It’s that time of year again - residency recruiting season! But this year, things will look very different, thanks to the COVID-19 pandemic. We talk with Dr. David Barnes, Emergency Medicine Residency Program Director at UC Davis, about some of the challenges for both applicants and residency leadership. He also offers some sound advice for students applying in EM - most importantly, be yourself and be flexible; this format is new to everyone.  Do you have questions or concerns about the residency application and interview process this year?  Send us your thoughts on social media @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. David Barnes, Professor of Emergency Medicine and Emergency Medicine Residency Program Director Equity at UC Davis Resources: UC Davis Emergency Medicine Residency Program Hammoud MM, Standiford T, Carmody JB. Potential Implications of COVID-19 for the 2020-2021 Residency Application Cycle [published online ahead of print, 2020 Jun 3]. JAMA. 2020;10.1001/jama.2020.8911. doi:10.1001/jama.2020.8911 ACEP Concensus Statement on the 2020-2021 Residency Application Process for U.S. Medical Students Planning Carter’s in Emergency Medicine in the Main Residency Match *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

“Less Lethal” Crowd Control You may have heard of “non-lethal” or “less lethal” weapons used for crowd control. These include things such as pepper spray, tear gas, bean bags, and rubber bullets. But, while these may be less lethal than standard weapons and bullets, they still cause serious harm and even death. As protests raged across the U.S. this summer, we have seen many injuries associated with these methods. Dr. James Chenoweth, an emergency physician and toxicologist, joins us to explain what these weapons are and what kind of damage they can cause, as well as some tips for treating these injuries. Dr. Kara Toles worked as a street medic in the recent protests in Sacramento. She shares her experience, including key supplies she carries in her pack, and what it’s like to be in the middle of a peaceful protest turned violent. As physicians, we should be concerned about the physical injuries these crowd control methods cause, as well as the psychological effects.   Have you treated patients with injuries from so called non lethal crowd control methods?  Share your thoughts and experiences with us on social media @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Kara Toles, Assistant Professor of Emergency Medicine and Director of Diversity Equity and Inclusion for the Department of Emergency Medicine at UC Davis Dr. James Chenoweth , Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis Resources: This Week in Toxicology Tear Gas, Pepper Spray, and Rubber Bullets: A Primer Penetrating Injuries from “Less Lethal” Beanbag Munitions. Correspondence in the New England Journal of Medicine, by Dr. Kristofor A. Olson et al. August 14 2020.  Sacramento Street EMS Sacramento Anti Police-Terror Project *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Has MIS-C changed the way you approach a febrile child? I know I struggle to understand this new disease. Fortunately Dr. Natasha Nakra, a Pediatric Infectious Disease Specialist, joins us this month to clarify what we know about MIS-C, when we should think about it, and what we should do. Have you seen a child with MIS-C? What tipped you off? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Natasha Nakra, MS Associate professor of pediatrics, Pediatric Infectious Disease Specialist at UC Davis  Resources:  Nakra, N.A.; Blumberg, D.A.; Herrera-Guerra, A.; Lakshminrusimha, S. Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management. Children 2020, 7, 69. CDC Multi-inflammatory syndrome: for healthcare providers. https://www.cdc.gov/mis-c/hcp/index.html

Welcome back to EM Pulse. It’s no secret that black, indigenous, and people of color are underrepresented in medicine and academics. This is largely due to structural or institutionalized racism, which is a massive topic for another time. While it may be difficult to swallow, white people have benefited from this system, and many of us are still learning just how our my privilege afforded us. This can be unnerving and even embarrassing at times, as we start to really appreciate the struggle our BIPOC friends and colleagues have faced, and continue to face. We want to be allies; we want to do something. This month’s heartbeat is geared specifically to people who want to be better allies in this fight. It is absolutely crucial to listen to voices of people of color and follow their lead, but, as we will discuss, it is not our non-white colleagues’ job to educate us! With that in mind, our guest is Dr. Colleen Sweeney, a Professor of biochemistry and molecular medicine at the UC Davis School of Medicine, who recently gave a talk on taking allyship to the next level.  We are still learning to be better advocates and welcome your comments and feedback. Connect with us on social media,  @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Host: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Colleen Sweeney, Professor of Biochemistry and Molecular Medicine at the UC Davis School of Medicine Resources:   Ibram X. Kendi, author of How to be an Anti-Racist, Stamped from the Beginning: the Definitive History of Racist Ideas in America, and others books Tervalon M, Murray-García J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998;9(2):117-125. doi:10.1353/hpu.2010.0233 Award winning documentary From the Community to the Classroom AAMC MedEdPortal: Antiracism in Medicine Collection AAMC: Racism and Health UC Davis Office of Diversity, Equity & Inclusion *** Register now for the 17th annual Emergency Medicine Update: Hot Topics 2020, November 3rd through 7th at the Fairmont Kea Lani in Maui! Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In the first half of our episode on surge, we heard first hand accounts of how COVID-19 impacted EDs and ICUs in hard hit areas. In the second half, we explore emergency preparedness at a more macro level. Experts, Dr. John Rose and Dr. Dan Colby, join us to discuss how county emergency medical services, hospital administration, and emergency departments are planning for a potential surge of COVID-19 cases. As new infections and hospitalizations are rising across most of the country, they offer some practical advice to help us manage the surge. . Has your hospital experienced a COVID surge? How did you handle it, or how are you preparing for a potential surge? Share your thoughts and experiences with us on social media @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for Part 2, when we’ll talk practical preparedness strategies from EMS, administration, and ED operations points of view - coming July 3rd! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. John Rose, Professor of Emergency Medicine at UC Davis and Medical Director for Yolo Emergency Medical Services Agency (YEMSA) Dr. Daniel Colby, Assistant Professor of Emergency Medicine and member of the ED Clinical Operations Team at UC Davis Resources: California Hospital Association Emergency Preparedness Hospital Incident Command System (HICS) Pediatric Overflow Planning Contingency Response Network (POPCoRN) ********************************************************************************************* Register now for the 17th annual Emergency Medicine Update: Hot Topics 2020, November 3rd through 7th at the Fairmont Kea Lani in Maui! Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

As we watched the novel coronavirus spread through China and Italy, we knew it was just a matter of time before a wave of illness hit the US. The surge struck early in New York and New Orleans, threatening to overwhelm health care resources, including PPE, ventilators, ICU beds, and hospital staff. We hear from Dr. Leslie Palmerlee, an emergency physician in New Orleans, about her experience there. Then we go in depth with Dr. Alfredo Astua, a critical care physician at one of New York’s hardest hit hospitals. We explore how they prepared for and managed the COVID-19 surge, how it affected every level of the health care system, and what they learned along the way. Has your hospital experienced a COVID surge? How did you handle it, or how are you preparing for a potential surge? Share your thoughts and experiences with us on social media @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for Part 2, when we’ll talk practical preparedness strategies from EMS, administration, and ED operations points of view - coming July 3rd! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Leslie Palmerlee, Assistant Professor of Emergency Medicine at LSU/University Medical Center in New Orleans, LA Dr. Alfredo Astua, Chair of Pulmonary Critical Care and Sleep Medicine at Elmhurst Hospital, Mount Sinai Services in Queens, NY Resources: US Department of Health and Human Services public health emergency preparedness resources  ACEP National Strategic Plan for Emergency Department Management of Outbreaks of COVID-19 ********************************************************************************************* Register now for the 17th annual Emergency Medicine Update: Hot Topics 2020, November 3rd through 7th at the Fairmont Kea Lani in Maui! Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

What are you seeing in your hospital? How did your system prepare for a surge? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for the June 17 episode on SURGE. We will hear from the critical care doctor who managed the surge from the provider standpoint with other experts on how we can prepare for a SURGE. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Alex Schmaltz, Senior Emergency Medicine Resident  at UC Davis *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.  

