importance of high-quality data. We discuss how AI can address traditional pitfalls of CDS, improve outcomes like sepsis care, and offer a glimpse into the future of AI in emergency settings. Plus, we look ahead to the critical conversation of AI governance and regulation in EM. Tune in as we break down what’s working, what’s next, and how frontline EM physicians can stay ahead of the curve.How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Gabriel Wardi, Associate Professor & Chief of the Division of Critical Care in the Department of Emergency Medicine at UC San DiegoResources:Boussina A, Shashikumar SP, Malhotra A, Owens RL, El-Kareh R, Longhurst CA, Quintero K, Donahue A, Chan TC, Nemati S, Wardi G. Impact of a deep learning sepsis prediction model on quality of care and survival. NPJ Digit Med. 2024 Jan 23;7(1):14. doi: 10.1038/s41746-023-00986-6. Erratum in: NPJ Digit Med. 2024 Jun 12;7(1):153. doi: 10.1038/s41746-024-01149-x. PMID: 38263386; PMCID: PMC10805720.***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode, we dive into how AI is changing emergency medicine with Dr. Peter Steel, an expert in AI and EM at Cornell. We break down the basics of AI, machine learning, and deep learning, explore real-world applications like improving triage and clinical decision-making, and tackle challenges like bias and integration in high-pressure settings. Dr. Steel shares insights on generative AI, large language models, and the exciting future of AI in EM. If you’re curious about how AI can transform patient care and what’s next for the field, this episode is for you!How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Peter Steel, Associate Professor of Clinical Emergency Medicine and Vice Chair of Clinical Services at Weill Cornell Medical CollegeResources:Challen R, Denny J, Pitt M, Gompels L, Edwards T, Tsaneva-Atanasova K. Artificial intelligence, bias and clinical safety. BMJ Qual Saf. 2019 Mar;28(3):231-237. doi: 10.1136/bmjqs-2018-008370. Epub 2019 Jan 12. PMID: 30636200; PMCID: PMC6560460.***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode, we dive into the rising threat of cyberattacks on healthcare systems and their profound impact on emergency medicine. With 386 attacks reported in 2024 alone (as of October 7th), the likelihood of your hospital being targeted is increasing. But why are these attacks happening, and what can we do to mitigate their effects? To explore this critical topic, we’re joined by Dr. In Kim, Executive Vice Chair of Pediatrics at the University of Louisville School of Medicine and a leader in advancing his university’s cyber capabilities. From real-world examples of devastating attacks to actionable steps for hospitals, departments, and individual physicians, we’ll break down what you need to know to protect your patients, your practice, and yourself. Don’t miss this essential discussion for every emergency medicine provider!Has your health system been the victim of a cyber attack? Tell us your story and keep the discussion going on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. In K. Kim, Executive Vice Chair and Professor of Pediatrics, Executive Medical Director, Norton Children’s Medical Group, and Director of the Center for Health Process Innovation at the University of Louisville Schools of Medicine and BusinessResources:American Hospital Association: A Look at 2024’s Health Care Cybersecurity Challenges  By John Riggi, National Advisor for Cybersecurity and Risk, AHAU.S. Department of Health and Human Services Office for Civil Rights Breach Portal***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode, we address the growing concern over political violence in the United States as the presidential election draws near. Political violence, defined as the intentional use of power and force to achieve political ends, is a significant public health issue. Violence researcher and emergency physician, Dr. Garen Wintemute, joins us to provide a clear, evidence-based perspective on the topic. We explore recent data and expert insights to better understand the threat of political violence, its potential impact in emergency departments, and what we can do about it.Please note: Views and opinions expressed in this episode are the speaker’s own and do not represent those of UC Davis or the University of California. Are you concerned about political violence related to the upcoming election? How are you and your ED preparing? Keep the discussion going on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Garen Wintemute, Distinguished Professor of Emergency Medicine and Director of the Violence Prevention Research Program at UC DavisResources:Opinion: Don’t underestimate threats of violence from Proud Boys and other right-wing groups. By Dr. Garen Wintemute. Los Angeles Times, September 20, 2024. Opinion: Too many Americans support political violence.  It’s up to the rest of us to dissuade them. By Dr. Garen Wintemute. Los Angeles Times, July 18, 2024.Wintemute GJ. Guns, violence, politics: the gyre widens. Inj Epidemiol. 2021 Nov 2;8(1):64. doi: 10.1186/s40621-021-00357-3.Wintemute GJ, Robinson SL, Crawford A, Tancredi D, Schleimer JP, Tomsich EA, Reeping PM, Shev AB, Pear VA. Views of democracy and society and support for political violence in the USA: findings from a nationally representative survey. Injury Epidemiology. 2023;10(1):45.FACT SHEETWintemute GJ, Robinson SL, Tomsich EA, Tancredi DJ. MAGA Republicans’ views of American democracy and society and support for political violence in the United States: a nationwide population-representative survey. PLOS ONE. 2024;19(1):e029574

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As emergency physicians, we are very familiar with giving naloxone to patients with concern for opioid overdose. Our EMS colleagues give naloxone all the time in the prehospital setting. We know it works well for patients who are obtained due to opioids, but what about for patients who have an out-of-hospital cardiac arrest? Our expert on todays episode, Dr. David Dillon, set out to find out. Were you surprised by the findings in Dr. Dillon’s study? Does it change your practice? Hit us up on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuests:David Dillon, M.D., M.Phil., Ph.D, Assistant Professor of Emergency Medicine at UC DavisResources:Dillon DG, Montoy JCC, Nishijima DK, Niederberger S, Menegazzi JJ, Lacocque J, Rodriguez RM, Wang RC. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Netw Open. 2024 Aug 1;7(8):e2429154.***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Acetaminophen overdose is one of the most common medication concerns we see in the ED. It is important to know when to be concerned and when to treat as true overdoses can cause liver failure and death. UC Davis medical toxicologist, Dr. Hoan Nguyen, joins us in this episode to discuss a new consensus statement published in JAMA Network Open in August 2023: Managing of Acetaminophen Poisoning in the US and Canada. We discuss the updated approach and walk through as hypothetical case. At the end of this episode, you’ll be able to identify high risk patients, know what labs to draw, when to start NAC, transfer, and call your local toxicologist.Do these updated guidelines change your practice? Hit us up on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuests:Dr. HoanVu Nguyen, Military Emergency Physician and Medical Toxicologist at UC Davis. Resources:Dart RC, Mullins ME, Matoushek T, et al. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement. JAMA Netw Open. 2023 Aug 1;6(8):e2327739. doi: 10.1001/jamanetworkopen.2023.27739. Erratum in: JAMA Netw Open. 2023 Sep 5;6(9):e2337926. doi: 10.1001/jamanetworkopen.2023.37926. PMID: 37552484.*Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This is the next episode of our Push Dose Pearls miniseries with ED Clinical Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode focuses on naloxone. Naloxone is a staple in every ED docs toolbox but it can save more lives if it’s immediately available in the community. We’ll discuss ED based naloxone programs, why they are important, how to get funding, and which patients could benefit.

Do you give out naloxone in your ED? Is it readily available in your community? We’d love to hear your experience. Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and former Assistant Professor at UC Davis

Resources:

Kids Considered Podcast – Naloxone and Opioid Overdose

Sindhwani MK, Friedman A, O’Donnell M, Stader D, Weiner SG. Naloxone distribution programs in the emergency department: A scoping review of the literature. J Am Coll Emerg Physicians Open. 2024 May 8;5(3):e13180. doi: 10.1002/emp2.13180. PMID: 38726467; PMCID: PMC11079430.

Jacka BP, Ziobrowski HN, Lawrence A, Baird J, Wentz AE, Marshall BDL, Wightman RS, Mello MJ, Beaudoin FL, Samuels EA. Implementation and maintenance of an emergency department naloxone distribution and peer recovery specialist program. Acad Emerg Med. 2022 Mar;29(3):294-307. doi: 10.1111/acem.14409. Epub 2021 Nov 23. PMID: 34738277..

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this special episode, we celebrate the incredible 19-year tenure of Dr. Nate Kuppermann as Chair of the UC Davis Emergency Department. As he transitions to his new role as Executive Vice President, Chief Academic Officer, and Chair of Pediatrics at Children’s National Hospital in Washington, D.C., Dr. Kuppermann reflects on the growth and evolution of the department since he started in 2006. He shares insights on the challenges and accomplishments throughout his career, offers advice for aspiring department chairs, and discusses the importance of social media in building a department’s presence. Join us as we bid farewell and thank Dr. Kuppermann for his remarkable contributions.

What would you like to hear more of on EM Pulse? Hit up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Professor of Pediatric Emergency Medicine and outgoing Chair of the Department of Emergency Medicine at UC Davis, now Executive Vice President, Chief Academic Officer and Chair of Pediatrics at Children’s National Hospital in Washington, DC

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Many of our ED patients come in because they were told to. Whether it’s by an advice nurse, primary care provider, urgent care, call center, specialty coordinator, etc., it often feels to us like the default is “go to the ED”. But, of course, that’s not the case. There are myriad reasons why patients may be sent to the ED. In this episode, we talk with two of our favorite outpatient physicians – a Pediatrician and an Internist – about when and why they refer patients to the ED, as well as what they do to try to keep them out of the ED!

Did you learn something new? Please share this podcast with your colleagues! Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Olivia Campa, Assistant Clinical Professor of Internal Medicine at UC Davis

Dr. Lena van der List , General Pediatrician at UC Davis, Host of Kids Considered Podcast

Resources:

Should you go to the emergency room (ER), urgent care or doctor’s office? UC Davis Health resource

I’m Sending You a Patient… by Keri Gardner, MD, MPH, FACEP. EP Monthly, April 30, 2018

When Urgent Care Center Refers Patient to ED, Reasons Might Be Unclear. ED Legal Letter, May 1, 2021.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Oncologic Emergencies: Part 2

In this two-part series, we dive into the world of oncological emergencies with guest expert, Dr. Monica Wattana. In part 1, we covered everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also discussed some of the tricky complications that often accompany cancer treatments, like mucositis, vomiting and diarrhea, anemia, and neuropathic pain.

In part 2, we tackle pain management, palliative care, and some tough ethical dilemmas. The goal is to make sure we’re all equipped to provide the best care possible for our patients with cancer.

Did you learn something new that changed your practice? We’d love to hear about it. Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Monica Wattana, Associate Professor and Education Director for the Department of Emergency Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas

Resources:

Pocket Guide to Oncologic Emergencies, by Dr. Monica Kathleen Wattana

Gould Rothberg BE, Quest TE, Yeung SJ, et al. Oncologic emergencies and urgencies: A comprehensive review. CA Cancer J Clin. 2022 Nov;72(6):570-593. doi: 10.3322/caac.21727. Epub 2022 Jun 2. PMID: 35653456.

Multinational Association of Supportive Care in Cancer (MASCC) Guidelines

SPIKES: A Strategy for Delivering Bad News, by Dr. Claire Ciarkowski

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this two-part series, we dive into the world of oncological emergencies. Our guest expert, Dr. Monica Watana, an emergency physician specializing in this area. In part 1, we cover everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also talk about some of the tricky complications that often accompany cancer treatments, like mucositis, vomiting and diarrhea, anemia, and neuropathic pain. The goal is to make sure we’re all equipped to provide the best care possible for our patients with cancer.

Stay tuned for part two, when we’ll tackle pain management, palliative care, and some tough ethical dilemmas.

Did you learn something new that changed your practice? We’d love to hear about it. Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Monica Wattana, Associate Professor and Education Director for the Department of Emergency Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas

Resources:

Pocket Guide to Oncologic Emergencies, by Dr. Monica Kathleen Wattana

Gould Rothberg BE, Quest TE, Yeung SJ, et al. Oncologic emergencies and urgencies: A comprehensive review. CA Cancer J Clin. 2022 Nov;72(6):570-593. doi: 10.3322/caac.21727. Epub 2022 Jun 2. PMID: 35653456.

Multinational Association of Supportive Care in Cancer (MASCC) Guidelines

SPIKES: A Strategy for Delivering Bad News, by Dr. Claire Ciarkowski

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode of Push Dose Pearls, we delve into the use of push dose pressors in emergency medicine. Dr. Chris Adams talks about their use, potential side effects, and the importance of a clear plan for the administration of push dose pressors.

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Managing pregnant patients in the ED can be stressful – especially because you have (at least) two patients to think about! Emergency physicians are generally comfortable managing first trimester emergencies but are less familiar with complications in the later stages of pregnancy. It is these complications that contribute in part to the maternal health crisis in the US. In this episode, we delve into the realm of obstetric emergencies in the ED with Dr. Jenna White, an EM physician with a special interest in OB. She introduces us to resources developed by the American College of Obstetrics and Gynecology (ACOG) to help ED providers identify common pathologies and navigate high-stakes scenarios, including screening for cardiovascular disorders, managing hypertension, and tackling the dreaded eclampsia.

How does your ED manage OB emergencies? Have you implemented the ACOG algorithms? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Jenna White, Associate Professor of Emergency Medicine at the University of New Mexico and chair of an Obstetrics Working Group jointly convened by ACOG and the CDC

Resources:

Identifying and Managing Obstetric Emergencies in Nonobstetric Settings, ACOG resources for Emergency providers.

Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 36 U.S. States, 2017–2019

Wolf LA, Delao AM, Evanovich Zavotsky K, Baker KM. Triage Decisions Involving Pregnancy-Capable Patients: Educational Deficits and Emergency Nurses’ Perceptions of Risk. J Contin Educ Nurs. 2021 Jan 1;52(1):21-29. doi: 10.3928/00220124-20201215-07. PMID: 33373003.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode we talk with Dr. Julie Leonard about the PECARN C-spine Rule that was just officially published! Dr. Leonard is the senior author of the study and walks us through the findings, why its important, and how she uses the rule in her own clinical practice.

Host:

Dr. Julia Magaña, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Julie Leonard, MD, MPH, Professor of Pediatrics at Nationwide Children’s Hospital and the Ohio State University College of Medicine.

Resources:

prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

EMSC Innovation and Improvement Center PEAK toolkits

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode of our ongoing miniseries “Push Dose Pearls,” we discuss the use of intranasal medications in the emergency department with Chris Adams, an ED clinical pharmacist at UC Davis. We talk about the benefits of intranasal administration, intranasal medications, and advantages for pediatric patients.

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Navigating breastfeeding as an EM physician

In the previous two episodes, we explored some of the challenges related to fertility and pregnancy for EM physicians. In the final episode of our three part series, we take it one step further to discuss yet another challenge: breastfeeding. Of course, fed is always best, and there are many reasons to formula feed, but providing breastmilk is very important to many families. For EM physicians, choosing to breastfeed usually means figuring out how to pump and store milk while you’re on shift. This can be daunting, especially for residents and junior physicians. How do you find time to sneak away? Is there an easily accessible pumping room close by? Will you feel supported by colleagues and your department? We cover these questions and much more with experts, Dr. Claire Abramoff, and Dr. Shada Rouhani.

Does your ED have policies to support breastfeeding and pumping? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Claire Abramoff, Assistant professor at Jefferson, Sidney Kimmel Medical Center College and Assistant Residency Program Director, Department of Emergency Medicine, Einstein Medical Center in Philadelphia, PA

Dr. Shada Rouhani, Assistant Professor of Emergency Medicine at Harvard Medical School and Emergency Physician at Brigham and Women’s Hospital in Boston, MA

Resources:

Practice Management Breastfeeding Disasters and Solutions for EPs, by Claire Abramoff, MD, for Emergency Medicine News, March 14, 2023.

Cleveland Manchanda EC, Vogel LD, Kass D, Rouhani SA. Best Practices for Lactation Support at Conferences and Standardized Testing Centers. Obstet Gynecol. 2020 Feb;135(2):475-478. doi: 10.1097/AOG.0000000000003661. PMID: 31923075.

McDonald L, Illg Z, Dow A, Gunaga S. Maternity Experiences and Perceptions of Emergency Medicine Physicians. Spartan Med Res J. 2021 Apr 13;6(1):22009. doi: 10.51894/001c.22009. PMID: 33870004; PMCID: PMC8043905.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this episode, we delve into a pivotal multi-center study validating the Pediatric Emergency Care Applied Research Network (PECARN) prediction rules for using CT imaging in children with blunt abdominal and minor head trauma. We discuss with the authors the study’s impact, how these validated rules can optimize pediatric trauma care, minimize radiation risks, and what this means for emergency practices worldwide. This conversation not only sheds light on the study’s intricate processes and outcomes, but also emphasizes the vital role of evidence-based guidelines in enhancing patient safety and care quality.

Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee

Dr. James Holmes, Professor of Emergency Medicine at UC Davis

Resources:

Holmes JF, Yen K, Ugalde IT, Ishimine P, Chaudhari PP, Atigapramoj N, Badawy M, McCarten-Gibbs KA, Nielsen D, Sage AC, Tatro G, Upperman JS, Adelson PD, Tancredi DJ, Kuppermann N. PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study. Lancet Child Adolesc Health. 2024 May;8(5):339-347. doi: 10.1016/S2352-4642(24)00029-4. PMID: 38609287.

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(24)00029-4/abstract

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Pregnancy is common during medical training and in the early years as an attending physician, as these stages often align with individuals’ reproductive potential. The experience can vary widely depending on factors such as workplace dynamics, scheduling, and the physical demands of the job. But let’s be real – running around a busy ED while carrying extra weight, feeling nauseated (maybe vomiting), and managing all of the physical and emotional changes that come with pregnancy is a real challenge that many of us have lived. There are numerous considerations to navigate, from how we wish to be perceived as a team member to the risks posed by the workload on our bodies. Additionally, departmental or hospital policies may have financial implications that further complicate the situation. Join us as and Dr. Katren Tyler – EM physician and mother of two – as we break it all down.

This the second episode in our three part series on infertility, pregnancy and breastfeeding as an Emergency Physician. If you missed it, go back and check out part 1! And stay tuned for our final episode of the series where we’ll delve into some of the challenges surrounding breastfeeding and pumping in the ED.

Does your ED have policies to help support people through pregnancy? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Katren Tyler, Professor of Emergency Medicine and Vice Chair of Geriatric Emergency Medicine and Wellness at UC Davis

Resources:

Tips for Pregnancy EM Physicians, by Sandra Williams, DO (ACEP)

MacVane CZ, Fix ML, Strout TD, et al. Congratulations, You’re Pregnant! Now About Your Shifts . . . : The State of Maternity Leave Attitudes and Culture in EM. West J Emerg Med. 2017 Aug;18(5):800-810. doi: 10.5811/westjem.2017.6.33843. Epub 2017 Jul 17. PMID: 28874931; PMCID: PMC5576615.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This the first episode in our three part series on infertility, pregnancy and breastfeeding as an Emergency Physician. In this installment, we shine a light on the often unspoken struggles of infertility among physicians, specifically focusing on the emergency medicine community. Join us and expert, Dr. Melissa Parsons, as we delve into the personal experiences, professional challenges, and nuanced perspectives of emergency physicians navigating the complex journey of infertility.

In part two, we’ll explore what it’s like to be a pregnant as an EM physician, and in our final episode of the series, we’ll talk about some of the challenges surrounding breastfeeding and pumping in the ED.

Do you have questions about fertility as an EM Physician? Or want to share your own experience? Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Melissa Parsons, Associate Professor of Emergency Medicine and Associate Residency Program Director at University of Florida College of Medicine in Jacksonville, FL

Resources:

Physicians should talk about the F word: fertility. Melissa E. Parsons, MD Physician March 3, 2019. KevinMD.com

Levy MS, Kelly AG, Mueller C, et al. Psychosocial Burdens Associated With Family Building Among Physicians and Medical Students. JAMA Intern Med. 2023 Sep 1;183(9):1018-1021. doi: 10.1001/jamainternmed.2023.2570. PMID: 37486671; PMCID: PMC10366942.

Parsons M, Mannix A, Gore K, et al. The current landscape of emergency medicine resident scheduling. AEM Educ Train. 2024 Jan 16;8(1):e10926. doi: 10.1002/aet2.10926. PMID: 38235394; PMCID: PMC10790185..

Pfennig CL, Wilson CA, Britt TW, et al. A comparative analysis on fertility success among physician specialties. Acad Emerg Med. 2022 Jun;29(6):792-794. doi: 10.1111/acem.14463. Epub 2022 Feb 27. PMID: 35178827; PMCID: PMC9305146.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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If you practice in emergency medicine you probably live on the look out for sepsis. You likely follow the 2016 Sepsis-3 guidelines for adults which really was a paradigm shift from an infection-associated SIRS, to infection-associated organ dysfunction with the SOFA score or sequential organ failure assessment score of at least 2 points in patients with suspected infection. However, the definition of sepsis in kids was not updated at that time in part because SOFA was not studied in children. That means that our current pediatric guidelines are from 2005! Good news though! The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force and we interviewed two of the task force members to help us operationalize it on our podcast.

Connect with us on social media @empulsepodcast or at ucdavisem.com

Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Halden Scott, Associate Professor of pediatrics a the university of Colorado and pediatric emergency physician at the children’s hospital Colorado

Dr. Fran Balamuth, Associate professor of pediatrics at Perlman school of medicine at the university of Pennsylvania, attending physician in the ED at CHOP, co-director of the pediatric sepsis program at CHOP

Resources:

The Phoenix sepsis criteria for sepsis and septic shock in children. Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):665-674. doi: 10.1001/jama.2024.0179. PMID: 38245889; PMCID: PMC10900966.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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People living with sickle cell disease can experience severe “pain crises”, or vaso-occlusive episodes (VOE), and are at increased risk for infections, strokes, heart failure, and other serious disease processes. When patients are out sickle cell present to the ED, it is crucial to initiate their evaluation and treatment as soon as possible. So what does this mean practically for us as clinicians? Hematologist and Sickle Cell expert, Dr. Bimpe Adesina, and Emergency Physician and researcher, Dr. Bryn Mumma, join us to explore this topic in depth.

In part 1, we delved into assessment and management of patients presenting with VOE. In part 2, we spoke with Dr. Chris Rees about the benefits of early opioid pain control for kids presenting with VOE.

In the final episode of our series we’re back with Dr. Mumma and Dr. Adesina to discuss the management of other emergent presentations related to sickle cell disease.

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Oyebimpe Adesina, Assistant Professor of Hematology and Oncology and Co-Director of the Adult Sickle Cell Clinical Program at UC Davis

Dr. Bryn Mumma, Professor of Emergency Medicine and Leader of the Research Subcommittee of CARPE DIEM at UC Davis

Resources:

ACEP Emergency Department Sickle Cell Care Coalition Resources

CHOP Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Sickle Cell Disease with Fever

DeBaun MR, Jordan LC, King AA, et al. American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. Blood Adv. 2020 Apr 28;4(8):1554-1588. doi: 10.1182/bloodadvances.2019001142. PMID: 32298430; PMCID: PMC7189278..

Chou ST, Alsawas M, Fasano RM, et al. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Blood Adv. 2020 Jan 28;4(2):327-355. doi: 10.1182/bloodadvances.2019001143. PMID: 31985807; PMCID: PMC6988392.

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People living with sickle cell disease can experience severe “pain crises”, or vaso-occlusive episodes (VOE), and are at increased risk for infections, strokes, heart failure, and other serious disease processes. In this 3 part series, we’re talking with experts to learn more about sickle cell disease and its complications and how we can best advocate for and treat these patients in the ED. In part 1, we delved into assessment and management of patients presenting with VOE.

In this episode, we focus specifically on kids presenting with VOE. We know these patients have usually exhausted their home pain control options and are still in excruciating pain when they arrive in the ED. We interviewed Dr. Chris Rees about his recent paper on the benefits of treating kids with VOE with an initial dose of intranasal fentanyl. The results are pretty impressive!

Stay tuned for Part 3 of our series where we’ll explore the management of other emergent presentations related to sickle cell disease!

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Chris Rees, Assistant Professor of Pediatrics and Emergency Medicine at Emory University

Resources:

Rees CA, Brousseau DC, Ahmad FA, et al; SCD Arginine Study Group and PECARN. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol. 2023 Apr;98(4):620-627. doi: 10.1002/ajh.26837. Epub 2023 Feb 6. PMID: 36606705; PMCID: PMC10023395..

Pediatric Emergency Care Applied Research Network (PECARN)

ACEP Emergency Department Sickle Cell Care Coalition Resources

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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People living with sickle cell disease can experience severe “pain crises”, or vaso-occlusive episodes (VOE), and are at increased risk for infections, strokes, heart failure, and other serious disease processes. When patients are out sickle cell present to the ED, it is crucial to initiate their evaluation and treatment as soon as possible. So what does this mean practically for us as clinicians? Hematologist and Sickle Cell expert, Dr. Bimpe Adesina, and Emergency Physician and researcher, Dr. Bryn Mumma, join us to explore this topic in depth.

In part 1, we delve into assessment and management of patients presenting with VOE. Stay tuned for parts 2 and 3, where we’ll explore the use of intranasal fentanyl and the management of other emergent presentations related to sickle cell disease!

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Oyebimpe Adesina, Assistant Professor of Hematology and Oncology and Co-Director of the Adult Sickle Cell Clinical Program at UC Davis

Dr. Bryn Mumma, Professor of Emergency Medicine and Leader of the Research Subcommittee of CARPE DIEM at UC Davis

Resources:

ACEP Emergency Department Sickle Cell Care Coalition Resources

CHOP Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Sickle Cell Disease with Fever

DeBaun MR, Jordan LC, King AA, et al. American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. Blood Adv. 2020 Apr 28;4(8):1554-1588. doi: 10.1182/bloodadvances.2019001142. PMID: 32298430; PMCID: PMC7189278..

Chou ST, Alsawas M, Fasano RM, et al. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Blood Adv. 2020 Jan 28;4(2):327-355. doi: 10.1182/bloodadvances.2019001143. PMID: 31985807; PMCID: PMC6988392.

NIH Expert Panel Report, 2014: Evidence Based Management of Sickle Cell Disease

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This is the next episode of our Push Dose Pearls miniseries with ED Clinical Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode focuses on RSI (rapid sequence intubation) meds – stuff every ED doc needs to know! What has changed and what are the latest recommendations? We’ll answer these questions and more!

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis

Resources:

Acquisto NM, Mosier JM, Bittner EA, Patanwala AE, Hirsch KG, Hargwood P, Oropello JM, Bodkin RP, Groth CM, Kaucher KA, Slampak-Cindric AA, Manno EM, Mayer SA, Peterson LN, Fulmer J, Galton C, Bleck TP, Chase K, Heffner AC, Gunnerson KJ, Boling B, Murray MJ. Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. Crit Care Med. 2023 Oct 1;51(10):1411-1430. doi: 10.1097/CCM.0000000000006000. Epub 2023 Sep 14. PMID: 37707379.

Engstrom K, Brown CS, Mattson AE, Lyons N, Rech MA. Pharmacotherapy optimization for rapid sequence intubation in the emergency department. Am J Emerg Med. 2023 Aug;70:19-29. doi: 10.1016/j.ajem.2023.05.004. Epub 2023 May 10. PMID: 37196592.

