EM Pulse Live Edition: WR SAEM Day 2 Wrap-up

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. 

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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.

EM Pulse Live Edition: WR SAEM Day 1 Wrap-up

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

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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.

“Hot” Off the Press: Infant Fever Rule

“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.

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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.

Bonus Episode: 2018 in Review

Bonus Episode: 2018 in Review

Happy New Year! 2018 was a big year for us, thanks to all of you! Here we are, almost 365 days since publishing our first episode, so let’s take a moment to reflect on our first year. We’re closing in on 30,000 downloads and have listeners in all 50 states, 2 territories, and 94 countries. We’ve been featured by several local news outlets, and one of our favorite EM blogs, lifeinthefastlane.com. And we even won an eHealthcare Leadership award! Wow. We are so grateful to you all for listening, subscribing, supporting, rating, reviewing, and sharing! 

In this episode, Sarah and Julia recall some of their moments – see below for links to the episodes mentioned. We look forward to bringing you many more great episodes in 2019!

What were your favorite moments? Did a particular episode resonate with you? Let us know 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

Episodes Referenced:

Pot Tarts

Sold for a Chrysler 300

The Game has Changed

Don’t be a Jerk

The Price of Beauty

Toddlers Will Sell Their Souls for Stickers

Last Stand in Santa Rosa

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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.

The Price of Beauty

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.

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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

These Are Our People – Episode 11

These Are Our People – Episode 11

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.

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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.

A cool tool.

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. 

Excuse me, Your Bias is Showing – Episode 10

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!

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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.

Dr. Tiffany Johnson (center)

 

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.

 

 

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.