COVID was supposed to be the great equalizer, but in reality not all of us are affected the same. Vulnerable populations experience higher rates of infection and death, and worse social outcomes. Access to healthcare is not equitable. In this episode we dive into why this is a thing and what we can do about this as providers. What are you seeing in your hospital? What are you or your systems doing to reduce implicit bias? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. And stay tuned for the June 3 Heartbeat on what is it like to work in a hospital in the bronx and lessons learned. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Kara Toles (@kat04747), Assistant Professor of Emergency Medicine at UC Davis and the Director of Equity and Inclusion in the Department of Emergency Medicine. Dr. Makini Chisholm-Straker, Assist Professor of Emergency Medicine at The Icahn School of Medicine, and works at Mt. Sinai Hospital, NYC Resources: Chisholm-Straker, M. COVID-19 is Our Chance at Rebirth. Medium.com. Accessed on May 18, 2020. https://medium.com/undercurrents-press/rebirthviacovid-369e073d7654 Wadhera RK, Wadhera P, Gaba P, et al. Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs [published online ahead of print, 2020 Apr 29]. JAMA. 2020;e207197. doi:10.1001/jama.2020.7197  https://jamanetwork.com/journals/jama/fullarticle/2765524?guestAccessKey=bea1171d-1ecd-49df-a55f-2e11ed68ec40&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=042920 Miller, H. Navajo Nation 3rd highest “state” per capita infections. Huffpost online May 14, 2020. https://m.huffpost.com/us/entry/us_5e94b532c5b6a50d4ae6d7e7 Kara, H. The coronavirus pandemic is hitting black and brown Americans especially hard on all fronts. CNN online. May 8, 2020.  https://www.cnn.com/2020/05/08/us/coronavirus-pandemic-race-impact-trnd/index.html Racial Data Transparency: States that have released breakdowns of COVID-19 data by race. Johns Hopkins Coronavirus Resource Center. Accessed on May 16, 2020. https://coronavirus.jhu.edu/data/racial-data-transparency Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

How do you treat the pain of pediatric long bone fractures? Is it equitable? In this episode the authors of Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures of Pediatrics May 2020 discuss if our care is equitable and why it may not be. It is an important discussion that pushes us to think about our perception of pain and how race and ethnicity impact our approach. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Host: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Monika Goyal, Associate Professor of Pediatrics and Emergency Medicine at the George Washington University School of Medicine. Associate Division Chief of Emergency Medicine and Trauma Services and Director of Academic Affairs and Research at Children's National Hospital. Dr. Tiffani Johnson, Assistant Professor of Pediatric Emergency Medicine at UC Davis Resources: Goyal MK, Johnson TJ, Chamberlain JM, et al. Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures [published online ahead of print, 2020 Apr 20]. Pediatrics. 2020;e20193370. doi:10.1542/peds.2019-3370  https://pubmed.ncbi.nlm.nih.gov/32312910/ Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

This is a challenging time for physicians and the entire healthcare workforce. That’s putting it mildly. The coronavirus pandemic is affecting all of us, physically and emotionally. In emergency medicine, we are used to dealing with stressful situations, but this pandemic brings new personal and professional challenges. We are managing severe illness for which we have no proven treatment, watching patients suffer and die alone, and living with constant worry of infecting our loved ones or even dying of the virus ourselves. Some of us are doing this in overwhelmed healthcare systems with limited resources, including personal protective equipment (PPE). How can we manage this new level of stress?   In this miniseries, we’ll dive deeper into some of the moral challenges we are facing, and explore some ways to cope. Dr. Wendy Lau, an EM physician and wellness expert, has been studying at the Upaya Institute and Zen Center. She emphasizes the power of human connection, and offers a framework, using the mnemonic GRACE, to help us think through and prepare for difficult moral dilemmas. How are you coping with the stress of the coronavirus pandemic? Did you find this miniseries helpful? Connect with us and share your thoughts and experiences, on social media @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Wendy Lau, Emergency Medicine Physician, Wellness Expert and Yoga Instructor, with a background in Zen Buddhism. Resources: Dr. Wendy Lau’s Website, including Physician Pandemic Support Roshi Joan Halifax, Abbot at Upaya Institute and Zen Center in Santa Fe, New Mexico Rushton, Cynda. Moral Resilience: Transforming Meal Suffering in Healthcare. Oxford University Press, October 2018.  Rushton, CH. Principled Moral Outrage: An Antidote to Moral Distress? AACN Advanced Critical Care 2013 Jan-Mar;24(1):82-9  Turner K, Rushton CH. “Why Are We Doing This?” Creating New Narratives to Meet Futility With Integrity. AACN Adv Criti Care. Summer 2019;30(2):198-203 Rushton CH. Cultivating Moral Resilience. Am J Nurs. 2017 Feb;117(2 Suppl 1):S11-S15 *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In this episode of our miniseries, EM physician and wellness expert, Dr. Wendy Lau, returns with a guided meditation, using the GRACE framework. This practice helps us breathe, relax, and cope with the stress we are all feeling during the coronavirus pandemic. Get comfortable, close your eyes, and meditate with us.  How are you coping with the stress of the coronavirus pandemic? Did you find this miniseries helpful? Connect with us and share your thoughts and experiences, on social media @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Wendy Lau, Emergency Medicine Physician, Wellness Expert and Yoga Instructor, with a background in Zen Buddhism. Resources: Dr. Wendy Lau’s Website, including Physician Pandemic Support Roshi Joan Halifax, Abbot at Upaya Institute and Zen Center in Santa Fe, New Mexico Rushton, Cynda. Moral Resilience: Transforming Meal Suffering in Healthcare. Oxford University Press, October 2018.  Rushton, CH. Principled Moral Outrage: An Antidote to Moral Distress? AACN Advanced Critical Care 2013 Jan-Mar;24(1):82-9  Turner K, Rushton CH. “Why Are We Doing This?” Creating New Narratives to Meet Futility With Integrity. AACN Adv Criti Care. Summer 2019;30(2):198-203 Rushton CH. Cultivating Moral Resilience. Am J Nurs. 2017 Feb;117(2 Suppl 1):S11-S15 *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In these uncertain times, poets, artists, musicians, psychiatrists, philosophers, and others, have stepped forward to offer inspiration, compassion, advice, and hope. In this episode of our miniseries, we share some of the words and art we found helpful. Thank you to the authors and artists featured, and to all those who are contributing positive energy during this time.  What art, words, or music have you found helpful or inspiring during the coronavirus pandemic? Please share them with us - on social media @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Featured: Fr. Richard Hendrick. Lockdown. Posted on Facebook March 13, 2020.  Dr. Peter Yellowlees “Good Stuff - Volume 45”, March 31, 2020. Received by Julia Magana, March 31, 2020. Rachmaninoff's Six Pieces, Op. 11: VI. Slava (Glory) performed by Dr. Andrew Wong and Dr. Gilbert Wong. Posted to Facebook on March 28, 2020. #songsofcomfort Resources: Dr. Wendy Lau’s Website, including Physician Pandemic Support *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

We’re in the midst of a global pandemic and, of course, everyone’s attention is focused on COVID-19. Other podcasts have excellent coverage of this situation. In this episode, we’ll be discussing other important infections that continue to affect our communities: HIV, hepatitis C, and syphilis. Over the past year, the UC Davis ED implemented a massive screening effort to identify patients who have become infected. Dr. Larissa May explains how the screening works and some of the surprising trends we’ve seen. Infection rates were higher than expected and many patients had no idea they were infected! One patient tells us how screening positive for HIV, and being connected to care, changed his life.  This topic, as with so many issues we cover, brings up the broader question: what is the role of the emergency department in the healthcare system? We will explore this further in an upcoming episode and we would love to hear from YOU.  What do YOU see as the role of the emergency department in the broader health system? Send us your answer via on social media, @empulsepodcast, or through our website, ucdavisem.com. And please pass the word along to your friends and colleagues! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Larissa May, Professor of Emergency Medicine with a Masters in Emerging Infectious Diseases, and Director of Emergency Department Antibiotic Stewardship at UC Davis. Resources: ACEP Policy Statement on HIV testing and screening in the ED Centers for Disease Control and Prevention (CDC) resources: Ending the HIV Epidemic: A Plan for America. HIV Nexus Clinician Resources Haukoos JS, Lyons MS, Rothman RE. The Evolving Landscape of HIV Screening in the Emergency Department. Ann Emerg Med. 2018 Jul;72(1):54-56. doi: 10.1016/j.annemergmed.2018.01.041. Epub 2018 Feb 17. PubMed PMID: 29459057; Leblanc J, Hejblum G, Costagliola D, Durand-Zaleski I, Lert F, de Truchis P, Verbeke G, Rousseau A, Piquet H, Simon F, Pateron D, Simon T, Crémieux AC; DICI-VIH (Dépistage Infirmier CIblé du VIH) Group. Targeted HIV Screening in Eight Emergency Departments: The DICI-VIH Cluster-Randomized Two-Period Crossover Trial. Ann Emerg Med. 2018 Jul;72(1):41-53.e9. doi: 10.1016/j.annemergmed.2017.09.011. Epub 2017 Oct 31. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