Bennett BL, Scherzer D, Gold D, Buckingham D, McClain A, Hill E, Andoh A, Christman J, Shonk A, Spencer SP. Optimizing Rapid Sequence Intubation for Medical and Trauma Patients in the Pediatric Emergency Department. Pediatr Qual Saf. 2020 Sep 25;5(5):e353. doi: 10.1097/pq9.0000000000000353. PMID: 33062904; PMCID: PMC7523837..

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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If you work in an ED, you’ve probably heard of EMTALA, or the Emergency Medical Treatment and Active Labor Act. But how much do you really know about this law? When does it apply and when does it not? EMTALA expert, Dr. Sophie Terp, helps us understand the history of EMTALA and what we need to know to ensure we provide the best care for our ED patients.

Do you have more questions about EMTALA? Have you ever witnessed a violation? Share your thoughts with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Sophie Terp, Associate Clinical Professor of Emergency Medicine at the Keck Schoo

of Medicine at the University if Southern California, and Quintiles Clinical Fellow at the Schaeffer Center for Health Policy and Economics

Resources:

The EMTALA origin story

U.S. Center for Medicare and Medicaid Services Interpretive Guidelines

Terp S, Seabury SA, Arora S, et al. Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014. Ann Emerg Med. 2017 Feb;69(2):155-162.e1. doi: 10.1016/j.annemergmed.2016.05.021. Epub 2016 Aug 2. PMID: 27496388; PMCID: PMC7176068..

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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We first explored the world of Telehealth back in February of 2021 in parts 1 and 2 of our telemedicine series. Telehealth has exploded since then, even after hospitals and clinics opened fully again when COVID restrictions loosened. Drs. Jenny McCormick and Kelly Owen join us to give an update on our very successful telehealth program at UC Davis, Express Care. How is it working for patients? How do physicians like it? Listen to find out!

Do you have Telehealth programs where you work? Who staffs it? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Jenny McCormick, Professor of Emergency Medicine and Associate Director of Express Care at UC Davis Health

Dr. Kelly Owen, Professor of Emergency, Medical Director Express Care, and Emergency Department Outpatient Operations Director at UC Davis Health

Resources:

UC Davis Health Express Care

Epic: On-Demand Virtual Care Offers Patients Convenience and Value, by

Celia Groff

Thomas D, Garate D, Fu S, Bashir A, Moss N, Nair M. Telehealth reform post-public health emergency: crucial next steps. Proc (Bayl Univ Med Cent). 2022 Dec 6;36(2):269-271. doi: 10.1080/08998280.2022.2153323. PMID: 36876246; PMCID: PMC9980665..

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This is the next episode of our Push Dose Pearls miniseries with ED Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode again focuses on common antibiotics we use in the ED. What has changed and what are the latest recommendations? We’ll answer these questions and more! Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.comHosts:Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisDr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC DavisGuests:Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC DavisResources:CDC STI Treatment GuidelinesMetlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437.ACEP EMRA Antibiotic Guide.***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In 2022, the U.S. Supreme Court ruled that the Constitution does not confer a right to abortion. This decision, known as the Dobbs decision, Overturned Roe v. Wade and ended the right to abortion that had been upheld for decades. In the wake of this decision, many states have passed laws banning or severely restricting abortion. So how does this affect our patients and the care we provide in the ED? How is it different in protected estates compared to restricted states?Join us for a deep dive into the health implications of recent changes in reproductive health policy with expert, Dr. Amy Paris. Please note that the opinions expressed in this episode are our own and do not necessarily represent the position of our employers or institutions. How have things changed in your state and your ED? Share your stories with us on social media, @empulsepodcast, or through our website, ucdavisem.com.Please rate us and leave us a review on iTunes! It helps us reach more people.~ Our episodes are now closed captioned! ~Hosts:Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Amy Paris, OB/Gyn and Complex Family Planning Subspecialist in New HampshireResources:Care Post Roe - UCSFThe Ryan ProgramReproductive Health Access Project State Facts About Abortion - The Guttmacher Institute***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Trigger warning: this episode includes discussion of child abuseIn our last episode, Identifying abuse: the LCAST app, we talked about recognizing subtle signs concerning for child abuse and how to use the new LCAST app to determine the risk of non-accidental trauma. But identifying potential abuse is just the first step in a long and often emotionally taxing process. How do you approach parents or caregivers with your concerns? What do you do if a caregiver doesn’t want to cooperate with your extended work-up? What information should you share with them? And how do we avoid bringing our own biases into the room? These are tough conversations. Our guest experts, Dr. Emily Fain and Dr. Elena Duma, and our own Dr. Julia Magaña are experts in this field. They walk us through how to approach these conversations in a compassionate and straightforward manner, centering the safety of the child as everyone’s primary concern. How do you approach these challenging conversations? Share what’s worked for you (or what hasn’t) with us via social media, @empulsepodcast, or through our website, ucdavisem.com.Please rate us and leave us a review on iTunes! It helps us reach more people.~ Our episodes are now closed captioned! ~Hosts:Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Emily Fain, Assistant Professor of Pediatric Emergency Medicine at Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, TNDr. Elena Duma, Associate Professor of Pediatric Emergency Medicine at Cincinnati Children’s Hospital in Cincinnati, OHResources:Riney L, Frey T, Fain E, Duma E, Chambers P. Improving Communication With Families for Evaluation of Child Abuse. J Patient Exp. 2020 Dec;7(6):827-829. doi: 10.1177/2374373520950987. Epub 2020 Aug 20. PMID: 33457503; PMCID: PMC7786754. .EIIC Pediatric Education and Advocacy Kit (PEAK): Child Abuse***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In March of this year, we published a Rebeat of one of our most powerful episodes, It Could Have Been Different. We took a deep dive into one of the most difficult aspects of our jobs as emergency physicians - recognizing and managing child abuse, or non-accidental trauma (NAT). Signs of abuse can often be subtle, but there are some very specific findings that should make us consider NAT. Our guest expert, Dr. Mary Clyde Pierce, helped us learn to identify NAT using the TEN-4 FACESp clinical prediction rule. In this episode, Dr. Pierce returns to discuss the new LCAST app developed by Lurie Children’s Hospital to help clinicians identify NAT. We love this app! It’s quick and easy to use - and it’s even better than using the decision rule alone. Listen to the episode to hear why!Have you tried the LCAST app? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.Please rate us and leave us a review on iTunes! It helps us reach more people.Hosts:Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC DavisDr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisGuest:Dr. Mary Clyde Pierce, Professor of Pediatric Emergency Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine.Resources:LCAST App - Lurie Children’s Child Injury Plausibility Assessment Support ToolEIIC PEAK Toolkit for Child AbuseEM Pulse Podcast: It Costs You NothingPierce MC, Kaczor K, Lorenz DJ, Bertocci G, Fingarson AK, Makoroff K, Berger RP, Bennett B, Magana J, Staley S, Ramaiah V, Fortin K, Currie M, Herman BE, Herr S, Hymel KP, Jenny C, Sheehan K, Zuckerbraun N, Hickey S, Meyers G, Leventhal JM. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e215832. doi: 10.1001/jamanetworkopen.2021.5832.***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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It’s been a while since we talked about social media in emergency medicine and a LOT has changed! We first explored this topic in 2019 with Dr. Meghan Ranney in our episode With Great Power Comes Great Responsibility. The following year, the pandemic hit and digital platforms exploded while many people isolated themselves or worked from home. Add in complications including the spread of disinformation, the rise of hate speech, Elon Musk’s takeover of Twitter, and the emergence of new platforms, and the landscape today looks very different. To help us understand how to navigate the current world of social media, including the benefits and potential pitfalls, we spoke with digital media expert, Lauren Suedkamp. Do you use social media professionally? What are your favorite platforms? Hit us up on Instagram, Twitter/X, and Threads as @empulsepodcast, or leave us a comment at ucdavisem.comHosts:Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC DavisDr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC DavisGuests:Lauren Suedkamp, Vice President at BCW Global, digital media and public relations strategist with a focus on health care, content creation/platform management, and crisis management. Resources:ACEP: Use of Social Media by Emergency PhysiciansHow to use social media in healthcare: examples + tips (Hootsuite)***Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Insulin EM Pulse PodcastThis is the next episode of our Push Dose Pearls miniseries with ED Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode again focuses on insulin. Should everyone with hyperglycemia get regular insulin? Is IV better than subcu? We’ll answer these questions and more as we discuss the latest recommendations for managing hyperglycemia and DKA in the ED. 

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis

Resources:

Hardern RD, Quinn ND Emergency management of diabetic ketoacidosis in adults Emergency Medicine Journal 2003;20:210-213

Schwartz X, Porter B, Gilbert MP, Sullivan A, Long B, Lentz S. Emergency Department Management of Uncomplicated Hyperglycemia in Patients without History of Diabetes. J Emerg Med. 2023 Aug;65(2):e81-e92. doi: 10.1016/j.jemermed.2023.04.018. Epub 2023 Apr 26. PMID: 37474343.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In the last episode, we replayed one of our most powerful episodes, Sold for a Chrysler 300. The episode featured Annika Huff sharing her story as a survivor of human trafficking, as well as recommendations on how to address trafficking from experts in the field. If you haven’t listened to that episode, we recommend checking it out!

In this follow up episode, our own Dr. Julia Magaña fills us in on what’s changed since 2018, including a new screening tool developed by Dr. Makini Chisholm-Straker and her team.

Have you used the RAFT in your clinical practice? Share your experience with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Resources:

Validation of a screening tool for labor and sex trafficking among emergency department patients.

Chisolm-Straker M, Singer E, Strong D, Loo GT, Rothman EF, Clesca C, d’Etienne J, Alanis N, Richardson LD. J Am Coll Emerg Physicians Open. 2021 Oct 12;2(5):e12558. doi: 10.1002/emp2.12558.

National Human Trafficking Resource Center 1-888-373-7888

https://humantraffickinghotline.org/

WEAVE is the primary provider of crisis intervention services for survivors of domestic violence and sexual assault in Sacramento County

https://www.weaveinc.org/

HEAL Trafficking

healtrafficking.org

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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It’s time for another Repeat! This is one of our earliest episodes and it is a favorite because of one woman’s powerful story. Annika Huff (formerly Annika Mack) is a survivor of human trafficking. She speaks with us about her experiences in the life, how she got out, and how she was able to move on with her life. Then, Dr. Bryn Mumma takes us through her research on how we can better identify potential victims in the ED. Dr. Rachel Robitz shares some advice on how to approach patients who may be trafficked, create a safe space, and offer support and resources. And, finally, our own Dr. Julia Magaña discusses how she manages this in pediatric patients. 

Stay tuned for our next episode for important new research and updates!

Did you listen to this episode when it first aired? How was your practice changed since then, in terms of screening for human trafficking? Share your thoughts with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Annika Huff, Advocate, Speaker and Survivor 

Dr. Bryn Mumma, Professor of Emergency Medicine at UC Davis

Dr. Rachel Robitz, Assistant Clinical Professor of Psychiatry, Program Director of Family Medicine/Psychiatry Residency at UC Davis

Dr. Nick Sawyer, Emergency Physician, former Assistant Professor at UC Davis

Resources:

Screening for Victims of Sex Trafficking in the Emergency Department: A Pilot Program. 

Mumma BE, Scofield ME, Mendoza LP, Toofan Y, Youngyunpipatkul J, Hernandez B. West J Emerg Med. 2017 Jun;18(4):616-620. doi: 10.5811/westjem.2017.2.31924. Epub 2017 Apr 17. PMID: 28611881 

National Human Trafficking Resource Center 1-888-373-7888

https://humantraffickinghotline.org/

WEAVE is the primary provider of crisis intervention services for survivors of domestic violence and sexual assault in Sacramento County

https://www.weaveinc.org/

HEAL Trafficking

healtrafficking.org

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This is the second episode in our Push Dose Pearls miniseries with ED Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode again focuses on antidotes – medications we can give to treat or reverse the harm caused by overdoses, intoxications, envenomations, etc.

What is your favorite antidote? Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis

Resources:

Life in the Fast Lane Antidotes Summary

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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This is the first episode in our Push Dose Pearls miniseries with ED Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. Our first episode will focus on antidotes – medications we can give to treat or reverse the harm caused by overdoses, intoxications, envenomations, etc.

What is your favorite antidote? Hit us up on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Christophe Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis

Resources:

Life in the Fast Lane Antidotes Summary

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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One of our quintessential roles as emergency physicians is managing and securing the emergent airway. This can be a life or death moment for the patient and often gets our own adrenaline pumping – it’s not a procedure we take lightly. Airway management in the ED can be complicated by physical and situational factors (beards, trauma, vomit), resource limitations, and our own emotional state. We sat down with emergency airway expert, Dr. Verena Schandera, to get the latest and greatest on airway management.

Have you had to manage a particularly difficult airway? Do you have any tips or tricks that have worked for you? Share your experiences with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Verena Schandera, Associate Professor of Emergency Medicine and Co-Director of the Emergency Airway Fellowship at UC Davis

Resources:

The Difficult Airway Course

Airway Cam

UC Davis Emergency Airway Management Fellowship

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Our last episode was a Rebeat of “The Game has Changed”, one of our earliest and most listened to episodes that explored medication assisted treatment (MAT) for opioid use disorder. A LOT has changed since we first published the episode in 2018! In this follow up episode, addiction medicine specialist, Dr. Aimee Moulin, talks to us about what’s new, including modifying treatment for people using fentanyl; and what’s old news – the X waiver!

How do you manage opioid use disorder in your practice? Share your experiences with us on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Professor of Emergency Medicine and Chief of the Division of Addiction Medicine at UC Davis

Resources:

CA Bridge

National Institute on Drug Abuse (NIDA) information on opioids

Buprenorphine vs. Methadone on atforum.com

Screening Brief Intervention & Referral to Treatment (SBIRT)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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It’s time for another Rebeat! We’re revisiting one of our favorite episodes from our very first season. The opioid epidemic is still very real and there are some new challenges with fentanyl as the predominant opioid on the street. But we’ve gained experience with medication assisted treatment (MAT) and it is now even easier to prescribe treatment for opioid use disorder. The Rebeat has been edited to reflect some of these changes, and our next episode will provide an update on MAT. Now on to the Rebeat…

Let’s talk about the opioid crisis. One woman tells her powerful story of opioid addiction, treatment, and recovery. Then, we discuss the role emergency physicians can play in controlling this epidemic with experts, Dr. Gail D’Onofrio and Dr. Josh Elder.

How do you manage opioid use disorder in your practice? Join the conversation on Social Media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Gail D’Onofrio, Professor of Emergency Medicine, Professor of Chronic Disease Epidemiology, and Professor of Internal Medicine, Core Faculty in Addiction, at Yale School of Medicine

Dr. Josh Elder, Former Assistant Professor of Emergency Medicine at UC Davis Health

Resources:

Screening Brief Intervention & Referral to Treatment (SBIRT)

CA Bridge

National Institute on Drug Abuse (NIDA) information on opioids

Buprenorphine vs. Methadone on atforum.com

Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial.

D’Onofrio G, O’Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. JAMA. 2015 Apr 28;313(16):1636-44. doi: 10.1001/jama.2015.3474. PMID: 25919527

Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention.

D’Onofrio G, Chawarski MC, O’Connor PG, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. J Gen Intern Med. 2017 Jun;32(6):660-666. doi: 10.1007/s11606-017-3993-2. Epub 2017 Feb 13. PMID: 28194688

Cost-effectiveness of emergency department-initiated treatment for opioid dependence.

Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O’Connor PG, D’Onofrio G. Addiction. 2017 Nov;112(11):2002-2010. doi: 10.1111/add.13900. Epub 2017 Aug 16. PMID: 28815789

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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There has been a lot in the news about “tranq dope”, especially following a recent New York Times article. Most concerning are the non-healing skin wounds that seem to be associated with its use. So what is tranq dope, or more formally, xylazine? And what do we need to know to safely treat our patients? We caught up with Dr. Hoan Nguyen, emergency physician and medical toxicologist at UC Davis, to get some answers.

Have you seen complications of xylazine in your ED? Share with us on social media, @empulsepodcast, via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Head over to iTunes and leave us a review – it helps us reach more people. And please pass the word along to your friends and colleagues!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Hoan Nguyen, Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources:

Tranq Dope: Animal Sedative Mixed with Fentanyl Brings Fresh Horror to U.S. Drug Zone,

by Jan Hoffman, New York Times, Jan 7 2023

The Fight Over a Drug that is Great for Horses but Horrific for Humans,

by Jan Hoffman, New York Times, April 20 2023

Gupta R, Holtgrave DR, Ashburn MA. Xylazine – Medical and Public Health Imperatives. N Engl J Med. 2023 Apr 26. doi: 10.1056/NEJMp2303120. Epub ahead of print. PMID: 37099338.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In our last episode, we spoke with negotiations expert and founder of the Center for Leadership, Dr. Cheri Hobgood, about the art of a good negotiation. This week, we’ve partnered with Women in PEM again to explore how negotiations can play out in the real world of emergency medicine. Dr. Selena Hariharan returns to share her personal experience and Dr. Elizabeth Alpern offers some concrete advice on how to prepare for an interview, read a contract, and make the outcome of the negotiation beneficial to all parties. It’s all about time, money, and power!

Was this series helpful to you? Have you been able to put some of these strategies into practice? We’d love to know! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Please encourage your friends and colleagues to listen and share their stories, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Elizabeth Alpern, Professor of Pediatric Emergency Medicine and Division Head of Emergency Medicine at Lurie Children’s Hospital of Chicago

Dr. Selena Hariharan, Women in PEM Co-Chair and Professor of Pediatrics Division of Pediatric Emergency Medicine at Cincinnati Children’s Hospital

Resources:

Women in PEM

SoMe: @womeninpem

Email: womeninpem@gmail.com

Center for Leadership Life

Barrick L, Bechtel K, Cooper G, Hall JE, Levine DA, Reichard KG, Reed J, White ML, Langhan ML. Building the Foundation: A Call to Action for Baseline Data. Pediatr Emerg Care. 2023 Apr 1;39(4):294-295. doi: 10.1097/PEC.0000000000002902. Epub 2023 Jan 8. PMID: 36625447.

Chumpitazi CE, Allister L, Cho C, Hoffmann JA, Hsu D, Iyer M, Mangold K, Marino M, Randell KA, Ponce H, Hariharan S. Career Development in Pediatric Emergency Medicine: What Do We Need? Pediatr Emerg Care. 2022 Sep 1;38(9):e1552-e1556. doi: 10.1097/PEC.0000000000002720. Epub 2022 Apr 28. PMID: 35470318; PMCID: PMC9912171.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Negotiating what you need and want in your career is an essential skill, for any emergency medicine physician – well, for anyone, really! So, whether you are in academic or community practice, or something completely unrelated, this episode is for you. We’ve teamed up with Women in PEM to bring you this illuminating interview with Dr. Cherri Hobgood, an emergency physician, expert in negotiations, and founder of the Center for Leadership Life. She takes us through the ins and outs of negotiating, including preparation, tactics, and even reading body language, to help us learn the art of a successful negotiation.

Do you find negotiations challenging? What strategies have been most successful for you? Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Please encourage your friends and colleagues to listen and share their stories, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Cherri Hobgood, Founder of the Center for Leadership Life, Certified Executive Coach, and Professor of Emergency Medicine at Penn State Health

Dr. Selena Hariharan, Women in PEM Co-Chair and Professor of Pediatrics Division of Pediatric Emergency Medicine at Cincinnati Children’s Hospital

Resources:

Women in PEM

SoMe: @womeninpem

Email: womeninpem@gmail.com

Center for Leadership Life

Barrick L, Bechtel K, Cooper G, Hall JE, Levine DA, Reichard KG, Reed J, White ML, Langhan ML. Building the Foundation: A Call to Action for Baseline Data. Pediatr Emerg Care. 2023 Apr 1;39(4):294-295. doi: 10.1097/PEC.0000000000002902. Epub 2023 Jan 8. PMID: 36625447.

Chumpitazi CE, Allister L, Cho C, Hoffmann JA, Hsu D, Iyer M, Mangold K, Marino M, Randell KA, Ponce H, Hariharan S. Career Development in Pediatric Emergency Medicine: What Do We Need? Pediatr Emerg Care. 2022 Sep 1;38(9):e1552-e1556. doi: 10.1097/PEC.0000000000002720. Epub 2022 Apr 28. PMID: 35470318; PMCID: PMC9912171.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Introducing EM Pulse Podcast™ Rebeat! In our Rebeat episodes, we will revisit important past episodes. In this Rebeat, we discuss a challenging but important aspect of emergency medicine – identifying and addressing child abuse or non-accidental trauma (NAT). We talk with expert Dr. Mary Clyde Pierce about her paper, which validates the TEN-4 FACESp clinical decision rule for predicting abuse in young children, and share insights on how we can save a child’s life through vigilance and awareness of specific findings.

Have you used TEN-4 FACESp to identify potential non-accidental trauma? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Mary Clyde Pierce, Professor of Pediatrics at Northwestern University, Pediatric Emergency Physician and Director of Child Abuse Research at Laurie Children’s Hospital.

Resources:

Pierce MC, Kaczor K, Lorenz DJ, Bertocci G, Fingarson AK, Makoroff K, Berger RP, Bennett B, Magana J, Staley S, Ramaiah V, Fortin K, Currie M, Herman BE, Herr S, Hymel KP, Jenny C, Sheehan K, Zuckerbraun N, Hickey S, Meyers G, Leventhal JM. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e215832. doi: 10.1001/jamanetworkopen.2021.5832.

Lorenz DJ, Pierce MC, Kaczor K, Berger RP, Bertocci G, Herman BE, Herr S, Hymel KP, Jenny C, Leventhal JM, Sheehan K, Zuckerbraun N. Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach. J Pediatr. 2018 Jul;198:144-150.e4. doi: 10.1016/j.jpeds.2018.01.033. Epub 2018 Mar 15. PMID: 29550228; PMCID: PMC6019119.

CDC Morbidity and Mortality Weekly Report: Trends in US Emergency Department Visits Related to Suspected or Confirmed Abuse and Neglect Among Children and Adolescents Aged <18 Years Before and During the COVID-19 Pandemic – United States, January 2019-September 2020

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Alcohol use disorder is extremely prevalent in the United States, affecting over 5% of the population 12 and older. We see patients suffering from this disease in our EDs – sometimes for complications of acute intoxication (like car accidents) and sometimes for withdrawal symptoms. In this two part series, we’re joined by Addiction Medicine Specialists, Dr. Aimee Moulin and Dr. Liz Johnson, to learn more about acute alcohol withdrawal and management of alcohol use disorder. In part 1, we discussed the presentation and emergent stabilization of patients with severe alcohol withdrawal. In part 2, we’ll focus on those patients who can be safely discharged, including ED management and outpatient medications and resources.

Special thanks for Phoebe for sharing her story of her personal battle with alcohol use disorder!

Do you prescribe naltrexone or acamprosate from the ED? How do you safely discharge patients with alcohol use disorder? Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Please encourage your friends and colleagues to listen and share their stories, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Professor of Emergency Medicine and Chief of the Division of Addiction Medicine at UC Davis

Dr. Liz Johnson, Assistant Professor of Emergency Medicine and Addiction Medicine Physician at UC Davis

Resources:

Substance Abuse and Mental Health Services Administrarion (SAMHSA)

Alcohol Facts and Statistics – National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute of Health (NIH)

Clinical Institute Withdrawal Assessment Alcohol Scale Revised (CIWA-AR)

Prediction of Alcohol Withdrawal Severity Scale (PAWSS)

Phoebe – The Dress Fiend

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Alcohol use disorder is extremely prevalent in the United States, affecting over 5% of the population 12 and older. We see patients suffering from this disease in our EDs – sometimes for complications of acute intoxication (like car accidents) and sometimes for withdrawal symptoms. In this two part series, we’re joined by Addiction Medicine Specialists, Dr. Aimee Moulin and Dr. Liz Johnson, to learn more about acute alcohol withdrawal and management of alcohol use disorder. In part 1, we discuss the presentation and emergent stabilization of patients with severe alcohol withdrawal.

Special thanks for Phoebe for sharing her story of her personal battle with alcohol use disorder!

What is your go to med for acute alcohol withdrawal? Does your hospital have set protocols? We always appreciate hearing how things are done at different institutions. Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Please encourage your friends and colleagues to listen and share their stories, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Professor of Emergency Medicine and Chief of the Division of Addiction Medicine at UC Davis

Dr. Liz Johnson, Assistant Professor of Emergency Medicine and Addiction Medicine Physician at UC Davis

Resources:

Substance Abuse and Mental Health Services Administrarion (SAMHSA)

Alcohol Facts and Statistics – National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute of Health (NIH)

Clinical Institute Withdrawal Assessment Alcohol Scale Revised (CIWA-AR)

Prediction of Alcohol Withdrawal Severity Scale (PAWSS)

Phoebe – The Dress Fiend

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren’t sure what we can do in our daily clinical practice to make a difference. That’s why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention.

We’ve covered how to APPROACH patients about gun safety and ASSESS risk, now we learn how to ACT. In the final episode of our series, Dr. Barnhorst explains what we can do as physicians to help mitigate risk. We’ll talk about options, including temporary transfer of firearms to a safe party, psychiatric holds when appropriate, and “red flag” laws that allow for emergent removal of firearms in extremely high risk situations.

Have you ever had a patient you felt was high risk intentional to accidental injury due to firearms? How did you act to reduce that risk? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED

Guest:

Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project

Resources:

The BulletPoints Project – Interventions

EM Pulse: Wraparound

California Firearm Violence Research Center (CA FVRC)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren’t sure what we can do in our daily clinical practice to make a difference. That’s why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention.

In the third episode of our gun violence prevention series, we delve into the second step of BulletPoints: ASSESS.

Do you talk to your patients about guns? What’s your approach? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED

Guest:

Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project

Resources:

The BulletPoints Project – The Basics

Guns and Suicide: the Hidden Toll a Special Report by Madeline Drexler, Editor, Harvard Public Health

California Firearm Violence Research Center (CA FVRC)

Gifford Law Center

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Happy New Year! We have an exciting lineup for 2023, but first, we’d like to reflect on a few things we learned this past year. Some favorites include our legal series and our series on women in EM – listen to the full episode to hear which juicy knowledge bites we can’t let go of!

What stuck with you this year? Do you enjoy our podcast series, or do you prefer stand alone episodes? We’d love to hear your thoughts. Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Resources:

Episodes referenced:

Do I really need to LP a febrile infant with a UTI?

Legal Part I: A subpoena is not a party invitation

Victims of our own success: ED crowding part 1

It isn’t just our problem: ED crowding part 2

Pay attention

Mind the gap

The leaky pipeline

My role is doctor

Please don’t hurt me!

Articles referenced:

Mahajan P, VanBuren JM, Tzimenatos L, et al. Serious Bacterial Infections in Young Febrile Infants With Positive Urinalysis Results. Pediatrics. 2022 Oct 1;150(4):e2021055633. doi: 10.1542/peds.2021-055633.

