Em Pulse

This is the next episode of our Push Dose Pearls miniseries with ED Clinical Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. In this epsidoe, we unpack the complexities of anticoagulation reversal in the emergency department - It’s not just about vitamin K anymore! Tune in as we explore the key reversal agents, when and why to use them, how fast they work, and the risks that come with turning off anticoagulation. From bleeding emergencies to stroke prevention, this quick dive offers practical pearls for navigating the coagulation cascade in real time. Have you had a bad GI bleed or intracranial hemorrhage in a patient on thinners?. Share your story with us on social media or at ucdavisem.com. Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical

Big news for emergency medicine residencies! The ACGME is proposing several major changes to EM program requirements. To comply with these new requirements, programs would need to be 4 years long. This is a hotly debated topic at the moment as most EM residencies in the U.S. currently are 3 year programs. So what are the proposed changes? How would they affect the curriculum and training for future EM physicians? To answer these questions, we sit down with UC Davis EM Program Director and medical education specialist, Dr. Aaron Danielson.  What do you think of these proposed changes? We’d love to hear from you. We’re on social media @empulsepodcast or connect with us on ucdavisem.com Host: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Aaron Danielson, Associate Professor of Emergency Medicine and Emergency Medicine Residency Program Director at UC Davis Resources: Share your comments with the ACGME ACEP: ACGME Releases Proposed Changes to EM Program Requirements U

In the fourth and final episode of our advocacy mini series with guest host, Dr. Anna Yap, we dive into a powerful story of advocacy led by a mother-daughter duo. Pediatric nurse practitioner Robyn Lao and her 9-year-old daughter, Addie, who has severe food allergies, turned their personal challenges into a statewide movement by co-authoring California Senate Bill 68—the Allergen Disclosure for Dining Experiences (ADDE) Act. Together, they share their journey from navigating daily food allergy struggles to pushing for legislative change, proving that anyone, at any age, can make a difference. Tune in to hear how their determination is shaping a safer future for millions. Have you been involved in health care related legislation? Share your story with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellows

In the third episode of our advocacy mini series with Dr. Anna Yap, we explore the evolving challenges faced by transgender patients and medical professionals in today’s political climate. We’re joined by Charlie Adams, a fourth-year medical student and dedicated advocate, who shares his powerful journey fighting for transgender rights and health equity. Together, we discuss the importance of gender-affirming care, the real-world impact of restrictive laws, and how we can improve emergency department care for transgender patients. Tune in for an insightful conversation on advocacy, inclusivity, and the role we all play in creating a more supportive healthcare system. How have your patients and your practice environment been affected by legal and political changes in transgender rights? Share your story with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medici

In the second episode of our advocacy mini series with Dr. Anna Yap, we dive into the critical intersection of emergency medicine and immigration health. As emergency physicians, we frequently care for undocumented patients, asylum seekers, and refugees—individuals who face significant barriers to medical care, including fear, cost concerns, and language obstacles. Dr. Ellen Shank, a UC Davis health policy fellow and expert in migrant healthcare, joins us to explore the legal and ethical responsibilities of emergency providers, including how to navigate interactions with immigration enforcement, protect patient rights, and provide trauma-informed care. We’ll discuss practical ways physicians can advocate for these vulnerable populations, from facilitating asylum medical exams to supporting protective hospital policies. Tune in for an essential discussion on how emergency physicians can go beyond medical treatment to become informed advocates for their patients in an evolving immigration landscape. Has ICE co

When corporate interests threaten patient care, who speaks up for doctors and their patients? This episode kicks off a special EM Pulse mini-series with guest host, Dr. Anna Yap, in which we explore the power of advocacy in medicine. In our first episode, Dr. Michelle Wiener shares how she and her colleagues took on a private equity-backed staffing group, formed a union, and fought for safer working conditions—proving that real change starts from within. Whether you’re new to advocacy or already involved, this series will inspire you to take action. Have you or you colleagues considered collective bargaining to address concerns in your ED?  We’d love to hear from you on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC Davis Guest: Dr. Michelle Wiener, Emergency Physician and Clinical

