Thriving not Surviving – Episode 9

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

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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.

 

 

If it Hurts, Don’t do it!

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

NCAA Concussion Diagnosis and Management Best Practices

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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.

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.