Emergency Department Crowding: The Canary in the Health Care System. Commentary in NEJM Catalyst by Gabor D. Kelen, MD, Richard Wolfe, MD, Gail D’Onofrio, MD, MS, Angela M. Mills, MD, Deborah Diercks, MD, et al. Sept 28, 2021.

Book referenced:

Brave, Not Perfect by Reshma Saujani

Video referenced:

PACES Just-in-time: Positions of Comfort

Guideline referenced:

EIIC/TREKK: Bottom Line Recommendations: Pain Treatment

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren’t sure what we can do in our daily clinical practice to make a difference. That’s why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention.

In the second episode of our series, we delve into the first step of BulletPoints: approach. Dr. Barnhorst takes us through how to start some of these challenging conversations. Hint: it starts with checking your own beliefs and biases.

Do you talk to your patients about guns? What’s your approach? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED

Guest:

Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project

Resources:

The BulletPoints Project – The Basics

Guns and Suicide: the Hidden Toll a Special Report by Madeline Drexler, Editor, Harvard Public Health

California Firearm Violence Research Center (CA FVRC)

Gifford Law Center

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

View Details

As emergency physicians, we are no strangers to firearm violence and its consequences. We explored this topic with renowned expert, Dr. Garen Wintemute, in our January 2019 episode, #thisismylane. Most physicians feel strongly that we have a role in gun violence prevention, but many of us aren’t sure what we can do in our daily clinical practice to make a difference. That’s why Psychiatrist Dr. Amy Barnhorst and her colleagues at the California Firearm Violence Research Center at UC Davis developed the BulletPoints Project. BulletPoints is a resource for clinicians and medical educators who are committed to firearm injury prevention.

In the first episode of our series, Dr. Barnhorst provides the background information we need to understand the scope of firearm violence in the US, and to begin to tackle the issue with practical solutions.

Do you talk to your patients about guns? What’s your approach? Tag us on social media, @empulsepodcast, reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too!

*Please rate us and leave us a review on iTunes! It helps us reach more people.*

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. Jonathan Kohler, Associate Professor of Surgery and Medical Director of Pediatric Trauma at UC Davis; Host of Country Hits: Rural Trauma from the Scene to the ED

Guest:

Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry and Vice Chair of Community Mental Health at UC Davis; Director of the BulletPoints Project

Resources:

The BulletPoints Project – Epidemiology

CDC firearm related death statistics

California Firearm Violence Research Center (CA FVRC)

Stop Handgun Violence

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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In this podcast we discuss the prevalence of bacteremia and even more interestingly the prevalence of meningitis in febrile infants <=60 days of age with a positive UA. Dr. Kuppermann from PECARN shares his approach to the febrile neonate with a UTI. 

Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee

Resources:

Mahajan P, VanBuren JM, Tzimenatos L, Cruz AT, Vitale M, Powell EC, Leetch AN, Pickett ML, Brayer A, Nigrovic LE, Dayan PS, Atabaki SM, Ruddy RM, Rogers AJ, Greenberg R, Alpern ER, Tunik MG, Saunders M, Muenzer J, Levine DA, Hoyle JD, Lillis KG, Gattu R, Crain EF, Borgialli D, Bonsu B, Blumberg S, Anders J, Roosevelt G, Browne LR, Cohen DM, Linakis JG, Jaffe DM, Bennett JE, Schnadower D, Park G, Mistry RD, Glissmeyer EW, Cator A, Bogie A, Quayle KS, Ellison A, Balamuth F, Richards R, Ramilo O, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Serious Bacterial Infections in Young Febrile Infants With Positive Urinalysis Results. Pediatrics. 2022 Oct 1;150(4):e2021055633. doi: 10.1542/peds.2021-055633. PMID: 36097858. https://publications.aap.org/pediatrics/article/150/4/e2021055633/189487/Serious-Bacterial-Infections-in-Young-Febrile?autologincheck=redirected?nfToken=00000000-0000-0000-0000-000000000000

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We’ve heard talk that the pandemic is “over”, but are we there?  It’s been a while since we talked about COVID, but it’s still out there, mutating and spreading. In this episode, we catch up with our infectious disease specialist, Dr. Dean Blumberg, to get all the up to date information on the virus, the new bivalent vaccine, and the meds available for treatment and prophylaxis. We discuss what to expect for the upcoming cold and flu season, and we get an update on monkeypox. Bottom line, the next few months aren’t going to be pretty. Go get your flu shot and your bivalent booster! 

We got our vaccines, have you?

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For most physicians, talk of court, lawyers, or subpoenas brings on a rush of anxiety. The medical and legal worlds can overlap in many ways. In this five part series, we’ll cover everything from the basics, to being a percipient or expert witness, to the dreaded malpractice lawsuits. Joining us as Guest Host, is Dr. John Rose, Professor of Emergency Medicine at UC Davis.

In the fifth and final episode of our series, we explore the role of expert witness with our own experts, Dr. Jim Holmes and Dr. David Barnes. We get into what it takes to be a medical expert and what to expect when you meet with the legal team and work through a case. There are benefits to being an expert witness, but it can also be a stressful and time consuming endeavor. Is it right for you?

Have you acted as an expert witness? What advice to you have for others? Please share! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Fellowship Director at UC Davis

Guest:

Dr. David Barnes, Professor of Emergency Medicine at UC Davis

Dr. James Holmes, Professor of Emergency Medicine at UC Davis

Resources:

Expert Witness Guidelines for the Specialty of Emergency Medicine, ACEP Policy Statement

NIH NLM StatPearls: Expert Witness, by Yasmyne Ronquillo, Kenneth J. Robinson, and Patricia P. Nouhan

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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For most physicians, talk of court, lawyers, or subpoenas brings on a rush of anxiety. The medical and legal worlds can overlap in many ways. In this five part series, we’ll cover everything from the basics, to being a percipient or expert witness, to the dreaded malpractice lawsuits. Joining us as Guest Host, is Dr. John Rose, Professor of Emergency Medicine at UC Davis.

In the fourth episode of our series,  we continue our conversation with Tom Doyle highlighting what EM physicians should know about being sued and living through a lawsuit. We delve into the importance of charting, including how the EMR can both help and hurt you.  And we address how to handle it when mistakes are made. 

Have you had to deal with a malpractice lawsuit? What advice to you have for others? Please share! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Fellowship Director at UC Davis

Guest:

Thomas J. Doyle, Partner at Schuering, Zimmerman & Doyle in Sacramento, CA.

Resources:

Law 101 for Experts: Understanding Jury Trials, by Dani Alexis Ryskamp, JD

1 in 3 physicians has been sued; by age 55, 1 in 2 hit with suit, by Kevin B. O’Reilly, News Editor, AMA

Getting Sued: A Resident's Perspective (ACEP)

Malpractice Litigation Stress: Doctors Beware, presentation by Dr. Gillian Schmitz (ACEP)

Things I Want You to Know About Malpractice Litigation, by Dr. Stacia Dearmin, founder of Thrive, for the ACEP section American Association of Women Emergency Physicians 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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For most physicians, talk of court, lawyers, or subpoenas brings on a rush of anxiety. The medical and legal worlds can overlap in many ways. In this five part series, we’ll cover everything from the basics, to being a percipient or expert witness, to the dreaded malpractice lawsuits. Joining us as Guest Host, is Dr. John Rose, Professor of Emergency Medicine at UC Davis.

In the third episode of our series, we get into what we all dread - being sued. We explore the ins and outs of a malpractice lawsuit with Tom Doyle, a Partner at Schuering, Zimmerman & Doyle who has 40 years of experience in the field. 

Have you had to deal with a malpractice lawsuit? What advice to you have for others? Please share! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Fellowship Director at UC Davis

Guest:

Thomas J. Doyle, Partner at Schuering, Zimmerman & Doyle in Sacramento, CA.

Resources:

1 in 3 physicians has been sued; by age 55, 1 in 2 hit with suit, by Kevin B. O’Reilly, News Editor, AMA

Getting Sued: A Resident's Perspective (ACEP)

Malpractice Litigation Stress: Doctors Beware, presentation by Dr. Gillian Schmitz (ACEP)

Things I Want You to Know About Malpractice Litigation, by Dr. Stacia Dearmin, founder of Thrive, for the ACEP section American Association of Women Emergency Physicians 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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For most physicians, talk of court, lawyers, or subpoenas brings on a rush of anxiety. The medical and legal worlds can overlap in many ways. In this five part series, we’ll cover everything from the basics, to being a percipient or expert witness, to the dreaded malpractice lawsuits. Joining us as Guest Host, is Dr. John Rose, Professor of Emergency Medicine at UC Davis.

In the second episode of our series, we talk about being a percipient witness. It’s not uncommon for EM physicians to be subpoenaed to testify as a percipient witness, so let’s delve into what that means and what you should do if you find yourself in this role.

What kinds of experiences have you had with the legal system? Please share! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Fellowship Director at UC Davis

Guest:

Chris Ore, Deputy District Attorney for Sacramento County and Supervisor of the Child Sexual Assault Unit 

Resources:

When is a Treating Physician Considered an Expert Witness?  (Expert Institute)

Medical Testimony: Code of Medical Ethics Opinion 9.7.1 (AMA)

The Treating Physician as a Witness (NPR Law)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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For most physicians, talk of court, lawyers, or subpoenas brings on a rush of anxiety. The medical and legal worlds can overlap in many ways. In this five part series, we’ll cover everything from the basics, to being a percipient or expert witness, to the dreaded malpractice lawsuits. Joining us as Guest Host, is Dr. John Rose, Professor of Emergency Medicine at UC Davis.

This first episode is a sort of legal 101. We discuss the basics of the legal system and what what EM Physicians need to know.

What kinds of experiences have you had with the legal system? Please share! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Fellowship Director at UC Davis

Guest:

Chris Ore, Deputy District Attorney for Sacramento County and Supervisor of the Child Sexual Assault Unit 

Resources:

Law 101 for Experts: Understanding the Legal System  (Expert Institute)

ACEP Medical-Legal Resources

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

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Integrating an ED clinical pharmacist was a complete practice changer for us at UC Davis! It is a positive trend across the US and in this episode, we talk with Chris Adams, Clinical Senior Pharmacist at UC Davis.

Tell us how YOUR department integrates a pharmacist @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their stories, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Chris Adams, Clinical Senior Pharmacist at UC Davis

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Resources:

Farmer BM, Hayes BD, Rao R, Farrell N, Nelson L. The role of clinical pharmacists in the emergency department. J Med Toxicol. 2018;14(1):114-116.

Acquisto NM, Hays DP, Fairbanks RJT, et al. The outcomes of emergency pharmacist participation during acute myocardial infarction. J Emerg Med. 2012;42(4):371-378.

Jacoby JS, Draper HM, Dumkow LE, Farooq MU, DeYoung GR, Brandt KL. Emergency medicine pharmacist impact on door-to-needle time in patients with acute ischemic stroke. Neurohospitalist. 2018;8(2):60-65.

Moussavi K, Nikitenko V. Pharmacist impact on time to antibiotic administration in patients with sepsis in an ED. Am J Emerg Med. 2016;34(11):2117-2121.

Patanwala AE, Sanders AB, Thomas MC, et al. A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department. Ann Emerg Med. 2012;59(5):369-373.

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Back in our March 2020 episode, This is Hope, we spoke with Dr. Larissa May about HIV screening in the ED. Screening programs, along with education and other resources, is making a difference, but there are still tens of thousands of new HIV cases in the U.S. each year, and probably 1-2 million new infections annually worldwide. There are clinical trials in progress studying potential HIV vaccines, which is exciting, but a widely available vaccine is still many years away. Luckily, we DO have a safe and effective way to help prevent new infections and transmission - pre-exposure prophylaxis (PrEP). Dr. Michael Casner joins us to share his expertise in all things PrEP, so we can help our patients stay safe and healthy. 

Do you talk to your patients about PrEP? Does your ED have a way to connect patients with resources to obtain PrEP? Share your experience with us on social media, @empulsepodcast, via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Then please head over to iTunes and leave us a review. And please pass the word along to your friends and colleagues!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Michael Casner, Emergency Physician at Mount Sinai and Holy Cross hospitals in Chicago, IL, and part-time Emergency Medicine Faculty at the University of Missouri, Kansas City, MO. 

Resources:

HIV.gov PrEP information and resources

Ready, Set, PrEP - medication at no cost for those who qualify

Preexposure Prophylaxis for the Prevention of HIV Infection in the United States—2021 Update—A Clinical Practice Guideline 

Rodger AJ, Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019;393(10189):2428-2438. doi:10.1016/S0140-6736(19)30418-0

Support Dr. Casner’s team in the AIDS/LifeCycle!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Dr Mike Casner

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Kids, pain, and the emergency department can be a set up for disaster.  In this podcast, three pediatric specialists get into why that is and how we can all be better at treating kids in pain.

Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Kimberly Wheatley, RN, UC Davis Pediatric Nurse

Katheryn Finan, UC Davis Child Life Specialist

Resources:

The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

Email km@emscimprovement.center

Follow on Twitter @EMSCImprovement

References:

EIIC Pediatric Pain toolkit

Goyal MK, Johnson TJ, Chamberlain JM, Cook L, Webb M, Drendel AL, Alessandrini E, Bajaj L, Lorch S, Grundmeier RW, Alpern ER; PEDIATRIC EMERGENCY CARE APPLIED RESEARCH NETWORK (PECARN). Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures. Pediatrics. 2020 May;145(5):e20193370. doi: 10.1542/peds.2019-3370. Epub 2020 Apr 20. PMID: 32312910; PMCID: PMC7193974.

Johnson TJ, Weaver MD, Borrero S, Davis EM, Myaskovsky L, Zuckerbraun NS, Kraemer KL. Association of race and ethnicity with management of abdominal pain in the emergency department. Pediatrics. 2013 Oct;132(4):e851-8. doi: 10.1542/peds.2012-3127. Epub 2013 Sep 23. PMID: 24062370; PMCID: PMC4074647.

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It can be overwhelming to read the news these days, with all the pain and suffering in the world. We may struggle with how to respond or what WE can do, but there are always ways to help. In this episode, we talk with Dr. Pranav Shetty about his recent trip to Eastern Europe to support medical and humanitarian efforts in Ukraine. Dr. Shetty has been involved in many disaster relief efforts in the past, but this experience brought some new challenges. 

What are some ways you’ve found to help people in need, both locally and abroad? Share your ideas and experiences with us on social media, @empulsepodcast, via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Then please head over to iTunes and leave us a review. And please pass the word along to your friends and colleagues! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Pranav Shetty, Assistant Professor of Emergency Medicine and Director of Disaster Services for the Department of Emergency Medicine at UC Davis.

Resources:

Project HOPE

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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This is the fourth and final episode of our Women in EM series. We’ve heard personal stories of lived experiences and microaggressions, learned about the “leaky pipeline” that leads to a dearth of women in leadership, and took a deep dive into the gender pay gap in medicine. In this episode, we explore the importance of male allyship - how to understand your female colleagues’ experiences, and support, mentor and sponsor women physicians throughout their careers. This episode is for everyone, but if you’re a male physician, it’s especially important!

Do you have more tips for being a male ally? Or suggestions on how to engage men in leadership? Please share! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or connect through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their perspective, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Nick Gorton, Emergency Physician at Sutter Hospital in Davis; Primary Care Physician at Lyon Martin Health Services in San Francisco 

Dr. Alden Landry, Assistant Professor of Emergency Medicine at Beth Israel Deaconess Medical Center; Assistant Dean for Diversity, Inclusion and Community Partnership at Harvard Medical School

Dr. Jeremy Toffle, General Pediatrician in Omaha, NE; Creator and Host of The Imperfect Dad Podcast

Resources:

The Imperfect Dad Podcast 

The Power of Allyship in Facilitating Female Leadership in Healthcare by Dr. Shikha Jain. Workspan Daily, March 23, 2022.

Hill EK, Stuckey A, Fiascone S, Raker C, Clark MA, Brown A, Gordinier M, Robison K. Gender and the Balance of Parenting and Professional Life among Gynecology Subspecialists. J Minim Invasive Gynecol. 2019 Sep-Oct;26(6):1088-1094. doi: 10.1016/j.jmig.2018.10.020. Epub 2018 Oct 30. PMID: 30389582.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Did you know that women physicians make 72 cents on every dollar their male counterparts make?! According to the New York Times, this leads to women earning about $2 million less than men over their careers as doctors. In the third episode of our series on women in emergency medicine, we explore the very real gender pay gap that exists in medicine. Dr. Amy Gottlieb is an expert on this topic, having written a book, published studies, and given multiple talks on the subject. She explains what the data show, helps us unpack some of the reasons behind the pay gap, and offers advice on how to move forward. 

Is there a gender pay gap where you practice? Tell your story and tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their stories, too!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Amy Gottlieb, Professor of Medicine and Obstetrics & Gynecology, and Associate Dean of Faculty Affairs, at the University of Massachusetts Chan Medical School - Baystate

Resources:

Closing the Gender Pay Gap in Medicine: A Roadmap for Healthcare Organizations and the Women Physicians Who Work for Them 1st ed. 2021 Edition by Amy S. Gottlieb, MD, FACP

Gottlieb AS, Jagsi R. Closing the Gender Pay Gap in Medicine. N Engl J Med. 2021 Dec 30;385(27):2501-2504. doi: 10.1056/NEJMp2114955. Epub 2021 Oct 20. PMID: 34670039.

Women Earn $2 Million Less Than Men in Their Careers as Doctors

By Azeri Ghorayshi, New York Times, Dec. 6, 2021

Take an IAT at Project Implicit

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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This is the second episode in our series on women in emergency medicine. In the first episode, My Role in Doctor,  women physicians shared their stories with us and we saw several themes emerge. Gender bias is, unfortunately, alive and well in our specialty. In this episode, we take a deeper dive into the issue with sex and gender expert, Dr. Angela Jarman. 

How do you deal with gender bias as a woman in EM? Tell your story and tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their stories, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Angela Jarman, Assistant Professor of Emergency Medicine and Sex and Gender Researcher at UC Davis

Resources:

ACEP, SAEM, AACEM and AAEM Joint Statement: Overcoming Barriers to Promotion of Women and Underrepresented in Medicine (URiM) Faculty in Academic Emergency Medicine

SGEM XTRA: From EBM to FBM - Gender Equity in the House of Medicine (10/10/21)

Take an IAT at Project Implicit

The Confidence Code by Katty Kay and Claire Shipman

Oh L, Linden JA, Zeidan A, Salhi B, Lema PC, Pierce AE, Greene AL, Werner SL, Heron SL, Lall MD, Finnell JT, Franks N, Battaglioli NJ, Haber J, Sampson C, Fisher J, Pillow MT, Doshi AA, Lo B. Overcoming barriers to promotion for women and underrepresented in medicine faculty in academic emergency medicine. J Am Coll Emerg Physicians Open. 2021 Dec 21;2(6):e12552. doi: 10.1002/emp2.12552. PMID: 34984414; PMCID: PMC8692182.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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This is the first episode in a multi-part series on women in emergency medicine. Being a woman in medicine, and our specialty specifically, is both challenging and rewarding. Over the next several episodes, we’ll explore how the experience of being an EM physician differs somewhat from that of our male colleagues. We’ll discuss why it’s important to identify and address these differences, and how both women and men can drive progress. To kick things off, we share stories recorded and tweeted by several women EM physicians across the country. If you’re a woman, you may identify with many of these stories. If you’re a man, take this opportunity to listen to the voices of your colleagues. 

Want to share your experience as a woman in EM? Tell your story and tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Encourage your friends and colleagues to listen and share their stories, too! Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In our last episode, we discussed several factors that lead to emergency department crowding, as well as the consequences for patients and providers, as presented in a recent commentary in NEJM Catalyst. We continue the conversation with one of the authors of the article, Dr. Deb Diercks, focusing on potential solutions. 

Is your ED overcrowded? How is your hospital handling it? Connect with us on social media, @empulsepodcast, on email empulsepodcast@gmail.com, or through our website, ucdavisem.com.

We’re working on an episode on what it’s like to be a woman in emergency medicine. We’d be honored if you’d share your story? Contact us as above, or leave your story on a brief voicemail at 951-251-4804  (don’t worry, we’ll edit it to make it sound smooth!). 

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Deborah Diercks, Chair of Emergency Medicine at UT Southwestern, President of the SAEM Academy for Academic Chairs in Emergency Medicine 

Resources:

Emergency Department Crowding: The Canary in the Health Care System. 

Commentary in NEJM Catalyst by Gabor D. Kelen, MD, Richard Wolfe, MD, Gail D’Onofrio, MD, MS, Angela M. Mills, MD, Deborah Diercks, MD, et al. Sept 28, 2021.

ERs are now swamped with seriously I’ll patients - but many don’t even have COVID. 

By Kate Wells. NPR CapRadio News, Oct 26, 2021.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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If you’ve been in the emergency department recently, either as an employee or as a patient, you’ve undoubtedly seen the effects of ED crowing - busy waiting rooms, long wait times, and delays in care, just to name a few. In part one of this two part series, we discuss some of the factors that lead to ED crowding and boarding of admitted patients, as well as some of the consequences. Stay tuned for part 2, when we’ll talk about potential solutions! 

Is your ED overcrowded? How is your hospital handling it? Connect with us on social media, @empulsepodcast, on email empulsepodcast@gmail.com, or through our website, ucdavisem.com.

We’re working on an episode on what it’s like to be a woman in emergency medicine. We’d be honored if you’d share your story? Contact us as above, or leave your story on a brief voicemail at 951-251-4804  (don’t worry, we’ll edit it to make it sound smooth!).  Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Deborah Diercks, Chair of Emergency Medicine at UT Southwestern, President of the SAEM Academy for Academic Chairs in Emergency Medicine 

Resources:

Emergency Department Crowding: The Canary in the Health Care System. 

Commentary in NEJM Catalyst by Gabor D. Kelen, MD, Richard Wolfe, MD, Gail D’Onofrio, MD, MS, Angela M. Mills, MD, Deborah Diercks, MD, et al. Sept 28, 2021.

ERs are now swamped with seriously I’ll patients - but many don’t even have COVID. 

By Kate Wells. NPR CapRadio News, Oct 26, 2021.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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General EM physicians are well trained to care for kids, and most of us care for them regularly in the ED. Usually it’s for common things like viral upper respiratory infections or playground injuries. But every once in a while, a critically ill or injured child comes in. Are you ready? Is your ED ready? Do you have tiny endotracheal tubes and nurses who can place IVs in those tiny veins? What else do we need to do to be “peds ready”? We’re glad you asked. In this episode, we talk with national leaders in the field of pediatric emergency medicine and pediatric emergency readiness. Listen to learn more about what it means to be peds ready and why it’s so important!

Is your ED peds ready? Have questions or want to learn more? Find us on social media, @empulsepodcast, on email empulsepodcast@gmail.com, or through our website, ucdavisem.com.

We’re working on an episode on what it’s like to be a woman in emergency medicine. We’d be honored if you’d share your story? Contact us as above, or leave your story on a brief voicemail at 951-251-4804  (don’t worry, we’ll edit it to make it sound smooth!). 

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Marianne Gausche-Hill, Medical Director for the LA County EMS Agency, Professor of Clinical Emergency Medicine and Pediatrics at UCLA and Harbor-UCLA, Senior Consultant to the EIIC, and member of the steering committee of the National Pediatric Readiness Project

Dr. Kate Remick, Pediatric Emergency and EMS Physician, Professor at the Dell Medical School at the University of Texas, Co-Director if the EIIC, and San Marco Hays County Medical Director

Resources:

PedsReady.org

EMSC Innovation and Improvement Center Pediatric Readiness Project Toolkit

NPRP assessment achieves 71% response rate!

Moore B, Shah MI, Owusu-Ansah S, Gross T, Brown K, Gausche-Hill M, Remick K, Adelgais K, Lyng J, Rappaport L, Snow S, Wright-Johnson C, Leonard JC; AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE AND SECTION ON EMERGENCY MEDICINE EMS SUBCOMMITTEE; AMERICAN COLLEGE OF EMERGENCY PHYSICIANS EMERGENCY MEDICAL SERVICES COMMITTEE; EMERGENCY NURSES ASSOCIATION PEDIATRIC COMMITTEE; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL SERVICES PHYSICIANS STANDARDS AND CLINICAL PRACTICE COMMITTEE; NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS EMERGENCY PEDIATRIC CARE COMMITTEE. Pediatric Readiness in Emergency Medical Services Systems. Pediatrics. 2020 Jan;145(1):e20193307. doi: 10.1542/peds.2019-3307. PMID: 31857380.

Ames SG, Davis BS, Marin JR, L. Fink EL, Olson LM, Gausche-Hill M, Kahn JM. Emergency Department Pediatric Readiness and Mortality in Critically Ill Children. Pediatrics. 2019;144(3):e20190568. Pediatrics. 2020 May;145(5):e20200542. doi: 10.1542/peds.2020-0542. Erratum for: Pediatrics. 2019 Sep;144(3): PMID: 32354750; PMCID: PMC8190968.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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It’s no secret that the U.S. population is aging. We are fully aware of this in the ED, where many of our sickest patients are older adults. But what many general EM providers don’t realize is just how different our elderly patients’ needs may be. In this episode, we talk with Geriatric Emergency Medicine specialist, Dr. Jennifer Kristjansson, about some health concerns that predominantly affect our geriatric patients. She highlights key areas we should we aware of and offers advice for optimizing ED care for older adults.  

Send us your questions and feedback on social media, @empulsepodcast, via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Head over to ITunes and leave us a review - it helps us reach more people. And please pass the word along to your friends and colleagues!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Jennifer Kristjansson, Assistant Professor of Emergency Medicine at UC Davis; fellowship trained in Geriatric Emergency Medicine

Resources:

ACEP Geriatric Emergency Department Guidelines

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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It’s time for another COVID-19 update! This time from PERN, the international Pediatric Emergency Research Network. Dr. Nate Kuppermann joins us to talk about a recently published study on kids with COVID. This multinational, prospective study looked at a large cohort of children who presented to EDs with COVID concerns. We discuss the findings, which kids we can feel good about discharging, and which ones might benefit from admission. Julia and Sarah also share their own personal experiences with COVID.

We hope you’re staying healthy through this omicron surge! Send us your questions about kids and COVID on social media, @empulsepodcast, on email empulsepodcast@gmail.com, or through our website, ucdavisem.com.

We’re working on an episode on what it’s like to be a woman in emergency medicine. Want to share your story? Contact us as above, or leave your story on a voicemail at 951-251-4804.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Pediatric Emergency Physician and Chair of the Department of Emergency Medicine at UC Davis; Founding Member of the Pediatric Emergency Research Network (PERN)

Resources:

Funk AL, Florin TA, Kuppermann N et Al; Pediatric Emergency Research Network-COVID-19 Study Team. Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments: The Global PERN-COVID-19 Study. JAMA Netw Open. 2022 Jan 4;5(1):e2142322. doi: 10.1001/jamanetworkopen.2021.42322. PMID: 35015063.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Happy New Year! Well, 2021 may not have been quite the year we hoped for, and 2022 is off to a bit of a rough start with the omicron variant.  But we’ve been fortunate to have some amazing guests on the podcast and we’ve learned a lot - we hope you have, too! In this episode, we follow up with experts from some of the episodes that really stuck with us. We get updates on COVID vaccinations for kids, vaccine mandates, long haul COVID, and trauma informed care. Wishing you all good health in the new year, and cheers to another year of EM Pulse!