In this final installment of our three-part series on artificial intelligence in emergency medicine, we explore the rapid expansion of AI and its implications for clinical practice. In previous episodes, we explored how AI is revolutionizing tasks like diagnosis, treatment planning, and patient monitoring. In this final chapter, guest expert, Dr. Brian Patterson, joins us to discuss how to safely integrate AI into clinical practice. We recap insights from previous episodes, including AI’s transformative potential and real-world applications, while diving into the challenges and regulatory efforts shaping this exploding field. Whether you’re an AI skeptic or an early adopter, this episode unpacks what you need to know about integrating AI safely and effectively into emergency medicine. How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric

In the second episode our three part series, we dive deeper into the practical impact of artificial intelligence on emergency medicine with expert, Dr. Gabriel Wardi. Building on our previous discussion about AI’s role in healthcare, we explore clinical decision support systems (CDS)—how they aim to improve diagnostic accuracy but can sometimes miss the mark. Dr. Wardi shares insights from his own experience implementing AI-driven CDS, highlighting both its successes and challenges, including bias, reliability, and the importance of high-quality data. We discuss how AI can address traditional pitfalls of CDS, improve outcomes like sepsis care, and offer a glimpse into the future of AI in emergency settings. Plus, we look ahead to the critical conversation of AI governance and regulation in EM. Tune in as we break down what’s working, what’s next, and how frontline EM physicians can stay ahead of the curve. How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Kee

In this episode, we dive into how AI is changing emergency medicine with Dr. Peter Steel, an expert in AI and EM at Cornell. We break down the basics of AI, machine learning, and deep learning, explore real-world applications like improving triage and clinical decision-making, and tackle challenges like bias and integration in high-pressure settings. Dr. Steel shares insights on generative AI, large language models, and the exciting future of AI in EM. If you’re curious about how AI can transform patient care and what’s next for the field, this episode is for you! How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Peter Steel, Associate Professor of Clinical Emergency Medicine and Vice Chair of Clinical Services at We

In this episode, we dive into the rising threat of cyberattacks on healthcare systems and their profound impact on emergency medicine. With 386 attacks reported in 2024 alone (as of October 7th), the likelihood of your hospital being targeted is increasing. But why are these attacks happening, and what can we do to mitigate their effects? To explore this critical topic, we’re joined by Dr. In Kim, Executive Vice Chair of Pediatrics at the University of Louisville School of Medicine and a leader in advancing his university’s cyber capabilities. From real-world examples of devastating attacks to actionable steps for hospitals, departments, and individual physicians, we’ll break down what you need to know to protect your patients, your practice, and yourself. Don’t miss this essential discussion for every emergency medicine provider! Has your health system been the victim of a cyber attack? Tell us your story and keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Ma

In this episode, we address the growing concern over political violence in the United States as the presidential election draws near. Political violence, defined as the intentional use of power and force to achieve political ends, is a significant public health issue. Violence researcher and emergency physician, Dr. Garen Wintemute, joins us to provide a clear, evidence-based perspective on the topic. We explore recent data and expert insights to better understand the threat of political violence, its potential impact in emergency departments, and what we can do about it. *Please note: Views and opinions expressed in this episode are the speaker’s own and do not represent those of UC Davis or the University of California.*  Are you concerned about political violence related to the upcoming election? How are you and your ED preparing? Keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeir

As emergency physicians, we are very familiar with giving naloxone to patients with concern for opioid overdose. Our EMS colleagues give naloxone all the time in the prehospital setting. We know it works well for patients who are obtained due to opioids, but what about for patients who have an out-of-hospital cardiac arrest? Our expert on todays episode, Dr. David Dillon, set out to find out.  Were you surprised by the findings in Dr. Dillon’s study? Does it change your practice? Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests: David Dillon, M.D., M.Phil., Ph.D, Assistant Professor of Emergency Medicine at UC Davis Resources: Dillon DG, Montoy JCC, Nishijima DK, Niederberger S, Menegazzi JJ, Lacocque J, Rodriguez RM, Wang RC. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Netw Open. 2024 Aug 1

Acetaminophen overdose is one of the most common medication concerns we see in the ED. It is important to know when to be concerned and when to treat as true overdoses can cause liver failure and death. UC Davis medical toxicologist, Dr. Hoan Nguyen, joins us in this episode to discuss a new consensus statement published in JAMA Network Open in August 2023: Managing of Acetaminophen Poisoning in the US and Canada. We discuss the updated approach and walk through as hypothetical case. At the end of this episode, you’ll be able to identify high risk patients, know what labs to draw, when to start NAC, transfer, and call your local toxicologist. Do these updated guidelines change your practice? Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. HoanVu Nguyen, Military Emergency Physician and Medical Toxicologist at UC Davis.  Resour