If you’ve ever watched a patient, friend, or family member have a seizure, you know how scary and stressful it can be for everyone involved. It’s even more stressful when you can’t get the seizure to stop - this is called status epilepticus. Usually, benzodiazepines are our first line medication. If benzos don’t work, we all have our favorite second, and even third line agents to try to break seizures. But how well do they really work? Is one better than another? Or safer?  This episode starts with a personal story told by parents of a child who suffers from epilepsy. Then we welcome guest host, Dr. Jason Woods of the Little Big Med podcast, to help us answer these questions. Dr. Jim Chamberlain is the pediatric principal investigator for the ESETT trial, in which he and his colleagues studied three common second line anti epileptic medications. He shares some of the novel statistical methods they used and the results that were recently published in the New England Journal of Medicine. Then we speak with our own Dr. Daniel Nishijima, general EM physician and site Co-PI for the trial, about the implications for adults and how the results have (or have not?) changed his practice.   What are your favorite first and second line medications for status epilepticus? When do you decide to intubate? We’d love to hear how you practice. Connect with us on social media, @empulsepodcast, or at ucdavisem.com.  *** Registration is still open for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe! *** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Dr. Jason Woods, Assistant Professor of Pediatric Emergency Medicine at Children’s Hospital Colorado, Host of the Little Big Med podcast Guests: Dr. Jim Chamberlain, Professor of Pediatrics and Emergency Medicine at George Washington University and Children’s National Hospital, Pediatric Principal Investigator for the ESETT trial Dr. Daniel Nishijima, Associate Professor of Emergency Medicine at UC Davis, Site Co-Pricipal Investigator for the ESETT trial Resources: SAEM seizure and status epilepticus resources Kapur J, Elm J, Chamberlain J, et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. N Engl J Med. 2019;381(22):2103-2113. Little Big Med Podcast Glauser T, Shinnar S, Gloss D, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr 2016;16: 48–61.  Dalziel SR, Borland ML, Furyk J, et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial. Lancet 2019; published online April 17. Lyttle MD, Rainford NEA, Gamble C, et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. Lancet 2019; published online April 17. Connor JT, Elm JJ, Broglio KR, ESETT and ADAPT-IT Investigators. Bayesian adaptive trials offer advantages in comparative effectiveness trials: an example in status epilepticus J Clin Epidemiol 2013;  Zaccara G, Giannasi G, Oggioni R, et al. Challenges in the treatment of convulsive status epilepticus. Seizure. 2017;47:17-24.  Ilvento L, Rosati A, Marini C, L’Erario M, Mirabile L, Guerrini R. Ketamine in refractory convulsive status epilepticus in children avoids endotracheal intubation. Epilepsy Behav. 2015;49:343-346.  Niquet J, Baldwin R, Norman K, Suchomelova L, Lumley L, Wasterlain C. Midazolam-ketamine dual therapy stops cholinergic status epilepticus and reduces Morris water maze deficits. Epilepsia. 2016;57(9):1406-1415.  ***

Happy National Women Physicians Day and National Wear Red Day, promoting awareness of heart disease in women! In this month’s Heartbeat, we have the privilege of speaking with the brilliant and visionary Dr. Alyson McGregor. Dr. McGregor is an emergency physician who specializes in sex and gender emergency medicine. She spoke with us about heart disease - the number one killer of women in the US - and how our current algorithms, diagnostic tests, and treatments are flawed. We’ll hear more from Alyson in an upcoming episode, so stay tuned! We’d love to hear from you! Connect with us on social media, @empulsepodcast, or on our website, ucdavisem.com.  *** Register now for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe! *** Please subscribe and leave us a review on iTunes - it helps others discover us!  Host: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Alyson McGregor, Associate Professor of Emergency Medicine and Director of the Division of Sex & Gender in Emergency Medicine at Brown University. Resources: Sex & Gender Specific Health - a project supported by the Texas Tech University Health Sciences Center Office of the President, Offices of the Deans of the Schools of Medicine, Pharmacy, Health Professions and Nursing, and the Laura W. Bush Institute for Women’s Health. Pre-order Dr. McGregor’s book on her website! Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It by Alyson J. McGregor, MD Ms. Diagnoseddocumentary film teaser Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review. McGregor AJ, Beauchamp GA, Wira CR 3rd, Perman SM, Safdar B. West J Emerg Med. 2017 Oct;18(6):1079-1090. doi: 10.5811/westjem.2017.8.34997. Epub 2017 Oct 6. Review. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Alyson McGregor

Happy 2020! Well, that’s a wrap on another year of EM Pulse. Our podcast continues to grow, as does our audience. We published another 25 new episodes this year and now have listeners in 114 countries around the world! We also did our first live podcast from the Western Regional SAEM Conference. There are more exciting things to come this year! In 2020, we are kicking off our Advisory Panel, a group of diverse physicians, and some non-physicians, to keep EM Pulse fresh and focused, and also add an element of peer review. We’ve also partnered with Cal ACEP to create an in-depth mini series on medication assisted treatment of opioid use disorder. More on that soon! So what were our favorite highlights from the 2019 season? Take a listen to find out! What were your most memorable moments? We want to know! What topics would you like to see us tackle this year? Connect with us on social media, @empulsepodcast, or at ucdavisem.com.  *** Register now for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe! *** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Episodes Referenced: Just Another Mass Shooting #thisismylane With Great Power Comes Great Responsibility The ED is my Doctor Futurecasting Medical Education “Hot” off the Press: Infant Fever Rule The Last Touchpoint EM Far Forward Operation Deep Freeze *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Matthew WetscherDr. Megan RanneyDr. Garen WintemuteRecording on locationDr. Mike GisondiRecording Dr. Rod FontenetteRecordingDr. Julia MagañaDr. Sarah MedeirosRecording on location

Welcome back and happy new year! If you are an EM or peds provider you likely know the name PECARN (Pediatric Emergency Care Applied Research Network).  This powerhouse was the first federally funded pediatric emergency medicine research network in the US and generates quality studies like nobody’s business.  We have reviewed three landmark PECARN studies: Hot off the Press infant fever rule, DKA it’s not about the fluids, A Cool Tool. And in the next few months we will discuss seizure management and talk about PERN.  So we thought this was a good time to really understand the machine of PECARN that is affecting us shift to shift. What is the history, why is it important, and what does the future look like?  In this podcast Dr. Nate Kuppermann tells it all. What is the best way investigators can get evidence into your hands?  How do you keep up with the onslaught of data being generated?  Lectures/conferences? Tweets? Podcasts? Friends? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people!  Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee Resources: Academic Life in Emergency Medicine (ALiEM) P3 App: https://www.aliem.com/p3-app-pecarn-publication-prospectus/ PECARN’s home website: https://www.pecarn.org ***REGISTER for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-28th at the Ritz Carlton in Lake Tahoe*** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Nate KuppermannDr. Julia Magana