What was your favorite episode of 2021? What topics would you like to hear on the podcast? Hot is up on social media, @empulsepodcast, on email empulsepodcast@gmail.com, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Dean Blumberg, Professor and Chief of Pediatric Infectious Disease at UC Davis, Co-Host of the Kids Considered Podcast

Dr. Hunter Pattison, Emergency Medicine Health Policy Research Fellow at UC Davis and Advocacy Fellow for California ACEP

Dr. Larissa May, Professor of Emergency Medicine with a Masters in Emerging Infectious Diseases, and Director of Emergency Department Antibiotic Stewardship at UC Davis.

Dr. Angela Jarman, Assistant Professor of Emergency Medicine and Sex and Gender Researcher at UC Davis

Dr. Bryn Mumma, Associate Professor of Emergency Medicine and Co-Chair of the Human Trafficking Workgroup at UC Davis

Resources:

The Long Haul, January 17, 2021

Trauma Informed Care 101, May 16 2021

A Mandate for Health, October 17, 2021

COVID-19 Kids Vaccine Considered, November 3, 2021

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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As Emergency Physicians, we are well equipped to deal with patients’ acute medical needs, but we often find ourselves without the knowledge or time to deal with many of our patients’ other needs. For social, financial, mental health, and substance use disorders, we lean heavily on other members of our ED team. In this episode, we explore one of the newer roles in this team, the ED Substance Abuse Navigator (SUN). A former patient shares her story of what’s it’s like to be in the ED seeking help with substance use, and Dr. Aimee Moulin talks about her efforts in collaboration with CA Bridge to expand the role of SUNs throughout California. Finally, we talk with two of our UC Davis SUNs, Sandra Overby and Jolie Reyna, who take us through what it’s like to be an ED SUN and how they have been able to help connect many patients with much needed treatment resources. 

Do you have a SUN in your ED?  Share your experience with us on social media, @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Professor of Emergency Medicine and Psychiatry, and Behavioral Health Director, at UC Davis; previous California ACEP President, Director of California Bridge

Sandra Overby, Substance Use Navigator and Addiction Counselor at UC Davis

Jolie Reyna, Substance Use Navigator and Addiction Counselor at UC Davis

Resources:

CA Bridge

Cal ACEP MAT Podcast produced by EM Pulse. Get free CME credit!

It’s all about Tommie EM Pulse episode, September 2018

Substance Use Navigation at UC Davis Medical Center

Snyder H, Kalmin MM, Moulin A, Campbell A, Goodman-Meza D, Padwa H, Clayton S, Speener M, Shoptaw S, Herring AA. Rapid Adoption of Low-Threshold Buprenorphine Treatment at California Emergency Departments Participating in the CA Bridge Program. Ann Emerg Med. 2021 Dec;78(6):759-772. doi: 10.1016/j.annemergmed.2021.05.024. Epub 2021 Aug 2. PMID: 34353655.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Emergency Medicine training can lead to amazing career opportunities. We’ve interviewed world renowned researchers, global health physicians, doctors who specialize in policy and advocacy, among others - but what about space medicine?! In this special episode, Dr. John Rose guest hosts to interview his friend and colleague, Dr. Jen Law. Dr. Law is a UC Davis EM graduate and Aerospace Medicine Specialist. Listen in to hear about her amazing career path and adventures, including being a finalist for the NASA astronaut program. 

Are you interested in aerospace medicine? Send us your questions on social media, @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. And please pass the word along to your friends and colleagues!

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest Host:

Dr. John Rose, Professor of Emergency Medicine and EMS Fellowship Director at UC Davis

Guest:

Dr. Jennifer Law, Emergency Physician and Aerospace Medicine Specialist

Resources:

Law J, Young M, Alexander D, Mason SS, Wear ML, Méndez CM, Stanley D, Ryder VM, Van Baalen M. Carbon Dioxide Physiological Training at NASA. Aerosp Med Hum Perform. 2017 Oct 1;88(10):897-902. doi: 10.3357/AMHP.4552.2017. PMID: 28923137.

NASA Aerospace Medicine Clerkship

UTMB Aerospace Medicine Residency Program

Space Adventures

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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If you’re an emergency physician, or have goals of becoming one, you have probably heard about ACEP’s workforce study. The findings first came out in April 2021, and were followed by a full paper in Annals of Emergency Medicine in August. The bottom line is that there is a predicted surplus of EM physicians of over 7,800 by 2030. How did we find ourselves here? What does this mean? And what should we do about it? We reached out to Emergency Physician and ACEP President Elect, Dr. Gillian Schmitz, to learn more. 

What was your reaction to the workforce report? What do you think is the path forward for our specialty? Connect with us on social media, @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Gillian Schmitz, ACEP President Elect, Associate Professor of Emergency Medicine at the Uniformed Services University of Health Sciences, Emergency Physician at Brooke Army Medical Center

Resources:

ACEP EM Physician Workforce of the Future

Reiter M, Allen BW. The Emergency Medicine Workforce: Shortage Resolving, Future Surplus Expected. J Emerg Med. 2020 Feb;58(2):198-202. doi: 10.1016/j.jemermed.2020.01.004. Epub 2020 Apr 3. 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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By the end of October 2021, almost 6.4 million children tested positive for COVID-19…6.4 million. In our first ever crossover podcast we discuss with Kids Considered host and Peds ID Dr. Dean Blumberg we discuss the recently approved pediatric COVID-19 vaccine!

We are planning to get our kids vaccinated. Are you? Share your questions and concerns with us  on social media,  @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. Host:

Dr. Julia Magaña, Associate Professor of Emergency Medicine at UC Davis

Guests:

Dr. Dean Blumberg, Professor and Chief of Pediatric Infectious Disease at UC Davis, Co-Host of the Kids Considered Podcast 

Resources:

Kids Considered Podcast: https://health.ucdavis.edu/blog/kids-considered

Healthy Kids “The Science Behind COIVD-19 Vaccines: Parent FAQs”: https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/The-Science-Behind-the-COVID-19-Vaccine-Parent-FAQs.aspx

AAP News “COVID-19 vaccine for children ages 5-11 receives final approval”: https://www.aappublications.org/news/2021/11/02/cdc-pfizer-covid-vaccine-children-110221

Children and COVID-19: State-Level Data Report: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/

UC Davis “Experts answer parents’ questions about COVID-19 vaccine for kids ages 5-11”: https://health.ucdavis.edu/health-news/newsroom/experts-answer-parents-questions-about-covid-19-vaccine-for-kids-ages-5-11/2021/11

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It’s no secret that COVID-19 hit the healthcare world hard, especially those on the frontlines. The best defense we have against this virus are vaccines. As you’ve heard on previous episodes, studies show the vaccines are safe and effective. Across the country, and especially in California, an overwhelming majority of ED physicians, and most ED nurses and support staff, have chosen to get vaccinated. But that still left many healthcare workers unvaccinated and at risk of getting sick or passing the virus to patients. So, the government stepped in to issue mandates. 

In this episode, we explore the recent California state and U.S. federal mandates that require healthcare workers to be vaccinated, or apply for a medical or religious exemption. We hear from nurses with differing opinions on the mandate, get into the details of the mandate with Health Policy and Advocacy Fellow, Dr. Hunter Pattison, and talk with Director of Emergency Services at UC Davis, Rupy Sandhu, about the challenges of implementation and lessons learned from this experience. 

How has your hospital or ED responded to the mandate? Share your questions, comments, and feedback with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Hunter Pattison, Emergency Medicine Health Policy Research Fellow at UC Davis and Advocacy Fellow for California ACEP

Rupy Sandhu, RN, Executive Director of Emergency Services at UC Davis

Resources:

White House Path out of the Pandemic

Vaccine mandates are working in California. Here’s what the numbers show. By Lara Korte. Sacramento Bee, Oct 3, 2021. 

Thousands of N.Y. Health Care Workers Get Vaccinated Ahead of Deadline. By Sharon Otterman and Joseph Goldstein. New York Times, Sept 28, 2021.

California vaccine mandate: most healthcare workers are complying, hospitals say. By Kristen Hwang. abc10, Sept 29, 2021. 

COVID Vaccine Facts for Nurses survey results

Year one COVID-19 Impact Assessment Survey by the American Nurses Foundation

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Let’s talk about gender equality in PEM.  Our guests are two PEM physicians who are creating innovative solutions to workforce inequality.  

Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Health

Guests:  

Dr. Lindsey Barrick, Assistant Professor at Cincinnati Children’s Hospital Medical Center, Vice-Chair of the Women in PEM AAP Subcommittee

Dr. Mariju Baluyot, Pediatric Emergency Medicine Faculty, Riley Hospital for Children Simulation Fellow at Indiana University, Women in PEM Social Media Director, Co-leader for the Diversity, Equity and Inclusion Dissemination Outreach Group

Resources:

Women in PEM on Twitter: https://twitter.com/WomeninPEM

Women in PEM: https://linktr.ee/WomeninPEM

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TeamSTEPPS is a curriculum designed for health care professionals that emphasizes good communication and teamwork. This toolkit is evidence based and available for free from the AHRQ and we use it at UC Davis to improve communication, teamwork and patient safety. In this episode we talk with our TeamSTEPPS champions about the curriculum and how we can be better team members. Share with us on @empulsepodcast if you use team steps and if so what your favorite tool is. 

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:  

Dr. David Barnes, Professor of Emergency Medicine at UC Davis, TeamSTEPPS Physician Champion

Leigh Clary, RN, UC Davis Emergency Department TeamSTEPPS Nurse Champion

Resources:

Contact us @empulsepodcast to connect with Dr. David Barnes or Leigh.

About TeamSTEPPS. Content last reviewed June 2019. Agency for Healthcare Research and Quality, Rockville, MD.

https://www.ahrq.gov/teamstepps/about-teamstepps/index.html

Morey, J. C., Simon, R., Jay, G. D., Wears, R. L., Salisbury, M., Dukes, K. A. (2002). Error reduction and performance improvement in the emergency department through formal teamwork training: Evaluation results of the MedTeams project.Health Services Research 37(6), 1553-81

Mazzocato, P., Forsberg, H., & Schwarz, U. (2011). Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work. Scandinavian Journal Of Trauma, Resuscitation And Emergency Medicine 19:70

Patel, P., & Vinson, D. (2005). Team assignment system: expediting emergency department care. Annals of Emergency Medicine 46(6), 499-506

Patterson, M. D., Geis, G. L., et al. (2013). In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Quality and Safety 22(6), 468-77

Turner, P. (2012). Implementation of TeamSTEPPS in the emergency department. Critical Care Nursing Quarterly 35(3), 208-12

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Here we highlight lessons learned about youth violence prevention and what you can do now, on your next shift to prevent violent injuries in youth. Dr. Joe Wright is an accomplished leader in Pediatric Emergency Medicine Physician and is a compelling voice for violence prevention.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guest:  

Dr. Joesph L. Wright, Senior Vice President and Chief Medical Officer, Capital Region Health/University of Maryland Medical System and Professor (adjunct), Pediatrics and Health Policy & Management, University of Maryland Schools of Medicine and Public Health

Resources:

American Academy Of Pediatrics election: https://www.aappublications.org/news/2021/08/01/electionguide080121

More information on the candidates: https://www.aap.org/elections

Committee on Injury, Violence, and Poison Prevention. Policy statement--Role of the pediatrician in youth violence prevention. Pediatrics. 2009 Jul;124(1):393-402. doi: 10.1542/peds.2009-0943. Epub 2009 Jun 11. PMID: 19520726.

Wright JL. Training healthcare professionals in youth violence prevention: closing the gap. Am J Prev Med. 2005 Dec;29(5 Suppl 2):296-8. doi: 10.1016/j.amepre.2005.08.025. PMID: 16376733.

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The opioid epidemic gets a lot of attention, but methamphetamine use may actually affect more of our patients in the emergency department. Those of us who work in the ED are all too familiar with the agitated delirium that meth can cause, as well as the long term effects, like heart failure. In this episode, we hear one woman’s story of her experience with methamphetamines and how substance use nearly destroyed her life. Then our Toxicology colleagues, Dr. Kelly Owen and Dr. Dan Colby, walk us through how meth works, how to manage acute intoxication and other dangerous consequences, and how we can better care for our patients who use methamphetamines.

We’d love to hear from you! Share your questions, comments, and feedback with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Dr. Dan Colby, Assistant Professor of Emergency Medicine, Medical Toxicologist and Addiction Medicine Specialist at UC Davis

Dr. Kelly Owen, Associate Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources:

DAWN and Methamphetamine

Richards JR, Hamidi S, Grant CD, Wang CG, Tabish N, Turnipseed SD, Derlet RW. Methamphetamine Use and Emergency Department Utilization: 20 Years Later. J Addict. 2017;2017:4050932. doi: 10.1155/2017/4050932. Epub 2017 Aug 17. 

The care of patients using methamphetamine in the emergency department: Perception of nurses, residents, and faculty 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In part 2 on workplace violence Brian describes when he was attacked at work and Dr. Aimee Moulin and Dr. Amy Barnhorst talk about how to cope with the threat of violence on a shift.  What can we do?  What do you do in your department to create a safe place? How do you protect yourself?  Share your experience with us on social media, @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guests:

Brian Stroben, Charge Nurse and Assistant Nurse Manager in the UC Davis Department of Emergency  Medicine

Dr. Amimee Moulin, Professor of Emergency Medicine, Behavioral Health Director

Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry at UC Davis, Vice Chair for Community Mental Health, Director of BulletPoints Project

Resources: ACEP Emergency Department Violence Poll research Results September 2018 https://www.emergencyphysicians.org/globalassets/files/pdfs/2018acep-emergency-department-violence-pollresults-2.pdf

Violence in the Emergency Department: Resources for a Safer Workplace – from the American College of Emergency Physicians (ACEP)

Violence and it’s Impact on the Emergency Nurse – Emergency Nurses Association (ENA) Position Statement

Stene J, Larson E, Levy M, Dohlman M. Workplace violence in the emergency department: giving staff the tools and support to report. Perm J. 2015;19(2):e113-e117. doi:10.7812/TPP/14-187

Understanding Agitation: De-escalation video by Dr. Scott Zeller

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Recently, we’ve explored how violence can affect our patients. Now, let’s how explore how we as emergency medicine providers are affected by violence in our own department. In part I of this two part series, we talk with UC Davis ED Charge Nurse and Assistant Nurse Manager, Brian Stroben, about workplace violence - what it is, how it affects us, and some things we can do to mitigate risk and keep our teams safe. 

Have you had a personal experience with workplace violence in your ED? Share your experience with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Guest:

Brian Stroben, Charge Nurse and Assistant Nurse Manager in the UC Davis Department of Emergency  Medicine

Resources:

Understanding Agitation: De-escalation video by Dr. Scott Zeller

Violence in the Emergency Department: Resources for a Safer Workplace - from the American College of Emergency Physicians (ACEP)

Violence and it's Impact on the Emergency Nurse - Emergency Nurses Association (ENA) Position Statement

Stene J, Larson E, Levy M, Dohlman M. Workplace violence in the emergency department: giving staff the tools and support to report. Perm J. 2015;19(2):e113-e117. doi:10.7812/TPP/14-187

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Do you have a similar program where you work, or are you interested in learning more about how to start one? Share your experiences and questions with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Terry Klassen, Professor, Pediatrics & Child Health, University of Manitoba

Resources:

"Wraparound" EM Pulse Podcast published June 17, 2021. https://ucdavisem.com/2021/06/17/wraparound/

Snider CE, Jiang D, Logsetty S, Chernomas W, Mordoch E, Cochrane C, Mahmood J, Woodward H, Klassen TP. Feasibility and efficacy of a hospital-based violence intervention program on reducing repeat violent injury in youth: a randomized control trial. CJEM. 2020 May;22(3):313-320. doi: 10.1017/cem.2019.406. PMID: 31645229.  https://pubmed.ncbi.nlm.nih.gov/31645229/ 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In the emergency department, we treat violently injured patients on nearly every shift. We can splint the broken bones, stitch up the cuts, and send seriously injured patients to the operating room with our surgical colleagues. We may be able to heal the physical wounds, but what about the emotional ones? And what happens to our patients when they go home to the same potentially unhealthy environments that led to the violent injury in the first place? The UC Davis Wraparound program addresses these issues and more. We talk with program Co-lead, Dr. Ian Brown, and Violence Intervention Specialist, Chevist Johnson, about how Wraparound works and why programs like these are so important. 

Do you have a similar program where you work, or are you interested in learning more about how to start one? Share your experiences and questions with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Ian Brown, Trauma Surgeon and Assistant Professor of Surgery at UC Davis; Co-Lead of the Wraparound Program

Chevist Johnson, Violence Intervention Specialist with the Wraparound Program at UC Davis 

Resources:

UC Davis Wraparound Program

UCSF Wraparound Program

Health Alliance for Violence Intervention (HAVI)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Trigger warning: this episode includes discussion of child abuse This is a follow up episode that dives deeper on why a bruised baby is worrisome, important aspects of a social history, and screening for abuse in the ED. Please listen to our first episode "It Could Have Been Different" for more! 

Have you used TEN-4 FACESp to identify potential non-accidental trauma? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Mary Clyde Pierce, Professor of Pediatrics at Northwestern University, Pediatric Emergency Physician and Director of Child Abuse Research at Laurie Children's Hospital.

Resources:

"It Could Have Been Different" EM Pulse Podcast published April 17, 2021. https://ucdavisem.com/2021/04/17/it-could-have-been-different/

Pierce MC, Magana JN, Kaczor K, Lorenz DJ, Meyers G, Bennett BL, Kanegaye JT. The Prevalence of Bruising Among Infants in Pediatric Emergency Departments. Ann Emerg Med. 2016 Jan;67(1):1-8. doi: 10.1016/j.annemergmed.2015.06.021. Epub 2015 Jul 29. PMID: 26233923; PMCID: PMC4695295.

Fingarson AK, Pierce MC, Lorenz DJ, Kaczor K, Bennett B, Berger R, Currie M, Herr S, Hickey S, Magana J, Makoroff K, Williams M, Young A, Zuckerbraun N. Who's Watching the Children? Caregiver Features Associated with Physical Child Abuse versus Accidental Injury. J Pediatr. 2019 Sep;212:180-187.e1. doi: 10.1016/j.jpeds.2019.05.040. Epub 2019 Jun 26. PMID: 31255388; PMCID: PMC6707841.

Pierce MC, Kaczor K, Thompson R. Bringing back the social history. Pediatr Clin North Am. 2014 Oct;61(5):889-905. doi: 10.1016/j.pcl.2014.06.010. Epub 2014 Aug 12. PMID: 25242704; PMCID: PMC4171692.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Trauma Informed Care 101

Trauma informed care has become quite the buzz word in medicine, and especially in emergency medicine.  But what does it mean? Why should you care? How can you use it on a shift?  We'll address these questions and more with experts, Dr. Angela Jarman, Dr. Bryn Mumma, and our own Dr. Julia Magaña.

What is a way you incorporate trauma informed care into your practice? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine and Co-Chair of the Human Trafficking Workgroup at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Angela Jarman, Assistant Professor of Emergency Medicine and Sex and Gender Researcher at UC Davis

Dr. Bryn Mumma, Associate Professor of Emergency Medicine and Co-Chair of the Human Trafficking Workgroup at UC Davis 

Resources:

Fischer KR, Bakes KM, Corbin TJ, Fein JA, Harris EJ, James TL, Melzer-Lange MD. Trauma-Informed Care for Violently Injured Patients in the Emergency Department. Ann Emerg Med. 2019 Feb;73(2):193-202. doi: 10.1016/j.annemergmed.2018.10.018. Epub 2018 Nov 28.

CA Bridge Trauma-Informed Care for Opioid Use Disorder

Substance Abuse and Mental Health Services Administration. SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Our first EM Pulse podcast called "Pot Tarts" was on marijuana legalization in California and ingestion in kids. In this episode we circle back to THC in kids with Dr. James Chenoweth on a an update of what has happened since legalizations.  

Have you seen an uptick in THC ingestions in children since legalization? Share your ideas and experiences with us on social media, @empulsepodcast, or through our website, ucdavisem.com. Please rate us and leave us a review on iTunes! It helps us reach more people. Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. James Chenoweth , Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources: 

First EM Pulse podcast episode "Pot Tarts" https://ucdavisem.com/2018/01/16/episode-1-pot-tarts/

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Trigger warning: this episode includes discussion of child abuse

As emergency physicians, we are uniquely positioned to identify and address child abuse, or non-accidental trauma (NAT). It's a challenging part of our job, but our vigilance can save a child's life. Signs of abuse can often be subtle, but there are some very specific findings that should make us consider NAT. In this episode, we talk with expert, Dr. Mary Clyde Pierce, about her recently published paper, coauthored by our own Dr. Julia Magaña, validating the TEN-4 FACESp clinical decision rule to predict abuse in young children. 

Have you used TEN-4 FACESp to identify potential non-accidental trauma? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Mary Clyde Pierce, Professor of Pediatrics at Northwestern University, Pediatric Emergency Physician and Director of Child Abuse Research at Laurie Children's Hospital.

Resources:

Pierce MC, Kaczor K, Lorenz DJ, Bertocci G, Fingarson AK, Makoroff K, Berger RP, Bennett B, Magana J, Staley S, Ramaiah V, Fortin K, Currie M, Herman BE, Herr S, Hymel KP, Jenny C, Sheehan K, Zuckerbraun N, Hickey S, Meyers G, Leventhal JM. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e215832. doi: 10.1001/jamanetworkopen.2021.5832.

Lorenz DJ, Pierce MC, Kaczor K, Berger RP, Bertocci G, Herman BE, Herr S, Hymel KP, Jenny C, Leventhal JM, Sheehan K, Zuckerbraun N. Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach. J Pediatr. 2018 Jul;198:144-150.e4. doi: 10.1016/j.jpeds.2018.01.033. Epub 2018 Mar 15. PMID: 29550228; PMCID: PMC6019119.

CDC Morbidity and Mortality Weekly Report: Trends in US Emergency Department Visits Related to Suspected or Confirmed Abuse and Neglect Among Children and Adolescents Aged <18 Years Before and During the COVID-19 Pandemic - United States, January 2019-September 2020

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Happy spring, everyone! This Heartbeat is all about joy and community, so come along with me to Macedonia Baptist Church in Sacramento, California, where community leaders, Pastor Jeffrey Johnson and Derrell Roberts, teamed up with Dr. Kevin Mackey, Medical Director for Sacramento Regional Fire, and UC Davis Emergency Medicine providers to offer COVID vaccinations to the local community. Equitable vaccine distribution is an ongoing concern across the US and, according to a recent CDC report (linked below), our most vulnerable communities are still under vaccinated. In Sacramento County and across the country, local physicians, administrators and community leaders are coming up with new strategies to reach these communities, including partnering with trusted community leaders. When things come together, the results are amazing, and the vaccine clinic at Macedonia Baptist is a shining example of this. 

What innovative strategies have you seen in your community to work toward vaccine equity? Share your ideas and experiences with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

And please pass the word along to your friends and colleagues!

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine

Larry Gomez, NP, Nurse Practitioner in the Department of Emergency Medicine

Dr. Kara Toles, Assistant Professor of Emergency Medicine and Director of Equity and Inclusion for the UC Davis Department of Emergency Medicine

Pastor Jeffrey Johnson, Pastor at Macedonia Baptist Church in Sacramento, CA

Macedonia Baptist Church community members

Resources:

Hughes MM, Wang A, Grossman MK, et al. County-Level COVID-19 Vaccination Coverage and Social Vulnerability - United States, December 14, 2020-March 1, 2021. MMWR Morb Mortal Wkly Rep. 2021 Mar 26;70(12):431-436. doi: 10.15585/mmwr.mm7012e1. PMID: 33764963.

Vaccines are about to become a free-for-all. Here’s how to ensure it’s done equitably.  Opinion by Harald Schmidt, Lawrence O. Gostin and Michelle Williams. The Washington Post. March 30, 2021

Macedonia Baptist Church of Sacramento

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Last month, Dr. Josh Elder spoke with us about how UC Davis Express Care allows patients to see a doctor via virtual urgent care visits. In this episode, we explore a different side of telemedicine: teleconsults. Dr. Jim Marcin is Director of the UC Davis Center for Health and a pioneer in telemedicine. As a Pediatric Critical Care Physician, Dr. Marcin has been facilitating teleconsults for physicians at rural hospitals to help provide the expertise needed for care for critically ill children. He explains the current model he and his colleagues are using, the data to support what works (and what doesn’t), and a glimpse into what he might expect in the future as telehealth becomes more widely available. 

Have you tried telemedicine, either as a patient of provider? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Jim Marcin, Professor of Pediatrics and Pediatric Critical Care, Vice Chair of Pediatric Clinical Research, and Director for the UC Davis Center for Health and Technology.

Resources:

UC Davis Center for Health and Technology

CDC: About Rural Health

Sauers-Ford HS, Hamline MY, Gosdin MM, Kair LR, Weinberg GM, Marcin JP, Rosenthal JL. Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program. Acad Emerg Med. 2019 Sep;26(9):1022-1033. doi: 10.1111/acem.13763. Epub 2019 May 2. PMID: 30974004; PMCID: PMC6732030.

Marcin JP, Shaikh U, Steinhorn RH. Addressing health disparities in rural communities using telehealth. Pediatr Res. 2016 Jan;79(1-2):169-76. doi: 10.1038/pr.2015.192. Epub 2015 Oct 14. PMID: 26466080.

Sauers-Ford HS, Marcin JP, Underwood MA, Kim JH, Nicolau Y, Uy C, Chen ST, Hoffman KR. The Use of Telemedicine to Address Disparities in Access to Specialist Care for Neonates. Telemed J E Health. 2019 Sep;25(9):775-780. doi: 10.1089/tmj.2018.0095. Epub 2018 Nov 3. PMID: 30394853.

Rural Health Information Hub: Critical Access Hospitals

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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“He came in by ambulance short of breath...” This is how Dr. Taylor Nichols’ tweet thread began. It’s a line many of us could have written - typical of an encounter in the COVID era. But the thread goes on to tell a more complicated story about racism, a physicians duty, and the toll this pandemic has had on many frontline healthcare providers. Dr. Nichols shares his story with us, along with the aftermath of his viral tweet, and his reflections three months on.   

Share your thoughts and reactions to Taylor’s story with us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

And please pass the word along to your friends and colleagues!

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Taylor Nichols, Emergency Medicine Physician in Sacramento, CA, and former Health Policy Fellow at UC Davis.

