Em Pulse

People living with sickle cell disease can experience severe “pain crises”, or vaso-occlusive episodes (VOE), and are at increased risk for infections, strokes, heart failure, and other serious disease processes. When patients are out sickle cell present to the ED, it is crucial to initiate their evaluation and treatment as soon as possible. So what does this mean practically for us as clinicians? Hematologist and Sickle Cell expert, Dr. Bimpe Adesina, and Emergency Physician and researcher, Dr. Bryn Mumma, join us to explore this topic in depth.  In part 1, we delve into assessment and management of patients presenting with VOE. Stay tuned for parts 2 and 3, where we’ll explore the use of intranasal fentanyl and the management of other emergent presentations related to sickle cell disease! 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 Profe

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 RSI (rapid sequence intubation) meds - stuff every ED doc needs to know! What has changed and what are the latest recommendations? We’ll answer these questions and more!  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 Resources: Acquisto NM, Mosier JM, Bittner EA, Patanwala AE, Hirsch KG, Hargwood P, Oropello JM, Bodkin RP, Groth CM, Kaucher KA, Slampak-Cindric AA, Manno EM, Mayer SA, Peterson LN, Fulmer J, Galton C, Bleck

If you work in an ED, you’ve probably heard of EMTALA, or the Emergency Medical Treatment and Active Labor Act. But how much do you really know about this law? When does it apply and when does it not? EMTALA expert, Dr. Sophie Terp, helps us understand the history of EMTALA and what we need to know to ensure we provide the best care for our ED patients.  Do you have more questions about EMTALA? Have you ever witnessed a violation? Share your thoughts with us 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: Dr. Sophie Terp, Associate Clinical Professor of Emergency Medicine at the Keck Schoo of Medicine at the University if Southern California, and Quintiles Clinical Fellow at the Schaeffer Center for Health Policy and Economics Resources: The EMTALA origin story U.S. Center for Medicare and Medicaid Services Interpretive Guideli

We first explored the world of Telehealth back in February of 2021 in parts 1 and 2 of our telemedicine series. Telehealth has exploded since then, even after hospitals and clinics opened fully again when COVID restrictions loosened. Drs. Jenny McCormick and Kelly Owen join us to give an update on our very successful telehealth program at UC Davis, Express Care. How is it working for patients? How do physicians like it? Listen to find out!  Do you have Telehealth programs where you work? Who staffs it? 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: Dr. Jenny McCormick, Professor of Emergency Medicine and Associate Director of Express Care at UC Davis Health  Dr. Kelly Owen, Professor of Emergency, Medical Director  Express Care, and Emergency Department Outpatient Operations Director at UC Davis Health Resources: UC

This is the next episode of our Push Dose Pearls miniseries with ED 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 again focuses on common antibiotics we use in the ED. What has changed and what are the latest recommendations? We’ll answer these questions and more!  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 Resources: CDC STI Treatment Guidelines Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases So

In 2022, the U.S. Supreme Court ruled that the Constitution does not confer a right to abortion. This decision, known as the Dobbs decision, Overturned Roe v. Wade and ended the right to abortion that had been upheld for decades. In the wake of this decision, many states have passed laws banning or severely restricting abortion. So how does this affect our patients and the care we provide in the ED? How is it different in protected estates compared to restricted states? Join us for a deep dive into the health implications of recent changes in reproductive health policy with expert, Dr. Amy Paris.  Please note that the opinions expressed in this episode are our own and do not necessarily represent the position of our employers or institutions.  How have things changed in your state and your ED? Share your stories 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.*** ~ Our episodes are now closed c

***Trigger warning: this episode includes discussion of child abuse*** In our last episode, Identifying abuse: the LCAST app, we talked about recognizing subtle signs concerning for child abuse and how to use the new LCAST app to determine the risk of non-accidental trauma. But identifying potential abuse is just the first step in a long and often emotionally taxing process. How do you approach parents or caregivers with your concerns? What do you do if a caregiver doesn’t want to cooperate with your extended work-up? What information should you share with them? And how do we avoid bringing our own biases into the room? These are tough conversations.  Our guest experts, Dr. Emily Fain and Dr. Elena Duma, and our own Dr. Julia Magaña are experts in this field. They walk us through how to approach these conversations in a compassionate and straightforward manner, centering the safety of the child as everyone’s primary concern.  How do you approach these challenging conversations? Share what’s worked for you (

