Don’t Be A Jerk – Episode 8

Don’t be a Jerk – Episode 8

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

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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.

 

 

 

LGBTQI, MD

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. 

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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.

Breaking Out of Concussion Jail – Episode 6

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

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

Anchors Away

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.

Not so FAST – Episode 5

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.

A safe place to come – Heartbeat

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

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 Game Has Changed – Episode 4

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.

 

 

 

Heartbeat: Flu Update

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.

I’m just a Reanimatologist – Episode 3

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.

Episode 2: Sold for a Chrysler 300

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

http://annikahuff.com/

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.