Resources:

Twitter thread by Dr. Taylor Nichols

Jewish doctor opens up about treating patient with Nazi tattoos (CNN)

The pandemic was already testing me. Then a man covered in Nazi tattoos showed up in my ER. Washington Post 

Pandemic patient with swastika tattoo leaves Nor Cal doctor questioning his compassion. (San Francisco Chronicle)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In our recent episode in the future of emergency medicine, several of our guests pointed to technological advances, including telemedicine, as key pieces in the evolution of our specialty. And, thanks in large part to the pandemic, the development and implementation of telemedicine has accelerated over the past year. In this episode, Dr. Josh Elder, Medical Director of Express Care at UC Davis, shares his experience creating a virtual urgent care. We discuss some of the advantages and disadvantages for both patients and providers, and explore how this service has proved to be a safe and efficient way to meet patients where they’re at. 

Have you tried telemedicine, either as a patient of provider? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.

Stay tuned for next month’s episode when we explore another side of telemedicine - specialty consults for physicians!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Josh Elder, Assistant Professor of Emergency Medicine and Medical Director of Express Care at UC Davis Health.

Resources:

Express Care at UC Davis Health

Zimiles, A. Four new statistics that prove telemedicine isn’t just a pandemic fad. Medical Economics. Jul 8 2020

Chou E, Hsieh YL, Wolfshohl J, Green F, Bhakta T. Onsite telemedicine strategy for coronavirus (COVID-19) screening to limit exposure in ED. Emerg Med J. 2020 Jun;37(6):335-337.

Golinelli, D., Boetto, E., Carullo, G., Landini, M. P., & Fantini, M. P. (2020). How the COVID-19 pandemic is favoring the adoption of digital technologies in healthcare: a rapid literature review. medRxiv. May 18, 2020. 

Bokolo Anthony Jnr. Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. J Med Syst. 2020 Jun 15;44(7):132.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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The COVID-19 pandemic has forced us all to become more comfortable with virtual engagement. From faculty and group meetings to conferences to kids’ school to social events - it seems everything is online these days. And while we may finally be getting used to this after many months, most of us still have a lot to learn in terms of how to best present ourselves in the virtual space. We’ll discuss our favorite tips and tricks, as well as some audiovisual equipment that can help you look and sound better, without breaking the bank. Happy Zooming!

Share your favorite tips and tricks with us on social media @empulsepodcast, or through our website, ucdavisem.com!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Resources and Recommended Equipment:

Microphones:

Shure MV7 Podcast Microphone

Shure MV5C Home Office Microphone

Shure MV88+ Video Kit Digital Stereo Condenser Microphone

Beyerdynamic FOX USB Studio Microphone

Headphones:

Beyerdynamic DT 770 Pro Headphones (32 ohm model)

SONY  MDR-7506  Professional Headphones

Apple AirPods Pro

Lights:

Dracast Halo Plus Series LED100

Lume Cube

Litra

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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The COVID-19 pandemic has affected all of us, and with vaccines starting to roll out, I think we’re all looking forward to getting past it. But some people who have had COVID-19, getting past it hasn’t been easy. In this Heartbeat, we talk with infectious disease expert, Dr. Larissa May, about “Long haul COVID”, or “Long COVID” - a syndrome that affects about 10% of people who have had COVID-19. 

Have you had long-haul COVID? We’d like to know how it affected you and what you’ve don’t to get through it. Share your story with us on social media, @empulsepodcast, or through our website, ucdavisem.com. And please pass the word along to your friends and colleagues!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Larissa May, Professor of Emergency Medicine with a Masters in Emerging Infectious Diseases, and Director of Emergency Department Antibiotic Stewardship at UC Davis.

Resources:

Information and resources for COVID-19 long-haulers at UC Davis

LongCOVID.org support, information and resources (UK based)

The Body Politic COVID-19 support group 

Rubin R. As Their Numbers Grow, COVID-19 "Long Haulers" Stump Experts. JAMA. 2020 Sep 23. doi: 10.1001/jama.2020.17709. Epub ahead of print. PMID: 32965460.

Townsend L, Dowds J, O'Brien K, Sheill G, Dyer AH, O'Kelly B, Hynes JP, Mooney A, Dunne J, Ni Cheallaigh C, O'Farrelly C, Bourke NM, Conlon N, Martin-Loeches I, Bergin C, Nadarajan P, Bannan C. Persistent Poor Health Post-COVID-19 Is Not Associated with Respiratory Complications or Initial Disease Severity. Ann Am Thorac Soc. 2021 Jan 8. doi: 10.1513/AnnalsATS.202009-1175OC. Epub ahead of print. PMID: 33413026.

Lehner, G.F., Klein, S.J., Zoller, H. et al. Correlation of interleukin-6 with Epstein–Barr virus levels in COVID-19. Crit Care 24, 657 (2020).

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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It’s 2021, and we couldn’t be happier to leave 2020 behind and start a new year. In the past few months, we’ve talked about the past and present of emergency medicine. In this episode, we’ll explore the future. We welcome back some of our specialty’s visionary leaders, Dr. Aimee Moulin, Dr. Gillian Schmitz, Dr. Cherri Hobgood, and Dr. J Adrian Tyndall, to discuss what’s ahead for EM. How has the pandemic changed things? What role will technology play? What should healthcare and insurance look like in the future? Listen and learn along with us. 

What do you think lies ahead for emergency medicine or the health system in general? Share your thoughts with us on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Professor of Emergency Medicine and Psychiatry, and Behavioral Health Director, at UC Davis; previous California ACEP President, Director of California Bridge

Gillian Schmitz, Associate Professor of Emergency Medicine at the Uniformed Services University of Health Sciences, Emergency Physician at Brooke Army Medical Center

Dr. Cherri Hobgood, Professor and Past Chair of Emergency Medicine at Indiana University Form Chair of the Board of ACEP, and previous President of SAEM

Dr. Joseph Adrian Tyndall, Professor and Chair of Emergency Medicine at the University of Florida College of Medicine, Interim Dean of the College of Medicine, Associate Vice President for Academic and Strategic Affairs for University of Florida Health, and Immediate Past Chair of the Florida chapter of ACEP

Resources:

The Alexandria Plan

The State of EM

Buntin, MB. A brief window to rethink emergency care. JAMA Health Forum. Published online October 14, 2020. doi:10.1001/jamahealthforum.2020.1297

Sklar DP, Handel DA, Hoekstra J, Baren JM, Zink B, Hedges JR. The future of emergency medicine: an evolutionary perspective. Acad Med. 2010 Mar;85(3):490-5. doi: 10.1097/ACM.0b013e3181ccb628. PMID: 20182124.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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I think we can all agree that this has been a long year. For those of us working in the emergency department, the stress of treating patients with COVID-19, while trying to keep our families and ourselves safe, has been overwhelming at times. But there is finally a light at the end of this tunnel - in the form of vaccines! Infectious disease specialist, Dr. Dean Blumberg, talks with us about how the coronavirus vaccines work, and answers questions about their safety, the approval process, side effects, and much more. 

We got our vaccines, will you? 💉 Share your questions and concerns with us  on social media,  @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Dean Blumberg, Professor and Chief of Pediatric Infectious Disease at UC Davis, Co-Host of the Kids Considered Podcast 

Resources:

The New York Times Coronavirus Vaccine Tracker

CDC vaccine information page

Rubin EJ, Longo DL. SARS-CoV-2 Vaccination - An Ounce (Actually, Much Less) of Prevention. N Engl J Med. 2020 Dec 10. doi: 10.1056/NEJMe2034717. Epub ahead of print. PMID: 33301245.

Mutambudzi M, Niedwiedz C, Macdonald EB, Leyland A, Mair F, Anderson J, Celis-Morales C, Cleland J, Forbes J, Gill J, Hastie C, Ho F, Jani B, Mackay DF, Nicholl B, O'Donnell C, Sattar N, Welsh P, Pell JP, Katikireddi SV, Demou E. Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants. Occup Environ Med. 2020 Dec 9:oemed-2020-106731. doi: 10.1136/oemed-2020-106731. Epub ahead of print. PMID: 33298533.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Open notes or the 21st Century Cures ACT introduces a brave new world of sharing the whole medical record immediately with our patients. In this episode we discuss with an informatics specialist what this mandate is, what the exceptions are, and why this can be good for us and our patients.  Let us know how Open Notes is going for you and your tips for other note writers.

Follow us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Scott MacDonald, Internal Medicine Physician, and the Medical Director for Clinical Informatics and the Electronic Health Record System at UC Davis

Resources:

https://www.opennotes.org/

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In our September episode, The Alexandria Plan, we journeyed back through the fascinating history of Emergency Medicine with some of the founders of our specialty. This month’s episode follows on, exploring the present state of EM. We talk with current leaders and visionaries, Dr. Aimee Moulin, Dr. Gillian Schmitz, Dr. Cherri Hobgood, and Dr. J Adrian Tyndall, about the role of EM and how the COVID-19 pandemic has changed us. We then delve into some of the major issues facing our specialty, and where we go from here. Stay tuned for part three of this series where we’ll discuss the future of emergency medicine!

How has COVID changed EM for you, and what do you see as the big issues facing our specialty? Share your thoughts with us on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Professor of Emergency Medicine and Psychiatry, and Behavioral Health Director, at UC Davis; previous California ACEP President, Director of California Bridge

Gillian Schmitz, Associate Professor of Emergency Medicine at the Uniformed Services University of Health Sciences, Emergency Physician at Brooke Army Medical Center

Dr. Cherri Hobgood, Professor and Past Chair of Emergency Medicine at Indiana University Form Chair of the Board of ACEP, and previous President of SAEM

Dr. Joseph Adrian Tyndall, Professor and Chair of Emergency Medicine at the University of Florida College of Medicine, Interim Dean of the College of Medicine, Associate Vice President for Academic and Strategic Affairs for University of Florida Health, and Immediate Past Chair of the Florida chapter of ACEP

Resources:

The Alexandria Plan

COVID-19: Emergency Medicine Physician Empowered to Shape Perspectives on This Public Health Crisis.

Gaeta C, Brennessel R. Cureus. 2020 Apr 1;12(4):e7504. doi: 10.7759/cureus.7504. PMID: 32257730; PMCID: PMC7117614.

Anyone, Anything, Anytime - a History if Emergency Medicine (2nd edition) by Dr. Brian Zink

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This is the fascinating story of Dr. Rory Stuart the Bronze Star recipient for his fight against COVID in Afghanistan. He shares what it was like to be blindsided by COVID in the Middle East and the lessons we can apply  stateside.

Follow us on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Rory Stuart, Associate Professor of Emergency Medicine at UC Davis

Resources: 

Facebook live discussion with Dr. Rory Stuart.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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The November 2020 election is right around the corner, and yet many Americans still aren’t registered to vote. Voting is not always a priority when people are struggling to meet their basic needs, yet the voices of people in underrepresented groups are essential to shaping policy that benefits everyone. We talk with Dr. Katren Tyler about VotER, a program started at Massachusetts General Hospital that helps ED physicians encourage interested patients to register, and provides easy ways to help them do so. Julia tells us about similar efforts promoted by the American Academy of Pediatrics that encouraged census completion, as well as voter registration. Finally, we talk with Dr. Taylor Nichols, an Emergency Physician and expert in health policy, about how policy has important downstream implications for health. He also gives us some things to think about when you cast your vote next month.

(Incidentally, the last day to register online or by mail is 10/19, but you can register in person through 11/3)

What do you think about programs like VotER? We’d love your feedback. Connect with us on social media @empulsepodcast, or through our website, ucdavisem.com.

Have we earned your vote? Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Katren Tyler, Professor of Emergency Medicine and Vice Chair of Wellness for the UC Davis Department of Emergency Medicine 

Dr. Taylor Nichols, Emergency Physician, former UC Davis EM Health Policy Fellow, and California ACEP Board Member

Resources:

VotER 

ACEP Now article on VotER

AAP News article on encouraging completion of the 2020 census

Breonna Center for Justice article on voter registration decline (

Liggett A, Sharma M, Nakamura Y, et al. Results of a voter registration project at 2 family medicine residency clinics in the Bronx, New York. Ann Fam Med. 2014;12(5):466-469.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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A new PECARN study found just a single episode of moderate-severe DKA impacts cognition! This game changing article challenges what we thought about glucose and the brain and really makes a case for aggressive DKA treatment and glucose control!

Let us know what you think @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Nicole Glaser, Professor of Pediatric Endocrinology at UC Davis

Dr. Simmona can you help meGhetti (@sghetti1) Professor Department of Psychology and Center for Mind and Brain at UC Davis

Resources: 

Ghetti S, Kuppermann N, Rewers A, Myers SR, Schunk JE, Stoner MJ, Garro A, Quayle KS, Brown KM, Trainor JL, Tzimenatos L, DePiero AD, McManemy JK, Nigrovic LE, Kwok MY, Perry CS 3rd, Olsen CS, Casper TC, Glaser NS; Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group. Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes. Diabetes Care. 2020 Sep 22:dc200187. doi: 10.2337/dc20-0187. Epub ahead of print. PMID: 32962981.

https://care.diabetesjournals.org/content/early/2020/09/10/dc20-0187.long

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Ever wondered how the specialty of Emergency Medicine came about? We take it for granted that we have emergency departments staffed 24/7 with board certified EM physicians, but this wasn’t always the case. Join us for a trip down memory lane, with the help of Dr. Brian Zink. Dr. Zink collected stories and audio recordings from some of the founders of our specialty. He shares several of these with us to give us a feel for what it was like in those early days. 

What did you think of this episode? We’d love your feedback. Connect with us on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Brian Zink, Professor of Emergency Medicine and Senior Associate Dean for Faculty and Faculty Development at the University of Michigan

Resources:

Anyone, Anything, Anytime - a History if Emergency Medicine (2nd edition) by Dr. Brian Zink

In Memory of Dr. Peter Rosen, a Founder of Emergency Medicine. 

George Podgorny, MD, Advocate and  Architect  of Emergency Medicine 

Rosen P. The biology of emergency medicine. JACEP. 1979;8(7):280-283. doi:10.1016/s0361-1124(79)80226-9

Emergency Physicians Gear up for Specialty Approval. Originally published in Hospital Practice in October, 1975

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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It’s that time of year again - residency recruiting season! But this year, things will look very different, thanks to the COVID-19 pandemic. We talk with Dr. David Barnes, Emergency Medicine Residency Program Director at UC Davis, about some of the challenges for both applicants and residency leadership. He also offers some sound advice for students applying in EM - most importantly, be yourself and be flexible; this format is new to everyone. 

Do you have questions or concerns about the residency application and interview process this year?  Send us your thoughts on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. David Barnes, Professor of Emergency Medicine and Emergency Medicine Residency Program Director Equity at UC Davis

Resources:

UC Davis Emergency Medicine Residency Program

Hammoud MM, Standiford T, Carmody JB. Potential Implications of COVID-19 for the 2020-2021 Residency Application Cycle [published online ahead of print, 2020 Jun 3]. JAMA. 2020;10.1001/jama.2020.8911. doi:10.1001/jama.2020.8911

ACEP Concensus Statement on the 2020-2021 Residency Application Process for U.S. Medical Students Planning Carter’s in Emergency Medicine in the Main Residency Match

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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“Less Lethal” Crowd Control

You may have heard of “non-lethal” or “less lethal” weapons used for crowd control. These include things such as pepper spray, tear gas, bean bags, and rubber bullets. But, while these may be less lethal than standard weapons and bullets, they still cause serious harm and even death. As protests raged across the U.S. this summer, we have seen many injuries associated with these methods. Dr. James Chenoweth, an emergency physician and toxicologist, joins us to explain what these weapons are and what kind of damage they can cause, as well as some tips for treating these injuries. Dr. Kara Toles worked as a street medic in the recent protests in Sacramento. She shares her experience, including key supplies she carries in her pack, and what it’s like to be in the middle of a peaceful protest turned violent. As physicians, we should be concerned about the physical injuries these crowd control methods cause, as well as the psychological effects.  

Have you treated patients with injuries from so called non lethal crowd control methods?  Share your thoughts and experiences with us on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Kara Toles, Assistant Professor of Emergency Medicine and Director of Diversity Equity and Inclusion for the Department of Emergency Medicine at UC Davis

Dr. James Chenoweth , Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources:

This Week in Toxicology Tear Gas, Pepper Spray, and Rubber Bullets: A Primer

Penetrating Injuries from “Less Lethal” Beanbag Munitions. Correspondence in the New England Journal of Medicine, by Dr. Kristofor A. Olson et al. August 14 2020. 

Sacramento Street EMS

Sacramento Anti Police-Terror Project

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Has MIS-C changed the way you approach a febrile child? I know I struggle to understand this new disease. Fortunately Dr. Natasha Nakra, a Pediatric Infectious Disease Specialist, joins us this month to clarify what we know about MIS-C, when we should think about it, and what we should do.

Have you seen a child with MIS-C? What tipped you off? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Natasha Nakra, MS Associate professor of pediatrics, Pediatric Infectious Disease Specialist at UC Davis 

Resources: 

Nakra, N.A.; Blumberg, D.A.; Herrera-Guerra, A.; Lakshminrusimha, S. Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management. Children 2020, 7, 69.

CDC Multi-inflammatory syndrome: for healthcare providers.

https://www.cdc.gov/mis-c/hcp/index.html

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Welcome back to EM Pulse. It’s no secret that black, indigenous, and people of color are underrepresented in medicine and academics. This is largely due to structural or institutionalized racism, which is a massive topic for another time. While it may be difficult to swallow, white people have benefited from this system, and many of us are still learning just how our my privilege afforded us. This can be unnerving and even embarrassing at times, as we start to really appreciate the struggle our BIPOC friends and colleagues have faced, and continue to face. We want to be allies; we want to do something.

This month’s heartbeat is geared specifically to people who want to be better allies in this fight. It is absolutely crucial to listen to voices of people of color and follow their lead, but, as we will discuss, it is not our non-white colleagues’ job to educate us! With that in mind, our guest is Dr. Colleen Sweeney, a Professor of biochemistry and molecular medicine at the UC Davis School of Medicine, who recently gave a talk on taking allyship to the next level. 

We are still learning to be better advocates and welcome your comments and feedback. Connect with us on social media,  @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Colleen Sweeney, Professor of Biochemistry and Molecular Medicine at the UC Davis School of Medicine

Resources:

Ibram X. Kendi, author of How to be an Anti-Racist, Stamped from the Beginning: the Definitive History of Racist Ideas in America, and others books

Tervalon M, Murray-García J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998;9(2):117-125. doi:10.1353/hpu.2010.0233

Award winning documentary From the Community to the Classroom

AAMC MedEdPortal: Antiracism in Medicine Collection

AAMC: Racism and Health

UC Davis Office of Diversity, Equity & Inclusion

Register now for the 17th annual Emergency Medicine Update: Hot Topics 2020, November 3rd through 7th at the Fairmont Kea Lani in Maui!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In the first half of our episode on surge, we heard first hand accounts of how COVID-19 impacted EDs and ICUs in hard hit areas. In the second half, we explore emergency preparedness at a more macro level. Experts, Dr. John Rose and Dr. Dan Colby, join us to discuss how county emergency medical services, hospital administration, and emergency departments are planning for a potential surge of COVID-19 cases. As new infections and hospitalizations are rising across most of the country, they offer some practical advice to help us manage the surge. .

Has your hospital experienced a COVID surge? How did you handle it, or how are you preparing for a potential surge? Share your thoughts and experiences with us on social media @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for Part 2, when we’ll talk practical preparedness strategies from EMS, administration, and ED operations points of view - coming July 3rd!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. John Rose, Professor of Emergency Medicine at UC Davis and Medical Director for Yolo Emergency Medical Services Agency (YEMSA)

Dr. Daniel Colby, Assistant Professor of Emergency Medicine and member of the ED Clinical Operations Team at UC Davis

Resources:

California Hospital Association Emergency Preparedness Hospital Incident Command System (HICS)

Pediatric Overflow Planning Contingency Response Network (POPCoRN)

Register now for the 17th annual Emergency Medicine Update: Hot Topics 2020, November 3rd through 7th at the Fairmont Kea Lani in Maui!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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As we watched the novel coronavirus spread through China and Italy, we knew it was just a matter of time before a wave of illness hit the US. The surge struck early in New York and New Orleans, threatening to overwhelm health care resources, including PPE, ventilators, ICU beds, and hospital staff. We hear from Dr. Leslie Palmerlee, an emergency physician in New Orleans, about her experience there. Then we go in depth with Dr. Alfredo Astua, a critical care physician at one of New York’s hardest hit hospitals. We explore how they prepared for and managed the COVID-19 surge, how it affected every level of the health care system, and what they learned along the way.

Has your hospital experienced a COVID surge? How did you handle it, or how are you preparing for a potential surge? Share your thoughts and experiences with us on social media @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for Part 2, when we’ll talk practical preparedness strategies from EMS, administration, and ED operations points of view - coming July 3rd!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Leslie Palmerlee, Assistant Professor of Emergency Medicine at LSU/University Medical Center in New Orleans, LA

Dr. Alfredo Astua, Chair of Pulmonary Critical Care and Sleep Medicine at Elmhurst Hospital, Mount Sinai Services in Queens, NY

Resources:

US Department of Health and Human Services public health emergency preparedness resources 

ACEP National Strategic Plan for Emergency Department Management of Outbreaks of COVID-19

Register now for the 17th annual Emergency Medicine Update: Hot Topics 2020, November 3rd through 7th at the Fairmont Kea Lani in Maui!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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What are you seeing in your hospital? How did your system prepare for a surge? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for the June 17 episode on SURGE. We will hear from the critical care doctor who managed the surge from the provider standpoint with other experts on how we can prepare for a SURGE.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Alex Schmaltz, Senior Emergency Medicine Resident  at UC Davis

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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COVID was supposed to be the great equalizer, but in reality not all of us are affected the same. Vulnerable populations experience higher rates of infection and death, and worse social outcomes. Access to healthcare is not equitable. In this episode we dive into why this is a thing and what we can do about this as providers.

What are you seeing in your hospital? What are you or your systems doing to reduce implicit bias? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for the June 3 Heartbeat on what is it like to work in a hospital in the bronx and lessons learned.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Kara Toles (@kat04747), Assistant Professor of Emergency Medicine at UC Davis and the Director of Equity and Inclusion in the Department of Emergency Medicine.

Dr. Makini Chisholm-Straker, Assist Professor of Emergency Medicine at The Icahn School of Medicine, and works at Mt. Sinai Hospital, NYC

Resources:

Chisholm-Straker, M. COVID-19 is Our Chance at Rebirth. Medium.com. Accessed on May 18, 2020. https://medium.com/undercurrents-press/rebirthviacovid-369e073d7654

Wadhera RK, Wadhera P, Gaba P, et al. Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs [published online ahead of print, 2020 Apr 29]. JAMA. 2020;e207197. doi:10.1001/jama.2020.7197  https://jamanetwork.com/journals/jama/fullarticle/2765524?guestAccessKey=bea1171d-1ecd-49df-a55f-2e11ed68ec40&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=042920

Miller, H. Navajo Nation 3rd highest “state” per capita infections. Huffpost online May 14, 2020. https://m.huffpost.com/us/entry/us_5e94b532c5b6a50d4ae6d7e7

Kara, H. The coronavirus pandemic is hitting black and brown Americans especially hard on all fronts. CNN online. May 8, 2020. 

https://www.cnn.com/2020/05/08/us/coronavirus-pandemic-race-impact-trnd/index.html

Racial Data Transparency: States that have released breakdowns of COVID-19 data by race. Johns Hopkins Coronavirus Resource Center. Accessed on May 16, 2020. https://coronavirus.jhu.edu/data/racial-data-transparency

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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How do you treat the pain of pediatric long bone fractures? Is it equitable? In this episode the authors of Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures of Pediatrics May 2020 discuss if our care is equitable and why it may not be. It is an important discussion that pushes us to think about our perception of pain and how race and ethnicity impact our approach.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Host:

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Monika Goyal, Associate Professor of Pediatrics and Emergency Medicine at the George Washington University School of Medicine. Associate Division Chief of Emergency Medicine and Trauma Services and Director of Academic Affairs and Research at Children's National Hospital.

Dr. Tiffani Johnson, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Resources:

Goyal MK, Johnson TJ, Chamberlain JM, et al. Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures [published online ahead of print, 2020 Apr 20]. Pediatrics. 2020;e20193370. doi:10.1542/peds.2019-3370  https://pubmed.ncbi.nlm.nih.gov/32312910/

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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This is a challenging time for physicians and the entire healthcare workforce. That’s putting it mildly. The coronavirus pandemic is affecting all of us, physically and emotionally. In emergency medicine, we are used to dealing with stressful situations, but this pandemic brings new personal and professional challenges. We are managing severe illness for which we have no proven treatment, watching patients suffer and die alone, and living with constant worry of infecting our loved ones or even dying of the virus ourselves. Some of us are doing this in overwhelmed healthcare systems with limited resources, including personal protective equipment (PPE). How can we manage this new level of stress?  

In this miniseries, we’ll dive deeper into some of the moral challenges we are facing, and explore some ways to cope. Dr. Wendy Lau, an EM physician and wellness expert, has been studying at the Upaya Institute and Zen Center. She emphasizes the power of human connection, and offers a framework, using the mnemonic GRACE, to help us think through and prepare for difficult moral dilemmas.

How are you coping with the stress of the coronavirus pandemic? Did you find this miniseries helpful? Connect with us and share your thoughts and experiences, on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Wendy Lau, Emergency Medicine Physician, Wellness Expert and Yoga Instructor, with a background in Zen Buddhism.

Resources:

Dr. Wendy Lau’s Website, including Physician Pandemic Support

Roshi Joan Halifax, Abbot at Upaya Institute and Zen Center in Santa Fe, New Mexico

Rushton, Cynda. Moral Resilience: Transforming Meal Suffering in Healthcare. Oxford University Press, October 2018. 

Rushton, CH. Principled Moral Outrage: An Antidote to Moral Distress? AACN Advanced Critical Care 2013 Jan-Mar;24(1):82-9 

Turner K, Rushton CH. “Why Are We Doing This?” Creating New Narratives to Meet Futility With Integrity. AACN Adv Criti Care. Summer 2019;30(2):198-203

Rushton CH. Cultivating Moral Resilience. Am J Nurs. 2017 Feb;117(2 Suppl 1):S11-S15

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In this episode of our miniseries, EM physician and wellness expert, Dr. Wendy Lau, returns with a guided meditation, using the GRACE framework. This practice helps us breathe, relax, and cope with the stress we are all feeling during the coronavirus pandemic. Get comfortable, close your eyes, and meditate with us. 

How are you coping with the stress of the coronavirus pandemic? Did you find this miniseries helpful? Connect with us and share your thoughts and experiences, on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Wendy Lau, Emergency Medicine Physician, Wellness Expert and Yoga Instructor, with a background in Zen Buddhism.

Resources:

Dr. Wendy Lau’s Website, including Physician Pandemic Support

Roshi Joan Halifax, Abbot at Upaya Institute and Zen Center in Santa Fe, New Mexico

Rushton, Cynda. Moral Resilience: Transforming Meal Suffering in Healthcare. Oxford University Press, October 2018. 

