Em Pulse

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 d

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

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 @empulsepodca

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 Au

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 Depart

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

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 Confer

“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, Ped

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 Da

#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-

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 o

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 tho

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 Professo

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

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 affect

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.

Excuse Me, Your Bias is Showing - Episode 10 We all have biases lurking in our unconscious mind. These are our implicit biases, and they affect how we relate to patients and, in turn, how they relate to us. But if these biases are unconscious, how do we identify them? And is it possible to change them? We share our own experiences with implicit bias, and we hear Dr. Rupa Marya’s story that went viral on social media. Then we dive a little deeper with researcher and pediatric emergency medicine physician, Dr. Tiffani Johnson. Want to check your own biases? Take an implicit association test (IAT) through Project Implicit. Let us know what you found and let’s continue the discussion on social media, @empulsepodcast. If you’d like to keep your results more private, send us a comment on our website, ucdavisem.com. 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. Tiffani Johnson, Pedi

It’s all about Tommie. Way back in March we discussed how “The Game has Changed” with Dr. Dr. Gail D’Onofrio and Dr. Josh Elder (https://twitter.com/joshuawelder).  They discussed how emergency departments can be a positive part of the opiate epidemic by offering buprenorphine (suboxone). In this episode we find out how the program is going and how the human element (aka Tommie, our substance use counselor) is helping it succeed. 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 Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and President of California ACEP Resources: ED Bridge (https://ed-bridge.org) emergency department support for development and implementation of buprenorphine treatment AMA END the EPIDEMIC (https://www.end-opioid-epidemic.org/resou

Thriving, not Surviving - Episode 9 Are you well? In this episode we tackle the issue of physician wellness. What does that mean? Why is it a problem? And what can we do to thrive, not just survive, in medicine? We discuss strategies with EM physicians of all levels, including Cal ACEP President, Dr. Aimee Moulin, and Dr. Katren Tyler, Vice Chair of Wellness for the UC Davis Department of Emergency Medicine. How do you define physician wellness? What is your personal recipe for THRIVING, not just surviving? Join the conversation on social media, @empulsepodcast, or at ucdavisem.com. 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. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and President of California ACEP Dr. Katren Tyler, Professor of Emergency Medicine and Vice Chair for Faculty Development, Wellness and Outreach in the UC Davis Department of Emergenc