Em Pulse

This episode of EM Pulse dives into one of the most stressful scenarios in the ED: the febrile infant in the first month of life. Traditionally, a fever in this age group has meant an automatic “full septic workup,” including the dreaded lumbar puncture (LP). But times are changing. We sit down with experts Dr. Nate Kuppermann and Dr. Brett Burstein to discuss a landmark JAMA study that suggests we might finally be able to safely skip the LP in many of our tiniest patients. The Study: A Game Changer for Neonates Our discussion centers on a massive international pooled study evaluating the PECARN Febrile Infant Rule specifically in infants aged 0–28 days. While previous guidelines were conservative due to a lack of data for this specific age bracket, this study provides the evidence we’ve been waiting for. The Cohort: A large pool of infants across multiple countries. The Findings: The PECARN rule demonstrated an exceptionally high negative predictive value for invasive bacterial infections. The B

  Reimagining Care Beyond Hospital Walls Hospitals are a finite resource—but patient needs are not. This episode continues our multi-part series on taking medicine to where patients are—rather than making them come to us. From preventative care to pediatricians meeting families in their own environments, the series has explored how medicine is evolving beyond traditional settings. In this episode, we explore one of the most compelling—and long-overdue—ideas yet: care at home. What Is Home-Based Medical Care? Joined by Dr. Kelly Owen, Professor of Emergency Medicine at UC Davis and Medical Director for Express Care and Dispatch Health, the conversation dives into what home-based care really looks like—from urgent care at home to ED-to-home follow-ups and post-hospital discharge support designed to prevent readmissions. A Patient-Centered Solution That Works Through a powerful real-world case, the team illustrates how mobile medical units can deliver wraparound care—medications, follow-up appointments, and

We’re stepping out of our Medicine on the Go series for a rapid-response episode on something hitting all of us hard right now: **influenza**. A lively debate among our colleagues sparked this conversation—especially around a newer flu antiviral, baloxavir (Xofluza). Who’s using it? When does it make sense? How much does it cost patients? And how does it really compare to the longtime staple oseltamivir (Tamiflu)? The questions came fast, the opinions were strong, and we knew it was time to dig in. With flu season in full swing, this episode is all about practical decision-making at the bedside. Back to Basics: How Flu Antivirals Work To help break it all down, we welcome back our trusted ED pharmacist, Haley Burhans. We begin with a quick review of how influenza antivirals have evolved. , approved in 1999, was the first widely used antiviral and works by blocking the neuraminidase enzyme. Over time, concerns about resistance led to the development of newer options. That brings us to baloxavir (Xofluza), appr

The next episode of our Medicine on the Go series features Dr. Serena Yang, Professor and Division Chief of General Pediatrics and Vice Chair of Community Engagement at UC Davis Health, as she shares how UC Davis Children’s Hospital’s Pediatric Mobile Clinic is bringing specialty care directly into schools and under-resourced communities across the Sacramento region. Learn how this innovative mobile model addresses urgent needs in child development, mental health, and asthma, removes barriers to care, and builds trust through strong school and community partnerships—offering an inspiring blueprint for delivering equitable pediatric care beyond the clinic walls. Does your health system have a mobile outreach clinic? Would you consider starting one? We’d love to hear from you! Share with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Se

In the second episode of our Medicine on the Go series, we step beyond the ED to explore how UC Davis Health and Sacramento County are partnering to deliver care directly to the community through the Wellness Without Walls (W3) street medicine program. We’re joined by Dr. MK Orsulak, Assistant Professor of Family Medicine at UC Davis. We discuss how a mobile clinic staffed by interdisciplinary teams brings primary care, wound care, mental health services, HIV/STI testing, vaccinations, and substance use treatment to people experiencing homelessness—meeting patients where they are and reducing preventable ED visits. This episode offers a powerful look at how innovative, cross-system collaboration can extend emergency care beyond hospital walls and improve access to the right care at the right time. Do you have a program similar to W3 in your area? We’d love to hear about it! Share with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergen

In this first installment of our Medicine on the Go series, we explore how care is moving beyond hospital walls and directly into the community through UC Davis Fire Department’s innovative mobile mental health crisis unit, Health 34. You’ll hear how this no-cost, 24/7 team—staffed by providers with paramedic backgrounds and lay counselor training—meets people where they are to prevent crises, support mental health needs, and connect patients to the right resources before problems escalate. Health 34 Provider, Blythe Clark, joins us to share the origins of the program, how it works, who it serves, and what other communities can learn from this model. We’ll explore how prehospital services can act as a powerful preventative tool and how collaborations like this could reshape the future of care far beyond campus. Do you have a program similar to Health 34 in your area? We’d love to hear how it’s working and what you’ve learned. Share with us on social media @empulsepodcast or connect with us on ucdavisem.com