Rushton, CH. Principled Moral Outrage: An Antidote to Moral Distress? AACN Advanced Critical Care 2013 Jan-Mar;24(1):82-9 

Turner K, Rushton CH. “Why Are We Doing This?” Creating New Narratives to Meet Futility With Integrity. AACN Adv Criti Care. Summer 2019;30(2):198-203

Rushton CH. Cultivating Moral Resilience. Am J Nurs. 2017 Feb;117(2 Suppl 1):S11-S15

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In these uncertain times, poets, artists, musicians, psychiatrists, philosophers, and others, have stepped forward to offer inspiration, compassion, advice, and hope. In this episode of our miniseries, we share some of the words and art we found helpful. Thank you to the authors and artists featured, and to all those who are contributing positive energy during this time. 

What art, words, or music have you found helpful or inspiring during the coronavirus pandemic? Please share them with us - on social media @empulsepodcast, or through our website, ucdavisem.com.

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Featured:

Fr. Richard Hendrick. Lockdown. Posted on Facebook March 13, 2020. 

Dr. Peter Yellowlees “Good Stuff - Volume 45”, March 31, 2020. Received by Julia Magana, March 31, 2020.

Rachmaninoff's Six Pieces, Op. 11: VI. Slava (Glory) performed by Dr. Andrew Wong and Dr. Gilbert Wong. Posted to Facebook on March 28, 2020. #songsofcomfort

Resources:

Dr. Wendy Lau’s Website, including Physician Pandemic Support

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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We’re in the midst of a global pandemic and, of course, everyone’s attention is focused on COVID-19. Other podcasts have excellent coverage of this situation. In this episode, we’ll be discussing other important infections that continue to affect our communities: HIV, hepatitis C, and syphilis. Over the past year, the UC Davis ED implemented a massive screening effort to identify patients who have become infected. Dr. Larissa May explains how the screening works and some of the surprising trends we’ve seen. Infection rates were higher than expected and many patients had no idea they were infected! One patient tells us how screening positive for HIV, and being connected to care, changed his life. 

This topic, as with so many issues we cover, brings up the broader question: what is the role of the emergency department in the healthcare system? We will explore this further in an upcoming episode and we would love to hear from YOU. 

What do YOU see as the role of the emergency department in the broader health system? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. And please pass the word along to your friends and colleagues!

Please rate us and leave us a review on iTunes! It helps us reach more people.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Larissa May, Professor of Emergency Medicine with a Masters in Emerging Infectious Diseases, and Director of Emergency Department Antibiotic Stewardship at UC Davis.

Resources:

ACEP Policy Statement on HIV testing and screening in the ED

Centers for Disease Control and Prevention (CDC) resources:

Ending the HIV Epidemic: A Plan for America.

HIV Nexus Clinician Resources

Haukoos JS, Lyons MS, Rothman RE. The Evolving Landscape of HIV Screening in the Emergency Department. Ann Emerg Med. 2018 Jul;72(1):54-56. doi: 10.1016/j.annemergmed.2018.01.041. Epub 2018 Feb 17. PubMed PMID: 29459057;

Leblanc J, Hejblum G, Costagliola D, Durand-Zaleski I, Lert F, de Truchis P, Verbeke G, Rousseau A, Piquet H, Simon F, Pateron D, Simon T, Crémieux AC; DICI-VIH (Dépistage Infirmier CIblé du VIH) Group. Targeted HIV Screening in Eight Emergency Departments: The DICI-VIH Cluster-Randomized Two-Period Crossover Trial. Ann Emerg Med. 2018 Jul;72(1):41-53.e9. doi: 10.1016/j.annemergmed.2017.09.011. Epub 2017 Oct 31.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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This month’s Heartbeat is about something most of never get enough of: SLEEP. Dr. Katren Tyler, emergency physician and Vice Chair of Wellness for the UC Davis Department of Emergency Medicine, shares some important information about sleep and shift work. Katren recently spoke on this topic at the UC Davis EM Winter Conference in Lake Tahoe. She explains how our sleep patterns change throughout our lives, and how shift work affects our health and our ability to do our job as physicians. She also offers some suggestions for how we can minimize the negative effects of shift work at both the personal and health system levels. 

How do you manage sleep and shift work? We’d love to hear from you! Connect with us on social media, @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and leave us a review on iTunes - it helps us reach more people! 

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Katren Tyler, Professor of Emergency Medicine and Vice Chair for Faculty Development, Wellness and Outreach in the UC Davis Department of Emergency Medicine

Resources:

Fischer D, Lombardi DA, Marucci-Wellman H, Roenneberg T. Chronotypes in the US - Influence of age and sex. PLoS One. 2017;12(6):e0178782. Published 2017 Jun 21. doi:10.1371/journal.pone.0178782

Kristen L. Knutson & Malcolm von Schantz (2018) Associations between chronotype, morbidity and mortality in the UK Biobank cohort, Chronobiology International, 35:8, 1045-1053, DOI: 10.1080/07420528.2018.1454458

Wolf Osterode, Sandra Schranz & Galateja Jordakieva (2018). Effects of night shift on the cognitive load of physicians and urinary steroid hormone profiles – a randomized crossover

trial, Chronobiology International, 35:7, 946-958, DOI: 10.1080/07420528.2018.1443942

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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If you’ve ever watched a patient, friend, or family member have a seizure, you know how scary and stressful it can be for everyone involved. It’s even more stressful when you can’t get the seizure to stop - this is called status epilepticus. Usually, benzodiazepines are our first line medication. If benzos don’t work, we all have our favorite second, and even third line agents to try to break seizures. But how well do they really work? Is one better than another? Or safer? 

This episode starts with a personal story told by parents of a child who suffers from epilepsy. Then we welcome guest host, Dr. Jason Woods of the Little Big Med podcast, to help us answer these questions. Dr. Jim Chamberlain is the pediatric principal investigator for the ESETT trial, in which he and his colleagues studied three common second line anti epileptic medications. He shares some of the novel statistical methods they used and the results that were recently published in the New England Journal of Medicine. Then we speak with our own Dr. Daniel Nishijima, general EM physician and site Co-PI for the trial, about the implications for adults and how the results have (or have not?) changed his practice. 

What are your favorite first and second line medications for status epilepticus? When do you decide to intubate? We’d love to hear how you practice. Connect with us on social media, @empulsepodcast, or at ucdavisem.com. 

Registration is still open for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe!

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Jason Woods, Assistant Professor of Pediatric Emergency Medicine at Children’s Hospital Colorado, Host of the Little Big Med podcast

Guests:

Dr. Jim Chamberlain, Professor of Pediatrics and Emergency Medicine at George Washington University and Children’s National Hospital, Pediatric Principal Investigator for the ESETT trial

Dr. Daniel Nishijima, Associate Professor of Emergency Medicine at UC Davis, Site Co-Pricipal Investigator for the ESETT trial

Resources:

SAEM seizure and status epilepticus resources

Kapur J, Elm J, Chamberlain J, et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. N Engl J Med. 2019;381(22):2103-2113.

Little Big Med Podcast

Glauser T, Shinnar S, Gloss D, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr 2016;16: 48–61. 

Dalziel SR, Borland ML, Furyk J, et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial. Lancet 2019; published online April 17.

Lyttle MD, Rainford NEA, Gamble C, et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. Lancet 2019; published online April 17.

Connor JT, Elm JJ, Broglio KR, ESETT and ADAPT-IT Investigators. Bayesian adaptive trials offer advantages in comparative effectiveness trials: an example in status epilepticus J Clin Epidemiol 2013; 

Zaccara G, Giannasi G, Oggioni R, et al. Challenges in the treatment of convulsive status epilepticus. Seizure. 2017;47:17-24. 

Ilvento L, Rosati A, Marini C, L’Erario M, Mirabile L, Guerrini R. Ketamine in refractory convulsive status epilepticus in children avoids endotracheal intubation. Epilepsy Behav. 2015;49:343-346. 

Niquet J, Baldwin R, Norman K, Suchomelova L, Lumley L, Wasterlain C. Midazolam-ketamine dual therapy stops cholinergic status epilepticus and reduces Morris water maze deficits. Epilepsia. 2016;57(9):1406-1415. 

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Happy National Women Physicians Day and National Wear Red Day, promoting awareness of heart disease in women! In this month’s Heartbeat, we have the privilege of speaking with the brilliant and visionary Dr. Alyson McGregor. Dr. McGregor is an emergency physician who specializes in sex and gender emergency medicine. She spoke with us about heart disease - the number one killer of women in the US - and how our current algorithms, diagnostic tests, and treatments are flawed. We’ll hear more from Alyson in an upcoming episode, so stay tuned!

We’d love to hear from you! Connect with us on social media, @empulsepodcast, or on our website, ucdavisem.com. 

Register now for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe!

Please subscribe and leave us a review on iTunes - it helps others discover us! 

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Alyson McGregor, Associate Professor of Emergency Medicine and Director of the Division of Sex & Gender in Emergency Medicine at Brown University.

Resources:

Sex & Gender Specific Health - a project supported by the Texas Tech University Health Sciences Center Office of the President, Offices of the Deans of the Schools of Medicine, Pharmacy, Health Professions and Nursing, and the Laura W. Bush Institute for Women’s Health.

Pre-order Dr. McGregor’s book on her website!

Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It by Alyson J. McGregor, MD

Ms. Diagnoseddocumentary film teaser

Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review.

McGregor AJ, Beauchamp GA, Wira CR 3rd, Perman SM, Safdar B. West J Emerg Med. 2017 Oct;18(6):1079-1090. doi: 10.5811/westjem.2017.8.34997. Epub 2017 Oct 6. Review.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Alyson McGregor

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Happy 2020! Well, that’s a wrap on another year of EM Pulse. Our podcast continues to grow, as does our audience. We published another 25 new episodes this year and now have listeners in 114 countries around the world! We also did our first live podcast from the Western Regional SAEM Conference. There are more exciting things to come this year! In 2020, we are kicking off our Advisory Panel, a group of diverse physicians, and some non-physicians, to keep EM Pulse fresh and focused, and also add an element of peer review. We’ve also partnered with Cal ACEP to create an in-depth mini series on medication assisted treatment of opioid use disorder. More on that soon!

So what were our favorite highlights from the 2019 season? Take a listen to find out!

What were your most memorable moments? We want to know! What topics would you like to see us tackle this year? Connect with us on social media, @empulsepodcast, or at ucdavisem.com. 

Register now for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe!

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Episodes Referenced:

Just Another Mass Shooting

thisismylane

With Great Power Comes Great Responsibility

The ED is my Doctor

Futurecasting Medical Education

“Hot” off the Press: Infant Fever Rule

The Last Touchpoint

EM Far Forward

Operation Deep Freeze

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Matthew WetscherDr. Megan RanneyDr. Garen WintemuteRecording on locationDr. Mike GisondiRecording Dr. Rod FontenetteRecordingDr. Julia MagañaDr. Sarah MedeirosRecording on location

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Welcome back and happy new year! If you are an EM or peds provider you likely know the name PECARN (Pediatric Emergency Care Applied Research Network).  This powerhouse was the first federally funded pediatric emergency medicine research network in the US and generates quality studies like nobody’s business. 

We have reviewed three landmark PECARN studies: Hot off the Press infant fever rule, DKA it’s not about the fluids, A Cool Tool. And in the next few months we will discuss seizure management and talk about PERN.  So we thought this was a good time to really understand the machine of PECARN that is affecting us shift to shift. What is the history, why is it important, and what does the future look like?  In this podcast Dr. Nate Kuppermann tells it all.

What is the best way investigators can get evidence into your hands?  How do you keep up with the onslaught of data being generated?  Lectures/conferences? Tweets? Podcasts? Friends? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people! 

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee

Resources:

Academic Life in Emergency Medicine (ALiEM) P3 App:

https://www.aliem.com/p3-app-pecarn-publication-prospectus/

PECARN’s home website: https://www.pecarn.org

REGISTER for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-28th at the Ritz Carlton in Lake Tahoe

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Nate KuppermannDr. Julia Magana

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Global health can be an amazing adventure or an unsettling disappointment. We can make a big difference in the lives of people around the world or drain local resources and have a feel good vacation. In this episode we hear meaningful international impact stories and from global health experts on how we can make a meaningful impact as well.

Have you worked internationally? Send us your story - it might even be featured in our global health mini series! Connect with us on social media at @empulsepodcast, via email at empulsepodcast@gmail.com, or on our website, ucdavisem.com.

Please subscribe and leave us a review on iTunes - it helps us reach more people!

Register now for the 43rd annual UC Davis Emergency Medicine Winter Conference. February 24th-29th at the Ritz Carlton in Lake Tahoe!

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis 

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Nathan Kuppermann, Pediatric Emergency Physician and Chair of the Department of Emergency Medicine at UC Davis

Dr. Christine McBeth, Assistant Professor of Emergency Medicine at UC Davis; Completed the Global Ultrasound Fellowship at UC Davis

Dr. Michael Schick, Associate Professor of Emergency Medicine and Director of Global Ultrasound at UC Davis; Director of Ultrasound for Global Emergency Care

Dr. Shakira Bandolin, Assistant Professor of Emergency Medicine at Director of the Global Health Fellowship at UC Davis.

Resources:

ACEP International Ambassador Map

ACEP Free international resources

The practitioner’s guide to global health course: FREE!

Dr. Schick's Website: sonostuff.com 

Idealist is a website that posts international opportunities. A variety of NGOs regularly post job listings on these sites:

Global Emergency Medicine Fellowship listings

Health Volunteers International: This is an organization Dr. Bandolin partnered with on projects in the past and is a great reference organization for medical providers who are interested in joining a ongoing project overseas. They offer a variety of placements ranging from 1 month to years.

Sacred Valley Health is the NGO that Shakira work closely with and referenced during the interview.

University of Wisconsin reference list for global health resources.

Dr. Shakira BandolinDr. Christine McBethDr. Nate KuppermannDr. Michael SchickDr. Julia MaganaDr. Sarah Medeiros

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Last month we explored leveraging tech for life long learning. In this heartbeat we discuss tech as a teaching tool with Dr. Emily Andrada, an amazing teacher who has mastered using technology for teaching. Hear about the ups and downs of using technology for education, Emily’s favorite tools, and a new resource available on www.ucdavisem.com - Unschooling Time.

What is your favorite tech teaching tool? How do you leverage tech as a teacher?

Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people! 

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Emily Andrada, Professor of Pediatric Emergency Medicine at UC Davis

Resources:

Tech savvy educators twitter handles mentioned: @cultofpedagogy, @jmattmiller, @ericcurts, @alicekeeler

Unschooling Time - Resource page

Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe

Dr. Emily AndradaDr. Julia Magana

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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The amount of information we are expected to learn in medical school, residency, and beyond can be overwhelming - like drinking from a firehose! In this episode, we explore some ways in which physicians can leverage technology to help manage all of this information and facilitate life long learning. Several residents and attendings discuss what works for them, including using apps and online resources, and listening to podcasts. We then talk with Dr. Ryan Ribeira and Dr. Adam Dougherty of SimX about how they are using augmented and virtual reality to revolutionize medical simulation. Next, we talk with with Dr. Dina Wallin, creator of the Leader’s Library, on how she uses Slack to create a learning community of physicians across the globe. Finally, we discuss with education researcher, Dr. Jeff Riddell, about how and why physicians are turning to podcasts for learning and staying up to date, including some of the benefits and potential caveats. 

Do you use technology for lifelong learning? Tell us how you do - or why you don’t! Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Subscribe and rate us on iTunes - it helps us reach more people! 

Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Adam Dougherty, Emergency Medicine Physician at Sutter Medical Center in Sacramento, CA; Chief Medical Officer at SimX

Dr. Ryan Ribeira, Clinical Assistant Professor of Emergency Medicine at Stanford University; Founder and Chief Executive Officer of SimX

Dr. Dina Wallin, Assistant Clinical Professor of Emergency Medicine and Pediatrics at UCSF Benioff Children’s Hospital; Creator of the ALiEM Leader’s Library

Dr. Jeff Riddell, Education Researcher and Assistant Professor of Clinical Emergency Medicine at the University of Southern California Keck School of Medicine

Resources:

SimX VR and AR digital simulation

ALiEM Leader’s Library

A Survey of Emergency Medicine Residents' Use of Educational Podcasts.

Riddell J, Swaminathan A, Lee M, Mohamed A, Rogers R, Rezaie SR.

West J Emerg Med. 2017 Feb;18(2):229-234. doi: 10.5811/westjem.2016.12.32850. Epub 2017 Jan 30.

Independent and Interwoven: A Qualitative Exploration of Residents' Experiences with Educational Podcasts.

Riddell J, Robins L, Brown A, Sherbino J, Lin M, Ilgen JS.

Acad Med. 2019 Sep 10. doi: 10.1097/ACM.0000000000002984. [Epub ahead of print]

Dr. Jeff RidellDr. Julia MagañaDr. Sarah MedeirosDr. Ryan Ribeira and Dr. Adam Dougherty

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In this heartbeat we do something a little different. We discuss the story behind EM Pulse and three lessons we learned in our creative pursuit. These three lessons can be applied to other creative pursuits as well. We would love to hear how you express your passion and what you have learned as well!

Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Please subscribe and rate us on iTunes – it helps us reach more people! 

Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Resources: 

Citing Audio and Video Publications on Your CV ALiEM Blog, Jan 18, 2018. (https://www.aliem.com/author/jessica-mason/)

Save the date for the 43rd Annual UC Davis Emergency Medicine Winter Conference February 24-28 at the Ritz Carlton, Lake Tahoe (https://ces.ucdavis.edu/confreg/?confid=1094)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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We are in the midst of a mental health crisis that impacts our patients, our hospitals, the health care system, and our daily work in the emergency department. It is easy to be caught up in own experience, or the problems of our own department. But when we look beyond our hospital, we see that this is a huge crisis at county, state, and national levels. To help us understand why we are in this situation, and how we can work to improve things, we spoke with UC Davis’ Director of Emergency Psychiatry, Dr. Lorin Scher, and Emergency Physician and ED Director of Behavioral Health, Dr. Aimee Moulin. Here of some of their suggestions:

The ED is often the only place patients in a mental health crisis have to go. These patients are suffering from serious, life threatening illness, and it is our job to care for them. Embrace it. Focus on patient centered care, including placing patients in an area where stimulation is minimized, away from doors, with mental health techs nearby, and employ early de-escalation strategies.Collaborate with psychiatrists, mental health professionals, and community partners. Consider implementing SMART clearance to minimize unnecessary blood draws and expedite treatment and placement in a psychiatric facility. This problem is bigger than our EDs. Talk with your administrators, local government, connect with ACEP and other advocacy groups to amplify your voice. Advocate to  increase primary care mental health integration through collaborative care models. We can be a voice for our patients who don’t have a voice. 

How is the mental health crisis impacting your department? Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Subscribe and rate us on iTunes - it helps us reach more people! 

***Registration is still open for UC Davis Emergency Medicine Update: Hot topics 2019!

November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii***

Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Lorin Scher, Associate Professor of Psychiatry, Director of Emergency Psychiatry at UC Davis, and Director of Integrated Behavioral Health Services in the UC Davis primary care network

Dr. Aimee Moulin, Associate Professor of Emergency Medicine and ED Behavioral Health Director at UC Davis

Resources:

Sacramento has a mental health crisis. Let’s switch from ‘emergency’ to strategy. 

By Dr. Lorin Scher, Special to The Sacramento Bee, May 5, 2019

California 5150 Law

ACEP Mental Health Advocacy

Dr. Lorin ScherDr. Amiee MoulinDr. Julia MaganaDr. Sarah Medeiros

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña and Isaiah Magaña at OM Audio Productions for audio production services.

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High sensitivity troponins are taking over the nation are you ready? Dr. Bryn Mumma is ready and in this heartbeat she shares what we need to know to be ready! 

Are you using high sensitivity troponins? How is it going?

Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Please subscribe and rate us on iTunes – it helps us reach more people! 

Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest: Dr. Bryn Mumma (bemumma@ucdavis.edu [bemumma@ucdavis.edu], Associate Professor of Emergency Medicine at UC Davis

Resources: 

Twerenbold, R, Boeddinghaus J. Clinical Use of High-Sensitivity Cardia Troponin in with Suspected Myocardial Infarction.  JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. VOL. 70, NO. 8, 2017  (http://www.onlinejacc.org/content/accj/70/8/996.full.pdf)

Email Dr. Bryn Mumma to get our protocol (bemumma@ucdavis.edu)

Boeddinghaus J, Twerenbold R, et al. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction.  Clin Chem. 2019 Sep 30.  (https://www.ncbi.nlm.nih.gov/pubmed/31570633)

Registration is still open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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There is an epidemic of poverty in America, and we see it firsthand in the ED. Dr. Donna Beegle has dedicated her life to studying this epidemic, and training others to help break the cycle of poverty. She shares her own personal story of growing up in generational poverty, then helps us understand the scope of poverty in the U.S., and how it affects health. UC Davis Emergency Medicine NP, Danise Seaters, joins us to discuss some strategies for medical providers to help recognize patients who may be struggling with poverty, and how to optimize their care in the ED. This starts with recognizing our own biases and making a conscious effort to avoid letting our biases affect how we interact with patients. Communication is also key - connect and identify with your patients, avoid medical jargon, and offer resources. 

What strategies do you use to identify and care for patients struggling with poverty? Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and rate us on iTunes - it helps us reach more people! 

***Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019!

November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii***

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Donna Beegle, President and Founder of Communications Without Borders

Danise J. Seaters, ACNP-bc, M.S., Emergency Medicine Nurse Practitioner at UC Davis

Resources:

Communication Across Barriers: a consulting firm founded by Dr. Beegle, providing training and resources to help break the cycle of poverty in America. Resourses include Dr, Beegle’s books, See Poverty…Be The Difference, and If Not Me, Then Who?

UC Davis Center for Poverty Research

Overcoming Obstacles to Health, Report From the Robert Wood Johnson Foundation to the Commission to Build a Healthier America

Development of a tool to identify poverty in a family practice setting: a pilot study.

Brcic V, Eberdt C, Kaczorowski J.

Int J Family Med. 2011;2011:812182. doi: 10.1155/2011/812182. Epub 2011 May 26. Erratum in: Int J Family Med. 2015;2015:418125.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Julia MagañaDr. Sarah MedeirosIts a ritual! We have tea when recording.Some of our recording tools

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Physician wellness is not JUST about going to a yoga class or two. In this episode we explore physician wellness from the perspective of the EM Chair of Stanford University. 

On the personal level we should jump in and check on each other, help each other out! Make sure your leadership knows physician wellness is crucial to providing care 24/7/365.

Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Please subscribe and rate us on iTunes – it helps us reach more people! 

Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest: Dr. Andra Blomkalns, Professor and Chair of the Department of Emergency Medicine at Stanford University

Resources: ACEP Wellness Resources  (https://www.acep.org/life-as-a-physician/wellness/)

SAEM Wellness Resources (https://www.acep.org/life-as-a-physician/wellness/)

UC Davis Physician Health and Well-being Program (https://health.ucdavis.edu/psychiatry/education/fellowships/phwb/index.html)

Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019!

November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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In Emergency Medicine, we are all too familiar with death and dying, but how equipped are we really to provide compassionate end of life care? Dr. Conor Mcwade shares his experience caring for a patient with end stage cancer, and the challenges of respecting the patient’s wishes, even when the family wanted to pursue aggressive measures. Then, palliative care trained physicians, Dr. Rupi Chima and Dr. Cherie Ginwalla, help define some terms and offer advice on how to best care for our dying patients - from pediatric to geriatric - and their families, as well as ourselves. 

How do you think we can improve care for the dying? Share your thoughts on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and rate us on iTunes - it helps us reach more people! 

***Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019!

November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii***

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Cherie Ginwalla, Associate Professor of Pediatrics at UC Davis, Pediatric Palliative Care doctor 

Dr. Rupi Chima, Emergency Medicine Physician at Kaiser South Sacramento, Palliative Care Team

Resources:

ACEP Palliative Medicine Section Tool Kit and Resources 

SAEM Palliative Medicine Online Education Resources

Education in Palliative and End-of-Life Care–Emergency Medicine (EPEC-EM) curriculum 

Being Mortal by Atul Gawande 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Rupi ChimaDr. Cherie GinwallaRecordingDr. Magaña and Dr. MedeirosRecording

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What is military emergency medicine all about? Many of us know physicians who are in the US Armed Forces, but few of us really know what that really entails. Dr. Rod Fontenette is an Emergency Medicine and Critical Care Physician at UC Davis and a Lieutenant Colonel in the US Air Force. He joins us to talk about Military EM, including training, emergency and critical care on the front lines (and at 30,000 feet!), and some of the challenges and rewards of choosing this career path. We have so much respect for what Rod and his colleagues do!

Would you (or have you) considered a career in military EM? Do the advantages and rewards outweigh the challenges and sacrifices? We’d love to hear what you think. Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com. 

If you like what you hear, please subscribe and leave us a review on iTunes - it helps others discover us! 

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Roderick Fontenette, Associate Professor of Emergency Medicine and Critical Care at UC Davis, Lieutenant Colonel US Air Force, Military Associate Program Director UC Davis USAF Integrated Residency Program

Resources:

UC Davis Emergency Medicine USAF Integrated Residency Program

Medicine + The Military: information about medical careers in the military

Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019!

November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Rod Fontenette

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Hafa adai! Or "Hello" in Chamorro, the native language of Guam. I just got back from the US territory of Guam and loved working in such a beautiful place with it’s own set of unique challenges. We spoke with local emergency medicine physician Gabriel David to hear about practicing in an isolated island where many can’t or don’t seek medical care until really ill, and start chewing betel nut at 7-8 years old.  

What atypical places have you  practiced in?  Share your experiences with us on social media, @empulsepodcast, or online at ucdavisem.com/em-pulse.

Please subscribe and leave us a review on iTunes! It help more people discover us.

Host:

Dr. Julia Magana, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Gabriel David, Emergency Medicine Physician Guam Regional Medical City and Guam SDA Urgent Care Clinic

Resources:

Areca Nut (Betel nut)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions. for audio production services.

Guam BeachSnorkeling in GuamBetel nut

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If you work in Emergency Medicine, you know that social and environmental factors greatly impact our patients’ health. This may not be a novel concept, but it is a relatively new field of study. Social Emergency Medicine is a growing branch of EM focused on identifying and studying how social factors affect health. We are especially interested in this topic as many of our episodes explore social issues, such as housing instability, substance use, firearm violence, and human trafficking. In this Heartbeat, we hear from Social EM expert, Dr. Harrison Altar, on what Social EM is all about. You might recognize Dr. Alter from a short segment on our WR SAEM Day 2 Wrap-up episode - now we’re back with his expended interview!

What social factors most impact your patients? How do these issues affect you as a physician or provider? Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and leave us a review on iTunes - it helps others discover us! 

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center

Resources:

The Andrew Levitt Center for Social Emergency Medicine

ACEP Social Emergency Medicine Section

Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019!

November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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How do we teach our medical students and residents to be doctors? Surprisingly, there is no agreed upon, standard approach. Dr. Aaron Danielson, fellowship trained medical educator at UC Davis, takes us through some of the common strategies that medical schools employ. He explains that, although many aspects of medical education have evolved over the past several decades, some things haven’t changed in the over one hundred years since the “Flexner Report”. Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford, takes us through his vision of how medicine is likely to change over the next several decades, and how medical education will need to adapt to train the doctors of the future.

