Em Pulse

Pregnancy is common during medical training and in the early years as an attending physician, as these stages often align with individuals’ reproductive potential. The experience can vary widely depending on factors such as workplace dynamics, scheduling, and the physical demands of the job. But let’s be real - running around a busy ED while carrying extra weight, feeling nauseated (maybe vomiting), and managing all of the physical and emotional changes that come with pregnancy is a real challenge that many of us have lived. There are numerous considerations to navigate, from how we wish to be perceived as a team member to the risks posed by the workload on our bodies. Additionally, departmental or hospital policies may have financial implications that further complicate the situation. Join us as and Dr. Katren Tyler - EM physician and mother of two - as we break it all down. This the second episode in our three part series on infertility, pregnancy and breastfeeding as an Emergency Physician. If  you missed

This the first episode in our three part series on infertility, pregnancy and breastfeeding as an Emergency Physician. In this installment, we shine a light on the often unspoken struggles of infertility among physicians, specifically focusing on the emergency medicine community. Join us and expert, Dr. Melissa Parsons, as we delve into the personal experiences, professional challenges, and nuanced perspectives of emergency physicians navigating the complex journey of infertility. In part two, we’ll explore what it’s like to be a pregnant as an EM physician, and in our final episode of the series, we’ll talk about some of the challenges surrounding breastfeeding and pumping in the ED.  Do you have questions about fertility as an EM Physician? Or want to share your own experience?  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 G

If you practice in emergency medicine you probably live on the look out for sepsis.  You likely follow the 2016 Sepsis-3 guidelines for adults which really was a paradigm shift from an infection-associated SIRS, to infection-associated organ dysfunction with the SOFA score or sequential organ failure assessment score of at least 2 points in patients with suspected infection. However, the definition of sepsis in kids was not updated at that time in part because SOFA was not studied in children. That means that our current pediatric guidelines are from 2005! Good news though! The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force and we interviewed two of the task force members to help us operationalize it on our podcast. Connect with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Halden Scott, As

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 delved into assessment and management of patients presenting with VOE. In part 2, we spoke with Dr. Chris Rees about the benefits of early opioid pain control for kids presenting with VOE.   In the final episode of our series we’re back with Dr. Mumma and Dr. Adesina to discuss 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 ucdavi

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. In this 3 part series, we’re talking with experts to learn more about sickle cell disease and its complications and how we can best advocate for and treat these patients in the ED. In part 1, we delved into assessment and management of patients presenting with VOE. In this episode, we focus specifically on kids presenting with VOE. We know these patients have usually exhausted their home pain control options and are still in excruciating pain when they arrive in the ED. We interviewed Dr. Chris Rees about his recent paper on the benefits of treating kids with VOE with an initial dose of intranasal fentanyl.  The results are pretty impressive!  Stay tuned for Part 3 of our series where we’ll explore the management of other emergent presentations related to sickle cell disease! Did this episode chan

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: