Em Pulse

If you’re an emergency physician, or have goals of becoming one, you have probably heard about ACEP’s workforce study. The findings first came out in April 2021, and were followed by a full paper in Annals of Emergency Medicine in August. The bottom line is that there is a predicted surplus of EM physicians of over 7,800 by 2030. How did we find ourselves here? What does this mean? And what should we do about it? We reached out to Emergency Physician and ACEP President Elect, Dr. Gillian Schmitz, to learn more.  What was your reaction to the workforce report? What do you think is the path forward for our specialty? 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.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Gillian Schmitz, ACEP President Elect, Associate

By the end of October 2021, almost 6.4 million children tested positive for COVID-19…6.4 million. In our first ever crossover podcast we discuss with Kids Considered host and Peds ID Dr. Dean Blumberg we discuss the recently approved pediatric COVID-19 vaccine! We are planning to get our kids vaccinated. Are you?

It’s no secret that COVID-19 hit the healthcare world hard, especially those on the frontlines. The best defense we have against this virus are vaccines. As you’ve heard on previous episodes, studies show the vaccines are safe and effective. Across the country, and especially in California, an overwhelming majority of ED physicians, and most ED nurses and support staff, have chosen to get vaccinated. But that still left many healthcare workers unvaccinated and at risk of getting sick or passing the virus to patients. So, the government stepped in to issue mandates.  In this episode, we explore the recent California state and U.S. federal mandates that require healthcare workers to be vaccinated, or apply for a medical or religious exemption. We hear from nurses with differing opinions on the mandate, get into the details of the mandate with Health Policy and Advocacy Fellow, Dr. Hunter Pattison, and talk with Director of Emergency Services at UC Davis, Rupy Sandhu, about the challenges of implementation and

Let’s talk about gender equality in PEM.  Our guests are two PEM physicians who are creating innovative solutions to workforce inequality.   Host: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Health Guests:   Dr. Lindsey Barrick, Assistant Professor at Cincinnati Children’s Hospital Medical Center, Vice-Chair of the Women in PEM AAP Subcommittee Dr. Mariju Baluyot, Pediatric Emergency Medicine Faculty, Riley Hospital for Children Simulation Fellow at Indiana University, Women in PEM Social Media Director, Co-leader for the Diversity, Equity and Inclusion Dissemination Outreach Group Resources: Women in PEM on Twitter: https://twitter.com/WomeninPEM Women in PEM: https://linktr.ee/WomeninPEM

TeamSTEPPS is a curriculum designed for health care professionals that emphasizes good communication and teamwork. This toolkit is evidence based and available for free from the AHRQ and we use it at UC Davis to improve communication, teamwork and patient safety. In this episode we talk with our TeamSTEPPS champions about the curriculum and how we can be better team members. Share with us on @empulsepodcast if you use team steps and if so what your favorite tool is.  Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests:   Dr. David Barnes, Professor of Emergency Medicine at UC Davis, TeamSTEPPS Physician Champion Leigh Clary, RN, UC Davis Emergency Department TeamSTEPPS Nurse Champion Resources: Contact us @empulsepodcast to connect with Dr. David Barnes or Leigh. About TeamSTEPPS. Content last reviewed June 2019. Agency for Healthcare Research and Quality, Rockville, MD. https://www.

Here we highlight lessons learned about youth violence prevention and what you can do now, on your next shift to prevent violent injuries in youth. Dr. Joe Wright is an accomplished leader in Pediatric Emergency Medicine Physician and is a compelling voice for violence prevention. Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guest:   Dr. Joesph L. Wright, Senior Vice President and Chief Medical Officer, Capital Region Health/University of Maryland Medical System and Professor (adjunct), Pediatrics and Health Policy & Management, University of Maryland Schools of Medicine and Public Health Resources: American Academy Of Pediatrics election: https://www.aappublications.org/news/2021/08/01/electionguide080121 More information on the candidates: https://www.aap.org/elections Committee on Injury, Violence, and Poison Prevention. Policy statement--Role of the pediatrician in youth violence prevention. Pediatrics. 2009 Jul;124(1):393-402. doi: 10.1542/peds.2009-094

The opioid epidemic gets a lot of attention, but methamphetamine use may actually affect more of our patients in the emergency department. Those of us who work in the ED are all too familiar with the agitated delirium that meth can cause, as well as the long term effects, like heart failure. In this episode, we hear one woman’s story of her experience with methamphetamines and how substance use nearly destroyed her life. Then our Toxicology colleagues, Dr. Kelly Owen and Dr. Dan Colby, walk us through how meth works, how to manage acute intoxication and other dangerous consequences, and how we can better care for our patients who use methamphetamines. We’d love to hear from you! Share your questions, comments, and feedback 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, Associate P

In part 2 on workplace violence Brian describes when he was attacked at work and Dr. Aimee Moulin and Dr. Amy Barnhorst talk about how to cope with the threat of violence on a shift.  What can we do?  What do you do in your department to create a safe place? How do you protect yourself?  Share your experience 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, Associate Professor of Emergency Medicine at UC Davis Guests: Brian Stroben, Charge Nurse and Assistant Nurse Manager in the UC Davis Department of Emergency  Medicine Dr. Amimee Moulin, Professor of Emergency Medicine, Behavioral Health Director Dr. Amy Barnhorst, Associate Clinical Professor of Psychiatry at UC Davis, Vice Chair for Community Mental Health, Director of BulletPoints Project Resources: ACEP Emergency Department

Recently, we’ve explored how violence can affect our patients. Now, let’s how explore how we as emergency medicine providers are affected by violence in our own department. In part I of this two part series, we talk with UC Davis ED Charge Nurse and Assistant Nurse Manager, Brian Stroben, about workplace violence - what it is, how it affects us, and some things we can do to mitigate risk and keep our teams safe.  Have you had a personal experience with workplace violence in your ED? Share your experience 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, Associate Professor of Emergency Medicine at UC Davis Guest: Brian Stroben, Charge Nurse and Assistant Nurse Manager in the UC Davis Department of Emergency  Medicine Resources: Understanding Agitation: De-escalation video by Dr.

Do you have a similar program where you work, or are you interested in learning more about how to start one? Share your experiences and questions 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 Guest: Dr. Terry Klassen, Professor, Pediatrics & Child Health, University of Manitoba Resources: “Wraparound” EM Pulse Podcast published June 17, 2021. https://ucdavisem.com/2021/06/17/wraparound/ Snider CE, Jiang D, Logsetty S, Chernomas W, Mordoch E, Cochrane C, Mahmood J, Woodward H, Klassen TP. Feasibility and efficacy of a hospital-based violence intervention program on reducing repeat violent injury in youth: a randomized control trial. CJEM. 2020 May;22(3):313-320. doi: 10.1017/cem.2019.406. PMID: 31645229.  https://pubmed.ncbi.nlm.nih.gov/31645229/  *** Thank you to the UC Davis Department of Emerge

In the emergency department, we treat violently injured patients on nearly every shift. We can splint the broken bones, stitch up the cuts, and send seriously injured patients to the operating room with our surgical colleagues. We may be able to heal the physical wounds, but what about the emotional ones? And what happens to our patients when they go home to the same potentially unhealthy environments that led to the violent injury in the first place? The UC Davis Wraparound program addresses these issues and more. We talk with program Co-lead, Dr. Ian Brown, and Violence Intervention Specialist, Chevist Johnson, about how Wraparound works and why programs like these are so important.  Do you have a similar program where you work, or are you interested in learning more about how to start one? Share your experiences and questions 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. Ju

***Trigger warning: this episode includes discussion of child abuse*** This is a follow up episode that dives deeper on why a bruised baby is worrisome, important aspects of a social history, and screening for abuse in the ED. Please listen to our first episode “It Could Have Been Different” for more!  Have you used TEN-4 FACESp to identify potential non-accidental trauma? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Mary Clyde Pierce, Professor of Pediatrics at Northwestern University, Pediatric Emergency Physician and Director of Child Abuse Research at Laurie Children’s Hospital. Resources: “It Could Have Been Different” EM Pulse Podcast published April 17, 2021. https://ucdavisem.com/2021/04/17/it-could-have-been-different/ Pierce MC, Magana JN, Kaczor K, Lor

Trauma Informed Care 101 Trauma informed care has become quite the buzz word in medicine, and especially in emergency medicine.  But what does it mean? Why should you care? How can you use it on a shift?  We’ll address these questions and more with experts, Dr. Angela Jarman, Dr. Bryn Mumma, and our own Dr. Julia Magaña. What is a way you incorporate trauma informed care into your practice? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine and Co-Chair of the Human Trafficking Workgroup at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Angela Jarman, Assistant Professor of Emergency Medicine and Sex and Gender Researcher at UC Davis Dr. Bryn Mumma, Associate Professor of Emergency Medicine and Co-Chair of the Human Trafficking Workgroup at UC

Our first EM Pulse podcast called “Pot Tarts” was on marijuana legalization in California and ingestion in kids. In this episode we circle back to THC in kids with Dr. James Chenoweth on a an update of what has happened since legalizations.   Have you seen an uptick in THC ingestions in children since legalization? Share your ideas 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 Guests: Dr. James Chenoweth , Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis Resources:  First EM Pulse podcast episode “Pot Tarts” https://ucdavisem.com/2018/01/16/episode-1-pot-tarts/ *** 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.  

***Trigger warning: this episode includes discussion of child abuse*** As emergency physicians, we are uniquely positioned to identify and address child abuse, or non-accidental trauma (NAT). It’s a challenging part of our job, but our vigilance can save a child’s life. Signs of abuse can often be subtle, but there are some very specific findings that should make us consider NAT. In this episode, we talk with expert, Dr. Mary Clyde Pierce, about her recently published paper, coauthored by our own Dr. Julia Magaña, validating the TEN-4 FACESp clinical decision rule to predict abuse in young children.  Have you used TEN-4 FACESp to identify potential non-accidental trauma? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicin

Happy spring, everyone! This Heartbeat is all about joy and community, so come along with me to Macedonia Baptist Church in Sacramento, California, where community leaders, Pastor Jeffrey Johnson and Derrell Roberts, teamed up with Dr. Kevin Mackey, Medical Director for Sacramento Regional Fire, and UC Davis Emergency Medicine providers to offer COVID vaccinations to the local community. Equitable vaccine distribution is an ongoing concern across the US and, according to a recent CDC report (linked below), our most vulnerable communities are still under vaccinated. In Sacramento County and across the country, local physicians, administrators and community leaders are coming up with new strategies to reach these communities, including partnering with trusted community leaders. When things come together, the results are amazing, and the vaccine clinic at Macedonia Baptist is a shining example of this.  What innovative strategies have you seen in your community to work toward vaccine equity? Share your ideas an

Last month, Dr. Josh Elder spoke with us about how UC Davis Express Care allows patients to see a doctor via virtual urgent care visits. In this episode, we explore a different side of telemedicine: teleconsults. Dr. Jim Marcin is Director of the UC Davis Center for Health and a pioneer in telemedicine. As a Pediatric Critical Care Physician, Dr. Marcin has been facilitating teleconsults for physicians at rural hospitals to help provide the expertise needed for care for critically ill children. He explains the current model he and his colleagues are using, the data to support what works (and what doesn’t), and a glimpse into what he might expect in the future as telehealth becomes more widely available.  Have you tried telemedicine, either as a patient of provider? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatr

“He came in by ambulance short of breath...” This is how Dr. Taylor Nichols’ tweet thread began. It’s a line many of us could have written - typical of an encounter in the COVID era. But the thread goes on to tell a more complicated story about racism, a physicians duty, and the toll this pandemic has had on many frontline healthcare providers. Dr. Nichols shares his story with us, along with the aftermath of his viral tweet, and his reflections three months on.    Share your thoughts and reactions to Taylor’s story 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.*** And please pass the word along to your friends and colleagues! Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Taylor Nichols, Emergency Medicine Physician in Sacramento, CA, and former Health Policy Fellow at UC Davis. Resources: Twitter thread by Dr. Taylor Nichols Jewish doctor

In our recent episode in the future of emergency medicine, several of our guests pointed to technological advances, including telemedicine, as key pieces in the evolution of our specialty. And, thanks in large part to the pandemic, the development and implementation of telemedicine has accelerated over the past year. In this episode, Dr. Josh Elder, Medical Director of Express Care at UC Davis, shares his experience creating a virtual urgent care. We discuss some of the advantages and disadvantages for both patients and providers, and explore how this service has proved to be a safe and efficient way to meet patients where they’re at.  Have you tried telemedicine, either as a patient of provider? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com. Stay tuned for next month’s episode when we explore another side of telemedicine - specialty consults for physicians! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts:

The COVID-19 pandemic has forced us all to become more comfortable with virtual engagement. From faculty and group meetings to conferences to kids’ school to social events - it seems everything is online these days. And while we may finally be getting used to this after many months, most of us still have a lot to learn in terms of how to best present ourselves in the virtual space. We’ll discuss our favorite tips and tricks, as well as some audiovisual equipment that can help you look and sound better, without breaking the bank. Happy Zooming! Share your favorite tips and tricks 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 Resources and Recommended Equipment: Microphones: Shure MV7 Podcast Microphone Shure MV5C Home Office