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UC Davis Department of Emergency Medicine
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Cyberattacks: I didn’t go to Med School for this

Cyberattacks: I didn’t go to Med School for this

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.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: 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 Business Resources: American Hospital Association: A Look at 2024’s Health Care Cybersecurity Challenges  By John Riggi, National Advisor for Cybersecurity and Risk, AHA U.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.
38:0120/11/2024
Political Violence

Political Violence

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.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Garen Wintemute, Distinguished Professor of Emergency Medicine and Director of the Violence Prevention Research Program at UC Davis Resources: 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 SHEET Wintemute 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
37:0104/11/2024
Cardiac Arrest: Can Naloxone Help?

Cardiac Arrest: Can Naloxone Help?

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.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: David Dillon, M.D., M.Phil., Ph.D, Assistant Professor of Emergency Medicine at UC Davis Resources: 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.
13:2717/10/2024
Update: Acetaminophen OD

Update: Acetaminophen OD

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.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. 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.
27:3607/10/2024
Push Dose Pearls: Naloxone

Push Dose Pearls: Naloxone

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.
12:0218/09/2024
The Story of a Department

The Story of a Department

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.
29:3304/09/2024
Sent to the ED

Sent to the ED

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.
35:2618/08/2024
Oncologic Emergencies: Part 2

Oncologic Emergencies: Part 2

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.
25:1705/08/2024
Oncologic Emergencies: Part 1

Oncologic Emergencies: Part 1

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, 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.
33:4420/07/2024
Push Dose Pearls: Push Dose Pressors

Push Dose Pearls: Push Dose Pressors

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, 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.
09:2408/07/2024
OB in the ED: what would ACOG do?

OB in the ED: what would ACOG do?

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.
00:0016/06/2024
Hot Off The Press: PECARN Cervical Spine Injury Rule

Hot Off The Press: PECARN Cervical Spine Injury Rule

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.
00:0005/06/2024
Push Dose Pearls: Intranasal Medications

Push Dose Pearls: Intranasal Medications

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.    
15:0125/05/2024
Navigating Breastfeeding As An EM Physician

Navigating Breastfeeding As An EM Physician

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.
00:0006/05/2024
PECARN Spotlight: Tools Validated

PECARN Spotlight: Tools Validated

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.
32:4219/04/2024
Navigating Pregnancy As An EM Physician

Navigating Pregnancy As An EM Physician

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.
31:4403/04/2024
Navigating Infertility As An EM Physician

Navigating Infertility As An EM Physician

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.
34:2118/03/2024
PHOENIX: A Better Way To Look At Peds Sepsis

PHOENIX: A Better Way To Look At Peds Sepsis

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.
22:3104/03/2024
Sickle Cell in the ED: Part 3

Sickle Cell in the ED: Part 3

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.
29:1619/02/2024
Sickle Cell in the ED: Part 2

Sickle Cell in the ED: Part 2

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.
20:0605/02/2024
Sickle Cell in the ED: Part 1

Sickle Cell in the ED: Part 1

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 
29:5317/01/2024
Push Dose Pearls: RSI

Push Dose Pearls: RSI

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.
17:5508/01/2024
The ins and outs of EMTALA

The ins and outs of EMTALA

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.
35:1418/12/2023
Express Care Now

Express Care Now

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.
24:4704/12/2023
Push Dose Pearls: Antibiotic Update

Push Dose Pearls: Antibiotic Update

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.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: CDC STI Treatment Guidelines Metlay 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.
26:3617/11/2023
ED Post Roe

ED Post Roe

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 Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Amy Paris, OB/Gyn and Complex Family Planning Subspecialist in New Hampshire Resources: Care Post Roe - UCSF The Ryan Program Reproductive 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.
41:1606/11/2023
Communicating About Child Abuse

Communicating About Child Abuse

***Trigger warning: this episode includes discussion of child abuse*** In 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 Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Emily Fain, Assistant Professor of Pediatric Emergency Medicine at Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, TN Dr. Elena Duma, Associate Professor of Pediatric Emergency Medicine at Cincinnati Children’s Hospital in Cincinnati, OH Resources: 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.
51:0518/10/2023
Identifying abuse: the LCAST app

Identifying abuse: the LCAST app

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 Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: 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 Tool EIIC PEAK Toolkit for Child Abuse EM Pulse Podcast: It Costs You Nothing 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. *** 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.
26:4904/10/2023
Social Media: Wonderful and Terrifying

Social Media: Wonderful and Terrifying

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.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: 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 Physicians How 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.
38:1818/09/2023
Push Dose Pearls: Insulin

Push Dose Pearls: Insulin

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.
20:4805/09/2023
Update: Human Trafficking

Update: Human Trafficking

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.
13:1018/08/2023
REBEAT: Sold for a Chrysler 300

REBEAT: Sold for a Chrysler 300

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 Associate 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.
33:5004/08/2023
Push Dose Pearls: Antidotes Part 2

Push Dose Pearls: Antidotes Part 2

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.
11:1117/07/2023
Push Dose Pearls: Antidotes Part 1

Push Dose Pearls: Antidotes Part 1

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.
20:5006/07/2023
Airway Update

Airway Update

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.
20:4318/06/2023
Update: MAT

Update: MAT

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.
25:1204/06/2023
REBEAT: The Game Has Changed

REBEAT: The Game Has Changed

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.
35:3318/05/2023
Tranq Dope

Tranq Dope

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 [email protected], 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.
13:1304/05/2023
It’s about shared success, NOT winning

It’s about shared success, NOT winning

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 [email protected], 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 Pediatrics, Division Head of Emergency Medicine, and Associate Chair for Faculty Development 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: [email protected] 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.
20:2218/04/2023
You had me at hello.

You had me at hello.

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 [email protected], 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: [email protected] 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.
49:3504/04/2023
Rebeat – It could have been different

Rebeat – It could have been different

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.
42:2617/03/2023
Alcohol Part 2: The power of recovery

Alcohol Part 2: The power of recovery

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 [email protected], 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.
32:2103/03/2023
Alcohol Part 1: There’s nothing worse than detoxing

Alcohol Part 1: There’s nothing worse than detoxing

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 [email protected], 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.
33:1419/02/2023
BulletPoints Project Series Part 4: Act

BulletPoints Project Series Part 4: Act

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 [email protected], 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.
30:5203/02/2023
BulletPoints Project Series Part 3: Assess

BulletPoints Project Series Part 3: Assess

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 [email protected], 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.
28:0118/01/2023
Three things I learned in 2022

Three things I learned in 2022

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 [email protected], 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.
09:1703/01/2023
BulletPoints Project Series Part 2: Approach

BulletPoints Project Series Part 2: Approach

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 [email protected], 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.
20:1218/12/2022
BulletPoints Project Series Part 1: Blood On My Shoes

BulletPoints Project Series Part 1: Blood On My Shoes

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 [email protected], 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.
22:0704/12/2022
Do I really need to LP a febrile infant with a UTI?

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

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
18:1617/11/2022
COVID Update

COVID Update

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? 💉 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, 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: Institute for Health Metrics and Evaluation (IHME) COVID-19 projections (University of Washington) CDC vaccine information page A tripledemic expected this winter, by Tricia Tomiyoshi, 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.
13:4203/11/2022