Global health can be an amazing adventure or an unsettling disappointment. We can make a big difference in the lives of people around the world or drain local resources and have a feel good vacation. In this episode we hear meaningful international impact stories and from global health experts on how we can make a meaningful impact as well. Have you worked internationally? Send us your story - it might even be featured in our global health mini series! Connect with us on social media at @empulsepodcast, via email at [email protected], or on our website, ucdavisem.com. Please subscribe and leave us a review on iTunes - it helps us reach more people! *** Register now for the 43rd annual UC Davis Emergency Medicine Winter Conference. February 24th-29th at the Ritz Carlton in Lake Tahoe! *** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis  Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Nathan Kuppermann, Pediatric Emergency Physician and Chair of the Department of Emergency Medicine at UC Davis Dr. Christine McBeth, Assistant Professor of Emergency Medicine at UC Davis; Completed the Global Ultrasound Fellowship at UC Davis Dr. Michael Schick, Associate Professor of Emergency Medicine and Director of Global Ultrasound at UC Davis; Director of Ultrasound for Global Emergency Care Dr. Shakira Bandolin, Assistant Professor of Emergency Medicine at Director of the Global Health Fellowship at UC Davis. Resources: ACEP International Ambassador Map ACEP Free international resources The practitioner’s guide to global health course: FREE! Dr. Schick's Website: sonostuff.com  Idealist is a website that posts international opportunities. A variety of NGOs regularly post job listings on these sites: Global Emergency Medicine Fellowship listings Health Volunteers International: This is an organization Dr. Bandolin partnered with on projects in the past and is a great reference organization for medical providers who are interested in joining a ongoing project overseas. They offer a variety of placements ranging from 1 month to years. Sacred Valley Health is the NGO that Shakira work closely with and referenced during the interview. University of Wisconsin reference list for global health resources. Dr. Shakira BandolinDr. Christine McBethDr. Nate KuppermannDr. Michael SchickDr. Julia MaganaDr. Sarah Medeiros **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Last month we explored leveraging tech for life long learning. In this heartbeat we discuss tech as a teaching tool with Dr. Emily Andrada, an amazing teacher who has mastered using technology for teaching. Hear about the ups and downs of using technology for education, Emily’s favorite tools, and a new resource available on www.ucdavisem.com - Unschooling Time. What is your favorite tech teaching tool? How do you leverage tech as a teacher? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people!  Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Emily Andrada, Professor of Pediatric Emergency Medicine at UC Davis Resources: Tech savvy educators twitter handles mentioned: @cultofpedagogy, @jmattmiller, @ericcurts, @alicekeeler Unschooling Time - Resource page ***Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe*** Dr. Emily AndradaDr. Julia Magana Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

The amount of information we are expected to learn in medical school, residency, and beyond can be overwhelming - like drinking from a firehose! In this episode, we explore some ways in which physicians can leverage technology to help manage all of this information and facilitate life long learning. Several residents and attendings discuss what works for them, including using apps and online resources, and listening to podcasts. We then talk with Dr. Ryan Ribeira and Dr. Adam Dougherty of SimX about how they are using augmented and virtual reality to revolutionize medical simulation. Next, we talk with with Dr. Dina Wallin, creator of the Leader’s Library, on how she uses Slack to create a learning community of physicians across the globe. Finally, we discuss with education researcher, Dr. Jeff Riddell, about how and why physicians are turning to podcasts for learning and staying up to date, including some of the benefits and potential caveats.  Do you use technology for lifelong learning? Tell us how you do - or why you don’t! Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com.  Subscribe and rate us on iTunes - it helps us reach more people!  ***Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Adam Dougherty, Emergency Medicine Physician at Sutter Medical Center in Sacramento, CA; Chief Medical Officer at SimX Dr. Ryan Ribeira, Clinical Assistant Professor of Emergency Medicine at Stanford University; Founder and Chief Executive Officer of SimX Dr. Dina Wallin, Assistant Clinical Professor of Emergency Medicine and Pediatrics at UCSF Benioff Children’s Hospital; Creator of the ALiEM Leader’s Library Dr. Jeff Riddell, Education Researcher and Assistant Professor of Clinical Emergency Medicine at the University of Southern California Keck School of Medicine Resources: SimX VR and AR digital simulation ALiEM Leader’s Library A Survey of Emergency Medicine Residents' Use of Educational Podcasts. Riddell J, Swaminathan A, Lee M, Mohamed A, Rogers R, Rezaie SR. West J Emerg Med. 2017 Feb;18(2):229-234. doi: 10.5811/westjem.2016.12.32850. Epub 2017 Jan 30. Independent and Interwoven: A Qualitative Exploration of Residents' Experiences with Educational Podcasts. Riddell J, Robins L, Brown A, Sherbino J, Lin M, Ilgen JS. Acad Med. 2019 Sep 10. doi: 10.1097/ACM.0000000000002984. [Epub ahead of print] Dr. Jeff RidellDr. Julia MagañaDr. Sarah MedeirosDr. Ryan Ribeira and Dr. Adam Dougherty *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In this heartbeat we do something a little different. We discuss the story behind EM Pulse and three lessons we learned in our creative pursuit. These three lessons can be applied to other creative pursuits as well. We would love to hear how you express your passion and what you have learned as well! Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people!  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Resources:  Citing Audio and Video Publications on Your CV ALiEM Blog, Jan 18, 2018. (https://www.aliem.com/author/jessica-mason/) Save the date for the 43rd Annual UC Davis Emergency Medicine Winter Conference February 24-28 at the Ritz Carlton, Lake Tahoe (https://ces.ucdavis.edu/confreg/?confid=1094) Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

We are in the midst of a mental health crisis that impacts our patients, our hospitals, the health care system, and our daily work in the emergency department. It is easy to be caught up in own experience, or the problems of our own department. But when we look beyond our hospital, we see that this is a huge crisis at county, state, and national levels. To help us understand why we are in this situation, and how we can work to improve things, we spoke with UC Davis’ Director of Emergency Psychiatry, Dr. Lorin Scher, and Emergency Physician and ED Director of Behavioral Health, Dr. Aimee Moulin. Here of some of their suggestions: The ED is often the only place patients in a mental health crisis have to go. These patients are suffering from serious, life threatening illness, and it is our job to care for them. Embrace it. Focus on patient centered care, including placing patients in an area where stimulation is minimized, away from doors, with mental health techs nearby, and employ early de-escalation strategies.Collaborate with psychiatrists, mental health professionals, and community partners. Consider implementing SMART clearance to minimize unnecessary blood draws and expedite treatment and placement in a psychiatric facility. This problem is bigger than our EDs. Talk with your administrators, local government, connect with ACEP and other advocacy groups to amplify your voice. Advocate to  increase primary care mental health integration through collaborative care models. We can be a voice for our patients who don’t have a voice.  How is the mental health crisis impacting your department? Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com.  Subscribe and rate us on iTunes - it helps us reach more people!  ***Registration is still open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii*** ***Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Lorin Scher, Associate Professor of Psychiatry, Director of Emergency Psychiatry at UC Davis, and Director of Integrated Behavioral Health Services in the UC Davis primary care network Dr. Aimee Moulin, Associate Professor of Emergency Medicine and ED Behavioral Health Director at UC Davis Resources: Sacramento has a mental health crisis. Let’s switch from ‘emergency’ to strategy.  By Dr. Lorin Scher, Special to The Sacramento Bee, May 5, 2019 California 5150 Law ACEP Mental Health Advocacy *** Dr. Lorin ScherDr. Amiee MoulinDr. Julia MaganaDr. Sarah Medeiros Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña and Isaiah Magaña at OM Audio Productions for audio production services.

High sensitivity troponins are taking over the nation are you ready? Dr. Bryn Mumma is ready and in this heartbeat she shares what we need to know to be ready!  Are you using high sensitivity troponins? How is it going? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people!  Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Bryn Mumma ([email protected] [[email protected]], Associate Professor of Emergency Medicine at UC Davis Resources:  Twerenbold, R, Boeddinghaus J. Clinical Use of High-Sensitivity Cardia Troponin in with Suspected Myocardial Infarction.  JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. VOL. 70, NO. 8, 2017  (http://www.onlinejacc.org/content/accj/70/8/996.full.pdf) Email Dr. Bryn Mumma to get our protocol ([email protected]) Boeddinghaus J, Twerenbold R, et al. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction.  Clin Chem. 2019 Sep 30.  (https://www.ncbi.nlm.nih.gov/pubmed/31570633) ***Registration is still open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii*** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

There is an epidemic of poverty in America, and we see it firsthand in the ED. Dr. Donna Beegle has dedicated her life to studying this epidemic, and training others to help break the cycle of poverty. She shares her own personal story of growing up in generational poverty, then helps us understand the scope of poverty in the U.S., and how it affects health. UC Davis Emergency Medicine NP, Danise Seaters, joins us to discuss some strategies for medical providers to help recognize patients who may be struggling with poverty, and how to optimize their care in the ED. This starts with recognizing our own biases and making a conscious effort to avoid letting our biases affect how we interact with patients. Communication is also key - connect and identify with your patients, avoid medical jargon, and offer resources.  What strategies do you use to identify and care for patients struggling with poverty? Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and rate us on iTunes - it helps us reach more people!  ***Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Donna Beegle, President and Founder of Communications Without Borders Danise J. Seaters, ACNP-bc, M.S., Emergency Medicine Nurse Practitioner at UC Davis Resources: Communication Across Barriers: a consulting firm founded by Dr. Beegle, providing training and resources to help break the cycle of poverty in America. Resourses include Dr, Beegle’s books, See Poverty…Be The Difference, and If Not Me, Then Who? UC Davis Center for Poverty Research Overcoming Obstacles to Health, Report From the Robert Wood Johnson Foundation to the Commission to Build a Healthier America Development of a tool to identify poverty in a family practice setting: a pilot study. Brcic V, Eberdt C, Kaczorowski J. Int J Family Med. 2011;2011:812182. doi: 10.1155/2011/812182. Epub 2011 May 26. Erratum in: Int J Family Med. 2015;2015:418125. Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Julia MagañaDr. Sarah MedeirosIts a ritual! We have tea when recording.Some of our recording tools