In this episode of EM Pulse, guest host Dr. Neelou Tabatabai joins Julia in a discussion with ED nurse and TeamSTEPPS advocate, Leigh Clary, to explore how structured communication tools can transform even the most high-stress medical and trauma resuscitations. Through a real-life story of conflict and resolution in the emergency department, Leigh illustrates how TeamSTEPPS strategies—like assertive communication, the Two-Challenge Rule, and CUS words—empower teams to speak up, de-escalate tension, and protect patient safety. Together, they unpack how calm, composed dialogue preserves respect, strengthens teamwork, and ensures every voice is heard when it matters most. Do you use TeamSTEPPS or a similar model in your ED? We’d love to hear what has been successful for your team. Hit us up on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Guest Host: Dr. Neelou Tabatabai, Assistant Professor of Emergency Medici

In this episode, we dive into the charged world of Morbidity and Mortality conferences—where good intentions can collide with fear, shame, and silence. We’ve all felt that jolt of adrenaline sitting in the audience—or worse, standing at the podium. Our guest expert, Dr. Jaymin Patel, helps us unpack why the traditional M&M model no longer works and how we can rebuild it into something better: a space that turns mistakes into meaningful learning, supports both patient and provider healing, and helps us face our ghosts without fear. How do you think we can improve M&M? Share your ideas with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Jaymin Patel, Assistant Professor of Emergency Medicine and Assistant Residency Program Director at UC Davis Resources: ALiEM: The M&M Shame Game; Case by Dr. Tamara McColl   Nussenbaum B, Chole

What happens when a febrile infant presents at 61 days old? Are they suddenly low risk for invasive bacterial infections? In this episode, we explore the gray zone of managing febrile infants aged 61–90 days with the help of two new clinical prediction rules from PECARN. Joining us are two powerhouses in pediatric emergency medicine: Dr. Nate Kuppermann and Dr. Paul Aronson, who walk us through their recent study published in Pediatrics. We discuss why prior research has traditionally stopped at 60 days, what the new data shows about risk in this slightly older age group, and how these rules might help guide clinical decision-making. This study fills a long-standing gap—but should we start using the rules now? Tune in for a nuanced discussion on sensitivity, missed cases, practical application, and the future of risk stratification in young infants with fever. What is your practice in terms of work-up of 2-3 month old febrile infants? Will this change what you do? Hit us up social media @empulsepodcast or co

Dive into the second half of our envenomation series! Dr. Jonathan Ford, a UC Davis Medical Toxicologist and Professor of Emergency Medicine, returns to the podcast to tackle scorpions and spiders. We're going beyond the basics to discuss the "why" and "how" of these bites and stings. Learn about the neurotoxic effects of bark scorpion venom and the life-threatening airway risks. Explore the mechanism behind black widow bites that leads to intense pain and spasms, and the crucial role of antivenom in severe cases. Plus, we're setting the record straight on a common myth—the brown recluse—and the proper supportive care for its nasty bite. Join us to discover the latest evidence-based approaches that could change how you manage your next bite or sting. Have you had a patient with a serious or challenging envenomation?  How did you manage it? Share your story with us social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis

Summer hikes and backyard play mean we’re bound to see a few snakebites in the ED—and getting the first steps right makes all the difference. In the first half of this 2 part series, Medical Toxicologist Dr. Jonathan Ford joins us to walk through the key steps in caring for patients with snake envenomations. We’ll walk through what to do (and not to do) in terms of pre-hospital care, how to triage and assess patients when they arrive in the ED, and how to decide which patients need antivenom. Dr. Ford reviews dosing strategies, monitoring, and key considerations for children, elderly, and pregnant patients. And we discuss practical guidance on supportive care, from pain control to wound management. By the end of this episode, you’ll be ready to provide effective, evidence-based care for your next snakebite patient. Have you had a patient with a serious or challenging envenomation?  How did you manage it? Share your story with us social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Ju

In the second half of this two part episode, Dr. David Leon unpacks some of the most hotly debated topics in resuscitation—fluids, blood products, ECMO, and post-arrest care. He breaks down the pros and cons of crystalloids (yes, even the “pasta water” debate), explains why lactated Ringer’s is often preferred over normal saline, and dips into the use of albumin and colloids. Dr. Leon also discusses the promise and challenges of extracorporeal life support (ECLS), the evolving role of targeted temperature management (TTM), and even peeks into what advances the future might hold. It’s a thoughtful, forward-looking conversation every resuscitationist should hear. What do you think of Dr. Leon’s tips? Are you using these tools in your practice? We’d love to hear from you. Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: D