In March of this year, we published a Rebeat of one of our most powerful episodes, It Could Have Been Different. We took a deep dive into one of the most difficult aspects of our jobs as emergency physicians - recognizing and managing child abuse, or non-accidental trauma (NAT). Signs of abuse can often be subtle, but there are some very specific findings that should make us consider NAT. Our guest expert, Dr. Mary Clyde Pierce, helped us learn to identify NAT using the TEN-4 FACESp clinical prediction rule.  In this episode, Dr. Pierce returns to discuss the new LCAST app developed by Lurie Children’s Hospital to help clinicians identify NAT. We love this app! It’s quick and easy to use - and it’s even better than using the decision rule alone. Listen to the episode to hear why! Have you tried the LCAST app? 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

It’s been a while since we talked about social media in emergency medicine and a LOT has changed! We first explored this topic in 2019 with Dr. Meghan Ranney in our episode With Great Power Comes Great Responsibility. The following year, the pandemic hit and digital platforms exploded while many people isolated themselves or worked from home. Add in complications including the spread of disinformation, the rise of hate speech, Elon Musk’s takeover of Twitter, and the emergence of new platforms, and the landscape today looks very different. To help us understand how to navigate the current world of social media, including the benefits and potential pitfalls, we spoke with digital media expert, Lauren Suedkamp.  Do you use social media professionally? What are your favorite platforms? Hit us up on Instagram, Twitter/X, and Threads as @empulsepodcast, or leave us a comment at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor o

Insulin EM Pulse PodcastThis is the next episode of our Push Dose Pearls miniseries with ED 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 again focuses on insulin. Should everyone with hyperglycemia get regular insulin? Is IV better than subcu? We’ll answer these questions and more as we discuss the latest recommendations for managing hyperglycemia and DKA in the ED.  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 Resources: Hardern RD, Quinn ND Emergency management of diabetic ketoacidosis in adults Emergency Medicine Journal 2003;20:210-213 Schwartz X,

In the last episode, we replayed one of our most powerful episodes, Sold for a Chrysler 300. The episode featured Annika Huff sharing her story as a survivor of human trafficking, as well as recommendations on how to address trafficking from experts in the field. If you haven’t listened to that episode, we recommend checking it out!  In this follow up episode, our own Dr. Julia Magaña fills us in on what’s changed since 2018, including a new screening tool developed by Dr. Makini Chisholm-Straker and her team.  Have you used the RAFT in your clinical practice? Share your experience with us on social media @empulsepodcast or at ucdavisem.com 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. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Resources: Validation of a screening tool for labor and sex trafficking among emergency department patients.  Ch

It’s time for another Repeat! This is one of our earliest episodes and it is a favorite because of one woman’s powerful story. Annika Huff (formerly Annika Mack) is a survivor of human trafficking. She speaks with us about her experiences in the life, how she got out, and how she was able to move on with her life. Then, Dr. Bryn Mumma takes us through her research on how we can better identify potential victims in the ED. Dr. Rachel Robitz shares some advice on how to approach patients who may be trafficked, create a safe space, and offer support and resources. And, finally, our own Dr. Julia Magaña discusses how she manages this in pediatric patients.  Stay tuned for our next episode for important new research and updates! Did you listen to this episode when it first aired? How was your practice changed since then, in terms of screening for human trafficking? Share your thoughts with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency

This is the second episode in our Push Dose Pearls miniseries with ED 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 again focuses on antidotes - medications we can give to treat or reverse the harm caused by overdoses, intoxications, envenomations, etc.  What is your favorite antidote? 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, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis Resources: Life in the Fast Lane Antidotes Summary *** 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.

This is the first episode in our Push Dose Pearls miniseries with ED 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. Our first episode will focus on antidotes - medications we can give to treat or reverse the harm caused by overdoses, intoxications, envenomations, etc.  What is your favorite antidote? 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, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christophe Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis Resources: Life in the Fast Lane Antidotes Summary *** 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.