Physician wellness is not JUST about going to a yoga class or two. In this episode we explore physician wellness from the perspective of the EM Chair of Stanford University.  On the personal level we should jump in and check on each other, help each other out! Make sure your leadership knows physician wellness is crucial to providing care 24/7/365. Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people!  Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Andra Blomkalns, Professor and Chair of the Department of Emergency Medicine at Stanford University Resources: ACEP Wellness Resources  (https://www.acep.org/life-as-a-physician/wellness/) SAEM Wellness Resources (https://www.acep.org/life-as-a-physician/wellness/) UC Davis Physician Health and Well-being Program (https://health.ucdavis.edu/psychiatry/education/fellowships/phwb/index.html) *** Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In Emergency Medicine, we are all too familiar with death and dying, but how equipped are we really to provide compassionate end of life care? Dr. Conor Mcwade shares his experience caring for a patient with end stage cancer, and the challenges of respecting the patient’s wishes, even when the family wanted to pursue aggressive measures. Then, palliative care trained physicians, Dr. Rupi Chima and Dr. Cherie Ginwalla, help define some terms and offer advice on how to best care for our dying patients - from pediatric to geriatric - and their families, as well as ourselves.  How do you think we can improve care for the dying? Share your thoughts on social media at @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and rate us on iTunes - it helps us reach more people!  ***Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Cherie Ginwalla, Associate Professor of Pediatrics at UC Davis, Pediatric Palliative Care doctor  Dr. Rupi Chima, Emergency Medicine Physician at Kaiser South Sacramento, Palliative Care Team Resources: ACEP Palliative Medicine Section Tool Kit and Resources  SAEM Palliative Medicine Online Education Resources Education in Palliative and End-of-Life Care–Emergency Medicine (EPEC-EM) curriculum  Being Mortal by Atul Gawande  *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Rupi ChimaDr. Cherie GinwallaRecordingDr. Magaña and Dr. MedeirosRecording

What is military emergency medicine all about? Many of us know physicians who are in the US Armed Forces, but few of us really know what that really entails. Dr. Rod Fontenette is an Emergency Medicine and Critical Care Physician at UC Davis and a Lieutenant Colonel in the US Air Force. He joins us to talk about Military EM, including training, emergency and critical care on the front lines (and at 30,000 feet!), and some of the challenges and rewards of choosing this career path. We have so much respect for what Rod and his colleagues do! Would you (or have you) considered a career in military EM? Do the advantages and rewards outweigh the challenges and sacrifices? We’d love to hear what you think. Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com.  If you like what you hear, please subscribe and leave us a review on iTunes - it helps others discover us!  Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Roderick Fontenette, Associate Professor of Emergency Medicine and Critical Care at UC Davis, Lieutenant Colonel US Air Force, Military Associate Program Director UC Davis USAF Integrated Residency Program Resources: UC Davis Emergency Medicine USAF Integrated Residency Program Medicine + The Military: information about medical careers in the military *** Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Rod Fontenette

Hafa adai! Or "Hello" in Chamorro, the native language of Guam. I just got back from the US territory of Guam and loved working in such a beautiful place with it’s own set of unique challenges. We spoke with local emergency medicine physician Gabriel David to hear about practicing in an isolated island where many can’t or don’t seek medical care until really ill, and start chewing betel nut at 7-8 years old.   What atypical places have you  practiced in?  Share your experiences with us on social media, @empulsepodcast, or online at ucdavisem.com/em-pulse. Please subscribe and leave us a review on iTunes! It help more people discover us. Host: Dr. Julia Magana, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Gabriel David, Emergency Medicine Physician Guam Regional Medical City and Guam SDA Urgent Care Clinic Resources: Areca Nut (Betel nut) *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions. for audio production services. Guam BeachSnorkeling in GuamBetel nut

If you work in Emergency Medicine, you know that social and environmental factors greatly impact our patients’ health. This may not be a novel concept, but it is a relatively new field of study. Social Emergency Medicine is a growing branch of EM focused on identifying and studying how social factors affect health. We are especially interested in this topic as many of our episodes explore social issues, such as housing instability, substance use, firearm violence, and human trafficking. In this Heartbeat, we hear from Social EM expert, Dr. Harrison Altar, on what Social EM is all about. You might recognize Dr. Alter from a short segment on our WR SAEM Day 2 Wrap-up episode - now we’re back with his expended interview! What social factors most impact your patients? How do these issues affect you as a physician or provider? Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and leave us a review on iTunes - it helps others discover us!  Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center Resources: The Andrew Levitt Center for Social Emergency Medicine ACEP Social Emergency Medicine Section ****** Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

How do we teach our medical students and residents to be doctors? Surprisingly, there is no agreed upon, standard approach. Dr. Aaron Danielson, fellowship trained medical educator at UC Davis, takes us through some of the common strategies that medical schools employ. He explains that, although many aspects of medical education have evolved over the past several decades, some things haven’t changed in the over one hundred years since the “Flexner Report”. Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford, takes us through his vision of how medicine is likely to change over the next several decades, and how medical education will need to adapt to train the doctors of the future. How do you see medical education changing over the next 30 years? What new methods and concepts should we embrace, and what should be done away with? We’d love to hear your thoughts. Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and leave us a review on iTunes - it helps us reach more people!  Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Aaron Danielson, Assistant Professor of Emergency Medicine at UC Davis, Fellowship trained in Medical Education Dr. Michael Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University Resources: The “Flexner Report” Medical Education in the United States and Canada: a Report to the Carnegie Foundation for he Advancement of Teaching by Dr. Abraham Flexner Medicine in 2035: Selected Insights From ACGME's Scenario Planning. Nasca TJ, Thomas CW. J Grad Med Educ. 2015 Mar;7(1):139-42. doi: 10.4300/JGME-D-14-00740.1. PMID: 26217449 Dr. Mike Gisondi’s Recommended Reading: Reinventing You by Dorie Clark Stand Out by Dorie Clark Thanks for the Feedback by Douglas Stone & Sheila Hern Make it Stick by Peter C. Brown Steal Like an Artist by Austin Kleon Illuminate by Nancy Duarte & Patti Sanchez Entrepreneurial You by Dorie Clark Show Your Work by Austin Kleon Hitting Pause by Gail Taylor Rice Slide:ology by Nancy Duarte Presentation Zen by Garr Reynolds *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Aaron DanielsonDr. Mike GisondiDr. Julia MagañaDr. Sarah Medeiros

What’s the craziest place you’ve ever worked? Few of us can top Dr. John Rose’s answer: the South Pole! John worked as the physician at Amundsen-Scott Station in Antarctica for four months during the austral summer of 2018-19. Taking care of a large crew of scientists and visitors in -70 degree weather at over 10,000 ft elevation is no easy feat! John tells us about his deployment, some of the common cases he saw, and the challenges of austere medicine.  Do you have a question for Dr. Rose? Or want to share your experience working in austere medicine? Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and leave us a review on iTunes - it helps us reach more people!  Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. John Rose, Professor of Emergency Medicine at UC Davis,  Resources: Amundsen-Scott South Pole Station ******************************** Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Mcmurdo StationDr. John RoseDr. Sarah Medeiros