In this high-yield two part episode, we dive into the evolving world of resuscitation with Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis. From the shift in priorities from ABC (Airway-Breathing-Circulation) to CAB (Circulation first) to the practical use of peripheral vasopressors and rapid infusion catheters, this episode breaks down how frontline ED care is adapting to sicker patients, longer ICU boarding times, and limited resources. Tune in for insights on advanced access strategies, pre-hospital blood products, and why old tools, like whole blood and vasopressin, are making a powerful comeback. What do you think of Dr. Leon’s tips? Are you using these tools in your practice? We’d love to hear from you. Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. David Leon, Assistant

We’re back with another episode of Push Dose Pearls with ED Clinical Pharacist, Haley Burhans! In this episode, we break down the essentials of managing agitation in the ED—starting with why you should avoid diphenhydramine in the elderly and benzodiazepines in the 3 D’s: drunk, delirium, and dementia. We discuss how to quickly assess the cause, choose the right medication, and decide between IM and IV routes. And Haley offers some key safety tips and considerations for special populations, including kids and the elderly.  Was this episode helpful? What other medications would you like to learn more about? 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, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: ACEP’s New Clinical Policy on Severe Agitation. By Molly E.W. Thiessen, MD, FACEP | on February 12, 2024

In this episode, we welcome back Dr. John Rose as cohost for a conversation with Dr. Gary Tamkin—Emergency Physician and Vice President of Provider Development at US Acute Care Solutions. Together, they explore what it really takes to find happiness and fulfillment in the high-stakes world of emergency medicine. From the trap of the arrival fallacy to the pressure of always chasing the next milestone, Dr. Tamkin shares personal insights and practical strategies tailored to the unique challenges EM clinicians face. You’ll come away with two actionable tools to help build more meaning, balance, and joy—both on shift and off. What are your tips for avoiding burnout and finding balance? Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest Host: Dr. John Rose, Professor of Emergency Medicine and EMS Medical Director at UC Davis

Hypoglycemia can be subtle—or dangerously obvious—and knowing when and how to treat it is critical. In her first episode as our new Push Dose Pearls expert, Emergency Medicine Clinical Pharmacist, Haley Burhans, joins us to break it down. We discuss glucose thresholds by age, when to draw critical labs, and how to choose the right treatment—whether it’s oral glucose, IV dextrose, or IM or intranasal glucagon. From neonates to older adults, Haley delivers practical, evidence-based pearls to help you manage low blood sugar safely and effectively in the ED. Was this episode helpful? What other medications would you like to learn more about? 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, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: Gandhi K. Approach to hypoglycemia in infants and children. Transl Pedia

Summer travel is in full swing and, for physicians, that means more than just packing swimsuits and sunscreen. In this episode of EM Pulse, we sit down with wilderness medicine expert, Dr. Mary Bing, to unpack the real-world essentials of travel medical kits. From duct tape and whistles to epinephrine and steroids, you’ll learn what to bring, how to tailor your supplies based on destination and group, and why your role as a physician—formal or not—comes with extra responsibilities. Whether you’re headed to the Alps or the backyard, this episode is your go-to guide for staying medically prepared on the move. Don’t just travel light—travel smart. What’s in your first aid kit? Hit us op on on social media @empulsepodcast or connect with us on 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: Dr. Mary Bing, Professor of Emergency Medicine and Assistant EM Residency Program Director at UC Davis

In this follow-up to our artificial intelligence in EM series, we’re diving into how AI can enhance your professional life outside of clinical shifts. Joined by Dr. Jaymin Patel—Assistant Residency Program Director and tech-savvy educator—we explore three practical AI tools that can streamline teaching, content creation, communication, and even how you consume literature on your commute. From ChatGPT to DALL·E to NotebookLM, we break down what each tool does, how to use it effectively, what pitfalls to avoid, and how even non-educators can leverage them. Tune in to learn how to use AI intentionally, efficiently, and ethically in your day-to-day professional life.  Are you using AI in your professional life? What’s your favorite tool? Share your experience with us on social media @empulsepodcast or connect with us on 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: Dr. Jaymin Patel, Assista

In this episode of EM Pulse, Dr. Daniel Hernandez, an emergency medicine and addiction specialist at UC Davis, joins the team to spotlight methadone—one of the original and still powerful tools for treating opioid use disorder (OUD). While newer medications like buprenorphine often steal the spotlight, methadone remains a critical option, especially in the era of fentanyl. Tune in for a practical conversation on when and how to initiate methadone in the ED, navigating regulatory barriers, arranging follow-up at opioid treatment programs, and managing pain in patients already on methadone. Whether you’re new to methadone or looking to sharpen your approach, this episode offers real-world insights and actionable pearls  Have you started methadone from the ED? Share your experience with us on social media @empulsepodcast or connect with us on 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: D

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