One of our quintessential roles as emergency physicians is managing and securing the emergent airway. This can be a life or death moment for the patient and often gets our own adrenaline pumping - it’s not a procedure we take lightly. Airway management in the ED can be complicated by physical and situational factors (beards, trauma, vomit), resource limitations, and our own emotional state. We sat down with emergency airway expert, Dr. Verena Schandera, to get the latest and greatest on airway management.  Have you had to manage a particularly difficult airway? Do you have any tips or tricks that have worked for you? Share your experiences with us 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: Dr. Verena Schandera, Associate Professor of Emergency Medicine and Co-Director of the Emergency Airway Fellowship at UC Davis Resources:

Our last episode was a Rebeat of “The Game has Changed”, one of our earliest and most listened to episodes that explored medication assisted treatment (MAT) for opioid use disorder. A LOT has changed since we first published the episode in 2018! In this follow up episode, addiction medicine specialist, Dr. Aimee Moulin, talks to us about what’s new, including modifying treatment for people using fentanyl; and what’s old news - the X waiver!   How do you manage opioid use disorder in your practice? Share your experiences with us 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: Dr. Aimee Moulin, Professor of Emergency Medicine and Chief of the Division of Addiction Medicine at UC Davis Resources: CA Bridge National Institute on Drug Abuse (NIDA) information on opioids Buprenorphine vs. Methadone on atforum.com Screening Brief Int

It’s time for another Rebeat! We’re revisiting one of our favorite episodes from our very first season. The opioid epidemic is still very real and there are some new challenges with fentanyl as the predominant opioid on the street. But we’ve gained experience with medication assisted treatment (MAT) and it is now even easier to prescribe treatment for opioid use disorder. The Rebeat has been edited to reflect some of these changes, and our next episode will provide an update on MAT. Now on to the Rebeat… Let’s talk about the opioid crisis. One woman tells her powerful story of opioid addiction, treatment, and recovery. Then, we discuss the role emergency physicians can play in controlling this epidemic with experts, Dr. Gail D’Onofrio and Dr. Josh Elder.  How do you manage opioid use disorder in your practice? Join the conversation 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 P

There has been a lot in the news about “tranq dope”, especially following a recent New York Times article. Most concerning are the non-healing skin wounds that seem to be associated with its use. So what is tranq dope, or more formally, xylazine? And what do we need to know to safely treat our patients? We caught up with Dr. Hoan Nguyen, emergency physician and medical toxicologist at UC Davis, to get some answers.    Have you seen complications of xylazine in your ED? Share with us on social media, @empulsepodcast, via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Head over to iTunes and leave us a review - it helps us reach more people. And please pass the word along to your friends and colleagues! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Hoan Nguyen, Assistant Professor of Emergency Medicine and Medical Toxicologist at UC Davis Resources: Tra

In our last episode, we spoke with negotiations expert and founder of the Center for Leadership, Dr. Cheri Hobgood, about the art of a good negotiation. This week, we’ve partnered with Women in PEM again to explore how negotiations can play out in the real world of emergency medicine. Dr. Selena Hariharan returns to share her personal experience and Dr. Elizabeth Alpern offers some concrete advice on how to prepare for an interview, read a contract, and make the outcome of the negotiation beneficial to all parties. It’s all about time, money, and power! Was this series helpful to you? Have you been able to put some of these strategies into practice? We’d love to know! Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Please encourage your friends and colleagues to listen and share their stories, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor o

Negotiating what you need and want in your career is an essential skill, for any emergency medicine physician - well, for anyone, really! So, whether you are in academic or community practice, or something completely unrelated, this episode is for you. We’ve teamed up with Women in PEM to bring you this illuminating interview with Dr. Cherri Hobgood, an emergency physician, expert in negotiations, and founder of the Center for Leadership Life. She takes us through the ins and outs of negotiating, including preparation, tactics, and even reading body language, to help us learn the art of a successful negotiation.  Do you find negotiations challenging? What strategies have been most successful for you? Tag us on social media, @empulsepodcast, or reach out via email empulsepodcast@gmail.com, or through our website, ucdavisem.com. Please encourage your friends and colleagues to listen and share their stories, too! ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Ju