Em Pulse

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

“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 injurie

I hope you learned as much as I did from Dr. Nakra. It makes a lot of sense as we figure this illness out to think about MIS-C in kids with other features such as GI symptoms, rashes early in the illness AND to pursue evaluation in those with fever of 5 days without any other symptoms. If you find elevated inflammatory markers with a history of COVID exposure or in areas with high prevalence admit. Also if they are hypotensive give fluids cautiously, consider pressers pearlier than you would in other kids because you might have cariogenic shock.  Transfer to a pediatric center with multi-disciplinary resources. I don’t know about you but that is something new for me and will change the way I approach my kiddos on my next shift.  Show notes: MIS-C—What do we do??? 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 sh

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 re

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.*

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 operatio

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 i

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. Ra

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 G

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,

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

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 s

This month’s Heartbeat is about something most of never get enough of: SLEEP. Dr. Katren Tyler, emergency physician and Vice Chair of Wellness for the UC Davis Department of Emergency Medicine, shares some important information about sleep and shift work. Katren recently spoke on this topic at the UC Davis EM Winter Conference in Lake Tahoe. She explains how our sleep patterns change throughout our lives, and how shift work affects our health and our ability to do our job as physicians. She also offers some suggestions for how we can minimize the negative effects of shift work at both the personal and health system levels.  How do you manage sleep and shift work? We’d love to hear from you! Connect with us on social media, @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe 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. Katren Tyler, Professor of Emergency Medicine a

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 o

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 Prof

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 Co

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

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 empulsepodcast@gmail.com, 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,

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