Em Pulse

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

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

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 supportin

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 strate

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 (bemumma@ucdavis.edu [bemumma@ucdavis.edu], 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 (bemumma@ucdavis.edu) Boeddinghaus J, Twerenbold R, et al. Clinical Use of a New High-Sensitivity Cardiac Tr

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