Dr. Matt Wetschler’s story represents the best and the worst of our healthcare system. Matt tells us about his near fatal injury, his miraculous recovery (thanks to modern medicine), and the complications with billing that plagued him for months after his accident. Matt’s story is one of several in the recent media highlighting the issue of “surprise billing”, and a subset of this issue referred to as “balance billing”. Drawing from his health policy background, Matt helps us understand balance billing and how patients are affected. Then, Dr. Tom Sugarman joins us to further explain the complexities of surprise billing. He shares how he and others are advocating at the national level to change the billing process, and offers some potential solutions going forward.  This is a hot button issue! Please remember that the opinions expressed in this podcast may not represent those of UC Davis or the University of California.  Have you had any experiences with surprise billing? As a health care provider, how do you address this issue with your patients? What potential solutions do you envision? Send us your comments and feedback on social media at @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and rate us on iTunes - it helps us reach more people!  Registration is now open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Matthew Wetschler, Emergency Physician with a Masters in Public Health and Health Policy, motivational speaker, and practicing artist in San Francisco, CA Dr. Tom Sugarman, Chair of Emergency Medicine at Sutter Delta Medical Center in Antioch, Senior Director of Government Affairs for Vituity, and active member and former President of Cal ACEP Media Credit: Opening audio is from a short film by Scott Fitzloff. Watch the video in its entirety at www.matthewwetschler.com Resources: More on Dr. Matt Wetschler’s personal experience with billing via CNBC.  Since his accident, Matt (AKA the Resurrection Artist) has rediscovered his passion for art. More on his story and his work at MatthewWetschler.com Dr. Wetschler recommends the book An American Sickness, by Elisabeth Rosenthal. AMA Issue brief explaining balance billing  ACEP policy on balance billing ACEP Commitment to Best Practices for EM Practice Groups President Trump’s recent comments on ending surprise medical billing ************************************ Dr. Matthew WetschlerPhoto by Saroyan HumphreyDr. Tom SugarmanDr. Julia MagañaDr. Sarah MedeirosPodcast RecordingPodcast RecordingRecording Dr. Wetschler Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Measles is a hot topic from your latest shift to the news measles is on everyone’s mind! Fortunately, Dr. Dean Blumberg an infectious disease physician and fellow podcast host walks us through the basics of measles from the standpoint of the emergency department.   Which patients do you screen for measles?  Have you seen any confirmed cases?  Share your thoughts with us on social media, @empulsepodcast, or online at ucdavisem.com/em-pulse. Please subscribe and leave us a review on iTunes! It help more people discover us. Host: Dr. Julia Magana, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Dean Blumberg, Associate Professor of Pediatrics at UC Davis, Chief of Pediatric Infectious Diseases and Host of Kids Considered. Resources: CDC’s Measles for Healthcare Providers (https://www.cdc.gov/measles/hcp/index.html) Kid’s Considered Podcast hosted by Dr. Dean Blumberg (https://blog.ucdmc.ucdavis.edu/twopedsinapod/) *************************************** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productionsfor audio production services. Dr. Dean BlumbergDr. Julia Magaña

In our January episode, #thisisourlane, we spoke with Dr. Garen Wintemute about firearm violence, and discussed the immediate and passionate social media outpouring from physicians in response to an NRA tweet. In this episode, we dive deeper into the topic of physician advocacy, and, more specifically, the role of social media in advocacy. Our guest, Dr. Megan Ranney, is an emergency medicine physician, educator, and digital health and public health researcher, and is an avid social media user herself. She discusses the power of social media to affect change, and offers some tips for how to make your voice heard, and how to navigate some of the pitfalls. Listen through to the end for thoughts from some other well known EM physicians, including Drs. Mike Gisondi, Steve Bird, and Nikita Joshi. How do you use social media? What do you think about health care professionals using social media for advocacy? Tell us how you’re getting involved - or why you’re staying away! Find us on social media as @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and rate us on iTunes - it helps us reach more people!  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Megan Ranney, Associate Professor of Emergency Medicine at Brown University, Chief Research Officer at AFFIRM Research Featuring: Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center  Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University Dr. Vishnu Parthasarathy, Emergency Medicine Resident at UC San Diego Dr. Steve Bird, President of SAEM, Vice Chair of Education at UMass Medical School Dr. Linda Herman, Emergency Medicine Residency Program Director at Kaweah Delta Dr. Nikita Joshi, Emergency Medicine Faculty at Alameda Health System Resources: AFFIRM Research Mayo Clinic 12 Word Social Media Policy Cyberbullying in Academic Medicine: A Framework for Managing Social Media Attacks. Cain J, Linos E, Chretien KC. Acad Med. 2019 Mar 26. doi: 10.1097/ACM.0000000000002649. [Epub ahead of print] Twitter as a tool for communication and knowledge exchange in academic medicine: A guide for skeptics and novices. Choo EK, Ranney ML, Chan TM, Trueger NS, Walsh AE, Tegtmeyer K, McNamara SO, Choi RY, Carroll CL. Med Teach. 2015 May;37(5):411-6. doi: 10.3109/0142159X.2014.993371. Epub 2014 Dec 19. It's Time for More Physicians to Embrace Advocacy, a Scientific American blog post by Dr. Angira Patel, March 13, 2018. ACEP Firearm Safety and Injury Prevention Policy Statement What You Can Do Dr. Julia Magaña and Dr. Sarah MedierosDr. Megan RanneyDr. Mike GisondiDr. Steve BirdDr. Harrison Alter *************************************** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

What is it like to be an Emergency Physician in the ED during a mass shooting? Dr. Austin Johnson was a senior resident at the University of Colorado Hospital on the night a gunman opened fire in a movie theater in Aurora, Colorado. He shares his firsthand experience as a physician in the ED that night, and discusses the effects of the event on providers, and how the experience has shaped his practice.  Have you been a provider during a mass casualty event? How has the experience affected you?  Share your thoughts with us on social media, @empulsepodcast, or online at ucdavisem.com/em-pulse. Please subscribe and leave us a review on iTunes! It help more people discover us. Host: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Austin Johnson, Assistant Professor is Emergency Medicine at UC Davis *************************************** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productionsfor audio production services.

EM Pulse Live Edition: WR SAEM Day 2 Wrap-up It was another exciting day at the Western Regional SAEM conference in Napa, CA! This episode recaps Day 2, including the Western EM Challenge and some fantastic plenary speakers. Highlights include time management for EM physicians, social emergency medicine, care for LGBTQI patients, the future of medical education, exercise in medicine, and building your social media brand. The conference is trending of social media - follow #WRSAEM19, @wrsaem19, and, of course, @empulsepodcast for all the details. How did we do? This is a new type of podcasting for us and we’d love your feedback! Hit us up on social media or at ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Linda Herman, Emergency Medicine Residency Program Director at Kaweah Delta  Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center  Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University Dr. Angela Jarman, Assistant Professor of Emergency Medicine at UC Davis Dr. Rachel Bentzen, Assistant Professor of Emergency Medicine and Sports Medicine at Oregon Health Science University Dr. Nikita Joshi, Emergency Medicine Faculty at Alameda Health System  Dr. Jim Holmes, Professor of Emergency Medicine at UC Davis and WR SAEM 2019 Conference Chair Resources: Nasca TJ, Thomas CW. Medicine in 2035: Selected Insights From ACGME's Scenario Planning. J Grad Med Educ. 2015;7(1):139-42. Kuppermann N, Dayan PS, Levine DA, et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections[published online ahead of print, 2019 Feb 18]. JAMA Pediatr. 2019;10.1001/jamapediatrics.2018.5501. doi:10.1001/jamapediatrics.2018.5501 Kuppermann N, Ghetti S, Schunk JE, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018;378(24):2275-2287.  ********************************************** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