How do you see medical education changing over the next 30 years? What new methods and concepts should we embrace, and what should be done away with? We’d love to hear your thoughts. Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and leave us a review on iTunes - it helps us reach more people! 

Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aaron Danielson, Assistant Professor of Emergency Medicine at UC Davis, Fellowship trained in Medical Education

Dr. Michael Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University

Resources:

The “Flexner Report”

Medical Education in the United States and Canada: a Report to the Carnegie Foundation for he Advancement of Teaching by Dr. Abraham Flexner

Medicine in 2035: Selected Insights From ACGME's Scenario Planning.

Nasca TJ, Thomas CW. J Grad Med Educ. 2015 Mar;7(1):139-42. doi: 10.4300/JGME-D-14-00740.1. PMID: 26217449

Dr. Mike Gisondi’s Recommended Reading:

Reinventing You by Dorie Clark

Stand Out by Dorie Clark

Thanks for the Feedback by Douglas Stone & Sheila Hern

Make it Stick by Peter C. Brown

Steal Like an Artist by Austin Kleon

Illuminate by Nancy Duarte & Patti Sanchez

Entrepreneurial You by Dorie Clark

Show Your Work by Austin Kleon

Hitting Pause by Gail Taylor Rice

Slide:ology by Nancy Duarte

Presentation Zen by Garr Reynolds

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Aaron DanielsonDr. Mike GisondiDr. Julia MagañaDr. Sarah Medeiros

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What’s the craziest place you’ve ever worked? Few of us can top Dr. John Rose’s answer: the South Pole! John worked as the physician at Amundsen-Scott Station in Antarctica for four months during the austral summer of 2018-19. Taking care of a large crew of scientists and visitors in -70 degree weather at over 10,000 ft elevation is no easy feat! John tells us about his deployment, some of the common cases he saw, and the challenges of austere medicine. 

Do you have a question for Dr. Rose? Or want to share your experience working in austere medicine? Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and leave us a review on iTunes - it helps us reach more people! 

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. John Rose, Professor of Emergency Medicine at UC Davis, 

Resources:

Amundsen-Scott South Pole Station

Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Mcmurdo StationDr. John RoseDr. Sarah Medeiros

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Dr. Matt Wetschler’s story represents the best and the worst of our healthcare system. Matt tells us about his near fatal injury, his miraculous recovery (thanks to modern medicine), and the complications with billing that plagued him for months after his accident. Matt’s story is one of several in the recent media highlighting the issue of “surprise billing”, and a subset of this issue referred to as “balance billing”. Drawing from his health policy background, Matt helps us understand balance billing and how patients are affected. Then, Dr. Tom Sugarman joins us to further explain the complexities of surprise billing. He shares how he and others are advocating at the national level to change the billing process, and offers some potential solutions going forward. 

This is a hot button issue! Please remember that the opinions expressed in this podcast may not represent those of UC Davis or the University of California. 

Have you had any experiences with surprise billing? As a health care provider, how do you address this issue with your patients? What potential solutions do you envision? Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and rate us on iTunes - it helps us reach more people! 

Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Matthew Wetschler, Emergency Physician with a Masters in Public Health and Health Policy, motivational speaker, and practicing artist in San Francisco, CA

Dr. Tom Sugarman, Chair of Emergency Medicine at Sutter Delta Medical Center in Antioch, Senior Director of Government Affairs for Vituity, and active member and former President of Cal ACEP

Media Credit:

Opening audio is from a short film by Scott Fitzloff. Watch the video in its entirety at www.matthewwetschler.com

Resources:

More on Dr. Matt Wetschler’s personal experience with billing via CNBC. 

Since his accident, Matt (AKA the Resurrection Artist) has rediscovered his passion for art. More on his story and his work at MatthewWetschler.com

Dr. Wetschler recommends the book An American Sickness, by Elisabeth Rosenthal.

AMA Issue brief explaining balance billing 

ACEP policy on balance billing

ACEP Commitment to Best Practices for EM Practice Groups

President Trump’s recent comments on ending surprise medical billing

Dr. Matthew WetschlerPhoto by Saroyan HumphreyDr. Tom SugarmanDr. Julia MagañaDr. Sarah MedeirosPodcast RecordingPodcast RecordingRecording Dr. Wetschler

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Measles is a hot topic from your latest shift to the news measles is on everyone’s mind! Fortunately, Dr. Dean Blumberg an infectious disease physician and fellow podcast host walks us through the basics of measles from the standpoint of the emergency department.  

Which patients do you screen for measles?  Have you seen any confirmed cases?  Share your thoughts with us on social media, @empulsepodcast, or online at ucdavisem.com/em-pulse.

Please subscribe and leave us a review on iTunes! It help more people discover us.

Host:

Dr. Julia Magana, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Dean Blumberg, Associate Professor of Pediatrics at UC Davis, Chief of Pediatric Infectious Diseases and Host of Kids Considered.

Resources:

CDC’s Measles for Healthcare Providers (https://www.cdc.gov/measles/hcp/index.html)

Kid’s Considered Podcast hosted by Dr. Dean Blumberg (https://blog.ucdmc.ucdavis.edu/twopedsinapod/)

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productionsfor audio production services.

Dr. Dean BlumbergDr. Julia Magaña

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In our January episode, #thisisourlane, we spoke with Dr. Garen Wintemute about firearm violence, and discussed the immediate and passionate social media outpouring from physicians in response to an NRA tweet. In this episode, we dive deeper into the topic of physician advocacy, and, more specifically, the role of social media in advocacy. Our guest, Dr. Megan Ranney, is an emergency medicine physician, educator, and digital health and public health researcher, and is an avid social media user herself. She discusses the power of social media to affect change, and offers some tips for how to make your voice heard, and how to navigate some of the pitfalls. Listen through to the end for thoughts from some other well known EM physicians, including Drs. Mike Gisondi, Steve Bird, and Nikita Joshi.

How do you use social media? What do you think about health care professionals using social media for advocacy? Tell us how you’re getting involved - or why you’re staying away! Find us on social media as @empulsepodcast, or on our website, ucdavisem.com. 

Please subscribe and rate us on iTunes - it helps us reach more people! 

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Megan Ranney, Associate Professor of Emergency Medicine at Brown University, Chief Research Officer at AFFIRM Research

Featuring:

Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center 

Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University

Dr. Vishnu Parthasarathy, Emergency Medicine Resident at UC San Diego

Dr. Steve Bird, President of SAEM, Vice Chair of Education at UMass Medical School

Dr. Linda Herman, Emergency Medicine Residency Program Director at Kaweah Delta

Dr. Nikita Joshi, Emergency Medicine Faculty at Alameda Health System

Resources:

AFFIRM Research

Mayo Clinic 12 Word Social Media Policy

Cyberbullying in Academic Medicine: A Framework for Managing Social Media Attacks.

Cain J, Linos E, Chretien KC. Acad Med. 2019 Mar 26. doi: 10.1097/ACM.0000000000002649. [Epub ahead of print]

Twitter as a tool for communication and knowledge exchange in academic medicine: A guide for skeptics and novices.

Choo EK, Ranney ML, Chan TM, Trueger NS, Walsh AE, Tegtmeyer K, McNamara SO, Choi RY, Carroll CL. Med Teach. 2015 May;37(5):411-6. doi: 10.3109/0142159X.2014.993371. Epub 2014 Dec 19.

It's Time for More Physicians to Embrace Advocacy, a Scientific American blog post by Dr. Angira Patel, March 13, 2018.

ACEP Firearm Safety and Injury Prevention Policy Statement

What You Can Do

Dr. Julia Magaña and Dr. Sarah MedierosDr. Megan RanneyDr. Mike GisondiDr. Steve BirdDr. Harrison Alter

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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What is it like to be an Emergency Physician in the ED during a mass shooting? Dr. Austin Johnson was a senior resident at the University of Colorado Hospital on the night a gunman opened fire in a movie theater in Aurora, Colorado. He shares his firsthand experience as a physician in the ED that night, and discusses the effects of the event on providers, and how the experience has shaped his practice. 

Have you been a provider during a mass casualty event? How has the experience affected you?  Share your thoughts with us on social media, @empulsepodcast, or online at ucdavisem.com/em-pulse.

Please subscribe and leave us a review on iTunes! It help more people discover us.

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Austin Johnson, Assistant Professor is Emergency Medicine at UC Davis

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productionsfor audio production services.

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EM Pulse Live Edition: WR SAEM Day 2 Wrap-up

It was another exciting day at the Western Regional SAEM conference in Napa, CA! This episode recaps Day 2, including the Western EM Challenge and some fantastic plenary speakers. Highlights include time management for EM physicians, social emergency medicine, care for LGBTQI patients, the future of medical education, exercise in medicine, and building your social media brand.

The conference is trending of social media - follow #WRSAEM19, @wrsaem19, and, of course, @empulsepodcast for all the details.

How did we do? This is a new type of podcasting for us and we’d love your feedback! Hit us up on social media or at ucdavisem.com. 

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Linda Herman, Emergency Medicine Residency Program Director at Kaweah Delta 

Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center 

Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University

Dr. Angela Jarman, Assistant Professor of Emergency Medicine at UC Davis

Dr. Rachel Bentzen, Assistant Professor of Emergency Medicine and Sports Medicine at Oregon Health Science University

Dr. Nikita Joshi, Emergency Medicine Faculty at Alameda Health System 

Dr. Jim Holmes, Professor of Emergency Medicine at UC Davis and WR SAEM 2019 Conference Chair

Resources:

Nasca TJ, Thomas CW. Medicine in 2035: Selected Insights From ACGME's Scenario Planning. J Grad Med Educ. 2015;7(1):139-42.

Kuppermann N, Dayan PS, Levine DA, et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections[published online ahead of print, 2019 Feb 18]. JAMA Pediatr. 2019;10.1001/jamapediatrics.2018.5501. doi:10.1001/jamapediatrics.2018.5501

Kuppermann N, Ghetti S, Schunk JE, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018;378(24):2275-2287. 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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This is a first for us! We’re podcasting live (or nearly live) from the 2019 Western Regional Society for Academic Emergency Medicine Annual Meeting in Napa, California. In this episode, we re-cap Day 1 of the conference, featuring the Advanced Airway Lab with Dr. Erik Laurin, Wellness in Academic EM with Dr. Andra Blomkalns, Experience in a Mass Shooting with Dr. Austin Johnson, The Value of Scholarship with Dr. Steve Bird, and much, much more!

The conference is trending of social media - follow #WRSAEM19, @wrsaem19, and, of course, @empulsepodcast for all the details.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Erik Laurin, Professor of Emergency Medicine at UC Davis

Dr. Andra Blomkalns, Professor and Chair of the Department of Emergency Medicine at Stanford University

Dr. Austin Johnson, Assistant Professor is Emergency Medicine at UC Davis

Dr. Steve Bird, Vice Chair of Education at UMass Medical School

Dr. Jim Holmes, Professor of Emergency Medicine at UC Davis and WR SAEM 2019 Conference Chair

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Heartbeat: The Mind of an Airway Enthusiast

We sit down with EM legend and airway guru, Dr. Rich Levitan. Dr. Levitan is a self-proclaimed airway enthusiast who has published extensively on laryngoscopes and airway management. He currently works clinically, mainly in rural, critical care access hospitals, and travels the country and the globe speaking and teaching courses on airway management.  So how does Dr. Levitan approach the “difficult airway”? It starts with mindset.  

Send us your questions and continue the conversation on social media@empulsepodcast or at ucdavisem.com.

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Rich Levitan, Emergency Physician, Adjunct Professor at Dartmouth Geisel School of Medicine, Visiting Professor at the University of Maryland School of Medicine. 

Resources:

AirwayCam.com

Ski and CME! Join us for the,UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe, CA.

Come play and learn with us at the Western Regional SAEM Annual Meeting, March 21-22 in beautiful Napa, CA! #WRSAEM19 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Rich LevitanDr. Sarah MedeirosQSC mixer, Apogee converters, Shure mics, Mogami Cables, Sony headphones

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“Hot” Off the Press: Infant Fever Rule - Episode 15

Talking about neonatal fever makes most people hot under the collar! Fortunately, PECARN is on the case. Their latest paper was just published TODAY in JAMA Peds: A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. In this month’s episode, we learn about some the challenges of having a febrile infant - from a mom’s perspective. Then we discuss when, why, and how to apply the latest PECARN rule with the notorious DNK, also known as Dr. Nate Kuppermann! 

What is your approach to the febrile infant? What are some of the hardest parts about providing care to our hot little ones? We want to know! Share your thoughts on social media, @empulsepodcast, or on our website, ucdavisem.com. 

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee

Resources:

A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. 

Nathan Kuppermann, MD, MPH1; Peter S. Dayan, MD, MSc2; Deborah A. Levine, MD3; et al. JAMA Pediatr. Published online February 18, 2019. doi:10.1001/jamapediatrics.2018.5501

Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants.

Gomez B, Mintegi S, Bressan S, Da Dalt L, et. al. Pediatrics. 2016 Aug;138(2). pii: e20154381. doi: 10.1542/peds.2015-4381. Epub 2016 Jul 5.

Management of the Febrile Young Infant: Update for the 21st Century. 

Woll C, Neuman MI, Aronson PL. Pediatr Emerg Care. 2017 Nov;33(11):748-753. doi: 10.1097/PEC.0000000000001303.

Accuracy of Complete Blood Cell Counts to Identify Febrile Infants 60 Days or Younger with Invasive Bacterial Infections. 

Cruz AT, Mahajan P, Bonsu BK, Bennett JE et. al. JAMA Pediatr. 2017 Nov 6;171(11):e172927. doi: 10.1001/jamapediatrics.2017.2927. Epub 2017 Nov 6.

Ski and CME! Join us for the,UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe, CA.

Come play and learn with us at the Western Regional SAEM Annual Meeting, March 21-22 in beautiful Napa, CA! #WRSAEM19 

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Nathan KuppermannSarah and Julia

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Treat others not as you want to be treated but as they want to be treated. Mai Lee, RN and Dan Colby join us to share some stories and talk about how culture can impact our care in the ED and what we can do about it. Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest: Dr. Daniel Colby, Assistant Professor of Emergency Medicine UC Davis

Guest: Mai Lee, RN, UC Davis Emergency Medicine CN II

Resources:

NIH Cultural Respect: https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/cultural-respect

Join us in Tahoe, March 4-8, at the 42nd Annual UC Davis Emergency Medicine Winter Conference!

We’ll also be teaching and podcasting at the Western Regional SAEM Annual Meeting in Napa, CA, March 21-22. Hope to see you there!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Cultural Compentency

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Thisismylane– Episode 14

If you work in the ED, you’ve likely seen your fair share of victims of gun violence. Though mass shootings have brought this issue into the public eye, firearm violence has been a public issue in our country for decades. In this episode, you’ll hear some powerful stories from providers about their experiences with people killed and injured by firearms. Then, we talk with researcher and expert, Dr. Garen Wintemute, about trends he’s seen, and discuss how we, as physicians and medical providers, can be part of the solution.  Clearly this is a charged and complex topic. Let’s respectfully share our thoughts on how we can help prevent gun violence. We want to know! Share your thoughts on social media, @empulsepodcast, or on our website, ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Garen Wintemute Professor of Emergency Medicine, Susan P. Baker-Stephen P. Teret Chair in Violence Prevention at UC Davis, and Director, Violence Prevention Research Program   Resources: UC Davis Violence Prevention Research Program Toolkit: What You Can Do to Stop Firearm Violence https://health.ucdavis.edu/vprp/WYCD.html Annals of Internal Medicine commitment and op ed: What You Can Do to Stop Firearm Violence http://annals.org/aim/pages/commitment-to-stop-firearm-violence Speak For Safety Video of Garen Talking about gun retailers taking a hard line against illegal gun sales: https://health.ucdavis.edu/publish/facultybio/search/faculty/242 Ski and CME! Join us for the,UC Davis Emergency Medicine Winter Conference March 4th-8th at the Ritz Carlton in Lake Tahoe. Come play and learn with at the Western Regional SAEM Annual Meeting, March 21-22 in beautiful Napa, CA! #WRSAEM19  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. While this is a UC Davis EM podcast and many of the voices you hear today, including our own, are those of UC Davis EM Physicians, the opinions expressed may not be those of the UC DAVIS institution and Health System.

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2018 In review. Some of our favorite episodes.

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Last Stand in Santa Rosa Imagine you’re working a shift in the Emergency Department when a fast moving wildfire hits. What would you do if you found out your home was burning? Or your family was in danger? And how do you react when the Fire Department tells you they are making a last stand a block away from your hospital? This situation is all too real for many physicians and providers affected by devastating wildfires in California. In this episode, we follow the story of the 2017 Santa Rosa fires from the perspective of three Emergency Physicians, Dr. Josh Weil, Dr. Suzy Fitzgerald, and Dr. Dane Stevenson. Their powerful story, and the lessons learned from their experience, are guaranteed to improve your personal and professional disaster preparedness.  Please also consider donating to ongoing relief efforts following the 2018 California wildfires through the Red Cross.  Do you know your hospital’s disaster plan? Do you have a personal plan? Have you lived through a disaster? Share your experience with us on social media, @empulsepodcast, or on our website, ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Susan Fitzgerald, Emergency Physician at Kaiser Santa Rosa and Emergency Management Physician Lead in the Diablo Service Area; Kaiser Permanente Northern California (KPNC) Regional Emergency Management Drill and Training Director and the Pediatric Surge Planning Chair for the KPNC Regional Emergency Management Committee. Dr. Joshua Weil, Emergency Physician at Kaiser Santa Rosa and Assistant Physician-in-Chief for Hospital Operations; Member of the American Red Cross Board of Directors, Board Chair for the Ceres Project, and Medical Director for the Jewish Community Free Clinic in Santa Rosa. Dr. Weil has been involved in major disaster relief efforts in the US and internationally, including Sri Lanka, Louisiana, Haiti, and the Philippines. Dr. Dane Stevenson, Emergency Physician at Kaiser Santa Rosa, with a Fellowship in Geriatric Emergency Medicine from UC Davis. Resources: ACEP Disaster Medicine Resources American College of Emergency Physicians Disaster Medicine resources, policies, and public training, including hospital disaster preparedness self assessment tool and hospital evacuation plan template.  “Healing and History after fire & Weil-Mollard Household”  Dr. Josh Weil and his wife, Claire Mollard, share their story on YouTube The story of Josh's goats! on NPR/Capitol Public Radio

Ski and CME! Join us for the UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe. Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.  

Dr. Joshua WeilDr. Susan FitzgeraldDr. Dane StevensonDrs. Magaña and Medeiros

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Camp Fire medicine

What are the medical needs when your WHOLE town burns down? What is it like to walk into a shelter with over a thousand friends and family still missing? What if the evacuees you are caring for are your neighbors? The California wildfires have been huge part of our personal and professional lives at UC Davis. In this Heartbeat we spoke with an EM resident who volunteered at a shelter in Chico, CA. Dr. Molly Hallweaver discusses what she saw, treated, and learned taking care of the victims of the Camp Fire. Burn care and inhalation injuries were not the most common needs in the shelter. More often people needed a shoulder on which to cry and treatment of chronic medical needs. 

We challenge you to think about what you would do if your community was burning down?  What if your hospital caught on fire? On our next episode we hear the story of Dane Stevenson, a Kaiser EM Physician, whose hospital caught on fire and the experts who can help the rest of us know what we can do to prepare for those moments. Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest: Dr. Molly Hallweaver  Emergency Medicine Resident at UC Davis

Resources: If you want to help the victims of the Camp Fire, monetary donations may be made to the American Red Cross. Visit www.redcross.org, call 1-800-RED CROSS, or text the word REDCROSS to 90999 to make a $10 donation.

The United Way of Northern California is taking donations for its NorCal Fire Relief Fund through its website and by text: send the message BUTTEFIRE to 91999.

Join us in Tahoe, March 4-8, at the 42nd Annual UC Davis Emergency Medicine Winter Conference!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

NASA Image of the Camp Fire

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Caring for kids in the ED can be challenging - they often can’t (or won’t) tell you what’s wrong or where it hurts; they may have trouble sitting still during an exam or procedure; and their screams put everyone on edge. But let’s think about it from their perspective. It must be pretty confusing and frightening at times. Did you ever have to go to the ED as a kid? Do you remember what it was like? We ask some kids to share their thoughts and experiences. Then we get some valuable tips from the experts - Child Life Specialists, Pediatric ED Nurses, and Pediatric Emergency Medicine Physicians, including our own Dr. Julia Magaña. Learn what you can do to improve the ED experience for both you and your young patients.

What tips do you have for taking care of kids in the ED? Did you try any of the things we mentioned in this episode? If so, did they work for you? We want to know! Share your thoughts on social media, @empulsepodcast, or on our website, ucdavisem.com. 

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guests:

The kids: Isa, Jordan, Benny, Katelyn, Wesley and Elia

UC Davis Department of Emergency Medicine Child Life Specialists, Nurses and Pediatric Emergency Medicine Physicians.

Resources:

DistrACTION Cards that Julia mentioned

Information and protocols for using intranasal medications at www.intranasal.net

Wong-Baker FACES pain scale

FLACC Score for pain in infants

ACEP Guidelines for Procedural Sedation and Analgesia in the Emergency Department (2013)

An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond.

Ali S, McGrath T, Drendel AL. Pediatr Emerg Care. 2016 Jan;32(1):36-42; quiz 43-4. doi: 10.1097/PEC.0000000000000669. Review.

Patient- and family-centered care of children in the emergency department.

Dudley N, Ackerman A, Brown KM, Snow SK; American Academy of Pediatrics Committee on Pediatric Emergency Medicine; American College of Emergency Physicians Pediatric Emergency Medicine Committee; Emergency Nurses Association Pediatric Committee.

Pediatrics. 2015 Jan;135(1):e255-72. doi: 10.1542/peds.2014-3424.

Ten Practical Ways to Make Your ED Practice Less Painful and More Child-Friendly

Amy L.DrendelDO, MS*SaminaAliMDCM, Clinical Pediatric Emergency Medicine

Volume 18, Issue 4, December 2017, Pages 242-255

Ski and CME! Join us for the UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Heartbeat: The Price of Beauty

As Emergency Physicians, we pride ourselves on recognizing and treating life-threatening conditions. But what if we’re missing important diagnoses and we don’t even know it? In this Heartbeat, we explore acute and chronic silicone syndromes, two potentially serious conditions caused by injecting liquid silicone into the body. Dr. Nick Gorton, previously featured on Episode 8: Don’t be a Jerk! and the LGBTQI, MD Heartbeat, joins us again with advice on how to diagnose and manage these conditions that predominantly affect women, especially transgender women. 

Are these diagnoses new to you? Have you seen and treated either of these conditions? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. R. Nick Gorton, Emergency Physician at Sutter Davis, and Primary Care Physician at the Lyon-Martino Clinic in San Francisco. 

Resources:

Silicone Pumping Harm Reduction Pamphlet

Dying to be a Woman trailer by TransLatin@ Coalition

TRANSLINE national online transgender medical consultation service - free and confidential. 

Lyon-Martin Health Services, San Francisco, CA.

Silicone embolism syndrome: a case report, review of the literature, and comparison with fat embolism syndrome.

Schmid A, Tzur A, Leshko L, Krieger BP.

Chest. 2005 Jun;127(6):2276-81. Review.

Join us in Maui for Emergency Medicine Hot Topics! November 6-10, 2018.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Nick Gorton

Dr. Sarah Medeiros

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If you have ever worked in an ED, you have taken care of a homeless patient. In fact, you’ve probably taken care of many patients you didn’t even know were struggling with homelessness. As providers, we know these people well. They are often labeled “superusers” and, in addition to sometimes acting as their primary care physicians, we often find ourselves trying to sort out their myriad social issues. In this episode, we talk with a homeless patient, multiple ED providers, and expert Dr. Bisan Salhi, about some of the health challenges that our undomiciled patients face, and what role the ED should play in caring for these patients. You’ll hear a variety of opinions on this controversial topic. We then talk with health policy experts, Dr. Nick Sawyer and Dr. Aimee Moulin, about the recently signed California Senate Bill 1152, and how it will affect hour care and discharge of self-identified homeless patients.

Do you screen for homelessness? How do you care for homeless patients in your ED? Will you be affected by CA Senate Bill 1152? This topic is likely to generate some heated conversation. Join us on social media, @empulsepodcast, or on our website, ucdavisem.com, to keep the discussion going. 

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Bisan Salhi,  Assistant Professor of Emergency Medicine at Emory and PhD in Anthropology

Dr. Nick Sawyer, Assistant Professor of Emergency Medicine at UC Davis, California ACEP Board Member

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and President of California ACEP

Resources:

Homelessness and Emergency Medicine: A Review of the Literature.

Salhi BA, White MH, Pitts SR, Wright DW.

Acad Emerg Med. 2018 May;25(5):577-593. doi: 10.1111/acem.13358. Epub 2018 Jan 11.

Get involved through California ACEP!

Read the complete California Senate Bill 1152.

What better place to earn CME than Maui! There's still time to register for the 15th Annual Emergency Medicine Hot Topics conference taking place Nov. 6-10, 2018 in Hawaii. Earn up to 20.5 CME credits!

Register today at tinyurl.com/EMHOTTOPICS

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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A cool tool.

In this episode Dr. Nate Kuppermann (@nkuppermann) discusses another amazing article on the PECARN TBI decision rule just published in JAMA Network Open. The article, Effect of the Head Computed Tomography Choice Decision Aid in Parents of Children With Minor Head Trauma: A Cluster Randomized Trial, and this episode explores shared decision making in the ED and a cool tool we can use to aid this process.

Send us your questions and continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest:

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee

Resources:

Effect of the Head Computed Tomography Choice Decision Aid in Parents of Children With Minor Head Trauma: A Cluster Randomized Trial.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2703135

Erik P. Hess, MD, MSc1,2,3; James L. Homme, MD4,5; Anupam B. Kharbanda, MD, MSc6; Leah Tzimenatos, MD7; Jeffrey P. Louie, MD8; Daniel M. Cohen, MD9; Lise E. Nigrovic, MD, MPH10; Jessica J. Westphal11; Nilay D. Shah, PhD12,13; Jonathan Inselman, MS13; Michael J. Ferrara2,14; Jeph Herrin, PhD15; Victor M. Montori, MD, MSc3; Nathan Kuppermann, MD, MPH6,16

JAMA Network Open. 2018;1(5):e182430. 

Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. (https://www.ncbi.nlm.nih.gov/pubmed/19758692)

Kuppermann  N, Holmes  JF, Dayan  PS,  et al; Pediatric Emergency Care Applied Research Network.  Lancet. 2009;374(9696):1160-1170.

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Excuse Me, Your Bias is Showing - Episode 10

We all have biases lurking in our unconscious mind. These are our implicit biases, and they affect how we relate to patients and, in turn, how they relate to us. But if these biases are unconscious, how do we identify them? And is it possible to change them? We share our own experiences with implicit bias, and we hear Dr. Rupa Marya’s story that went viral on social media. Then we dive a little deeper with researcher and pediatric emergency medicine physician, Dr. Tiffani Johnson.

