Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When utilizing a cut off of ≧ 2 points, the qPS4 was highly sensitive and specific, an…

As emergency physicians, we are very familiar with giving naloxone to patients with concern for opioid overdose. Our EMS colleagues give naloxone all the time in the prehospital setting. We know it works well for patients who are obtained due to opioids, but what about for patients who have an out-of-hospital cardiac arrest? Our expert on todays ep…

Acetaminophen overdose is one of the most common medication concerns we see in the ED. It is important to know when to be concerned and when to treat as true overdoses can cause liver failure and death. UC Davis medical toxicologist, Dr. Hoan Nguyen, joins us in this episode to discuss a new consensus statement published in JAMA Network Open in Aug…

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 naloxone. Naloxone is a staple in every ED docs toolbox but it can save more lives if it’s immediat…

There is a wide variation in practice, particularly in obtaining neuro-imaging in patients presenting with vertigo. Many patients are imaged and subjected to a longer length of stay, and on the other side of the coin, some patients with serious pathology fall through the cracks. The authors of this study set out to create a risk score to apply to p…

In this special episode, we celebrate the incredible 19-year tenure of Dr. Nate Kuppermann as Chair of the UC Davis Emergency Department. As he transitions to his new role as Executive Vice President, Chief Academic Officer, and Chair of Pediatrics at Children’s National Hospital in Washington, D.C., Dr. Kuppermann reflects on the growth and evolut…

Many of our ED patients come in because they were told to. Whether it’s by an advice nurse, primary care provider, urgent care, call center, specialty coordinator, etc., it often feels to us like the default is “go to the ED”. But, of course, that’s not the case. There are myriad reasons why patients may be sent to the ED. In this episode, we talk …

Oncologic Emergencies: Part 2 In this two-part series, we dive into the world of oncological emergencies with guest expert, Dr. Monica Wattana. In part 1, we covered everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also discussed some of the tricky complications that often ac…

Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world. Sepsis as a disease process has been difficult to both clearly define and quickly recognize. Many metrics for recognition and management of sepsis are dependent upon various s…

In this two-part series, we dive into the world of oncological emergencies. Our guest expert, Dr. Monica Watana, an emergency physician specializing in this area. In part 1, we cover everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also talk about some of the tricky complicat…

In patients with cirrhosis and ongoing bleeding, it can be challenging to determine whether or not patients are hyper or hypocoagulable. Traditional markers of coagulation status like INR can be difficult to interpret in patients with abnormal synthetic function and potentially increase consumption of coagulation factors. Can TEG (thromboelastograp…

In this episode of Push Dose Pearls, we delve into the use of push dose pressors in emergency medicine. Dr. Chris Adams talks about their use, potential side effects, and the importance of a clear plan for the administration of push dose pressors. Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com…

In this journal club recap, Dr Sarah Moulds recaps a recent meta-analysis of papers looking at the therapeutic effect of TXA in patients with severe trauma. Are their higher rates of thromboembolic complications? Is mortality improved? This article by Fouche et al attempts to answer these questions.Por UC Department of Emergency Medicine

Out of hospital cardiac arrest (OOHCA) represents a great cause of morbidity and mortality. Approximately 350,000 cardiac arrests occur in North America annually and 20% can be attributed to Ventricular tachydysrhythmias (i.e. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse). In this journal club recap, Dr Kelly …

Managing pregnant patients in the ED can be stressful – especially because you have (at least) two patients to think about! Emergency physicians are generally comfortable managing first trimester emergencies but are less familiar with complications in the later stages of pregnancy. It is these complications that contribute in part to the maternal h…

In this most recent Journal Club recap podcast, Dr. Cole Davis covers a paper investigating the use of sterile vs clean gloves for laceration repair in the ED.Por UC Department of Emergency Medicine

In this episode we talk with Dr. Julie Leonard about the PECARN C-spine Rule that was just officially published! Dr. Leonard is the senior author of the study and walks us through the findings, why its important, and how she uses the rule in her own clinical practice. Host: Dr. Julia Magaña, Associate Professor of Emergency Medicine at UC Davis Gue…

In this episode of our ongoing miniseries "Push Dose Pearls," we discuss the use of intranasal medications in the emergency department with Chris Adams, an ED clinical pharmacist at UC Davis. We talk about the benefits of intranasal administration, intranasal medications, and advantages for pediatric patients.Did this episode change your practice? …

Navigating breastfeeding as an EM physician In the previous two episodes, we explored some of the challenges related to fertility and pregnancy for EM physicians. In the final episode of our three part series, we take it one step further to discuss yet another challenge: breastfeeding. Of course, fed is always best, and there are many reasons to fo…

In this episode, we delve into a pivotal multi-center study validating the Pediatric Emergency Care Applied Research Network (PECARN) prediction rules for using CT imaging in children with blunt abdominal and minor head trauma. We discuss with the authors the study’s impact, how these validated rules can optimize pediatric trauma care, minimize rad…

In this journal club breakdown, we analyze an article examining the relationship between invasive arterial line blood pressure measurements and non-invasive cuff measurements.Por UC Department of Emergency Medicine

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 carryi…

Can the addition of high-dose methylprednisolone to the treatment of out-of-hospital cardiac arrest make a meaningful difference? In this post-hoc analysis of a placebo-controlled randomized control trial comparing high-dose methylprednisolone versus placebo in out-of-hospital cardiac arrest (OHCA), the authors aimed to assess the hemodynamic effec…

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 persona…

In this podcast, Dr Charlie Brower PGY-3 at the University of Cincinnati leads a discussion of a recent journal club article looking at the impact of a subcutaneous insulin treatment pathway for mild and moderate DKA. We explore the financial and operational impacts of this pathway as compared to traditional treatment with IV insulin…

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…

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 wha…

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 advoc…

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 wha…

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 …