This is a first for us! We’re podcasting live (or nearly live) from the 2019 Western Regional Society for Academic Emergency Medicine Annual Meeting in Napa, California. In this episode, we re-cap Day 1 of the conference, featuring the Advanced Airway Lab with Dr. Erik Laurin, Wellness in Academic EM with Dr. Andra Blomkalns, Experience in a Mass Shooting with Dr. Austin Johnson, The Value of Scholarship with Dr. Steve Bird, and much, much more! The conference is trending of social media - follow #WRSAEM19, @wrsaem19, and, of course, @empulsepodcast for all the details. Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Erik Laurin, Professor of Emergency Medicine at UC Davis Dr. Andra Blomkalns, Professor and Chair of the Department of Emergency Medicine at Stanford University Dr. Austin Johnson, Assistant Professor is Emergency Medicine at UC Davis Dr. Steve Bird, Vice Chair of Education at UMass Medical School Dr. Jim Holmes, Professor of Emergency Medicine at UC Davis and WR SAEM 2019 Conference Chair ********************************************** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Heartbeat: The Mind of an Airway Enthusiast We sit down with EM legend and airway guru, Dr. Rich Levitan. Dr. Levitan is a self-proclaimed airway enthusiast who has published extensively on laryngoscopes and airway management. He currently works clinically, mainly in rural, critical care access hospitals, and travels the country and the globe speaking and teaching courses on airway management.  So how does Dr. Levitan approach the “difficult airway”? It starts with mindset.   Send us your questions and continue the conversation on social media@empulsepodcast or at ucdavisem.com. Host: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Rich Levitan, Emergency Physician, Adjunct Professor at Dartmouth Geisel School of Medicine, Visiting Professor at the University of Maryland School of Medicine.  Resources: AirwayCam.com ********************************************************** Ski and CME! Join us for the,UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe, CA. Come play and learn with us at the Western Regional SAEM Annual Meeting, March 21-22 in beautiful Napa, CA! #WRSAEM19  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Rich LevitanDr. Sarah MedeirosQSC mixer, Apogee converters, Shure mics, Mogami Cables, Sony headphones

“Hot” Off the Press: Infant Fever Rule - Episode 15 Talking about neonatal fever makes most people hot under the collar! Fortunately, PECARN is on the case. Their latest paper was just published TODAY in JAMA Peds: A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. In this month’s episode, we learn about some the challenges of having a febrile infant - from a mom’s perspective. Then we discuss when, why, and how to apply the latest PECARN rule with the notorious DNK, also known as Dr. Nate Kuppermann!  What is your approach to the febrile infant? What are some of the hardest parts about providing care to our hot little ones? We want to know! Share your thoughts on social media, @empulsepodcast, or on our website, ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee Resources: A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections.  Nathan Kuppermann, MD, MPH1; Peter S. Dayan, MD, MSc2; Deborah A. Levine, MD3; et al. JAMA Pediatr. Published online February 18, 2019. doi:10.1001/jamapediatrics.2018.5501 Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants. Gomez B, Mintegi S, Bressan S, Da Dalt L, et. al. Pediatrics. 2016 Aug;138(2). pii: e20154381. doi: 10.1542/peds.2015-4381. Epub 2016 Jul 5. Management of the Febrile Young Infant: Update for the 21st Century.  Woll C, Neuman MI, Aronson PL. Pediatr Emerg Care. 2017 Nov;33(11):748-753. doi: 10.1097/PEC.0000000000001303. Accuracy of Complete Blood Cell Counts to Identify Febrile Infants 60 Days or Younger with Invasive Bacterial Infections.  Cruz AT, Mahajan P, Bonsu BK, Bennett JE et. al. JAMA Pediatr. 2017 Nov 6;171(11):e172927. doi: 10.1001/jamapediatrics.2017.2927. Epub 2017 Nov 6. *************************************** Ski and CME! Join us for the,UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe, CA. Come play and learn with us at the Western Regional SAEM Annual Meeting, March 21-22 in beautiful Napa, CA! #WRSAEM19  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Nathan KuppermannSarah and Julia

Treat others not as you want to be treated but as they want to be treated. Mai Lee, RN and Dan Colby join us to share some stories and talk about how culture can impact our care in the ED and what we can do about it. Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Daniel Colby, Assistant Professor of Emergency Medicine UC Davis Guest: Mai Lee, RN, UC Davis Emergency Medicine CN II Resources: NIH Cultural Respect: https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/cultural-respect ****************************************************************** Join us in Tahoe, March 4-8, at the 42nd Annual UC Davis Emergency Medicine Winter Conference! We’ll also be teaching and podcasting at the Western Regional SAEM Annual Meeting in Napa, CA, March 21-22. Hope to see you there! Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Cultural Compentency

#Thisismylane– Episode 14 If you work in the ED, you’ve likely seen your fair share of victims of gun violence. Though mass shootings have brought this issue into the public eye, firearm violence has been a public issue in our country for decades. In this episode, you’ll hear some powerful stories from providers about their experiences with people killed and injured by firearms. Then, we talk with researcher and expert, Dr. Garen Wintemute, about trends he’s seen, and discuss how we, as physicians and medical providers, can be part of the solution.  Clearly this is a charged and complex topic. Let’s respectfully share our thoughts on how we can help prevent gun violence. We want to know! Share your thoughts on social media, @empulsepodcast, or on our website, ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Garen Wintemute Professor of Emergency Medicine, Susan P. Baker-Stephen P. Teret Chair in Violence Prevention at UC Davis, and Director, Violence Prevention Research Program   Resources: UC Davis Violence Prevention Research Program Toolkit: What You Can Do to Stop Firearm Violence https://health.ucdavis.edu/vprp/WYCD.html Annals of Internal Medicine commitment and op ed: What You Can Do to Stop Firearm Violence http://annals.org/aim/pages/commitment-to-stop-firearm-violence Speak For Safety Video of Garen Talking about gun retailers taking a hard line against illegal gun sales: https://health.ucdavis.edu/publish/facultybio/search/faculty/242 Ski and CME! Join us for the,UC Davis Emergency Medicine Winter Conference March 4th-8th at the Ritz Carlton in Lake Tahoe. Come play and learn with at the Western Regional SAEM Annual Meeting, March 21-22 in beautiful Napa, CA! #WRSAEM19  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. While this is a UC Davis EM podcast and many of the voices you hear today, including our own, are those of UC Davis EM Physicians, the opinions expressed may not be those of the UC DAVIS institution and Health System.  

2018 In review. Some of our favorite episodes.

Last Stand in Santa Rosa Imagine you’re working a shift in the Emergency Department when a fast moving wildfire hits. What would you do if you found out your home was burning? Or your family was in danger? And how do you react when the Fire Department tells you they are making a last stand a block away from your hospital? This situation is all too real for many physicians and providers affected by devastating wildfires in California. In this episode, we follow the story of the 2017 Santa Rosa fires from the perspective of three Emergency Physicians, Dr. Josh Weil, Dr. Suzy Fitzgerald, and Dr. Dane Stevenson. Their powerful story, and the lessons learned from their experience, are guaranteed to improve your personal and professional disaster preparedness.  Please also consider donating to ongoing relief efforts following the 2018 California wildfires through the Red Cross.  Do you know your hospital’s disaster plan? Do you have a personal plan? Have you lived through a disaster? Share your experience with us on social media, @empulsepodcast, or on our website, ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Susan Fitzgerald, Emergency Physician at Kaiser Santa Rosa and Emergency Management Physician Lead in the Diablo Service Area; Kaiser Permanente Northern California (KPNC) Regional Emergency Management Drill and Training Director and the Pediatric Surge Planning Chair for the KPNC Regional Emergency Management Committee. Dr. Joshua Weil, Emergency Physician at Kaiser Santa Rosa and Assistant Physician-in-Chief for Hospital Operations; Member of the American Red Cross Board of Directors, Board Chair for the Ceres Project, and Medical Director for the Jewish Community Free Clinic in Santa Rosa. Dr. Weil has been involved in major disaster relief efforts in the US and internationally, including Sri Lanka, Louisiana, Haiti, and the Philippines. Dr. Dane Stevenson, Emergency Physician at Kaiser Santa Rosa, with a Fellowship in Geriatric Emergency Medicine from UC Davis. Resources: ACEP Disaster Medicine Resources American College of Emergency Physicians Disaster Medicine resources, policies, and public training, including hospital disaster preparedness self assessment tool and hospital evacuation plan template.  “Healing and History after fire & Weil-Mollard Household”  Dr. Josh Weil and his wife, Claire Mollard, share their story on YouTube The story of Josh's goats! on NPR/Capitol Public Radio ***************************************************************** Ski and CME! Join us for the UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe. Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.   Dr. Joshua WeilDr. Susan FitzgeraldDr. Dane StevensonDrs. Magaña and Medeiros