This is the next episode of our Push Dose Pearls miniseries with ED Clinical Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode focuses on naloxone. Naloxone is a staple in every ED docs toolbox but it can save more lives if it’s immediately available in the community. We’ll discuss ED based naloxone programs, why they are important, how to get funding, and which patients could benefit.  Do you give out naloxone in your ED? Is it readily available in your community? We’d love to hear your experience. Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and former Assistant Professor at UC Davis Resources: Kids Considered Podcast - Naloxone and Opioid

In this special episode, we celebrate the incredible 19-year tenure of Dr. Nate Kuppermann as Chair of the UC Davis Emergency Department. As he transitions to his new role as Executive Vice President, Chief Academic Officer, and Chair of Pediatrics at Children’s National Hospital in Washington, D.C., Dr. Kuppermann reflects on the growth and evolution of the department since he started in 2006. He shares insights on the challenges and accomplishments throughout his career, offers advice for aspiring department chairs, and discusses the importance of social media in building a department's presence. Join us as we bid farewell and thank Dr. Kuppermann for his remarkable contributions. What would you like to hear more of on EM Pulse? Hit up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Nate Kuppermann, Professor of Pediatric Emergency Med

Many of our ED patients come in because they were told to. Whether it’s by an advice nurse, primary care provider, urgent care, call center, specialty coordinator, etc., it often feels to us like the default is “go to the ED”. But, of course, that’s not the case. There are myriad reasons why patients may be sent to the ED. In this episode, we talk with two of our favorite outpatient physicians - a Pediatrician and an Internist - about when and why they refer patients to the ED, as well as what they do to try to keep them out of the ED!  Did you learn something new? Please share this podcast with your colleagues! Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. Olivia Campa, Assistant Clinical Professor of Internal Medicine at UC Davis Dr. Lena van der List , General Pediatrician at UC Davis, Host of Kids Considered Podcast Res

Oncologic Emergencies: Part 2 In this two-part series, we dive into the world of oncological emergencies with guest expert, Dr. Monica Wattana. In part 1, we covered everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also discussed some of the tricky complications that often accompany cancer treatments, like mucositis, vomiting and diarrhea, anemia, and neuropathic pain. In part 2, we tackle pain management, palliative care, and some tough ethical dilemmas. The goal is to make sure we're all equipped to provide the best care possible for our patients with cancer.  Did you learn something new that changed your practice? We’d love to hear about it. Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. Monica Wattana, Associate Professor and Education Director for

In this two-part series, we dive into the world of oncological emergencies. Our guest expert, Dr. Monica Watana, an emergency physician specializing in this area. In part 1, we cover everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also talk about some of the tricky complications that often accompany cancer treatments, like mucositis, vomiting and diarrhea, anemia, and neuropathic pain. The goal is to make sure we're all equipped to provide the best care possible for our patients with cancer. Stay tuned for part two, when we’ll tackle pain management, palliative care, and some tough ethical dilemmas.  Did you learn something new that changed your practice? We’d love to hear about it. Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Monica Wattana, Associa

In this episode of Push Dose Pearls, we delve into the use of push dose pressors in emergency medicine. Dr. Chris Adams talks about their use, potential side effects, and the importance of a clear plan for the administration of push dose pressors. Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Managing pregnant patients in the ED can be stressful - especially because you have (at least) two patients to think about! Emergency physicians are generally comfortable managing first trimester emergencies but are less familiar with complications in the later stages of pregnancy. It is these complications that contribute in part to the maternal health crisis in the US. In this episode, we delve into the realm of obstetric emergencies in the ED with Dr. Jenna White, an EM physician with a special interest in OB. She introduces us to resources developed by the American College of Obstetrics and Gynecology (ACOG) to help ED providers identify common pathologies and navigate high-stakes scenarios, including screening for cardiovascular disorders, managing hypertension, and tackling the dreaded eclampsia. How does your ED manage OB emergencies? Have you implemented the ACOG algorithms? Share your experience with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Profes