Want to check your own biases? Take an implicit association test (IAT) through Project Implicit. Let us know what you found and let’s continue the discussion on social media, @empulsepodcast. If you’d like to keep your results more private, send us a comment on our website, ucdavisem.com.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Tiffani Johnson, Pediatric Emergency Medicine Physician and Faculty at the Policy Lab at Children’s Hospital of Philadelphia (CHOP) 

Special thanks to Dr. Rupa Marya and Bonnie Castillo for allowing us to use the audio from this video that was featured on NowThis Politics

Resources:

The Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias.

Johnson TJ, Hickey RW, Switzer GE, Miller E, Winger DG, Nguyen M, Saladino RA, Hausmann LR. Acad Emerg Med. 2016 Mar;23(3):297-305. doi: 10.1111/acem.12901. Epub 2016 Feb 22. PMID: 26763939

Comparison of Physician Implicit Racial Bias Toward Adults Versus Children.

Johnson TJ, Winger DG, Hickey RW, Switzer GE, Miller E, Nguyen MB, Saladino RA, Hausmann LR. Acad Pediatr. 2017 Mar;17(2):120-126. doi: 10.1016/j.acap.2016.08.010. Epub 2016 Sep 13. PMID: 27620844

Project Implicit - take an IAT!

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Dr. Tiffany Johnson (center)

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It’s all about Tommie.

Way back in March we discussed how “The Game has Changed” with Dr. Dr. Gail D’Onofrio and Dr. Josh Elder (https://twitter.com/joshuawelder).  They discussed how emergency departments can be a positive part of the opiate epidemic by offering buprenorphine (suboxone). In this episode we find out how the program is going and how the human element (aka Tommie, our substance use counselor) is helping it succeed.

Send us your questions and continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Hosts:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and President of California ACEP

Resources:

ED Bridge (https://ed-bridge.org) emergency department support for development and implementation of buprenorphine treatment

AMA END the EPIDEMIC (https://www.end-opioid-epidemic.org/resources/california-acep-safe-prescribing-guidelines/) multi-specialty resources 

California ACEP (https://californiaacep.site-ym.com/forums/posts.aspx?group=&topic=1427775&page=1&hhSearchTerms=%22buprenorphine%22#post_1427775) Dr. A Moulin’s message on Substance Use Disorder Treatment in the ED-stay tuned for more resources at this website

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open at www.cevs.ucdavis.edu/confreg/?confid=960

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Thriving, not Surviving - Episode 9

Are you well? In this episode we tackle the issue of physician wellness. What does that mean? Why is it a problem? And what can we do to thrive, not just survive, in medicine? We discuss strategies with EM physicians of all levels, including Cal ACEP President, Dr. Aimee Moulin, and Dr. Katren Tyler, Vice Chair of Wellness for the UC Davis Department of Emergency Medicine.

How do you define physician wellness? What is your personal recipe for THRIVING, not just surviving? Join the conversation on social media, @empulsepodcast, or at ucdavisem.com.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and President of California ACEP

Dr. Katren Tyler, Professor of Emergency Medicine and Vice Chair for Faculty Development, Wellness and Outreach in the UC Davis Department of Emergency Medicine

Various UC Davis Department of Emergency Medicine residents, fellows, and faculty.

Resources:

Ten commandments of physician wellness.

Krall EJ. Clin Med Res. 2014 Sep;12(1-2):6-9. doi: 10.3121/cmr.2013.1211. Epub 2014 Jan 10. No abstract available. PMID: 24415746

What Do We Mean by Physician Wellness? A Systematic Review of Its Definition and Measurement.

Brady KJS, Trockel MT, Khan CT, Raj KS, Murphy ML, Bohman B, Frank E, Louie AK, Roberts LW.

Acad Psychiatry. 2018 Feb;42(1):94-108. doi: 10.1007/s40596-017-0781-6. Epub 2017 Sep 14. Review. PMID: 28913621

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open!

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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If it Hurts, Don’t do it!

Let’s revisit concussion and return to play with UC Davis Head Team Physician, Dr. Jeremiah Ray. This Heartbeat was originally recorded as a Facebook LIVE for the UC Davis Health page. We first talked about concussion in May’s episode, “Breaking Out of Concussion Jail". This Heartbeat is a little more casual and offers some practical information for how to recognize and manage concussion in athletes - plus, it provides a little spaced repetition to help us remember what we learned! 

Send us your questions and continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Jeremiah Ray, Head Team Physician for UC Davis Intercollegiate Athletics

Resources:

SCAT 5 (Sports Concussion Assessment Tool - 5th Edition)

CDC HEADS UP to Brain Injury Awareness

Resources for Health Care Providers Resources for Parents

NCAA Concussion Diagnosis and Management Best Practices

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open at www.cevs.ucdavis.edu/confreg/?confid=960

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Dr. R Nick Gorton and Dr. Kara Toles are back to talk about transgender care in the Emergency Department. Did you know you already have the skills to advocate for and care for transgender patients? You do! Let’s sum it up in four words: DON’T BE A JERK! Treat your patients like you’d want your family member to be treated. We’ll explore some of the challenges and concerns specific to transgender patients — JM Jaffe shares a very personal account of their experience. Drs. Gorton and Toles then review Nick’s recent paper on the topic and give us some practical tips to help us gracefully navigate the complexities of the gender spectrum in the ED. 

How does your department (or residency, med school, etc.) address the topic of transgender care? Join the conversation on social media, @empulsepodcast, or at ucdavisem.com.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

JM Jaffe, Trans Health Manager at Lyon Martin Clinic

Dr. Kara Toles, Assistant professor of Emergency Medicine at UC Davis and Emergency Physician at UTMB Health. 

Dr. R. Nick Gorton, Emergency Physician at Sutter Davis, and Primary Care Physician at the Lyon-Martino Clinic in San Francisco. 

Resources:

TRANSLINE national online transgender medical consultation service - free and confidential. 

Lyon-Martin Health Services, San Francisco, CA.

Improving the Quality of Emergency Care for Transgender Patients

Gorton RN, Berdahl CT. Ann Emerg Med. 2018 Feb;71(2):189-192.e1. doi: 10.1016/j.annemergmed.2017.12.003. Epub 2018 Feb 5.

“Sometimes You Feel Like the Freak Show”: A Qualitative Assessment of Emergency Care Experiences Among Transgender and Gender-Nonconforming Patients

Elizabeth A. Samuels, Chantal Tape, Naomi Garber, Sarah Bowman, Esther K. Choo

Ann Emerg Med. 2018 Feb;71(2):170-182.e1. doi: 10.1016/j.annemergmed.2017.05.002. Epub 2017 Jul 14.

Transgender and Gender-Nonconforming Patients in the Emergency Department: What Physicians Know, Think, and Do

Makini Chisolm-Straker, Cathleen Willging, Adrian D. Daul, Shannon McNamara, S. Cham Sante, Daniel G. Shattuck II, Cameron S. Crandall

Ann Emerg Med. 2018 Feb;71(2):183-188.e1. doi: 10.1016/j.annemergmed.2017.09.042. Epub 2017 Nov 3.

Improving Care for Lesbian, Gay, Bisexual, and Transgender Patients in the Emergency Department 

Ann Emerg Med. 2015 Oct;66(4):417-23. doi: 10.1016/j.annemergmed.2015.02.004. Epub 2015 Mar 5.

Sara Jalali, Lauren M. Sauer

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open at www.cevs.ucdavis.edu/confreg/?confid=960

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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LGBTQI, MD

Happy Pride, everyone! June is coming to an end and we’ve enjoyed celebrating all the diverse and beautiful people in our communities. In the spirit of Pride month, this Heartbeat explores what it’s like to be an LGBTQI physician. For those unaware, LGBTQI stands for lesbian, gay, bisexual, transgender, queer (or questioning), and intersex. Many people also add an A for asexual, or allies. Dr. Kara Toles and Dr. Nick Gorton graciously share their stories with us, as well as their advice for future doctors who may identify with any of the letters in the acronym. Dr. Gorton and Dr. Toles will also be joining us in an upcoming full episode that we are really excited about. Stay tuned!

Do you identify as LGBTQIA? We’d love to hear your story. Please send us your thoughts or experiences through our website, ucdavisem.com, or on social media, @empulsepodcast. We look forward to hearing from you!

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Kara Toles, Assistant professor of Emergency Medicine at UC Davis and Emergency Physician at UTMB Health. 

Dr. R. Nick Gorton, Emergency Physician at Sutter Davis, and Primary Care Physician at the Lyon-Martino Clinic in San Francisco. 

Resources:

GLMA - Gay and Lesbian Medical Association - Ensuring equality in healthcare for LGBT individuals and healthcare professionals. 

It Gets Better Project

Lyon-Martin Health Services, San Francisco, CA. 

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open at www.cevs.ucdavis.edu/confreg/?confid=960

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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DKA: It’s Not About the Fluids! - Episode 7

Hot of the presses! We are thrilled to speak with the amazing husband and wife research team of Dr. Nate Kuppermann and Dr. Nicole Glaser, on their practice changing paper that was just, and we mean JUST, published in the New England Journal of Medicine. DKA (diabetic ketoacidosis) is a potentially life threatening condition that can be complicated to treat, especially in children. First, we’ll hear from 9-year-old Whitley and her mom, Amanda, about what it’s like to be a kid living with diabetes, and what it feels like to have the dreaded DKA. Then we’ll dive into the research with Drs. Kuppermann and Glaser and learn how their findings revolutionize the way we treat DKA in kids.

How does this paper change the way you approach children with DKA in your practice? Continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Whitley and Amanda, a mother and daughter team living with diabetes

Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee

Dr. Nicole Glaser, Professor of Pediatric Endocrinology at UC Davis

Resources:

Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis

Nathan Kuppermann, M.D., M.P.H., Simona Ghetti, Ph.D., Jeff E. Schunk, M.D., Michael J. Stoner, M.D., Arleta Rewers, M.D., Ph.D., Julie K. McManemy, M.D., M.P.H., Sage R. Myers, M.D., M.S.C.E., Lise E. Nigrovic, M.D., M.P.H., Aris Garro, M.D., M.P.H., Kathleen M. Brown, M.D., Kimberly S. Quayle, M.D., Jennifer L. Trainor, M.D., Leah Tzimenatos, M.D., Jonathan E. Bennett, M.D., Andrew D. DePiero, M.D., Maria Y. Kwok, M.D., M.P.H., Clinton S. Perry, III, Ph.D., Cody S. Olsen, M.S., T. Charles Casper, Ph.D., J. Michael Dean, M.D., and Nicole S. Glaser, M.D. for the PECARN DKA FLUID Study Group.

N Engl J Med. 2018 June 14, 378:2275-2287

Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics.

Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, Kaufman F, Quayle K, Roback M, Malley R, Kuppermann N; Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. N Engl J Med. 2001 Jan 25;344(4):264-9. 

PMID: 11172153 

PECARN (Pediatric Emergency Care Applied Research Network)

For those of you who want more, here is the unedited interview: Drs. Kuppermann and Glaser

Join us in Maui for Emergency Medicine Hot Topics! 

November 6-10, 2018. Registration is now open at www.cevs.ucdavis.edu/confreg/?confid=960

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Catching Pee in the ED

In this Heartbeat we go over two alternatives to cathing that infant in your ED.  If you had an infant who needed to be cathed, ever seen an infant cathed, or even heard a child cathed, you know it is less than fun. Here are two different, published methods that we attempted, back to back, on an infant…then we ended up doing the cath anyway!

Join the conversation on Social Media @empulsepodcast or at ucdavisem.com

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis.

Guest:

Keyon Mitchell, UC Davis Medical School Graduate Class of 2018.

Resources:

Hall-million S, Howard PK. Does Suprapubic Stimulation in Infants Facilitate Collection of a Clean Catch Urine Specimen? Adv Emerg Nurs J. 2017 Oct/Dec;39(4):236-239. https://www.ncbi.nlm.nih.gov/pubmed/29095174

Kaufman J, Tosif S, Fitzpatrick P, Hopper SM, Bryant PA, Donath SM, Babi FE. Quick Wee: a novel non-invasive urine collection method. Emerg Med J. 2017 jan;34(1):63-64. https://www.ncbi.nlm.nih.gov/pubmed/27565196

Kaufman J, Fitzpatrick P, Tosif S, Hopper SM, Donath SM, Vryant PA, Babe FE. Faster clean catch urine collection (Quick-Wee method) from infants: randomized controlled trial. BMJ 2017 Apr 7; 356:j1341. https://www.ncbi.nlm.nih.gov/pubmed/28389435

Labrosse M, Levy A, Autmizguine J, Gravel J. Evaluation of a New Strategy for Clean-Catch Urine in Infants. Pediatrics. 2016 Sep;138(3). pie:e20160573. https://www.ncbi.nlm.nih.gov/pubmed/27542848

Ray S, Forbes O. Quick-Wee is an effective technique for urine collection in infants. Arch Dis Child Edu Pract Ed. 2017 Oct 9. https://www.ncbi.nlm.nih.gov/pubmed/28993431

Tran A, Fortier C, Giovanni-chami L, demnchy D, Caci H, Desmontilis J, Montaudie-Dumas I, Bensaid R, Haas H, Berard E. Evaluation of the Bladder Stimulation Technique to Collect Midstream Urine in Infants in a Pediatric Emergency Department. PLoS one. 2016 mar 31;11(3):e0152598. https://www.ncbi.nlm.nih.gov/pubmed/?term=Evaluation+of+the+Bladder+Stimulation+technique+to+collect+midstream+urine

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Breaking Out of Concussion Jail - Episode 6

Suffering a concussion can make you feel like a prisoner, especially if you’re a student athlete. Cameron Wright, a division I water polo player who suffered a concussion last year, knows this first hand. In this episode, he shares his experience with concussion, and how he finally returned to the sport he loves. Dr. Roger Zemek, one of the leading investigators studying concussion and return to play, discusses how recent research is changing our approach to recovery. Finally, Dr. Jeremiah Ray, a Sports Medicine and Emergency trained physician, talks about how he manages concussion in his college athletes, and gives us his recommendations for assessing and counseling patients in the ED. 

How do you manage concussion in your practice? Does what you’ve heard change anything for you? Continue the conversation on social media @empulsepodcast or at ucdavisem.com.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Cameron Wright, Men’s Water Polo Player at UC Berkeley

Dr. Roger Zemek, FRCPC Associate Professor Pediatrics and Emergency Medicine University of Ottawa, Vice chair pediatric emergency research Canada (PERC), Clinical Research chair in Pediatric Concussion University of Ottawa 

Dr. Jeremiah Ray, Head Team Physician for UC Davis Intercollegiate Athletics

Resources:

SCAT 5 (Sports Concussion Assessment Tool - 5th Edition)

CDC HEADS UP to Brain Injury Awareness

Resources for Health Care Providers Resources for Parents

NCAA Concussion Diagnosis and Management Best Practices

The National Institute of Neurological Disorders and Stroke and Department of Defense Sport-Related Concussion Common Data Elements Version 1.0 Recommendations.

Broglio SP, Kontos AP, Levin H, Schneider K, Wilde EA, Cantu RC, Feddermann-Demont N, Fuller G, Gagnon I, Gioia G, Giza CC, Griesbach GS, Leddy JJ, Lipton ML, Mayer A, McAllister T, McCrea M, McKenzie L, Putukian M, Signoretti S, Suskauer SJ, Tamburro R, Turner M, Yeates KO, Zemek R, Ala'i S, Esterlitz J, Gay K, Bellgowan PSF, Joseph K. J Neurotrauma. 2018 May 2. doi: 10.1089/neu.2018.5643. [Epub ahead of print] PMID: 29717643

Full Interview with Dr. Roger Zemek

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Anchors away

In this Heartbeat we talk with a child abuse pediatrician who has seen what happens when we can’t see past a single diagnosis. She defines anchoring bias, how it can trip us up, and how to see past it.

Join the conversation on Social Media @empulsepodcast or at ucdavisem.com

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis.

Guest:

Antoinette “Tony” Laskey MD, MPH, MBA Professor of Pediatrics and Division Chief University of Utah Pediatrics. She is also the medical director of Safe and Healthy Families, a child abuse assessment and treatment center.

Resources:

How doctors think by Jerome Groopman https://www.amazon.com/How-Doctors-Think-Jerome-Groopman-ebook/dp/B003JTHWGE/ref=sr_1_1?ie=UTF8&qid=1525122494&sr=8-1&keywords=how+doctors+think

Pat Croskerry, MD: Gating the holes in the Swiss cheese (part I): Expanding professor Reason's model for patient safety. (link: https://www.ncbi.nlm.nih.gov/pubmed/29168290)

Seshia SS, Bryan Young G, Makhinson M, Smith PA, Stobart K, Croskerry P. J Eval Clin Pract. 2018 Feb;24(1):187-197. doi: 10.1111/jep.12847. Epub 2017 Nov 23

Read Jon Ilgen, MD (@Jon_Ilgen) EM tweet about cognitive biases.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Not so FAST - Episode 5

Should we be doing FAST exams on all pediatric trauma patients? In this episode, we hear about a case where the FAST may have saved a child’s life. Then we talk with peds trauma experts, Drs. Nate Kuppermann and Jim Holmes, about their recent study on the utility of the FAST exam in stable pediatric trauma patients. Ultrasound expert, Ken Kelley, shares his thoughts on the paper and the role of the FAST exam in kids.

Do you FAST all of your pediatric trauma patients? Join the conversation on social media @empulsepodcast or at ucdavisem.com.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guest Host: Dr. Michael Schick, Assistant Professor of Emergency Medicine and Global Ultrasound Fellowship Director at UC Davis

Guests:

Dr. Nate Kuppermann, Professor and Chair of the Department of Emergency Medicine at UC Davis, Founding Chair of the PECARN Steering Committee

Dr. Jim Holmes, Professor of Emergency Medicine at UC Davis, SAEM Secretary-Treasurer

Dr. Ken Kelley, Associate Professor of Emergency Medicine and Ultrasound Fellowship Director at UC Davis

Case retold by Dr. Nathan Vanden Berge, Emergency Medicine Resident at UC Davis

Resources:

Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial.

Holmes JF, Kelley KM, Wootton-Gorges SL, Utter GH, Abramson LP, Rose JS, Tancredi DJ, Kuppermann N. JAMA. 2017 Jun 13;317(22):2290-2296. doi: 10.1001/jama.2017.6322. PMID: 28609532

Use of the focused assessment with sonography for trauma (FAST) examination and its impact on abdominal computed tomography use in hemodynamically stable children with blunt torso trauma.

Menaker J, Blumberg S, Wisner DH, Dayan PS, Tunik M, Garcia M, Mahajan P, Page K, Monroe D, Borgialli D, Kuppermann N, Holmes JF; Intra-abdominal Injury Study Group of the Pediatric Emergency Care Applied Research Network (PECARN). J Trauma Acute Care Surg. 2014 Sep;77(3):427-32. doi: 10.1097/TA.0000000000000296. PMID: 25159246

Sonostuff.com

FAST in Trauma Part 1 Video

FAST in Trauma Part 2 Video

SAEM: FAST examination

ACEP Pediatric Emergency Ultrasound Update: The Unique Pediatric FAST

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

The FAST exam from the case in this episode reveals a massive hemopericardium with tamponade, shown here in the subxiphoid view.

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A SAFE PLACE TO COME - HEARTBEAT

In this Heartbeat we get a fresh perspective on how you can identify and help victims of human trafficking on your next shift and we revisit a few principles learned in episode #2 - Sold for a Chrysler 300. Join the conversation on Social Media @empulsepodcast or at ucdavisem.com

Host:

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis.

Guest:

Dr. Hanni Stoklosa, emergency medicine physician at Brigham and Women’s Hospital with appointments at Harvard Medical School and the Harvard T.H. Chan School of Public Health. In addition, she is the Executive Director of HEAL Trafficking. She is an expert in helping survivors of human trafficking.

Resources:

Find resources and join the community fighting human trafficking at https://healtrafficking.org

endtrafficking

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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The Game Has Changed - Episode 4

Let’s talk about the opioid crisis. One woman tells her powerful story of opioid addiction, treatment, and recovery. Then, we discuss the role Emergency Physicians can play in controlling this epidemic with experts, Dr. Gail D’Onofrio and Dr. Josh Elder.

How do you manage opioid use disorder in your practice? Join the conversation on Social Media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Gail D’Onofrio, Professor and Chair of the Department of Emergency Medicine at Yale

Dr. Josh Elder, Assistant Professor of Emergency Medicine at UC Davis Health

Resources:

Screening Brief Intervention & Referral to Treatment (SBIRT)

National Institute on Drug Abuse (NIDA) information on opioids

Buprenorphine vs. Methadone on atforum.com

Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial.

D'Onofrio G, O'Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. JAMA. 2015 Apr 28;313(16):1636-44. doi: 10.1001/jama.2015.3474. PMID: 25919527

Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention.

D'Onofrio G, Chawarski MC, O'Connor PG, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. J Gen Intern Med. 2017 Jun;32(6):660-666. doi: 10.1007/s11606-017-3993-2. Epub 2017 Feb 13. PMID: 28194688

Cost-effectiveness of emergency department-initiated treatment for opioid dependence.

Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G. Addiction. 2017 Nov;112(11):2002-2010. doi: 10.1111/add.13900. Epub 2017 Aug 16. PMID: 28815789

You can listen to the entire interview with "Rachel" here: Rachel's Story

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Heartbeat: Flu Update

EM Pulse “Heartbeats” are mini episodes focused on current, relevant topics. On this Heartbeat, Dr. Larissa May gives us a brief update on the 2017-18 flu season, recommendations for treating with oseltamivir, and why it’s not too late to get (or give!) the flu shot.

You can watch the Facebook Live version of this Heartbeat at facebook.com/UCDavisEM, and join the conversation on Social Media @empulsepodcast or at ucdavisem.com

Host:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Guest:

Dr. Larissa May, Associate Professor of Emergency Medicine and Director of Emergency Department Antibiotic Stewardship at UC Davis.

Resources:

The Center for Disease Control influenza page: www.cdc.gov/flu

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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I’m just a Reanimatologist - Episode 3

This month’s episode explores the controversial topic of Emergency Department initiated extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS). Dr. Jonathon Ford relives a challenging case of beta blocker and calcium channel blocker overdose. Then, we have a front row seat in the heated battle of words between Dr. John Rose and Dr. Dan Colby on the pros and cons of ED ECMO.

Where do you stand? Join the conversation on Social Media @empulsepodcast or at https://ucdavisem.com

Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Assistant Professor of Emergency Medicine at UC Davis – Pediatric Emergency Medicine

Guests: Dr. Jonathon Ford, Assistant Professor of Emergency Medicine, and Medical Toxicologist at UC Davis Health Dr. Dan Colby, Assistant Professor of Emergency Medicine, and Medical Toxicologist at UC Davis Health Dr. John Rose, Professor of Emergency Medicine at UC Davis Health, and EMS Medical Director for Yolo County

Resources: Massive diltiazem and metoprolol overdose rescued with extracorporeal life support https://www.ncbi.nlm.nih.gov/pubmed/28705745 Chenoweth JA, Colby DK, Sutter ME, Radke JB, Ford JB, Nilas Young J, Richards JR. Am J Emerg Med. 2017 Oct;35(10):1581.e3-1581.e5. doi: 10.1016/j.ajem.2017.07.023. Epub 2017 Jul 6. PubMed PMID: 28705745.

The ED ECMO Project and Podcast with Doctors Joe Bellezzo, Zack Shinar, and Scott Weingart. http://edecmo.org

ECLS Registry Report on http://elso.org

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Episode 2: Sold for a Chrysler 300

January is National Human Trafficking Awareness Month. In light of this, we have a very special episode for you. Annika Huff (formerly Annika Mack), a trafficking survivor, speaks with us about her experiences in the life, how she got out, and what she is doing now. Then, Dr. Bryn Mumma takes us through her research on how we can better identify potential victims in the ED. Dr. Rachel Robitz shares some advice on how to approach these patients, create a safe space, and offer support and resources, and our own Dr. Julia Magaña discusses how she manages this in pediatric patients.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Assistant Professor of Emergency Medicine at UC Davis – Pediatric Emergency Medicine

Dr. Nick Sawyer, Assistant Professor of Emergency Medicine at UC Davis, California ACEP Board Member, and Director of UC Davis UNITED

Guests:

Annika Huff (formerly Annika Mack), Advocate, Speaker and Survivor

Dr. Bryn Mumma, Assistant Professor of Emergency Medicine at UC Davis

Dr. Rachel Robitz, Assistant Clinical Professor of Psychiatry, Associate Training Director of Family Medicine/Psychiatry

Resources:

Screening for Victims of Sex Trafficking in the Emergency Department: A Pilot Program.

https://www.ncbi.nlm.nih.gov/m/pubmed/28611881/

Mumma BE, Scofield ME, Mendoza LP, Toofan Y, Youngyunpipatkul J, Hernandez B. West J Emerg Med. 2017 Jun;18(4):616-620. doi: 10.5811/westjem.2017.2.31924. Epub 2017 Apr 17. PMID: 28611881

National Human Trafficking Resource Center 1-888-373-7888

https://humantraffickinghotline.org/

WEAVE is the primary provider of crisis intervention services for survivors of domestic violence and sexual assault in Sacramento County

https://www.weaveinc.org/

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

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Episode 1: Pot-Tarts

In our first full episode, we explore the dangers of marijuana ingestion in kids. With several states legalizing marijuana for recreational use, we are likely to see a lot more of this in our EDs. Emergency Physicians, Dr. John Richards and Dr. Aimee Moulin, take us through their recent systematic review of unintentional cannabis ingestion in children. Medical Toxicologist, Dr. Daniel Colby, revisits an interesting case and leaves us with some pearls for identifying and managing potential marijuana ingestion.

Hosts:

Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis

Dr. Julia Magana, Assistant Professor of Emergency Medicine at UC Davis - Pediatric Emergency Medicine

Guests:

Dr. John Richards, Professor of Emergency Medicine at UC Davis, Chair of Quality Management for SAEM

Dr. Aimee Moulin, Associate Professor of Emergency Medicine and Director of Behavioral Health at UC Davis, President of California ACEP

Dr. Daniel Colby, Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis

Resources:

Unintentional Cannabis Ingestion in Children: A Systematic Review.

https://www.ncbi.nlm.nih.gov/pubmed/28888560

Richards JR, Smith NE, Moulin AK.

J Pediatr. 2017 Nov;190:142-152. doi: 10.1016/j.jpeds.2017.07.005. Epub 2017 Sep 6. Review. PMID: 28888560

If you are concerned that your patient may have ingested cannabis, you can call the Poison Control Center 24 hours a day at (800) 222-1222.

Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magana at OM Audio Productions for audio production services.

For more Toxicology, Pediatrics, and myriad other topics, join us at the UC Davis Emergency Medicine Winter Conference at the Ritz-Carlton in Lake Tahoe, February 26 through March 2nd. More information at https://www.ucdmc.ucdavis.edu/cme/course_pages/EM/emmed_pagelink.html

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Introduction to EM Pulse. Bringing research and expert opinion to the bedside.