Camp Fire medicine What are the medical needs when your WHOLE town burns down? What is it like to walk into a shelter with over a thousand friends and family still missing? What if the evacuees you are caring for are your neighbors? The California wildfires have been huge part of our personal and professional lives at UC Davis. In this Heartbeat we spoke with an EM resident who volunteered at a shelter in Chico, CA. Dr. Molly Hallweaver discusses what she saw, treated, and learned taking care of the victims of the Camp Fire. Burn care and inhalation injuries were not the most common needs in the shelter. More often people needed a shoulder on which to cry and treatment of chronic medical needs.  We challenge you to think about what you would do if your community was burning down?  What if your hospital caught on fire? On our next episode we hear the story of Dane Stevenson, a Kaiser EM Physician, whose hospital caught on fire and the experts who can help the rest of us know what we can do to prepare for those moments. Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Molly Hallweaver  Emergency Medicine Resident at UC Davis Resources: If you want to help the victims of the Camp Fire, monetary donations may be made to the American Red Cross. Visit www.redcross.org, call 1-800-RED CROSS, or text the word REDCROSS to 90999 to make a $10 donation. The United Way of Northern California is taking donations for its NorCal Fire Relief Fund through its website and by text: send the message BUTTEFIRE to 91999. *************************************************************************************************** Join us in Tahoe, March 4-8, at the 42nd Annual UC Davis Emergency Medicine Winter Conference! Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. NASA Image of the Camp Fire

Caring for kids in the ED can be challenging - they often can’t (or won’t) tell you what’s wrong or where it hurts; they may have trouble sitting still during an exam or procedure; and their screams put everyone on edge. But let’s think about it from their perspective. It must be pretty confusing and frightening at times. Did you ever have to go to the ED as a kid? Do you remember what it was like? We ask some kids to share their thoughts and experiences. Then we get some valuable tips from the experts - Child Life Specialists, Pediatric ED Nurses, and Pediatric Emergency Medicine Physicians, including our own Dr. Julia Magaña. Learn what you can do to improve the ED experience for both you and your young patients. What tips do you have for taking care of kids in the ED? Did you try any of the things we mentioned in this episode? If so, did they work for you? We want to know! Share your thoughts on social media, @empulsepodcast, or on our website, ucdavisem.com.  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: The kids: Isa, Jordan, Benny, Katelyn, Wesley and Elia UC Davis Department of Emergency Medicine Child Life Specialists, Nurses and Pediatric Emergency Medicine Physicians. Resources: DistrACTION Cards that Julia mentioned Information and protocols for using intranasal medications at www.intranasal.net Wong-Baker FACES pain scale FLACC Score for pain in infants ACEP Guidelines for Procedural Sedation and Analgesia in the Emergency Department (2013) An Evidence-Based Approach to Minimizing Acute Procedural Pain in the Emergency Department and Beyond. Ali S, McGrath T, Drendel AL. Pediatr Emerg Care. 2016 Jan;32(1):36-42; quiz 43-4. doi: 10.1097/PEC.0000000000000669. Review. Patient- and family-centered care of children in the emergency department. Dudley N, Ackerman A, Brown KM, Snow SK; American Academy of Pediatrics Committee on Pediatric Emergency Medicine; American College of Emergency Physicians Pediatric Emergency Medicine Committee; Emergency Nurses Association Pediatric Committee. Pediatrics. 2015 Jan;135(1):e255-72. doi: 10.1542/peds.2014-3424. Ten Practical Ways to Make Your ED Practice Less Painful and More Child-Friendly Amy L.DrendelDO, MS*SaminaAliMDCM, Clinical Pediatric Emergency Medicine Volume 18, Issue 4, December 2017, Pages 242-255 ********************************************************* Ski and CME! Join us for the UC Davis Emergency Medicine Winter Conference, March 4th-8th at the Ritz Carlton in Lake Tahoe. Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Heartbeat: The Price of Beauty As Emergency Physicians, we pride ourselves on recognizing and treating life-threatening conditions. But what if we’re missing important diagnoses and we don’t even know it? In this Heartbeat, we explore acute and chronic silicone syndromes, two potentially serious conditions caused by injecting liquid silicone into the body. Dr. Nick Gorton, previously featured on Episode 8: Don’t be a Jerk! and the LGBTQI, MD Heartbeat, joins us again with advice on how to diagnose and manage these conditions that predominantly affect women, especially transgender women.  Are these diagnoses new to you? Have you seen and treated either of these conditions? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Host: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. R. Nick Gorton, Emergency Physician at Sutter Davis, and Primary Care Physician at the Lyon-Martino Clinic in San Francisco.  Resources: Silicone Pumping Harm Reduction Pamphlet Dying to be a Woman trailer by TransLatin@ Coalition TRANSLINE national online transgender medical consultation service - free and confidential.  Lyon-Martin Health Services, San Francisco, CA. Silicone embolism syndrome: a case report, review of the literature, and comparison with fat embolism syndrome. Schmid A, Tzur A, Leshko L, Krieger BP. Chest. 2005 Jun;127(6):2276-81. Review. *************************************************************************************************** Join us in Maui for Emergency Medicine Hot Topics! November 6-10, 2018. Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services. Dr. Nick Gorton Dr. Sarah Medeiros

If you have ever worked in an ED, you have taken care of a homeless patient. In fact, you’ve probably taken care of many patients you didn’t even know were struggling with homelessness. As providers, we know these people well. They are often labeled “superusers” and, in addition to sometimes acting as their primary care physicians, we often find ourselves trying to sort out their myriad social issues. In this episode, we talk with a homeless patient, multiple ED providers, and expert Dr. Bisan Salhi, about some of the health challenges that our undomiciled patients face, and what role the ED should play in caring for these patients. You’ll hear a variety of opinions on this controversial topic. We then talk with health policy experts, Dr. Nick Sawyer and Dr. Aimee Moulin, about the recently signed California Senate Bill 1152, and how it will affect hour care and discharge of self-identified homeless patients. Do you screen for homelessness? How do you care for homeless patients in your ED? Will you be affected by CA Senate Bill 1152? This topic is likely to generate some heated conversation. Join us on social media, @empulsepodcast, or on our website, ucdavisem.com, to keep the discussion going.  Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Bisan Salhi,  Assistant Professor of Emergency Medicine at Emory and PhD in Anthropology Dr. Nick Sawyer, Assistant Professor of Emergency Medicine at UC Davis, California ACEP Board Member Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and President of California ACEP Resources: Homelessness and Emergency Medicine: A Review of the Literature. Salhi BA, White MH, Pitts SR, Wright DW. Acad Emerg Med. 2018 May;25(5):577-593. doi: 10.1111/acem.13358. Epub 2018 Jan 11. Get involved through California ACEP! Read the complete California Senate Bill 1152. ****************************************************** What better place to earn CME than Maui! There's still time to register for the 15th Annual Emergency Medicine Hot Topics conference taking place Nov. 6-10, 2018 in Hawaii. Earn up to 20.5 CME credits! Register today at tinyurl.com/EMHOTTOPICS Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

A cool tool. In this episode Dr. Nate Kuppermann (@nkuppermann) discusses another amazing article on the PECARN TBI decision rule just published in JAMA Network Open. The article, Effect of the Head Computed Tomography Choice Decision Aid in Parents of Children With Minor Head Trauma: A Cluster Randomized Trial, and this episode explores shared decision making in the ED and a cool tool we can use to aid this process. Send us your questions and continue the conversation on social media @empulsepodcast or at ucdavisem.com. Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Nate Kuppermann, Pediatric Emergency Physician, Professor and Chair of the UC Davis Department of Emergency Medicine, Founding Chair of the PECARN Steering Committee Resources: Effect of the Head Computed Tomography Choice Decision Aid in Parents of Children With Minor Head Trauma: A Cluster Randomized Trial. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2703135 Erik P. Hess, MD, MSc1,2,3; James L. Homme, MD4,5; Anupam B. Kharbanda, MD, MSc6; Leah Tzimenatos, MD7; Jeffrey P. Louie, MD8; Daniel M. Cohen, MD9; Lise E. Nigrovic, MD, MPH10; Jessica J. Westphal11; Nilay D. Shah, PhD12,13; Jonathan Inselman, MS13; Michael J. Ferrara2,14; Jeph Herrin, PhD15; Victor M. Montori, MD, MSc3; Nathan Kuppermann, MD, MPH6,16 JAMA Network Open. 2018;1(5):e182430.  Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. (https://www.ncbi.nlm.nih.gov/pubmed/19758692) Kuppermann  N, Holmes  JF, Dayan  PS,  et al; Pediatric Emergency Care Applied Research Network.  Lancet. 2009;374(9696):1160-1170.